Does preoperative silodosin administration facilitate ureteral dilatation during flexible ureterorenoscopy? A randomized clinical trial,International Urology and Nephrology

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Does preoperative silodosin administration facilitate ureteral dilatation during flexible ureterorenoscopy? A randomized clinical trial
International Urology and Nephrology ( IF 1.8 ) Pub Date : 2023-10-30 , DOI: 10.1007/s11255-023-03824-6
Tamer Diab ₁ , Waleed El-Shaer ₁ , Saad Ibrahim ₁ , Ehab El-Barky ₁ , Ahmed Abou Elezz ₁

Affiliation

Purpose

To assess whether preoperative administration of silodosin can facilitate the placement of ureteral access sheath (UAS) prior to flexible ureteroscopy (F-URS) and reduce the occurrence of ureteric injury in challenging cases.

Methods

This prospective randomized clinical trial was carried out on 147 patients diagnosed with upper ureteric stone or stone kidney, non-stented. The patients were randomly divided into two equal groups. Group A (silodosin group) included patients in whom F-URS was done with daily preoperative intake of 8 mg silodosin for 1 week and group B (placebo/control group) included patients in whom F-URS was done with daily preoperative intake of placebo tablets.

Results

In group A, a total of 23 (33.3%) experienced ureteral wall injury following UAS insertion, while in group B, this occurred in 40 patients (59.7%). There was a statistically significant difference in the grade of ureteral wall injury between the two groups (P < 0.001). In the multiple regression analysis, age, operative time and silodosin were found to be significant risk factors for ureteral wall injury (P = 0.007, 0.041 and < 0.001, respectively).

Conclusions

The administration of silodosin prior to retrograde intrarenal surgery (RIRS) effectively prevented significant ureteral wall damage and reduced initial postoperative discomfort.

中文翻译：

术前给予西洛多辛是否有助于输尿管软镜检查期间的输尿管扩张？随机临床试验

目的

评估术前给予西洛多辛是否有助于在输尿管软镜检查 (F-URS) 之前放置输尿管通路鞘 (UAS)，并减少疑难病例中输尿管损伤的发生。

方法

这项前瞻性随机临床试验对 147 名诊断为输尿管上段结石或肾结石（未置入支架）的患者进行。将患者随机分为相等的两组。 A 组（西洛多辛组）包括接受 F-URS 治疗且每天术前服用 8 mg 西洛多辛，持续 1 周的患者；B 组（安慰剂/对照组）包括接受 F-URS 治疗且每天术前服用安慰剂的患者片剂。

结果

在 A 组中，共有 23 名患者 (33.3%) 在 UAS 插入后出现输尿管壁损伤，而在 B 组中，有 40 名患者 (59.7%) 发生这种情况。两组输尿管壁损伤程度比较，差异有统计学意义（ P <0.001）。多元回归分析发现，年龄、手术时间和西洛多辛是输尿管壁损伤的显着危险因素（ P分别为0.007、0.041和<0.001）。