A COMPARATIVE STUDY OF EFFICACY OF TAMSULOSIN PLUS NIFEDIPINE VERSUS TAMSULOSIN PLUS TADALAFILAS MEDICAL EXPULSIVE THERAPY OF DISTAL URETERIC STONES

Background and Aims: Urolithiasis is one of the common disorder with which about 1/5th is found in the ureter, of which 2/3rd is seen in the lower ureter. Medical expulsive therapy is one of the routine modalities of treatment which uses various drugs acting on the ureter smooth muscle by different mechanism. Many studies had compared efcacy of combination drugs versus single drug. This study will compare the efcacy of the combination of tamsulosin and tadalal against a standard drug combination of tamsulosin and nifedipine as medical expulsive therapy of distal ureteric stones. Materials and Methods: This Randomized Control Study was performed from December 2020 to July 2022. Atotal of 120 adult patients presenting with distal ureteric stones (5-10mm) were randomized to treatment with Tamsulosin 0.4mg+Nifedipine 30mg once daily (Group A) and Tamsulosin 0.4mg+Tadalal 10mg once daily (Group B). Therapy was given for a maximum of 4 weeks. The stone expulsion rate was the primary endpoint. Time to stone expulsion, frequency of analgesic use, number of hospital visits for pain and adverse effects of the drugs were noted. Results: 60 patients were included in group A and group B respectively. No statistically signicant differences were observed regarding patients' age, sex, and stone size distribution between both groups. There was a statistically signicant reduction in time to stone expulsion in group B (9.69 ± 4.37) as compared to group A(12.88 ± 5.13), p = 0.043. No statistical difference was found for adverse drug effects. Statistically signicant reduction in analgesic use was noted in the group B compared to group A. (p=0.02) Conclusion:According to the ndings of this study, Tamsulosin plus tadalal is more effective than tamsulosin plus nifedipine as a medical expulsive therapy for distal ureteric stones.