Abstract Objective: To evaluate the efficacy of silodosin therapy, as a new aadrenergic
receptor (a-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,
ne 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 analgesiawas 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.