Silodosin versus Tamsulosin for Medical Expulsive Therapy of Ureteral Stones: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Medicina (Kaunas). 2022 Dec 6;58(12):1794. doi: 10.3390/medicina58121794.


Background and Objectives: This systematic review and meta-analysis of randomized controlled trials was performed to compare the therapeutic effects and safety profiles of silodosin and tamsulosin for medical expulsive therapy (MET) of ureteral stones. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library, and Web of Science to identify articles published before July 2022 that described randomized controlled trials comparing silodosin and tamsulosin for MET of ureteral stones. Endpoints were stone expulsion rate, stone expulsion time, and total complication rate. Results: In total, 14 studies were included in our analysis. The size of ureteral stones was <1 cm. Compared with tamsulosin, silodosin resulted in a significantly higher stone expulsion rate (p < 0.01, odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.91 to 3.06, I2 = 0%) and significantly shorter stone expulsion time (p < 0.01, mean difference = −3.04, 95% CI = −4.46 to −1.63, I2 = 89%). The total complication rate did not significantly differ between silodosin and tamsulosin (p = 0.33, OR = 1.15, 95% CI = 0.87 to 1.52, I2 = 7%). Conclusions: Compared with tamsulosin, silodosin resulted in significantly better expulsion of ureteral stones <1 cm. The total complication rate did not significantly differ between silodosin and tamsulosin. Thus, silodosin may be superior to tamsulosin for MET of ureter stones <1 cm.

Keywords: adrenergic alpha-1 receptor antagonists; meta-analysis; systematic review; ureteral calculi.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adrenergic alpha-1 Receptor Antagonists / therapeutic use
  • Humans
  • Randomized Controlled Trials as Topic
  • Tamsulosin / therapeutic use
  • Treatment Outcome
  • Ureteral Calculi* / drug therapy


  • Tamsulosin
  • silodosin
  • Adrenergic alpha-1 Receptor Antagonists

Grants and funding

This research received no external funding.