Background: Urolithiasis is a common urological disorder worldwide and contributes significantly to morbidity due to recurrent episodes of renal colic and ureteric obstruction. Distal ureteric calculi constitute a substantial proportion of ureteric stones because of physiological narrowing at the vesico ureteric junction. Stones measuring less than 10 mm often pass spontaneously, however, ureteric spasm, edema, and increased intraluminal pressure can hinder expulsion. Medical Expulsive Therapy (MET) using alpha-adrenergic blockers has been widely adopted to facilitate stone passage by reducing ureteric smooth muscle tone and improving peristalsis. Tamsulosin, a selective α1-adrenergic antagonist, has long been used in MET, while Silodosin, a newer highly selective α1A-adrenergic blocker, may offer improved efficacy due to its greater receptor selectivity in the distal ureter.

Objective: To compare the efficacy of Silodosin and Tamsulosin in the medical expulsive therapy of distal ureteric calculi less than 10 mm with respect to stone expulsion and analgesic requirement.

Methods: A observational Cross sectional study was conducted in the Department of General Surgery, K. H. Patil Institute of Medical Sciences, Gadag. Two hundred patients with distal ureteric calculi measuring less than 10 mm were enrolled and managed conservatively using either Silodosin or Tamsulosin. Patient demographics, stone characteristics, analgesic usage, and treatment outcomes were analyzed.

Results: Both medications demonstrated satisfactory stone expulsion rates. However, patients receiving Silodosin exhibited higher stone expulsion rates and required fewer days of analgesic therapy compared with those receiving Tamsulosin.

Conclusion: Silodosin demonstrated superior clinical efficacy over Tamsulosin in facilitating distal ureteric stone passage and reducing analgesic requirement.