Yuceturk Cem Nedim, Dadali Mumtaz, Bagbanci Muhammed Sahin, Ozgur Berat Cem, Aydogmus Yasin, Yildiz Yildiray, Kilinc Muhammet Fatih
Department of Urology, Ankara Training and Research Hospital, Alt?nda?, Ankara, 06000Turkey.
Department of Urology, Medical Faculty, Ahi Evran University, K?r?ehir 04000 Turkey.
Urol J. 2017 Jan 18;14(1):2944-2948.
We aimed to investigate the efficacy of silodosin 4 mg/day and 8 mg/day for medical expulsive therapy(MET) of lower ureteral stones.
We retrospectively analyzed the medical records of 161 patients admitted to urologyclinics of Ahi Evran University Medical Faculty and Ankara Training and Research Hospital with distal ureteralstones and treated with MET with different doses of silodosin between January 2013 and August 2015. 81 patientswere treated with silodosin 4mg/day in group-1 and 80 patients with silodosin 8mg/day in group-2. Age, gender,complaints on admission, stone size, the distance between the stone and ureterovesical junction, stone passage rate,duration of stone passage after starting MET, and adverse effects were noted from the charts of the patients, andthe groups were compared.
There were 81 patients in group-1, and 80 patients in group-2. Two groups were similar for age (P =.38)and gender (P =.92). Spontaneous stone passage was seen in 41 (50.9%) patients in group-1, and in 59 (73.8%)patients in group 2. The groups were different for spontaneous stone passage rate (P =.002). In group-1, 10 (25%)patients that could not pass their stones spontaneously and were treated with extracorporeal shockwave lithotripsy(SWL), and 30 (75%) of them were treated with ureterolithotripsy. Eight (38%) patients that could not undergoureterolithotripsy and/or anesthesia and were not able to pass their stones were treated with SWL, and 13 (62%)patients were treated with ureterolithotripsy in group-2. All of the patients were stone free at the end of the treatment.
A dose of 8 mg/day should be preferred if silodosin is to be preferred for MET in lower ureteral stones.
我们旨在研究每天4毫克和8毫克的西洛多辛用于输尿管下段结石药物排石治疗(MET)的疗效。
我们回顾性分析了2013年1月至2015年8月期间在阿希埃夫兰大学医学院泌尿外科诊所和安卡拉培训与研究医院收治的161例输尿管下段结石患者的病历,这些患者接受了不同剂量西洛多辛的MET治疗。第1组81例患者接受每天4毫克西洛多辛治疗,第2组80例患者接受每天8毫克西洛多辛治疗。从患者病历中记录年龄、性别、入院时的症状、结石大小、结石与输尿管膀胱连接处的距离、结石排出率、开始MET后结石排出的持续时间以及不良反应,并对两组进行比较。
第1组有81例患者,第2组有80例患者。两组在年龄(P = 0.38)和性别(P = 0.92)方面相似。第1组41例(50.9%)患者结石自然排出,第2组59例(73.8%)患者结石自然排出。两组在结石自然排出率方面存在差异(P = 0.002)。在第1组中,10例(25%)不能自然排出结石的患者接受了体外冲击波碎石术(SWL)治疗,其中30例(75%)接受了输尿管镜碎石术治疗。第2组中,8例(38%)不能接受输尿管镜碎石术和/或麻醉且无法排出结石的患者接受了SWL治疗,13例(62%)患者接受了输尿管镜碎石术治疗。所有患者在治疗结束时均无结石。
如果在输尿管下段结石的MET中首选西洛多辛,应首选每天8毫克的剂量。