BACKGROUND 70% of ureteral stones are located in the lower third of the ureter. Medical expulsive therapy (MET) using adrenergic antagonists has recently emerged as an alternative strategy for the initial management of small distal ureteral stones. We planned a study to compare the efficacy of silodosin 8 mg/ day with tamsulosin 0.4 mg/ day with respect to stone expulsion time and stone expulsion rate. MATERIALS AND METHODSA randomised controlled study was carried out on 70 cases having distal ureteric stones (DUS) of size ≤ 10 mm. All cases were above 20 years of age. 35 patients received single dose of tamsulosin 0.4 mg/ day and 35 patients received single dose of silodosin 8 mg/ day. Patients were followed by ultrasonography till stones were passed or upto 4 weeks after initiation of medical expulsive therapy. RESULTS15 out of 27 cases in group tamsulosin and 23 out of 28 cases in group silodosin expelled the stones by the end of study. The mean time of expulsion in tamsulosin group was 19.1 ± 8.6 days, while silodosin group was 16.7 ± 6.8 days. The difference between tamsulosin and silodosin group did not reach statistical significance. The expulsion rate in tamsulosin group was 55.5% and silodosin group was 82.1%, which had statistical significance. The outcome of silodosin and tamsulosin was found to be not affected by the gender of patients. Silodosin is more effective in patients with distal ureteric calculi > 7 mm. CONCLUSIONSilodosin was found to be more effectual than tamsulosin in terms of stone expulsion rate and stone expulsion time for the management of distal ureteric stones of size ≤ 10 mm.

BACKGROUNDBenign prostatic hyperplasia is one of the most common ailments affecting elderly men. The lower urinary tract symptoms caused by it are distressing and cause significant morbidity. Most symptoms are manifested as derangement in urination due to the close anatomical relation between the bladder and the prostate.The present study was undertaken to study the surgical management of benign prostatic hyperplasia with emphasis on transurethral resection of prostate, transurethral vapourisation and open prostatectomy. MATERIALS AND METHODSThe study was a prospective hospital-based time-bound observational study conducted between December 2013 and May 2015 at a Medical College Hospital. RESULTSThe maximum incidence of the disease was in the age group of 61 -70 years. The next commonest mode of presentation was acute retention of urine followed by a weak stream. The average operating time for open prostatectomy was significantly higher. Urinary incontinence following minimally invasive procedures like TURP and TUVP was more common than following open prostatectomy. The average improvement in the symptoms of the patients who underwent TURP and TUVP for BPH at 3 months are similar and less when compared to open prostatectomy. CONCLUSIONTURP is the gold standard in the management of benign prostatic hyperplasia with earlier recovery and lesser postoperative complications. The lower urinary tract symptoms (LUTS) caused due to it are depressing and cause significant morbidity. These include obstructive or voiding symptoms and irritative or storage symptoms. Voiding symptoms include weak urinary stream, hesitancy, intermittency, dribbling and incomplete emptying. Storage symptoms include frequency, nocturia, urgency, urge incontinence and dysuria. The prevalence of LUTS in the male population increases with age and has been estimated to be 20% -25% for the middle-aged men and 40% -70% for men aged 70 years and above. (1,2) In 1992, The American Urological Association (AUA) published the Symptom Scoring Index, 'Financial or Other Competing Interest': None. Submission 17-07-2017, Peer Review 07-11-2017, Acceptance 14-11-2017, Published 20-11-2017. Corresponding Author: Dr. Aswathy Chandran, Room No. 49, Chetana Hostel, KIMS Campus, Hubli. E-mail: aswathydot@gmail.com DOI: 10.14260/jemds/2017/1387 which was adopted by the World Health Organisation in 1993 as the International Prostate Symptom Score (IPSS). It consists of seven questions referring to LUTS as in AUA symptom index with an additional question referring to quality of life. (3) The treatment of BPH has undergone a long development in the past two decades. Surgical modalities have undergone a revolutionary change with minimally invasive techniques, such as transurethral resection of prostate (TURP) becoming the mainstay of operative management with open surgery being reserved for larger glands associated with urethral stricture. Transurethral electrovaporisation of the prostate (TUVP) is a modification of the existing transurethral technolog...