Original articlePreliminary study of the efficacy of the combination of tamsulosin and trospium as a medical expulsive therapy for distal ureteric stones

ObjectivesTo evaluate and compare the efficacy of tamsulosin (0.4 mg, once/day) and combinations of it with trospium (20 mg, twice/day) in the treatment of single small lower ureteral stones.Patients and methodsA total of 126 patients presenting to urology outpatient clinics from July 2012 to May 2015, with a single 5-10 mm sized lower ureteral stone were randomly classified into two treatment groups. Patients in group A (n = 62) received an oral dose of 0.4 mg tamsulosin once daily and 20 mg trospium chloride twice daily. Patients in group B (n = 64) received 0.4 mg tamsulosin once daily and placebo twice daily. The spontaneous passage of stones, the stone expulsion time, and adverse effects were evaluated.ResultsThere were no significant differences in baseline characteristic of the patients in both groups. Stone expulsion was observed in 47 patients (75.8%), and 58 (90.62%) in groups A and B respectively. The average time to expulsion was 11.65 ± 5.32 days in group A and 17.35 ± 6.21 days in group B. The spontaneous stone passage rate through the ureter was significantly higher and the stone expulsion time was faster in groups A than in group B (p < 0.05). The adverse effects observed in both groups were comparable and were mild.ConclusionsThe combination of 0.4 mg tamsulosin and 40 mg trospium as MET for single lower ureteral stones <10 mm is safe and more effective than 0.4 mg tamsulosin as a mono-therapy.