Purpose: To compare the efficacy of silodosin, silodosin plus
tadalafil and placebo as a medical expulsive therapy (MET) for
distal ureteral calculi. Subjects & methods: This prospective
randomized clinical trial was conducted on 120 renal colic patients
with distal ureteric stones (5-10mm) over a period of 6 months (1st
February 2022 to 1st August 2022). The patients were randomly
divided into three equal groups. Patients included in group A
received Placebo treatment once daily, in group B received
Silodosin 8 mg once daily, while patients in group C received
Silodosin 8 mg in combination with tadalafil 10mg once daily.
Therapy was given for a maximum of 4 weeks. Stone free rate,
time to stone expulsion, dose and duration of nonsteroidal antiinflammatory drugs (NSAIDs), hospital visits due to pain, and adverse effects induced by the drugs
were recorded. Results: The expulsion rate significantly differed between the studied groups (P <
0.001). Post hoc analysis revealed it was significantly higher in group C (87.5%) and B (72.5%)
than in group A (47.5%), with no significant difference between groups B and C (P < 0.05).
Regarding expulsion time, there was a significant difference between the studied groups (P <
0.001), and post hoc analysis revealed it was significantly lower in group C (10 ±3 days) than in
groups B (14 ±5) and A (21 ±4). Additionally, it was significantly lower in group C than in group
B. Conclusion: Medical expulsive therapy for distal ureteric stone using Tadalafil in combination
with silodosin is safe, well tolerated, and more effective than silodosin alone.