Effect of preoperative Silodosin on facilitating access sheath placement in retrograde intrarenal surgery. A randomized controlled studys

Abstract

Introduction: to evaluate the effect of preoperative Silodosin on ureteric dilatation to facilitate ureteral access sheath (UAS) placement and reduction of ureteral wall injury in retrograde intrarenal surgery (RIRS). Methods: one hundred and twenty patients with renal or ureteric stones were randomly allocated into 2 equal groups. Group A represents patients who received a 7-day preoperative single dose Silodosin before RIRS while Group B represents patients who received a placebo for the same regimen. Our primary outcome was to assess the success rate of (UAS) placement. Our secondary outcomes were to evaluate the perioperative complication rate, stone-free rate, hospital stay, and cost analysis. Results: In our study, Silodosin showed a higher success rate for (UAS) insertion compared to placebo with a statistically significant difference (p-value = 0.04). Spontaneous UAS insertion in the Silodosin group was 58.3%, which was increased with active ureteric dilatation to 98.3%. Preoperative Silodosin led to less postoperative pain and analgesics requirements without impacting postoperative hospital stay or stone-free rate. There was less ureteric injury incidence in the Silodosin group compared to placebo with a statistically significant difference (p-value = 0.002). Conclusion: Preoperative Silodosin facilitates UAS insertion with a protective role against ureteric injury compared to placebo.