The urinary stone disease is one of the most common afflictions of the modern society and it has been described since antiquity with the westernization of global culture. The efficacy of mini-invasive therapies, such as Extracorporeal Shock Wave Lithotripsy [ESWL] and ureteroscopy are not risk free, are problematic and are quite expensive. Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitate stone expulsion. MATERIALS AND METHODSThis prospective randomised study was conducted between September 2015 and May 2016 at Rajarajeshwari Medical College and Hospital, Bangalore. The cohort comprised 100 adult patients (54 men and 46 women) who presented with a symptomatic, unilateral, single, uncomplicated lower ureteric stone of ≤ 10 mm. Patients were randomized into two equal groups, 50 (50%) patients received a daily single dose of tamsulosin 0.4 mg for 28 days and 50 (50%) patients received a daily single dose of silodosin 8 mg for 28 days. Both groups were compared in terms of patient's demographics, socioeconomic status, stone size and side, type of MET, stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use and incidence of side effects. Subgroup analysis was performed according to stone size ≤ or > 5 mm. RESULTSNo significant differences among the two groups for patient's age, gender, stone side and stone size. Spontaneous stone expulsion rate within 28 days was observed in 44 (88%) patients in the tamsulosin group and in 45 (90%) patients in the silodosin group without statistically significant differences. There were no statistically significant differences observed in terms of mean expulsion time, mean number of pain episodes and need for analgesics. Retrograde ejaculation was significantly higher in the silodosin arm, while the incidence of side effects related to peripheral vasodilation were higher in the tamsulosin arm, but it was statistically insignificant. CONCLUSIONTamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associated with a lower incidence of side effects related to peripheral vasodilation, but a higher incidence of retrograde ejaculation when compared to tamsulosin. However, a multicentre study on a larger scale is needed to evaluate the current medicines. KEYWORDSTamsulosin, Silodosin, Stone Expulsion Rate, Medical Expulsion Therapy (MET). Financial or Other, Competing Interest: None. Submission 18-06-2016, Peer Review 13-07-2016, Acceptance 18-07-2016, Published 25-07-2016. Corresponding Author: Dr. Sreedhar Reddy, Professor and HOD, Department of Urology Raja Rajeshwari Medical College and Hospital, Bangalore. E-mail: urologyreddy@yahoo.com DOI: 10.14260/jemds/2016 Nevertheless these techniques are not risk free, are problematic and are quite expensive. (4) Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitat...

The placement of stents has been a standard practice since 1967. The advantage of routine stenting is that it minimizes postoperative ureteral obstruction and renal colic that may result from ureteral oedema caused by balloon dilatation or stone manipulation. There are various disadvantages resulting from it including flank pain, voiding symptoms, infections, stent related stone formation and encrustation. Various studies recommend them to be used only for procedures with complications such as ureteric injury or if a stone fragment remained at the end of the procedure. The aim of our study was to assess the need for routine ureteral stenting after uncomplicated ureteroscopic stone removal. MATERIALS AND METHODSThis study was conducted at Rajarajeshwari Medical College and Hospital, Bangalore, as a prospective randomized controlled trial in Department of Urology between January 2015 and May 2016. In this hospital-based prospective, comparative study, all patients were treated by ureteroscopic lithotripsy. Following the procedure, patients were randomized to the non-stented (n=44) who had no stent placed at the end of the operation and stented (n=52) group having Double DJ stent placement. The assessment criteria included operative time, success rate, postoperative analgesia, complications including (Flank pain, dysuria, haematuria, frequency/urgency), UTI, fever, rehospitalisation and hospital stay. RESULTSThe two groups were comparable with respect to baseline variables of age, gender, mean stone size, side of stone and number of patients turning for radiological follow-up at 3 months. The mean operative time was 38.12±10.76 minutes in the stented group and 32.22±6.72 minutes in the non-stented group. However, this difference was statistically insignificant. There was no significant difference in the two treatment groups with regard to use of intracorporeal lithotripsy. Ureteral dilatation was not required in any patient in both groups. A successful outcome was achieved in 100% of the cases in both groups. Patients with double J stents had statistically significantly more frequency/urgency, dysuria and need of analgesics compared to those without stents. There was no significant difference between the three groups regarding haematuria, fever, flank pain, urinary tract infection, rehospitalisation and mean hospital stay. CONCLUSIONRoutine ureteral stenting does not appear to be warranted in those patients who do not require ureteral dilation during ureteroscopic procedures. Patients without stents had significantly less pain, fewer urinary symptoms and decreased analgesic use postoperatively. Another advantage is cost effectiveness and avoidance of cystoscopy for stent removal.

In the past few years, the bipolar technique of resecting the prostate has become available worldwide, and currently alongside other minimally invasive techniques, especially different laser modalities, challenges the monopolar transurethral resection of the prostate (TURP) as being the gold standard in treating benign prostatic hyperplasia (BPH). The proposed advantages of bipolar resection are improved haemostasis, better intraoperative visualisation, use of saline as an irrigant, which reduces the risk for TUR syndrome, shorter catheterisation time and reduced hospital stay. This study compares monopolar and bipolar TURP with respect to safety, efficacy and complications.

Percutaneous nephrolithotomy (PCNL) was introduced in 1976, and rapidly evolved into the gold standard for treatment of large and complex renal stones. The procedure continues to evolve with an emphasis on maintaining a high success rate of stone treatment while improving patient outcome with decreased morbidity. With the improvement of instrumentation and experience of PCNL, several modifications to the procedure have taken place in order to reduce the morbidity & early return to normal lifestyle. First described by Wickham et al., another technical variation of tubeless PCNL is totally tubeless approach. The aim of this study is to compare standard and totally tubeless PCNL with respect to safety and efficacy.