A Comparative Study between Tamsulosin and Doxazosin for Management of Lower Ureteral Stones


Background: recent studies have reported excellent results with medical expulsive therapy (MET) for lower ureteral calculi, both in terms of stone expulsion and control of ureteral colic pain.Objective: Aim of this study was to compare the efficacy and safety of tamsulosin and doxazosin as a medical expulsive therapy for symptomatic, uncomplicated lower ureteral stones.Patients and Methods: one hundred patients with lower ureteral stones of ≤10 mm were randomly divided into 3 groups, where 33 patients received tamsulosin 0.4 mg daily (group I); 33 patients received doxazosin 4 mg daily (group II), and 34 patients were considered as control group (group III) as did not receive tamsulosin or doxazosin. All groups received meloxicam regularly for one week and then on demand. Follow up was done on a weekly basis for 45 days.Results: stone size mean was comparable in the three groups (6.17±3.44, 6.25±2.93, and 5.97±4.11mm; respectively for groups I, II, and III). Stone expulsion rate was 82%, 76%, and 47% in groups I, II, and III, respectively. The difference in expulsion rate for groups I and II with respect to group III was significant (p<0.05). Mean expulsion time for groups I, II, and III was 7.87±6.43, 8.12±5.67, and 15.23±7.21 days, respectively. The expulsion time was significantly shorter in groups I and II than in group III (p<0.05). Patients taking tamsulosin and doxazosin had fewer pain attacks than did group III patients (1.14±0.32, 1.32±0.43 vs. 2.16±0.52). Emergency room visits was nil for all patient groups and only 3 cases of drug side effects, one in group I and two in group II, were recorded. Conclusion: using of tamsulosin or doxazosin for medical treatment of lower ureteric stones is safe and effective. Tamsulosin did not have any significant benefits over doxazosin.Keywords: tamsulosin, doxazosin, lower ureteral stone.