Objective: To compare the efficacy and safety of silodosin
against tamsulosin as medical expulsion therapeutic agent
in stone lower 1/3rd ureter. Patients and Methods: One hundred
fifty patients divided equally into 2 groups I and II received
silodosin 8 mg and tamsulosin 0.4 mg respectively.
Patients aged 18 years or older having single unilateral stone
10 mm or less were included in the study. Patients with bilateral
or multiple stones, marked hydronephrosis, previous
open or endoscopic surgery and having urinary infection
were excluded. Patients were followed weekly for 4 weeks
by ultrasonography, plain radiography of the urinary tract
and CT of the urinary tract when indicated. Results: Silodosin
showed better results against tamsulosin as stone expulsion
rate in silodosin and tamsulosin groups was 82.4 and 61.5%
respectively with significant difference (p = 0.007). Also, the
stone expulsion time was significantly lower in silodosin
against tamsulosin groups as it was 9.4 ± 3.8 vs. 12.7 ± 5.1
days in group I and II respectively (p = 0.001). The adverse
effects were comparable with non-significant more retrograde
ejaculation in the silodosin group. Conclusion: Silodosin
showed better efficacy in the stone expulsion rate and
time with comparable safety of both drugs, with nonsignificant
more retrograde ejaculation in silodosin.