Comparison Between Tamsulosin and Silodosin in Lower Ureteric Stone- A Randomised Controlled Study

Priyanka, P.; R, Ravikumar Jadhav

doi:10.14260/jemds/2017/1465

Cited by 4 publications

(8 citation statements)

References 13 publications

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“…There were no significant differences between respective groups regarding sex, age, or stone size. In terms of stone location, 13 studies [ 18 , 22 – 25 , 28 – 35 ] included patients with DUSs, and three studies [ 21 , 26 , 27 ] not only focused on DUSs but also on middle ureteral stones or any location of ureteral stones. Most trials used kidney, ureter, bladder (KUB), ultrasound, or computed tomography (CT) for diagnosing ureteral stones.…”

Section: Resultsmentioning

confidence: 99%

“…For co-medication, there were variations in the doses of analgesics and the hydration status. The dropout rate was low across the studies, except for one study [ 28 ]. The time of follow-up ranged from 2~4 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…Five [ 18 , 21 , 23 , 24 , 26 ] of 13 RCTs had a low risk of performance bias. One study [ 28 ] had a high risk of attrition bias (incomplete outcome data). Seven studies [ 21 , 22 , 27 – 29 , 31 , 32 ] were rated as having a high risk of bias due to no prespecified sample size calculation.…”

Section: Resultsmentioning

confidence: 99%

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Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: A systematic review and meta-analysis

Hsu

Bai

et al. 2018

PLoS ONE

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Silodosin, a recently introduced selective α-blocker, has a much higher selectivity for the α-1A receptor. The efficacy and safety of silodosin compared to tamsulosin in medical expulsive therapy (MET) are controversial. The objective of this study was to assess the efficacy and safety of silodosin compared to tamsulosin for treating ureteral stones <10 mm in diameter. We systematically searched the PubMed, EMBASE, Cochrane library, and Scopus databases from their inception to May 2018. We included randomized controlled studies (RCTs) and observational studies, which investigated stone expulsion rates using silodosin compared to tamsulosin. Data were synthesized using a random-effects model. Sixteen studies with 1824 patients were eligible for inclusion. Silodosin achieved significantly higher expulsion rates than tamsulosin (pooled risk difference (RD): 0.13, 95% confidence interval (CI): 0.09 to 0.18, GRADE: high). A subgroup analyses showed that silodosin has a significantly higher expulsion rate on stone sizes of 5–10 mm than tamsulosin (pooled RD: 0.14, 95% CI: 0.06 to 0.22, I2 = 0%). The superior effect was not observed on stone sizes <5 mm. A multivariate regression showed that the RD was negatively associated with the control expulsion rate after adjusting for age and gender (coefficient -0.658, p = 0.01). A sensitivity analysis showed that our findings were robust. Patients receiving silodosin also probably had a significantly shorter expulsion time (pooled mean difference (MD): -2.55 days, 95% CI: -4.06 to -1.04, I2 = 85%, GRADE: moderate) and may have fewer pain episodes (pooled MD: -0.3, 95% CI: -0.51 to -0.09, GRADE: low) but a higher incidence of retrograde ejaculation by 5% compared to those receiving tamsulosin. In conclusion, compared to tamsulosin, silodosin provided significantly better stone passage for patients with ureteral stones (particularly for sizes of 5~10 mm), shorter expulsion times, and fewer pain episodes but caused a higher incidence of retrograde ejaculation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: A systematic review and meta-analysis

Hsu

Bai

et al. 2018

PLoS ONE

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“…However, the incidence of retrograde ejaculation was considerably higher in the silodosin group. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Alpha-adrenergic receptors are observed throughout the human ureter, predominantly in the distal ureter. 25 Stimulation of these receptors increases the force of contraction of the ureter and the ureteral peristaltic frequency.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety comparison between silodosin and tamsulosin as medical expulsive therapy for distal ureteral stones

Rahman,

Leonardo,

Ardaya

et al. 2024

Med J Indones

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BACKGROUND Ureteral stones are a common urological condition causing significant discomfort and morbidity. Medical expulsive therapy (MET) is a noninvasive approach to facilitate the passage of stones. This study aimed to compare the efficacy and safety of silodosin and tamsulosin as MET in patients with distal ureteral stones (DUS). METHODS We searched CINAHL, Cochrane Library, PubMed, and ScienceDirect for randomized controlled trials (RCTs) on the administration of silodosin and tamsulosin for DUS. The primary outcomes analyzed were stone expulsion rates and expulsion times, measured as risk ratio (RR) and mean difference (MD), respectively. Statistical analyses were performed using Review Manager 5.4 and STATA 17. RESULTS 14 RCTs comprising 1,535 patients (770 received silodosin) met the inclusion criteria. The silodosin group had notably higher stone expulsion rates (RR 1.20, 95% confidence interval [CI] 1.13–1.27, p<0.00001, I² = 37%), shorter expulsion times (MD −2.98, 95% CI −4.35–−1.62, p<0.01, I² = 85%), and fewer colicky pain episodes (MD −0.35, 95% CI −0.59–−0.10, p<0.01, I² = 83%) than the tamsulosin group. Retrograde ejaculation was the only adverse event that had a significant difference between both groups, statistically favoring tamsulosin (RR 1.61, 95% CI 1.12–2.33, p = 0.01, I² = 0%). CONCLUSIONS Silodosin should be preferred as the first-line MET agent for DUS owing to its better expulsion rate, shorter stone expulsion time, and fewer colicky pain episodes. However, tamsulosin may be used in selected cases where patients experience retrograde ejaculation after receiving silodosin.

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“…Table 1 shows the characteristics of the 14 included studies [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. These comparative studies described patients who had received silodosin and tamsulosin for MET of ureteral stones ≤1 cm.…”

Section: Characteristic Of Included Studiesmentioning

confidence: 99%

Silodosin versus Tamsulosin for Medical Expulsive Therapy of Ureteral Stones: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2022

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Background and Objectives: This systematic review and meta-analysis of randomized controlled trials was performed to compare the therapeutic effects and safety profiles of silodosin and tamsulosin for medical expulsive therapy (MET) of ureteral stones. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library, and Web of Science to identify articles published before July 2022 that described randomized controlled trials comparing silodosin and tamsulosin for MET of ureteral stones. Endpoints were stone expulsion rate, stone expulsion time, and total complication rate. Results: In total, 14 studies were included in our analysis. The size of ureteral stones was <1 cm. Compared with tamsulosin, silodosin resulted in a significantly higher stone expulsion rate (p < 0.01, odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.91 to 3.06, I2 = 0%) and significantly shorter stone expulsion time (p < 0.01, mean difference = −3.04, 95% CI = −4.46 to −1.63, I2 = 89%). The total complication rate did not significantly differ between silodosin and tamsulosin (p = 0.33, OR = 1.15, 95% CI = 0.87 to 1.52, I2 = 7%). Conclusions: Compared with tamsulosin, silodosin resulted in significantly better expulsion of ureteral stones <1 cm. The total complication rate did not significantly differ between silodosin and tamsulosin. Thus, silodosin may be superior to tamsulosin for MET of ureter stones <1 cm.

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Comparison Between Tamsulosin and Silodosin in Lower Ureteric Stone- A Randomised Controlled Study

Cited by 4 publications

References 13 publications

Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: A systematic review and meta-analysis

Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: A systematic review and meta-analysis

Efficacy and safety comparison between silodosin and tamsulosin as medical expulsive therapy for distal ureteral stones

Silodosin versus Tamsulosin for Medical Expulsive Therapy of Ureteral Stones: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

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