Abdullah Atif, Basoo Gupta Yogendra, Selvaraj Sudhakaran, Ganapathy Ramesh, Ilangovan Ananda Kumar, Sivalingam Senthilkumar, Prasad Srikala
Urology, Chengalpattu Medical College Hospital, Chengalpattu, IND.
Cureus. 2023 Oct 14;15(10):e47008. doi: 10.7759/cureus.47008. eCollection 2023 Oct.
Medical expulsive therapy (MET) is an established treatment option for distal ureteric stones. Tamsulosin, a selective alpha-1 blocker, has been used for MET with good results, while silodosin, a more selective alpha-1a blocker, is more effective than tamsulosin for MET. Thus, this study aimed to compare the efficacy of silodosin with tamsulosin.
This prospective randomized study was conducted at the Department of Urology, Government Chengalpattu Medical College Hospital, Tamil Nadu, India. Eighty patients who presented with ureteric colic and were radiologically diagnosed with distal ureteric calculus of size <10mm were included. Participants in the silodosin group received tablet silodosin 8mg OD until the passage of the stone, not more than two weeks, and analgesics as per demand. And participants in the tamsulosin group received tablet tamsulosin 0.4mg OD until the passage of the stone, not more than two weeks, and analgesics as per demand.
A total of 80 patients were included in the study. Forty patients in the silodosin group and forty patients in the tamsulosin group were included. In the silodosin group, out of 40 patients, 38 expelled the calculus. In the tamsulosin group, out of 40 patients, 28 expelled the calculus. The silodosin group had a significantly higher rate of expulsion, with a p-value of 0.003. Stone expulsion time was shorter in the silodosin group when compared with the tamsulosin group (10.15 vs. 13.4 days). Analgesic usage during medical expulsive therapy was lower in the silodosin group (5.68 vs. 8.4). We observed significant differences in comparing the outcome, stone expulsion time, and analgesic requirement between the silodosin and tamsulosin groups. We observed no significant difference between the groups for age-wise and gender-wise comparisons. Furthermore, non-expulsion of calculus in four patients and pain in eight patients were the reasons for intervention in the tamsulosin group. The reason for intervention in the silodosin group was the non-expulsion of calculus in two patients.
Using silodosin for MET of distal ureteric calculus, we found to have a better stone expulsion rate, early expulsion time, and reduced analgesic requirement.
药物排石疗法（MET）是治疗远端输尿管结石的既定治疗选择。坦索罗辛，一种选择性α-1阻滞剂，已用于药物排石疗法且效果良好，而西洛多辛，一种更具选择性的α-1a阻滞剂，在药物排石疗法中比坦索罗辛更有效。因此，本研究旨在比较西洛多辛与坦索罗辛的疗效。
这项前瞻性随机研究在印度泰米尔纳德邦坦贾武尔政府医学院医院泌尿外科进行。纳入80例出现输尿管绞痛且经放射学诊断为远端输尿管结石大小<10mm的患者。西洛多辛组参与者服用西洛多辛片8mg每日一次，直至结石排出，最长不超过两周，并按需服用镇痛药。坦索罗辛组参与者服用坦索罗辛片0.4mg每日一次，直至结石排出，最长不超过两周，并按需服用镇痛药。
本研究共纳入80例患者。西洛多辛组40例患者，坦索罗辛组40例患者。在西洛多辛组，40例患者中有38例排出结石。在坦索罗辛组，40例患者中有28例排出结石。西洛多辛组的结石排出率显著更高，p值为0.003。与坦索罗辛组相比，西洛多辛组的结石排出时间更短（10.15天对13.4天）。药物排石疗法期间西洛多辛组的镇痛药使用量更低（5.68对8.4）。我们观察到西洛多辛组和坦索罗辛组在治疗结果、结石排出时间和镇痛药需求方面存在显著差异。在按年龄和性别比较时，我们观察到两组之间无显著差异。此外，坦索罗辛组有4例患者结石未排出和8例患者疼痛是进行干预的原因。西洛多辛组进行干预的原因是2例患者结石未排出。
使用西洛多辛进行远端输尿管结石的药物排石疗法，我们发现其结石排出率更高、排出时间更早且镇痛药需求减少。
