Inclusion Criteria:  Age from 14 to 70 years old. Patient with ureteric stone 5-10 MM. Patient with acute renal colic presented to emergency with obstructed kidney with urgent MSCT show stone ureter 5-10 MM and patient come without colic with CT showing lower third stone of the same measurement.  Exclusion Criteria:  Age less than 14 or more than 70. Chronically diseased patient cardiac that contraindicated to take PD5I or tamsulosin. Only functioning kidney. CKD Patient. Bilateral ureteric stone. urinary tract infection. severe refractory pain. severe hydronephrosis. multiple ureteric stones. ischemic heart disease, congestive cardiac failure, or complicated hypertension. pregnant or lactating mothers. patient refuse medical treatment. congenital anomalies. previous ureteric surgery.