Effect of Silodosin in the Treatment of Distal Ureteral Stone

Abstract

Background: Ureteral stones are a common type of urinary tract stones, accounting for 20% of all cases. The majority of these stones, approximately 70%, are located in the distal ureter. Recent studies have shown that α1- Adrenergic blockers can enhance the spontaneous passage of distal ureteral stones. Objectives: This study was done to compare the outcomes of treating distal ureteral stone with Silodosin, an α1- A adrenergic blocker, versus without Silodosin. Materials and Methods: A total of 70 patients aged between 18 and 50 years, diagnosed with distal ureteral stone, were enrolled in the study, which took place at the Department of Urology, Dhaka Medical College, from October 2017 to March 2019. The patients were divided into two groups: Group A and Group B. Group A consisted of 35 patients who were instructed to drink 3 litres of water daily, while Group B received the same instruction and also received Silodosin 8 mg/day. The treatment duration was four weeks, during which patients were monitored weekly through history, serum creatinine levels, X-ray KUB, and ultrasonogram of KUB. The number of stone expulsions, duration of spontaneous stone passage through the ureter, analgesic dosages, and adverse effects were recorded. Results: The higher expulsion rate in Group B (91.4%) compared to Group A (71.4%) (P=0.031). The mean expulsion duration was significantly shorter in Group B (8.94±3.58 days) compared to Group A (13.08±7.26 days) (P<0.00298). Additionally, Group B required significantly lower analgesic dosages (115.71±75.51 mg) compared to Group A (255.71±108.31 mg) (P=0.00001). No adverse effects were observed in Group A, while two patients in Group B experienced adverse effects (retrograde ejaculation and postural hypotension). Conclusion: These results indicate that 8 mg/day of silodosin facilitates the expulsion of distal ureteral stone of about 5 to 10 mm in diameter in the largest dimension and significantly reduces the number of analgesic dosages.