Efficacy of a highly selective α-1 adrenoceptor antagonist in expulsive therapy of distal ureteral stones: A randomized controlled study

The objective of this study was to evaluate the clinical role of a specific α-1 blocker in medical expulsive therapy of symptomatic distal ureteral stones. Two hundred four patients with symptomatic distal ureteral stones with a diameter of <10 mm were enrolled in this prospective study. The patients were randomly divided into three groups: tamsulosin treatment (Group 1, n=67), silodosin treatment (Group 2, n=68), or a placebo (Group 3, n=69). The patients recorded the number of colic episodes, lower urinary tract symptoms, analgesics dosages, and number of days for spontaneous passage of the stones through the ureter in a diary. Expulsion was observed in 85.11% in group 1, 79.17% in Group 2, and 59.18% in Group 3. The expulsion time was significantly shorter in Groups 1 and 2 compared to that in Group 3. The average expulsion time in Groups 1, 2, and 3 was 6.28±2.41, 6.03±2.72, and 9.79±2.71 days, respectively. The average expulsion time was significantly shorter in Groups 1 and 2 compared to that in Group 3. The occurrence of adverse effects was significantly different in the three groups, with 12.50% of patients in Group 2 reporting adverse effects compared to 2.13 and 0% in Groups 1 and 3, respectively. Adverse effects were noted in 12.50% of the patients in Group 2, with a statistically significant difference compared to Groups 1 and 3. Medical expulsion therapy with α-1A blockers is safe and effective, as demonstrated by the increased stone expulsion rate, reduced expulsion time, and reduced need for analgesics.