Sildenafil may be useful asmedical expulsive therapy for distalureteric stones 5–10 mm in diameter,according to research findings publishedin the Arab Journal of Urology(2016;14:1-6).

Ahmed A. Shokeir, MD, and colleaguesat Mansoura Universityin Mansoura, Egypt, comparedsildenafil, a phosphodiesterase type5 (PDE5) inhibitor, with placebo ina randomized, double-blind studythat enrolled 100 patients with distal ureteric stones: 50 who receivedsildenafil 50 mg daily and 50 whoreceived placebo. The groups werecomparable with respect to age andstone characteristics.Of the 100 patients, 49 and 47patients in sildenafil and placeboarms, respectively, were availablefor analysis. 

Spontaneous stoneexpulsion occurred in 33 patients(67.3%) in the sildenafil groupcompared with 19 (40.4%) placeborecipients, a significant differencebetween the groups. In multivariableanalysis, sildenafil treatment wasassociated with a significant 2.7times increased likelihood of stoneexpulsion compared with placebo,according to the researchers. 

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