World J Urol. 2026 Aug 29;44(1):621. doi: 10.1007/s00345-026-06657-x.
ABSTRACT
OBJECTIVE: This study aimed to compare the efficacy of tamsulosin monotherapy versus tamsulosin combined with tolterodine for facilitating the expulsion of distal ureteral stones.
METHODS: A prospective, randomized controlled trial was conducted between 2022 and 2023 at the Urology Clinic of Imam Reza Hospital, Ardabil. A total of 120 patients diagnosed with distal ureteral stones (4-10 mm in size) were randomized into two groups: Group A received 0.4 mg tamsulosin daily, and Group B received 0.4 mg tamsulosin daily plus 2 mg tolterodine twice daily. Treatment duration was up to 4 weeks. Primary outcomes included stone expulsion rate and expulsion time. Secondary outcomes comprised pain control (visual analog scale, VAS), analgesic requirement, and incidence of side effects.
RESULTS: The two groups were comparable at baseline in terms of demographic and stone characteristics. The stone expulsion rate was significantly higher in Group B (tamsulosin + tolterodine) at 83.3% (50/60) compared to Group A (tamsulosin alone) at 66.7% (40/60) (p = 0.03). The mean stone expulsion time was also significantly shorter in Group B (10.5 ± 3.2 days) compared to Group A (14.8 ± 4.1 days) (p < 0.001). Patients in Group B reported lower mean pain scores (VAS) and required less rescue analgesia. The incidence of adverse effects was comparable between the groups, with dry mouth being slightly more common in Group B.
CONCLUSION: The combination of tamsulosin and tolterodine demonstrated superior efficacy in terms of stone expulsion rate and reduced expulsion time for distal ureteral stones compared to tamsulosin monotherapy. This combination therapy may offer a more effective medical expulsive therapy option for patients with distal ureteral calculi.
PMID:42667316 | DOI:10.1007/s00345-026-06657-x
