1. Efficacy of silodosin on the outcome of semi-rigid ureteroscopy for the management of large distal ureteric stones: blinded randomised trial
- Author
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Yasser A. Noureldin, Mostafa M.H. Khalil, Ahmed Mohey, Ahmed Abou-Taleb, Tarek Gharib, and Hisham Alazaby
- Subjects
medicine.medical_specialty ,Urology ,Non contrast ct ,030232 urology & nephrology ,α-AR, α-adrenergic receptor ,NCCT, non-contrast CT ,03 medical and health sciences ,0302 clinical medicine ,Silodosin ,KUB, plain abdominal radiograph of the kidneys, ureters and bladder ,Ureteroscopy ,medicine ,Stone/Endourology ,Shockwave lithotripsy ,α adrenergic receptors ,medicine.diagnostic_test ,US, ultrasonography ,business.industry ,Diseases of the genitourinary system. Urology ,SWL, shockwave lithotripsy ,Management ,URS, ureteroscopy ,030220 oncology & carcinogenesis ,RC870-923 ,Ultrasonography ,business ,Ureteric stones ,medicine.drug - Abstract
Objective: To evaluate the efficacy of silodosin therapy, as a new α-adrenergic receptor (α-AR) blocker, on the success rate of semi-rigid ureteroscopy (URS) for the management of large distal ureteric stones. Patients and methods: This prospective study recruited 127 adult patients with single distal ureteric stone of ≥1 cm. The patients were randomly allocated to two groups: the first group included 62 patients who received silodosin (8 mg) for 10 days before URS (Silodosin group), whilst the second group included 65 patients who received placebo, in the form of multivitamins, for 10 days before URS (Placebo group). All patients underwent URS and a pneumatic lithoclast was used for stone fragmentation. Results: The mean (SD) operative time was shorter in the Silodosin group compared with the Placebo group, at 41.61 (4.67) vs 46.85 (4.6) min, respectively. Furthermore, advancing the ureteroscope to access the stone failed in a statistically significant number of patients in the Placebo group compared with the Silodosin group (13 vs two, respectively). The complication rate was significantly higher in the Placebo group compared with the Silodosin group (20% vs 6.4%, P = 0.036). Additionally, the need for postoperative analgesia was significantly lower in the Silodosin group compared with the Placebo group (8.1% vs 26.2%, P = 0.009). Conclusion: Silodosin therapy prior to URS management of large distal ureteric stones seems to be associated with better advancing of the ureteroscope to access the stone, shorter procedure time, higher stone-free rate, lower incidence of complications, and lesser need for postoperative analgesia. Keywords: Silodosin, Ureteroscopy, Ureteric stones, Management
- Published
- 2018