الفهرس 
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Abstract
This study was done to compare the efficacy and safety of Nifedipine and Tamsulosin as medical expulsive therapy for patients suffering from distal ureteral calculi ≤ 10 mm in size. The study included 90 patients (males and females) divided randomly into 3 equal groups. group (1) included 30 patients that received Nifedipine 30 mg daily for one month. group (2) received Tamsulosin 0.4 mg daily for one month. group (3) received no medical expulsive therapy (control group). All patients in the 3 groups were followed for one month. The results of that study showed that the stone expulsion rate at the end of study period was 76.7%, 83.3% and 40% in the Nifedipine, Tamsulosin and control group, respectively. There was no statistically significant difference between Nifedipine group and Tamsulosin group as regard stone expulsion rate but both groups were significantly better than the control group as regard stone expulsion rate. Also, stone expulsion time (days) was 9.3, 8.1, and 13.8 in the Nifedipine, Tamsulosin and control group , respectively. There was no statistically significant difference between Nifedipine group and Tamsulosin group as regards stone expulsion time but both groups were significantly better than the control group as regard stone expulsion time. In this study, analgesia was required in 56.7%, 46.7% and 80% of patients in the Nifedipine, Tamsulosin and control group respectively. Also the mean dose of analgesia was 65 mg, 50 mg and 252 mg in the Nifedipine, Tamsulosin and control groups respectively. There was no statistically significant difference between Nifedipine and Tamsulosin groups as regard analgesic requirement and analgesic dose but both groups were significantly better than the control group as regard analgesic requirement and analgesic dose Drug related adverse effects occurred in 9 patients in Nifedipine group (2 hypotension, 2 headache, 3 dizziness and 2 vomiting) in 8 patients in Tamsulosin group (1 hypotension, 2 headache, 2 dizziness and 3 vomiting), and in 2 patients in control group ( 1 dizziness and 1 vomiting). Retrograde ejaculation in married male patients occurred in 1 patient of Nifedipine group, 3 patients of Tamsulosin group and no patients in the control group. During the course of the study, none of the patients experienced intractable pain requiring hospitalization , no urosepsis was recorded , no narcotic drugs were administrated , no fever or severe hydronephrosis. The reported side effects in the present study groups were mild to moderate and were well tolerated, probably because of the younger study population and the lack of associated comorbidity. None of the patients withdrew from the study because of side effects caused by the medications. In conclusion, distal ureteral calculi can be treated with medical expulsive therapy in patients when a watchful waiting approach is possible. Our results showed that MET with either Nifedipine or Tamsulosin proved to be effective by increasing stone expulsion rate and reducing stone expulsion time. Also, they reduced the number of analgesic requirement and dose of analgesia with low incidence of side effects. Neither of both drugs was superior to the other as regards efficacy and safety. We recommend using Nifedipine and Tamsulosin as MET for DUC ≤ 10 mm in size with great efficacy and safety.