Title |
Tamsulosin vs. Tadalafil as medical expulsive therapy for distal ureteral stones: a systematic review and meta-analysis
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Published in |
International Brazilian Journal of Urology, December 2023
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DOI | 10.1590/s1677-5538.ibju.2023.0345 |
Pubmed ID | |
Authors |
Mikhael Belkovsky, Giulia Veneziani Zogaib, Carlo Camargo Passerotti, Everson Luiz de Almeida Artifon, José Pinhata Otoch, José Arnaldo Shiomi da Cruz |
Abstract |
Medical expulsive therapy (MET) is recommended for distal ureteral stones from 5 to 10 mm. The best drug for MET is still uncertain. In this review, we aim to compare the effectiveness of tadalafil and tamsulosin for distal ureteral stones from 5 to 10 mm in terms of stone expulsion rate (SER), stone expulsion time (SET) and the side effect profile. A comprehensive literature search was conducted on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science, from inception until April 2023. Only randomized controlled trials were included in the analysis. Eleven publications with 1,330 patients were included. We observed that tadalafil has a higher SER (OR 0.55, CI 95% 0.38;0.80, p=0.02, I2=52%) and the same efficacy in SET (MD 1.07, CI 95% -0.25; 2.39, p=0.11, I2=84%). No differences were found when comparing side effects as headache, backache, dizziness, and orthostatic hypotension. Tadalafil has a higher stone expulsion rate than tamsulosin as a medical expulsive therapy for patients with distal stones from 5 to 10 mm without differences in side effects. |
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Geographical breakdown
Country | Count | As % |
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Argentina | 3 | 27% |
Peru | 1 | 9% |
Unknown | 7 | 64% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 7 | 64% |
Practitioners (doctors, other healthcare professionals) | 3 | 27% |
Scientists | 1 | 9% |