Zahraa Nasser Abdul Ghani¹ , Hayder Abdulhafedh Kurji², Inas Sami Ali³, Wisam Ghazi Sanad⁴

Abstract

Purpose: To investigate the efficacy of tamsulosin in combination with tadalafil compared to tamsulosin alone in distal ureteral stones. Methods: A total of 80 adult patients with single distal ureteral stones (5–12 mm) were included in this randomized open-label study. The patients were randomly and equally assigned into study and control groups. Study group (n = 40) received tamsulosin (0.4 mg) plus tadalafil (5 mg) daily, and control group received (n = 40) received tamsulosin (0.4 mg) alone. Follow-up was done for 20 days, and clinical parameters such as stone expulsion rate, time of expulsion, frequency of pain episodes, analgesic requirements, and side effects were compared between both groups. Categorical data were compared using chi-square test. Measurement data were compared using the independent sample t-test. P < 0.05 was considered statistically significant Results: Stone expulsion rate was significantly higher, and mean stone expulsion time was significantly shorter in study group compared to control (p < 0.05). Furthermore, patients in study group experienced significantly fewer pain episodes and required analgesics less frequently (p < 0.05). Adverse effects were milder with no significant difference between the groups (p > 0.05), with no major complications. Conclusion: Tadalafil in combination with tamsulosin significantly increases expulsion rate, accelerates stone expulsion, reduces pain and analgesic use in patients with distal ureteral calculi without any significant increase in side effects.