Objectives To determine the optimum combination therapy of Silodosin–Tadalafl versus Silodosin–Vardenafl in terms of
both tolerability and efcacy for the management of distal ureteric stones.
Methods This prospective, double blinded, randomized clinical trial included 140 patients with distal ureteric stones, randomized into two groups: Group I (n=67) received Silodosin 8 mg once daily combined with Tadalafl 5 mg once daily, and
Group II (n=68) received Silodosin 8 mg once daily combined with Vardenafl 10 mg once daily. The primary outcome
was the tolerability of the combination therapies, assessed through the incidence of adverse events. Secondary outcomes
included stone expulsion rate, expulsion time, and the need for analgesics.
Results Both combination therapies demonstrated similar efcacy, with no signifcant diferences in stone expulsion rate
(70.1% vs. 67.6%, P=0.754), expulsion time (19±3 days for both groups, P=0.793), and analgesic requirements (P>0.05).
However, the Silodosin–Tadalafl combination showed a signifcantly lower occurrence of adverse events, with notable differences in headache (23.9% vs. 57.4%, P