Prospective Randomized Trial Comparing Efficacy of Alfuzosin and Tamsulosin in Management of Lower Ureteral Stones

Objectives

To study the efficacy of alfuzosin compared with tamsulosin in the management of lower ureteral stones.

Methods

A total of 102 patients with stones <1 cm size and located in the lower ureter were enrolled in the present study and randomized into 3 equal groups. Group 1 patients (n = 34) received 0.4 mg tamsulosin daily, group 2 patients (n = 34) received 10 mg alfuzosin daily, and group 3 patients (n = 34) received placebo (control group). The patients were given 75 mg diclofenac injection intramuscularly on demand and were followed up for 4 weeks.

Results

The average stone size for groups 1, 2, and 3 was comparable (6.17, 6.70, and 6.35 mm, respectively). Stone expulsion was observed in 28 of 34 patients (82.3%) in group 1, 24 of 34 patients (70.5%) in group 2, and 12 of 34 patients (35.2%) in group 3. The average expulsion time for groups 1, 2, and 3 was 12.3, 14.5, and 24.5 days, respectively. The results of both study groups (groups 1 and 2) were superior to those in the placebo group (P = .003 and P = .001, respectively), but the study failed to show any statistically significant differences between tamsulosin and alfuzosin (P = .25). Alfuzosin was associated with fewer side effects than tamsulosin, especially in terms of retrograde ejaculation.

Conclusions

Medical treatment of lower ureteral calculi with tamsulosin and alfuzosin resulted in a significantly increased stone expulsion rate, decreased expulsion time, and a reduced need for analgesic therapy.