Does preoperative silodosin administration facilitate ureteral dilatation during flexible ureterorenoscopy? A randomized clinical trial

Abstract

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.

Trifecta in flexible ureteroscopy for treatment of renal and upper ureteral calculi: A multicenter study

“…Recently, flexible-tip ureteral access sheath with suction was proved to increase the stone-free rate and decrease complications of FURS in treatment of renal calculi [ 15 ]. Diab et al showed the preoperative silodosin resulted in decreased incidence of ureteric injury during FURS [ 16 ]. Another study showed that the RIRS stone complexity score could predict stone-free status after FURS, but no scoring system could predict complications [ 17 ].…”