Tamsulosin vs. Tadalafil as medical expulsive therapy for distal ureteral stones: a systematic review and meta-analysis.

IF 3.1 3区医学 Q1 UROLOGY & NEPHROLOGY

International Braz J Urol Pub Date : 2023-11-01 DOI:10.1590/S1677-5538.IBJU.2023.0345

Mikhael Belkovsky, Giulia Veneziani Zogaib, Carlo Camargo Passerotti, Everson Luiz de Almeida Artifon, José Pinhata Otoch, José Arnaldo Shiomi da Cruz

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Abstract

Purpose: Medical expulsive therapy (MET) is recommended for distal ureteral stones from 5 to 10 mm. The best drug for MET is still uncertain. In this review, we aim to compare the effectiveness of tadalafil and tamsulosin for distal ureteral stones from 5 to 10 mm in terms of stone expulsion rate (SER), stone expulsion time (SET) and the side effect profile.

Materials and methods: A comprehensive literature search was conducted on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science, from inception until April 2023. Only randomized controlled trials were included in the analysis.

Results: Eleven publications with 1,330 patients were included. We observed that tadalafil has a higher SER (OR 0.55, CI 95% 0.38;0.80, p=0.02, I2=52%) and the same efficacy in SET (MD 1.07, CI 95% -0.25; 2.39, p=0.11, I2=84%). No differences were found when comparing side effects as headache, backache, dizziness, and orthostatic hypotension.

Conclusion: Tadalafil has a higher stone expulsion rate than tamsulosin as a medical expulsive therapy for patients with distal stones from 5 to 10 mm without differences in side effects.

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Tamsulosin与Tadalafil作为药物推进治疗输尿管远端结石：一项系统综述和荟萃分析。

目的：建议对5至10mm的输尿管远端结石采用药物推进治疗（MET）。治疗MET的最佳药物尚不确定。在这篇综述中，我们旨在从结石排出率（SER）、结石排出时间（SET）和副作用方面比较他达拉非和坦索罗辛治疗5至10mm输尿管远端结石的有效性。材料和方法：从成立到2023年4月，在MEDLINE、EMBASE、Cochrane对照试验中央注册中心、Scopus和Web of Science上进行了全面的文献检索。只有随机对照试验被纳入分析。结果：纳入了11份出版物，涉及1330名患者。我们观察到，他达拉非在SET中具有更高的SER（OR 0.55，CI 95%0.38；0.80，p=0.02，I2=52%）和相同的疗效（MD 1.07，CI 95%-0.25；2.39，p=0.11，I2=84%）。在比较头痛、背痛、头晕和直立性低血压等副作用时没有发现差异。结论：对于5至10mm的远端结石患者，他达拉非的排石率高于坦索罗辛，副作用无差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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