الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 65 |  |  |
| | | from | 65 | | |
Abstract
Tamsulosin, a selective alpha-blocker with equal affinity for both α-1A and α-1D receptors, has a proven role in MET in increasing the stone expulsion rate and decreasing expulsion time.(102, 103)
A newly launched phosphodiesterase-5 (PDE-5) inhibitor, tadalafil, has emerged which acts on the NO/cGMP-signaling pathway of smooth muscles, resulting in increased levels of cyclic guanosine monophosphate, causing ureteric relaxation. Due to its smooth muscle relaxation property, tadalafil was approved by the FDA for use in lower urinary tract symptoms in patients with benign prostatic hyperplasia and erectile dysfunction. It also received FDA approval for use in pulmonary arterial hypertension for both men and women.(12, 92)
So we conducted a comparative study between tamsulosin and tadalafil as a medical expulsive therapy in lower third ureteric stone less than 1 cm.
It’s a prospective, randomized, placebo controlled comparative study carried out in Minia Urology and Nephrology University Hospital. Our study included 99 patients who randomized into 3 equal groups, 33 patients in each group.
A) First group received Tadalafil 5 mg.
B) Second group received Tamsulosin 0.4mg
C) Third group was control group (placebo)
In our study all groups showed no significant difference in percentage of gender, median age, stone laterality, median stone width and , distance form intramural part and degree of ureteric dilatation.
The stone expulsion rate was 78.8%, 81.8% and 54.5% respectively, with a significant difference between group (A,B) and group (C).
Mean days till stone passed was (11.17±5.1), (10.27±4.17) and (15.7±3.66) respectively, the difference is statistically significant.