EDITORIAL COMMENT

Urolithiasis is a common and increasing urologic problem in Anatolia region of Turkey. This situation necessitates safe and efficacious treatment. Medical expulsive therapy is a proven treatment modality in informed patients according to the guidelines. Alpha blockers and nifedipine are accepted therapeutics while tamsulosin is the most used one. In this study, patients were randomized to one of three groups (n=90, each). Interestingly, one arm was composed of tadalafil. The hypothesis was ureteral relaxation by NO/cGMP pathway. Absence of placebo arm is a negative point for the design of this study. All patients had 5-10 mm stones localized in the distal ureter. They found that silodosin group had significantly higher stone-free rate and shorter stone expulsion time than tamsulosin and tadalafil groups (83%, 64%, and 66%, respectively). A brief conclusion of this study indicates that tadalafil was as effective as tamsulosin while silodosin was the most potent one. In the literature, tadalafil and medical expulsive therapy search meets only three studies with this same group. Therefore, it is early to give a comment on this topic, but it would be clarified in near future.