Tadalafil Facilitates the Distal Ureteral Stone Expulsion: A Meta-Analysis

Abstract Objective: To assess the efficacy and safety of tadalafil in facilitating the spontaneous passage of distal ureteral stones. Methods: The relevant studies were identified by searching MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to November 2016. Randomized controlled trials evaluating effects of tadalafil for distal ureteral stones were included. Results: Six publications involving 921 patients were included. Compared with tamsulosin monotherapy, tadalafil monotherapy or combined with tamsulosin has a significantly higher stone expulsion rate (relative risk [RR], 1.16; 95% confidence interval [CI], 1.05 to 1.29; p = 0.004; RR, 1.24; 95% CI, 1.09 to 1.42; p = 0.001, respectively) and shorter time to stone expulsion (mean difference [MD], −1.33 days; 95% CI, −2.44 to −0.23; p = 0.02; MD, −1.98 days; 95% CI, −3.08 to −0.88; p = 0.0004, respectively). Statistically significant differences were noted in pain episodes and analgesic use in favor of group tadalafil alone co...