The Use of Selective Alpha Blockers (Silodosin) in Management of Lower Ureteral Stones larger than 6 mm in diameter

Abstract

Introduction:

-The prevalence of urinary stones has doubled over the past 15 years, mainly due to increasing obesity, poor metabolic syndrome, and diabetes, of all urinary tract stones, ureteral stones constitute 22%, and approximately two-thirds of them are located in the distal ureter.

Management of ureteral stones requires taking into account symptoms and complications.

-This research aims to study the effectiveness of silodosin in the management of lower ureter stones larger than 6 mm in diameter in terms of the affected ureter (right or left), the size of the stone, the degree of hydronephrosis, the rate of stone expulsion(day), whether the stone was completely expelled or not, and the side effects of silodosin.

Methods

A prospective cohort study between Oct 2022 and Oct 2023 enrolled Patients attending the urology Clinic at Al-Assad University Hospital, who meet the criteria for entry into the study during the study period.

A total of 100 participants were diagnosed with a distal unilateral ureteral stone larger than 6 mm in diameter. The sample was divided into two groups, where the first group was the case group, with a population of 50 patients, and the second group was the control group, with a population of 50 patients.

Results

A large percentage of patients who were treated with silodosin (cases) were able to expel the stone completely, at a rate of 76%. On the other hand, 92% of the patients who did not take silodosin (controls) were unable to expel the stone.

We observed a clear decrease in stone excretion rates expulsion (day) in the group of cases who took silodosin, as the rate was 15.2-day in the case group compared to 30.4-day in the controls.

The most common side effect was retrograde ejaculation at 60% of the total sample size, followed by feeling tired at 28%, while the least side effects were diarrhea at 4% and vomiting at 6%.

Conclusion

Silodosin is considered one of the most effective medications in managing and treating lower ureteral stones, as it reduces the time required for stone expulsion.