Re: Ramadhani MZ, Kloping YP, Rahman IA, Yogiswara N, Soebadi MA, Renaldo J. Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis. Indian J Urol 2023;39:21-6.

Abstract

I read with great interest an article published by Ramadhani et al.[1] in the latest edition of the Journal. In this study, the authors have performed a systematic review and meta-analysis of the studies examining the role of silodosin as a medical expulsive therapy for distal ureteric stones. I would like to congratulate the authors on their publication. Multiple randomized control trials have established the efficacy of alpha‐blockers as a part of medical expulsive therapy for distal ureteric stones. Most of the studies conducted in this field have been small, single‐center, poor‐quality randomized studies. Therefore, there is still a scope for a well-conducted multicentric randomized control trial to close this debate. This is where systematic reviews and meta-analyses have proved handy by performing a pooled analysis of these small randomized studies. However, this pooling of data may not be without limitations as there would be heterogeneity in the patient population and outcomes studied. In the present meta-analysis, the authors have tried to handle this delicate issue; however, there are still limitations that need to be addressed.