Comparison of Safety and Efficacy of Tamsulosin alone and Combination of Tadalafil and Tamsulosin as Medical Expulsive Therapy for Ureteric Stone

Background and objectives: The medical expulsion therapy is essential to avoid invasive treatment of ureteric stones. The aim was to compare the safety and efficacy of Tamsulosin alone and combination of Tadalafil and Tamsulosin. Methods: A retrospective cross-sectional study implemented in private clinic in Erbil city, Kurdistan Region-Iraq from 1st of February, 2022 to 31st of January, 2024 on one hundred and eighty-four patients with ureteric stones (92 patients with Tamsulosin only and 92 patients with Tadalafil & Tamsulosin). Post-treatment outcomes and adverse effects were assessed and managed accordingly. Results: Number of analgesic injections were higher among patients treated by Tamsulosin only zero injection (39/92),1-3 times (44/92), and >3 times (9/92) while in Tamsulosin Tadalafil group were zero injection ( 65/92) , 1-3 times (24/92) and >3 times ( 3/92) with statistical value (p<0.001).also number of emergency visits were higher in Tamsulosin only group zero visit (57/92),1-3 visits (30/92),>3 visits (5/92) in compare to the Tamsulosin Tadalafil group zero visit(85/92) , 1-3 visits (5/92) and >3 visits (2/92) and the statistical value was ( p<0.001). also, stone expulsion rates were higher with Tadalafil & Tamsulosin therapy (70/92) while in Tamsulosin only group (66/92) and the statistical value was (p=0.02). dizziness adverse effect was more with Tadalafil & Tamsulosin therapy (5/92) in compare to the Tamsulosin only were (0/92) with statistical value (p=0.02). Conclusion: Tadalafil & Tamsulosin is safe and more effective in medical expulsion therapy of ureteric stones than Tamsulosin alone.