***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To study the efficacy of alfuzosin compared with tamsulosin in the management of lower ureteral stones . METHODS A total of 102 patients with stones < 1 cm size and located in the lower ureter were enrolled in the present study and r and omized into 3 equal groups . Group 1 patients ( n = 34 ) received 0.4 mg tamsulosin daily , group 2 patients ( n = 34 ) received 10 mg alfuzosin daily , and group 3 patients ( n = 34 ) received placebo ( control group ) . The patients were given 75 mg diclofenac injection intramuscularly on dem and and were followed up for 4 weeks . RESULTS The average stone size for groups 1 , 2 , and 3 was comparable ( 6.17 , 6.70 , and 6.35 mm , respectively ) . Stone expulsion was observed in 28 of 34 patients ( 82.3 % ) in group 1 , 24 of 34 patients ( 70.5 % ) in group 2 , and 12 of 34 patients ( 35.2 % ) in group 3 . The average expulsion time for groups 1 , 2 , and 3 was 12.3 , 14.5 , and 24.5 days , respectively . The results of both study groups ( groups 1 and 2 ) were superior to those in the placebo group ( P = .003 and P = .001 , respectively ) , but the study failed to show any statistically significant differences between tamsulosin and alfuzosin ( P = .25 ) . Alfuzosin was associated with fewer side effects than tamsulosin , especially in terms of retro grade ejaculation . CONCLUSIONS Medical treatment of lower ureteral calculi with tamsulosin and alfuzosin result ed in a significantly increased stone expulsion rate , decreased expulsion time , and a reduced need for analgesic therapy BACKGROUND Using a selective α-blocker for medical expulsive therapy ( MET ) is a cost-effective treatment approach widely used for ureteral stones . OBJECTIVE To evaluate the efficacy of silodosin , a selective α-1a receptor antagonist , in this setting . DESIGN , SETTING , AND PARTICIPANTS This was a multicenter , phase 2 study conducted in adult patients with a unilateral ureteral calculus of 4 - 10 mm . Of 239 patients in the safety population , six discontinued due to adverse events . INTERVENTION Patients were r and omized 1:1 to receive silodosin 8 mg or placebo for up to 4 wk . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was spontaneous stone passage , analyzed using logistic regression . Secondary outcomes included time to stone passage , emergency room ( ER ) visits , hospital admissions , analgesic use , and incidence and severity of pain . RESULTS AND LIMITATIONS No significant differences between the silodosin and placebo groups were observed for passage rate of all stones ( 52 % vs 44 % , respectively ; p=0.2 ) . However , silodosin achieved a significantly greater rate of distal ureter stone passage  than placebo ( p=0.01 ) . Significant differences were not observed for ER visits , hospital admission , or use of analgesics . The number of patients in the intent-to-treat population was slightly below the calculated sample size ( 232 vs 240 ) and sample sizes were not calculated for subgroup analyses . CONCLUSIONS This is among the first prospect i ve , r and omized , multi-institutional trials to examine the efficacy of a selective α-1a antagonist as MET in patients with ureteral calculi and did not demonstrate a benefit to the entire ureter . However , silodosin was found to be well tolerated and beneficial in facilitating the passage of distal ureteral stones , warranting additional future studies on distal stone elimination . PATIENT SUMMARY In this report , we looked at the efficacy of silodosin for the treatment of ureteral stones . We found that silodosin  increased passage of distal ureteral stones BACKGROUND Urolithiasis is a chronic disease of mankind , which has enormous public health importance and it accounts for a substantial economic burden on our society . Hence , it becomes all the more important to formulate cheaper and easier means for treating this condition . The past few years have seen a number of drugs being introduced and successfully used in the medical expulsion therapy of small , uncomplicated ureteral calculi , with each drug cl aim ing to provide better results than the others . Ours is perhaps the first study which has compared the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi . AIMS To compare the efficacy of tamsulosin ( 0.4 mg ) vs silodosin ( 8 mg ) , both in terms of the stone expulsion rate and the time to stone expulsion . SETTING S AND DESIGN A prospect i ve and a r and omized controlled study was conducted in the Department of Urology , Regional Institute of Medical Sciences ( RIMS ) , Imphal , Manipur , India . MATERIAL AND METHODS From February to August 2012 , 100 patients who were between the age group of 18 - 50 years , who had unilateral , uncomplicated middle or lower ureteral stones < /= 1 cm were enrolled and they were divided into two groups . Group 1 received tamsulosin ( 0.4 mg ) daily , whereas Group 2 received silodosin ( 8 mg ) daily for a maximum period of 4 weeks . The patients were followed up weekly or biweekly with imaging studies . The primary endpoint was the stone expulsion rate and the secondary endpoints were the stone expulsion time , the rate of the interventions and the side effects . STATISTICAL ANALYSIS The statistical analysis was performed by using the Student 's t-test and the Chi-squared test . A p value of < 0.05 was considered to be statistically significant . The SPSS-16 software was used for the statistical analysis of the data . RESULTS A spontaneous stone expulsion was observed in 58 % of the patients in group 1 and in 82 % of the patients in Group 2 , which was statistically significant . There was also a significant difference between the groups with regards to the mean stone expulsion time . A lower analgesic use was found in Group 2 . CONCLUSION In our study , silodosin was found to be clinical ly superior to tamsulosin , both in terms of the stone expulsion rate and the stone expulsion time Purpose We evaluated and compared the efficacy of tamsulosin and alfuzosin in the medical treatment of symptomatic , uncomplicated distal ureteral stones . Material s and Methods A total of 87 patients with distal ureteral stones of ≤10 mm were r and omly divided into 3 groups . Group I patients ( n=29 ) received 0.4 mg tamsulosin daily , group II patients ( n=30 ) received 10 mg alfuzosin daily , and group III patients ( n=28 ) were not given tamsulosin or alfuzosin . Patients in all groups received Diclofenac sodium regularly for 1 week and then on dem and . Follow-up was done on a weekly basis for 30 days . Results The mean stone size was comparable in the 3 groups ( 4.97±2.24 , 5.47±2.13 , and 5.39±1.81 mm , respectively ) . The stone expulsion rate was 86.2 % , 76.6 % , and 50 % in groups I , II , and III , respectively . The difference in groups I and II with respect to group III was significant ( p=0.0028 and 0.035 ) . The mean expulsion time for groups I to III was 7.52±7.06 , 8.26±7.34 , and 13.90±6.99 days , respectively . The expulsion time was significantly shorter in groups I and II than in group III ( p=0.0097 and 0.026 ) . Patients taking tamsulosin and alfuzosin had fewer pain attacks than did group III patients ( 1.24±0.57 vs. 1.43±0.67 vs. 1.75±1.17 ) . Only 3 cases of drug side effects , 2 in group I and 1 in group II , were recorded . Conclusions The use of tamsulosin or alfuzosin for the medical treatment of lower ureteric stones proved to be safe and effective . Moreover , tamsulosin did not have any significant benefits over alfuzosin Background : Alpha – 1 blockers decrease the tension and release the spasm of smooth muscles and thus lessen the obstruction and irritation symptoms in the lower urinary tract ( LUTS ) . They make a faster passing of calculi from the terminal part of the ureters possible . Objectives : The goal of this study was to objective ly assess the improvement of difficulties caused by obstructions in ureterolithiasis localized in the lower part of the ureters of 104 r and omly chosen patients ( pts . ) in a double-blind study . Methods : During a period of 2 and half years ( June 1999–January 2002 ) 104 pts . suffering from ureterolithiasis of the lower urinary tract were treated and observed . Patients were divided into two groups : A ( n:53 ; later only 51 were evaluated ) which was subjected to st and ard treatment and group B ( n:51 ) where the st and ard treatment was supplemented by the alpha – 1 blocker . As alpha – 1 blocker one capsule of Tamsulosin /OMNIC 0.4 / was administered daily . Results : With alpha – 1 blocker , we have registered a more speedy passing of calculi from the terminal parts of ureters in 17.6 % of pts . Recurrence of renal colics was less frequent and occurred in one of eight pts . as compared with group A ( without the alpha – 1 blocker ) where a recurrence of the renal colic was observed in about every fifth pts . In group A ( n:51 ) , 62.8 % of the pts . passed the calculi , whereas in group B ( n:51 ) , where st and ard treatment was supplemented by the administration of the alpha – 1 blocker Tamsulosin , this percentage increased to 80.4 % . Conclusion : The treatment by alpha – 1 blockers considerably decreased not only LUTS but also helped to accelerate the passing of minor calculi from the terminal parts of the ureters of 80.4 % of pts . It seems that alpha – 1 blockers potentiate the spasmoanalgetic action of drugs used in st and ard methods of treatment PURPOSE We evaluated the efficacy of alfuzosin as medical expulsive therapy for distal ureteral stone passage . MATERIAL S AND METHODS A total of 76 patients with a distal ureteral calculus provided consent for the study . Patients were r and omized between placebo and study medication , and investigators and patients were blinded to the r and omization scheme . Followup was done on a weekly basis and continued until the patient was rendered stone-free . The patient blood pressure , discomfort level , stone position on imaging , number of remaining pills and any adverse events were assessed . Statistical analysis was performed with the Student t test with p < 0.05 considered significant . RESULTS The overall spontaneous stone passage rate was 75 % , including 77.1 % for placebo and 73.5 % for alfuzosin ( p = 0.83 ) . Mean + /- SD time needed to pass the stone was 8.54 + /- 6.99 days for placebo vs 5.19 + /- 4.82 days for alfuzosin . ( p = 0.003 ) . There was no difference in the size or volume of stones that passed spontaneously between the placebo and alfuzosin arms , as measured on baseline computerized tomography ( 4.08 + /- 1.17 and 3.83 + /- 0.95 mm , p = 0.46 ) and by a digital caliper after stone expulsion ( 3.86 + /- 1.76 and 3.91 + /- 1.06 mm , respectively , p = 0.57 ) . When comparing the improvement from the baseline pain score , the alfuzosin arm experienced a greater decrease in pain score in the days after the initial emergency department visit to the date of stone passage ( p = 0.0005 ) . CONCLUSIONS Alfuzosin improves the patient discomfort associated with stone passage and decreases the time to distal ureteral stone passage but it does not increase the rate of spontaneous stone passage PURPOSE Recent studies show the interesting efficacy of different drug combinations for the spontaneous expulsion of distal ureteral stones . We performed a r and omized , prospect i ve study to assess and compare the efficacy of 3 drugs as medical expulsive therapy for distal ureteral calculi . MATERIAL S AND METHODS A total of 210 symptomatic patients with distal ureteral calculi greater than 4 mm were r and omly allocated to home treatment with phloroglucinol , tamsulosin or nifedipine ( groups 1 to 3 , respectively ) . Each group was given a corticosteroid drug and antibiotic prophylaxis with an injectable nonsteroidal anti-inflammatory drug was also used on dem and . The primary end point was the expulsion rate and the secondary end points were expulsion time , analgesic use , need for hospitalization and endoscopic treatment as well as the number of workdays lost , quality of life and drug side effects RESULTS The expulsion rate was significantly higher in group 2 ( 97.1 % ) than in groups 1 ( 64.3 % , p < 0.0001 ) or 3 ( 77.1 % , p < 0.0001 ) . Group  
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The expulsion rate of all ureteral stones ( OR 1.59 , 95 % CI 1.08 , 2.36 , P = 0.02 ) , the expulsion rate of distal ureteral stones ( OR 2.82 , 95 % CI 1.70 , 4.67 , P < 0.0001 ) and the expulsion time ( days ) of distal ureteral stones ( st and ard mean difference ( SMD ) -4.71 , 95 % CI -6.60 , -2.83 , P < 0.00001 ) indicated that silodosin was more effective than the placebo .
This meta- analysis indicated that silodosin was superior to placebo or tamsulosin in the efficacy for distal ureteral calculi with better control of pain .
The safety profile of silodosin was similar to tamsulosin though retro grade ejaculation was worse for silodosin use .
We conclude that silodosin might have potential as a MET for ureteral stones