Efficacy and safety of tamsulosin vs. alfuzosin as medical expulsive therapy for ureteric stones

To evaluate and compare the efficacy of tamsulosin and alfuzosin as medical expulsive therapy for ureteric stones. In all, 112 patients with ureteric stones of ⩽10mm, located along the ureter, were randomly divided into three groups. In group I, 32 patients received no α-blockers (controls), in group II 40 patients received tamsulosin 0.4mg daily, and in group III 40 patients received alfuzosin 10mg daily. All patients were given analgesia and antibiotics when indicated. The follow-up was weekly for 4weeks. The mean stone size and age were comparable in the three groups. The stone expulsion rate was 44%, 85% and 75% in groups I, II and III, respectively. Half of the stones in group II passed within 2weeks, half in group III passed within 3weeks, while more than half of the stones in group I did not pass even after 4weeks. The mean number of painful episodes was 2.45, 1.38 and 1.64 in groups I, II and III, respectively. The drug-related side-effects reported by patients were mild and transient. The use of tamsulosin or alfuzosin as medical expulsive therapy for ureteric stones in the three sections of the ureter (upper, middle and lower) was safe and effective, as shown by the increased overall stone expulsion rate, reduced stone expulsion time and fewer pain episodes. Tamsulosin was associated with a greater rate of stone expulsion than was alfuzosin.