Silodosin 8 mg Versus Double J-Stent Application before Primary Ureteroscopy in Management of Upper and Middle Ureteric Stones in Adults.
Okasha, A., ABDELMONEM, H., Nabeeh, M., elbadry, M. (2025). Silodosin 8 mg Versus Double J-Stent Application before Primary Ureteroscopy in Management of Upper and Middle Ureteric Stones in Adults.. EKB Journal Management System, (), -. doi: 10.21608/arcmed.2025.358853.1090
Abdelrahman Mohamed Okasha; HOSSAM ABDELSAMIE ABDELMONEM; Mohamed Adel Nabeeh; Mohamed Salah elbadry. "Silodosin 8 mg Versus Double J-Stent Application before Primary Ureteroscopy in Management of Upper and Middle Ureteric Stones in Adults.". EKB Journal Management System, , , 2025, -. doi: 10.21608/arcmed.2025.358853.1090
Okasha, A., ABDELMONEM, H., Nabeeh, M., elbadry, M. (2025). 'Silodosin 8 mg Versus Double J-Stent Application before Primary Ureteroscopy in Management of Upper and Middle Ureteric Stones in Adults.', EKB Journal Management System, (), pp. -. doi: 10.21608/arcmed.2025.358853.1090
Okasha, A., ABDELMONEM, H., Nabeeh, M., elbadry, M. Silodosin 8 mg Versus Double J-Stent Application before Primary Ureteroscopy in Management of Upper and Middle Ureteric Stones in Adults.. EKB Journal Management System, 2025; (): -. doi: 10.21608/arcmed.2025.358853.1090

Silodosin 8 mg Versus Double J-Stent Application before Primary Ureteroscopy in Management of Upper and Middle Ureteric Stones in Adults.

ARCADEs of MEDICINE
Articles in Press, Accepted Manuscript, Available Online from 21 July 2025  XML
Document Type: Original Research
DOI: 10.21608/arcmed.2025.358853.1090
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Authors
Abdelrahman Mohamed Okasha email 1; HOSSAM ABDELSAMIE ABDELMONEM2; Mohamed Adel Nabeeh3; Mohamed Salah elbadry4
1MSc, Urology Department, Armed Forces College of Medicine, Cairo, Egypt
2MD, Lecturer of Urology, Urology Department, AFCM, Cairo, Egypt
3MD, Lecturer of Urology, Urology Department, Faculty of Medicine, Suez University, Cairo, Egypt
4MD, Professor of Urology, Urology Department, AFCM, Cairo, Egypt
Abstract
Background:

Ureteroscopy with stone disintegration is the standard treatment for upper and middle ureteric stones when medical therapy fails. The benefit of placing a preoperative double-J stent remains controversial. Silodosin, an alpha-1 adrenergic blocker, may facilitate ureteroscopic access by relaxing distal ureter. This study aimed to compare the clinical outcomes of preoperative 8 mg silodosin and DJ stenting before ureteroscopy in adults with upper or middle ureteric stones. The primary outcome was the success rate; secondary outcomes included hospital stay, operative time, and postoperative complications.

Methods:

This randomized controlled trial included 102 adult patients (18–72 years) with unilateral upper or middle ureteric stones (5–15 mm) treated in 2024 across three Egyptian military hospitals. Patients were randomized into three equal groups: Group A received silodosin, Group B underwent DJ stenting, and Group C proceeded directly to ureteroscopy without preoperative intervention. All patients underwent semirigid ureteroscopy with Holmium:YAG laser lithotripsy.

Results:

Operation times were significantly shorter in Group A (53.6±6.3 min) and Group B (53.5±6 min) compared to Group C (58±4.6 min), with P-values of 1 (A vs B), 0.005 (A vs C), and 0.0043 (B vs C). Need for balloon dilatation was also lower in Groups A and B versus C (P = 0.02, 0.028, and 0.001, respectively). No statistically significant differences were found between groups in stone-free rate, success rate, hospital stay, or postoperative complications.

Conclusion:

Preoperative silodosin and DJ stenting are both safe and effective, reducing operative time compared to direct URS, with no superiority of stenting over silodosin
Keywords
Ureteroscopy (URS); Silodosin; Double J (DJ)
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