Can Silodosin Replace the Stent in Post Ureteroscopic Lithotripsy Patients: Initial Report of 20 Patients Each

Abstract

INTRODUCTION:Routinely we insert stent after Ureteroscopic lithotripsy, can silodosin be used instead of stent after ureteroscopic lithotripsy in order to avoid stent related morbidity. OBJECTIVE: This study compares efficacy of silodosin with stent to prevent stent related morbidity in post URSL patients. MATERIALS AND METHODS: From August 2013 to July 2014, 40 consecutive patients with 5 to 18 mm ureteral stones undergoing URS using pneumatic lithotripsy were alternatively grouped into each group. Group 1 (20 patients) stent removed after 2 week, and group 2 (20 patients) silodosin 8mg given daily night for 2weeks. After discharge patients were asked to report either immediately if they develop flank pain and fever or on post-operative day 3, 7, and 15. RESULTS: The two groups were comparable in relation with the duration of stent and silodosin therapy, 3 out of 20 patients in whom silodosin was given had flank pain which subsided with analgesics. CONCLUSION: This study demonstrates that silodosin can be used safely instead of stent in an uncomplicated URSL but, needs large scale multicentric randomized control trails. KEYWORDS: Silodosin, Stent, Post URSL. INTRODUCTION:Routinely we insert stent after Ureteroscopic lithotripsy as the placement of a Double-J stent helps to avoid the complications of pain and infection that can result from ureteral edema.But Stenting can cause discomfort 1,2 to the patients, presence of intraureteral stent carries risk of bacterial colonization and subsequent urinary tract infection 3 and encrustation. 4 In addition to these, presence of intraureteral stents induces vesico-ureteral reflux specifically with high bladder pressure during voiding, 5 and there is need for stent removal as an additional procedure.Silodosin is a selective α-1 receptor (1A, 1B, 1D) antagonist with documented use in urology in the management of LUTS in BPH 6 and also in spontaneous expulsion of distal ureteric stones 7 .So we wanted to know if silodosin can be used instead of stenting to serve the same purpose.