Imperatore Vittorio, Fusco Ferdinando, Creta Massimiliano, Di Meo Sergio, Buonopane Roberto, Longo Nicola, Imbimbo Ciro, Mirone Vincenzo
Department of Urology, Buon Consiglio Fatebenefratelli Hospital, Naples.
Arch Ital Urol Androl. 2014 Jun 30;86(2):103-7. doi: 10.4081/aiua.2014.2.103.
To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones.
Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared.
Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant). The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant). Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups.
Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.
比较坦索罗辛和西洛多辛在远端输尿管结石药物排石治疗（MET）中的疗效和安全性。
回顾性收集2012年1月至2013年1月接受西洛多辛（N = 50）或坦索罗辛（N = 50）进行MET治疗的患者的观察数据。纳入标准为：年龄≥18岁，有一枚位于骶髂关节下缘与膀胱输尿管连接处之间、最大径为10 mm或更小的单侧、有症状、不透X线的输尿管结石。比较结石排出率、结石排出时间、疼痛发作次数、使用镇痛药的必要性及副作用发生率。
西洛多辛组和坦索罗辛组的结石排出率分别为88%和82%（p无统计学意义）。西洛多辛组和坦索罗辛组的平均排出时间分别为6.7天和6.5天（p无统计学意义）。西洛多辛组和坦索罗辛组的平均疼痛发作次数分别为1.6次和1.7次（p无统计学意义）。西洛多辛组和坦索罗辛组的平均镇痛药使用次数分别为0.84次和0.9次（p无统计学意义）。总体而言，两组的副作用发生率相似。与服用坦索罗辛的患者相比，服用西洛多辛的患者逆行射精发生率较高，但外周血管扩张相关副作用发生率较低。亚组分析显示，两组中结石≤5 mm的患者平均排出时间和疼痛发作次数显著更低。
坦索罗辛和西洛多辛作为10 mm或更小的远端输尿管结石的MET治疗同样有效。与坦索罗辛相比，西洛多辛进行MET治疗时外周血管扩张相关副作用发生率较低，但逆行射精发生率较高。
