Efficacy of DJ Stenting versus Silodosin after Ureteroscopic Lithotripsy for Lower Ureteric Stones: A Prospective Randomized Clinical Trial

Abstract

Background: A Double J (DJ) stent utilizing following ureteroscopy facilitates the residual fragments passage and provides pain  alleviation produced by mucosal swelling & obstruction, despite several complaints of stent related pain postoperatively.

Objective: The current work aimed to compare DJ stenting and Silodosin following ureteroscopy lithotripsy for lower ureteric stones.

Patients and methods: This prospective randomized open label parallel clinical trial was carried out on 70 cases diagnosed with lower  ureteric stone 5-18 mm in size and scheduled for ureteroscopic lithotripsy. Cases were randomly allocated into 2 equal groups; group A  had a 5 Fr DJ stent to be removed after 3 weeks and group B who get 1 silodosin capsule 8 mg at night preoperatively and for 3 weeks  postoperatively. All cases underwent plain X-ray of the kidneys, ureters, and bladder (KUB), ultrasonography, and non-contrast CT of  abdomen and pelvis before operation.

Results: Group B had a significantly shorter operative time than group A (21.7 ± 4.65 min vs. 38.6 ± 4.82 min, P <0.001 respectively).  Postoperative follow-up of symptoms at days 3, 7, and 15 were insignificantly different between both groups. Group B had a significantly  higher stone free rate 24 hours than group A (91.43% vs 68.57%, P =0.034). Group A had a significantly higher need for secondary  procedure & residual fragmentation than group B (P <0.001)

Conclusion: Compared to the DJ Stent group, operative time is significantly  shorter in cases received silodosin after ureteroscopic laser lithotripsy.