Comparison of Silodosin and Tamsulosin for Medical Expulsive Therapy in Patients With Ureteral Stones

NCT06999135 | Completed DMC

• 1 other identifier: No.31-Synopsis-FCPS-Pharma/FJ
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

This study compares the effectiveness and side effect profiles of Tamsulosin and Silodosin in medical expulsive therapy (MET) for ureteric stones. Conducted as a randomized control trial at Sir Ganga Ram Hospital, Lahore, 180 patients were analyzed-89 on Tamsulosin and 93 on Silodosin. Results showed that Silodosin had a higher stone expulsion rate, especially within 14 days, and fewer side effects compared to Tamsulosin. Common side effects included orthostatic hypotension, abnormal ejaculation, and headaches, with Silodosin showing a better overall safety profile.

Conditions

Tamsulosin; Silodosin; Medical Expulsive Therapy

Outcome Measures

Primary Outcomes (2)

• STONE EXPULSION RATE

  This measure evaluates the proportion of patients who pass ureteral stones within specific time frames (0-14 days, 15-21 days, and 22-28 days) when treated with Silodosin versus Tamsulosin.

  6 MONTHS

• TIME TO STONE EXPULSION

  Number of days from treatment initiation to confirmed stone passage, measured by imaging and patient report.

  6MONTHS

Secondary Outcomes (7)

• INCIDENCE OF ORTHOSTATIC HYPOTENSION

  6 months

• Incidence of Abnormal Ejaculation

  6 months

• Incidence of Headache Percentage of patients reporting headaches, assessed via patient questionnaires.

  6 months

• Analgesic Requirement:

  6 months

• Need for Auxiliary Procedures

  6 months

Other Outcomes (1)

• BMI

  6 MONTHS

Study Arms (2)

TAMSULOSIN

ACTIVE COMPARATOR

Tamsulosin is an alpha-1 adrenergic receptor blocker commonly used to treat benign prostatic hyperplasia (BPH) by relaxing the smooth muscles in the prostate and bladder neck. In the context of medical expulsive therapy (MET), it helps facilitate the passage of ureteric stones by relaxing the smooth muscles of the lower ureter, reducing ureteric spasm, and easing stone expulsion. It is widely used due to its effectiveness and relatively well-tolerated side effect profile.

Drug: Silodosin

Silodosin

EXPERIMENTAL

Silodosin is used as a medical expulsive therapy (MET) to facilitate the passage of distal ureteral stones, particularly those sized between 4 to 10 mm. It works by selectively blocking alpha-1A adrenergic receptors in the ureter, relaxing the smooth muscle, which helps stones pass more easily and quickly.

Drug: Silodosin

Interventions

Silodosin DRUG

Silodosin is an oral medication primarily used to treat benign prostatic hyperplasia (BPH) by relaxing the muscles in the prostate and bladder neck to improve urine flow. It belongs to a class of drugs called alpha-1 adrenergic antagonists, which block receptors responsible for muscle contraction in these areas. This action helps relieve symptoms such as difficulty urinating, urgency, and weak urine stream. Silodosin is taken once daily with food and is known for its high selectivity for alpha-1A receptors, contributing to its effectiveness and safety profile

Also known as: Sildat, Sildoso

Silodosin; TAMSULOSIN

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients between ages 18 years - 55 years.
• Solitary unilateral ureteral stone
• Stone sizes less than 10 mm measured on non-contrast computed tomography of kidney, ureter and bladder.
• Stones being treated primarily with medical expulsive therapy
• Radio opaque Stone

You may not qualify if:

• Pregnancy
• Untreated UTI
• Bleeding disorders
• Obstruction distal to stone
• Serum Creatinine \> 1.3 mg/dl in males and \> 1.2 mg/dl in females.
• Congenital renal anomaly/ skeletal malformation
• Previous treatment for the same stone (PCNL/ URS / push back)
• Solitary Kidney
• Prior JJ stent insertion
• Bilateral ureteral stone

Sponsors & Collaborators

• Fatima Jinnah Medical University: lead

Study Sites (1)

Fatima Jinnah Medical University

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (17)

• Itoh Y, Okada A, Yasui T, Hamamoto S, Hirose M, Kojima Y, Tozawa K, Sasaki S, Kohri K. Efficacy of selective alpha1A adrenoceptor antagonist silodosin in the medical expulsive therapy for ureteral stones. Int J Urol. 2011 Sep;18(9):672-4. doi: 10.1111/j.1442-2042.2011.02810.x. Epub 2011 Jun 26.

  PMID: 21707766 BACKGROUND

• Thongprayoon C, Krambeck AE, Rule AD. Determining the true burden of kidney stone disease. Nat Rev Nephrol. 2020 Dec;16(12):736-746. doi: 10.1038/s41581-020-0320-7. Epub 2020 Aug 4.

  PMID: 32753740 BACKGROUND

• Kino M, Hayashi T, Hino D, Nakada T, Kitoh H, Akakura K. Patients' poor performance status is an independent risk factor for urosepsis induced by kidney and ureteral stones. Urolithiasis. 2021 Oct;49(5):477-484. doi: 10.1007/s00240-021-01256-4. Epub 2021 Mar 23.

  PMID: 33755744 BACKGROUND

• 17. REHMAN I, KHAN H, FAROOQ A, MAHMOOD A, DIN QAM, HABIB B. Study on Uroliths Composition in Tertiary Care Hospital of Pakistan. Magnesium. 2021;7:18-9.

  BACKGROUND

• Halinski A, Bhatti KH, Boeri L, Cloutier J, Davidoff K, Elqady A, Fryad G, Gadelmoula M, Hui H, Petkova K, Popov E, Rawa B, Saltirov I, Spivacow FR, Belthangady Monu Zeeshan Hameed, Trinchieri A, Buchholz N. Stone composition of renal stone formers from different global regions. Arch Ital Urol Androl. 2021 Oct 1;93(3):307-312. doi: 10.4081/aiua.2021.3.307.

  PMID: 34839635 BACKGROUND

• Hsu YP, Hsu CW, Bai CH, Cheng SW, Chen KC, Chen C. Silodosin versus tamsulosin for medical expulsive treatment of ureteral stones: A systematic review and meta-analysis. PLoS One. 2018 Aug 28;13(8):e0203035. doi: 10.1371/journal.pone.0203035. eCollection 2018.

  PMID: 30153301 BACKGROUND

• Rahman MJ, Faridi MS, Mibang N, Singh RS. Comparing tamsulosin, silodosin versus silodosin plus tadalafil as medical expulsive therapy for lower ureteric stones: A randomised trial. Arab J Urol. 2017 Dec 24;16(2):245-249. doi: 10.1016/j.aju.2017.11.012. eCollection 2018 Jun.

  PMID: 29892490 BACKGROUND

• Sharma G, Pareek T, Kaundal P, Tyagi S, Singh S, Yashaswi T, Devan SK, Sharma AP. Comparison of efficacy of three commonly used alpha-blockers as medical expulsive therapy for distal ureter stones: A systematic review and network meta-analysis. Int Braz J Urol. 2022 Sep-Oct;48(5):742-759. doi: 10.1590/S1677-5538.IBJU.2020.0548.

  PMID: 34003612 BACKGROUND

• Malin JM Jr, Deane RF, Boyarsky S. Characterisation of adrenergic receptors in human ureter. Br J Urol. 1970 Apr;42(2):171-4. doi: 10.1111/j.1464-410x.1970.tb10018.x. No abstract available.

  PMID: 5420156 BACKGROUND

• Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, Macaluso JN Jr. Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association. J Urol. 1997 Nov;158(5):1915-21. doi: 10.1016/s0022-5347(01)64173-9.

  PMID: 9334635 BACKGROUND

• Ibrahim AI, Shetty SD, Awad RM, Patel KP. Prognostic factors in the conservative treatment of ureteric stones. Br J Urol. 1991 Apr;67(4):358-61. doi: 10.1111/j.1464-410x.1991.tb15161.x.

  PMID: 2032074 BACKGROUND

• Pietropaolo A, Proietti S, Geraghty R, Skolarikos A, Papatsoris A, Liatsikos E, Somani BK. Trends of 'urolithiasis: interventions, simulation, and laser technology' over the last 16 years (2000-2015) as published in the literature (PubMed): a systematic review from European section of Uro-technology (ESUT). World J Urol. 2017 Nov;35(11):1651-1658. doi: 10.1007/s00345-017-2055-z. Epub 2017 Jun 7.

  PMID: 28593477 BACKGROUND

• Hughes T, Ho HC, Pietropaolo A, Somani BK. Guideline of guidelines for kidney and bladder stones. Turk J Urol. 2020 Nov;46(Supp. 1):S104-S112. doi: 10.5152/tud.2020.20315. Epub 2020 Oct 9.

  PMID: 33052834 BACKGROUND

• Strohmaier WL, Wrobel BM, Schubert G. Overweight, insulin resistance and blood pressure (parameters of the metabolic syndrome) in uric acid urolithiasis. Urol Res. 2012 Apr;40(2):171-5. doi: 10.1007/s00240-011-0403-9. Epub 2011 Aug 25.

  PMID: 21866382 BACKGROUND

• Ahmed AF, Al-Sayed AY. Tamsulosin versus Alfuzosin in the Treatment of Patients with Distal Ureteral Stones: Prospective, Randomized, Comparative Study. Korean J Urol. 2010 Mar;51(3):193-7. doi: 10.4111/kju.2010.51.3.193. Epub 2010 Mar 19.

  PMID: 20414396 BACKGROUND

• Soliman MG, El-Gamal O, El-Gamal S, Abdel Raheem A, Abou-Ramadan A, El-Abd A. Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study. Urol Int. 2021;105(7-8):568-573. doi: 10.1159/000513074. Epub 2021 Feb 1.

  PMID: 33524970 RESULT

• Morita T, Wada I, Saeki H, Tsuchida S, Weiss RM. Ureteral urine transport: changes in bolus volume, peristaltic frequency, intraluminal pressure and volume of flow resulting from autonomic drugs. J Urol. 1987 Jan;137(1):132-5. doi: 10.1016/s0022-5347(17)43904-8.

  PMID: 3795356 RESULT

MeSH Terms

Interventions

silodosin

Study Officials

• PROF MUNIZA QAYYUM, PHD PHARMACOLOGY

  FATIMA JINNAH MEDICAL UNIVERSITY LAHORE

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: ASSOCIATE PROFESSOR

Study Record Dates

• First Submitted: April 17, 2025
• First Posted: May 31, 2025
• Study Start: October 1, 2023
• Primary Completion: April 1, 2024
• Study Completion: August 15, 2024
• Last Updated: May 31, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)