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Alwan MG, Nima MH, Alquraishi FS, Rashid NR. Deciding on a novel predictive value to gauge how well patients with lower ureteric stones respond to medical expulsive therapy. Urolithiasis 2024; 52:41. [PMID: 38441660 DOI: 10.1007/s00240-024-01549-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/19/2024] [Indexed: 03/07/2024]
Abstract
This study, conducted over 4 years in Baghdad, Iraq, aimed to determine the importance of ureteric jet assessment in medical expulsive therapy (MET) for distal ureteral stones. A total of 156 patients with distal ureteral stones (≤ 10 mm) participated, and their ureteric jets were observed using a color Doppler scanner before and after 2 weeks of MET. The main focus was the success rate of stone expulsion. Our results showed that 50% of patients had detectable ureteric jets after 2 weeks of MET, and 21.8% experienced successful stone expulsion. After 4 weeks, 23.7% achieved stone expulsion, while 54.5% still had remaining stones. Patients who had a positive baseline ureteric jet were significantly more likely to successfully expel their stones. This study highlights the importance of monitoring ureteric jet movement in MET for distal ureteral stones.
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Affiliation(s)
| | | | | | - Najah Raham Rashid
- Ibn Sina University for Medical and Pharmaceutical Sciences, Baghdad, Iraq
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Li H, Jelley CR, Forster L, Arad J, Mudhar GS, Bardgett HP, Stewart AB, Forster JA. Ultra-low-dose CTKUB: the new standard of follow-up of ureteric calculi not visible on plain radiograph? Int Urol Nephrol 2022. [PMID: 35129775 DOI: 10.1007/s11255-022-03134-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE With sensitivities over 95%, non-contrast computer tomography of kidney, ureter and bladder (CTKUB) is the investigation of choice in renal colic to diagnose or exclude ureteric calculi. CTKUB delivers an average effective radiation dose of 5.4 millisievert (mSv) and is used to follow-up calculi not visible on plain X-ray, whereas plain radiography has a radiation exposure of 0.7 mSv and is used to follow-up radio-opaque calculi. We assessed the effectiveness of using ultra-low-dose CTKUB (ULDCTKUB) for the follow-up of ureteric calculi not visible on plain radiograph of the kidneys, ureter and bladder (KUB), as an emerging option to reduce radiation exposure compared to standard dose CTKUB. METHODS Between 2013 and 2016 we retrospectively analysed 86 patients who underwent ULDCTKUB for CTKUB-confirmed ureteric calculi that were not visible on plain radiography. Patients were identified from our Radiology Management System with additional information from electronic patient records. RESULTS 98% of ULDCTKUBs were of diagnostic quality; two patients required further cross-sectional imaging. 67% of patients had passed their calculi after the initial diagnostic CTKUB. In the remaining 33% who had persistent calculi on ULDCTKUB, 20% required surgical intervention and 13% required no intervention. The mean ULDCTKUB effective radiation dose was six times lower than conventional CTKUB (0.8 vs 5.4 mSv). 67% of patients had a radiation dose equivalent to X-ray KUB (< 1 mSv). CONCLUSION ULDCTKUB is a reliable and safe follow-up investigation of ureteric calculi and has absorbed radiation doses similar to plain radiography and lower than annual background radiation. We advocate ULDCTKUB as the primary imaging modality in the follow-up of ureteric calculi not visible on plain radiograph.
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Cassell III AK, Manobah B. Management of genitourinary trauma – current evaluation from the Sub-Saharan region: A systematic review. World J Crit Care Med 2021; 10:377-389. [PMID: 34888163 PMCID: PMC8613721 DOI: 10.5492/wjccm.v10.i6.377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/19/2021] [Accepted: 08/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Trauma is a major cause of morbidity globally and the sixth leading cause of death, accounting for 10% of all mortalities. The genitourinary trauma is estimated for approximately 10% of all patients presenting with trauma, and the kidney is the most injured genitourinary organ globally. However, there is a paucity of data on genitourinary injury from the Sub-Saharan, and there may be variations from common genitourinary organs injured in developed nations.
AIM To provide insight on the epidemiology and management of genitourinary trauma in Sub-Saharan Africa with recommendations based on international guidelines.
METHODS A thorough literature search of genitourinary trauma was conducted using PubMed, Google Scholar and African Journal Online.
RESULTS A total of 30 studies from the Sub-Saharan region were eligible for the study and reviewed for epidemiology, biodata, types of injury, mechanisms of injury, treatment and follow-up. After evaluating 21904 patients presenting with urological emergencies, approximately 6.6% of cases were due to genitourinary trauma. The commonest injury was urethral 42.9% (22.2-62.2%) followed by injury to the external genitalia (penis, scrotum, testes) 25.1% (8.8-67.7%).
CONCLUSION Genitourinary injury in Sub-Saharan Africa is underreported, and the presence of more trauma registries, trained urologists and trauma facilities could improve the overall standard of care as well as providing data for research and development in the field.
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Affiliation(s)
- Ayun K Cassell III
- Department of Surgery, John F. Kennedy Medical Center, Monrovia 100010, Liberia
| | - Burgess Manobah
- Department of Surgery, John F. Kennedy Medical Center, Monrovia 100010, Liberia
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Chandrasekharam VVS, Babu R. Robot-assisted laparoscopic extravesical versus conventional laparoscopic extravesical ureteric reimplantation for pediatric primary vesicoureteric reflux: a systematic review and meta-analysis. Pediatr Surg Int 2020; 36:1371-1378. [PMID: 32980963 DOI: 10.1007/s00383-020-04749-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 01/30/2023]
Abstract
To perform a systematic review and meta-analysis comparing the outcomes of robotic-assisted laparoscopic extravesical ureteric reimplantation (RALUR) with conventional laparoscopic extravesical ureteric reimplantation (LEVUR) for primary vesicoureteric reflux in children. We searched the databases to identify all papers of RALUR and LEVUR between 2001 and 2020. Systematic review was performed to identify patient data, age, reflux grades, laterality, duration of surgery, time to discharge, success rate and complications. Heterogeneity was reported with I2 statistics and publication bias was assessed by Doi curve and Luis Furuya-Kanamori index. Pooled data from both groups were compared with Student's t test and Fisher's exact test, wherever appropriate. From a total of 43 articles screened, 28 articles were included (18 RALUR and 10 LEVUR). The I2 statistics for RALUR and LEVUR showed heterogeneity of 86% and 25%, respectively. Both groups had comparable minor publication bias. RALUR had higher proportion of grade 5 VUR (p < 0.001) and bilateral reimplantations (p < 0.001). The success rate of RALUR was significantly lower than that of LEVUR (97.6% vs. 93.4%, p = 0.0018). RALUR took a significantly longer duration for surgery compared to LEVUR, both for unilateral and bilateral cases (p < 0.001). The complication rate was not significantly different: 6.6% for RALUR and 5.35% for LEVUR (p = 0.32). The most common complication in both groups was post-operative urinary retention in bilateral cases. Articles on LEVUR reported more consistent success. RALUR series had higher proportion of grade 5 cases and bilateral reimplantations. RALUR reported longer operative time and lower success compared to LEVUR, with a complication rate comparable to LEVUR.
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Affiliation(s)
- V V S Chandrasekharam
- Pediatric Surgery, Pediatric Urology and MAS, Ankura Hospitals for Women and Children, Hyderabad, Telangana, India.
| | - Ramesh Babu
- Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Leong JY, Steward JE, Healy KA, Hubosky SG, Bagley DH. Indwelling ureteric stents: Patterns of use and nomenclature. Arab J Urol 2020; 18:241-246. [PMID: 33312735 PMCID: PMC7717614 DOI: 10.1080/2090598x.2020.1761675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objectives: To evaluate ureteric stenting practice patterns amongst a range of academic and community urologists, and to examine the nomenclature used to identify an indwelling ureteric stent from both our questionnaire and from a review of the literature. Subjects and methods: A 16-question, peer-reviewed online survey was distributed to members of the Mid-Atlantic American Urological Association. Responses were collected over a 1-month period. Questions included demographics, ureteric stenting practice patterns, and utilization of stenting nomenclature. Inappropriate use of nomenclature was defined as a mismatch between the visually depicted stents and the written description amongst urologists. Trends in ureteric stenting and nomenclature usage were tabulated and analyzed. Results: Of 863 members, 105 (12.2%) responded to the survey. There was a wide variety of practice settings, with the single-specialty group (44.2%) and academic/university (27.9%) being the two most common. Most providers used both cystoscopy and fluoroscopy to place stents (87.5%) as compared to fluoroscopy alone (12.5%). Most urologists (63.5%) removed stents with cystoscopy as compared to using a stent string (36.5%). While about half (51.0%) of the respondents left stents in situ for ≤3 months, many respondents (43.3%) felt comfortable with maximum dwell times of up to 6 months. The most commonly placed stent was the double pigtail stent (80.8%). However, most respondents inappropriately described this stent design as a Double J stent (72.1%). In the recent literature, 80% of articles clearly defined as using double pigtail stents, incorrectly identified their stent as a ‘Double J’. Conclusions: Variations in ureteric stenting practice patterns exist amongst community and academic urologists. Although most urologists utilize double pigtail ureteric stents, the majority inaccurately identified this stent design as a Double J. We propose use of the term ‘indwelling ureteric stent’ (IUS) unless describing any specific stent design.
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Affiliation(s)
- Joon Yau Leong
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - James E Steward
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kelly A Healy
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Scott G Hubosky
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Demetrius H Bagley
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
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D'Cruz R, Stronks K, Rowan CJ, Rosenblum ND. Lineage-specific roles of hedgehog-GLI signaling during mammalian kidney development. Pediatr Nephrol 2020; 35:725-31. [PMID: 30923969 DOI: 10.1007/s00467-019-04240-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/22/2019] [Accepted: 03/14/2019] [Indexed: 01/20/2023]
Abstract
Aberrant hedgehog (Hh) signaling during embryogenesis results in various severe congenital abnormalities, including renal malformations. The molecular mechanisms that underlie congenital renal malformations remain poorly understood. Here, we review the current understanding of the lineage-specific roles of Hh signaling during renal morphogenesis and how aberrant Hh signaling during embryonic kidney development contributes to renal malformation.
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Prattley S, Rice P, Pietropaolo A, Geraghty R, Babawale O, Somani BK. Predictors and Results of Negative Ureteroscopy for Treatment of Consecutive Ureteric Stones Done as a Primary Procedure: Prospective Outcomes from a University Hospital. Urol Int 2019; 103:143-148. [PMID: 31291641 DOI: 10.1159/000501658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/21/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION While negative ureteroscopy (URS) can be considered as an unnecessary procedure with medico-legal consequences, this avoids radiation from repeat CT scan and sometimes may be the only way to reassure patients with ongoing symptoms. We wanted to analyze our predictors and results of negative URS for treatment of ureteric stones. METHODS AND MATERIALS Between March 2012 and August 2018, data on consecutive patients with ureteric stones undergoing a primary URS (without a pre-operative stent) were prospectively collected for patient demographics and outcomes. Comparison was done for patients with diagnostic and therapeutic primary URS for ureteric stones. Patients with renal stones were excluded from the study. RESULTS A total of 270 patients underwent URS for ureteric stones during the study period of which 35 (13%) had a negative diagnostic URS. The patients who had negative URS were younger (p = 0.001), had smaller stones (p < 0.001), and more stones located in the distal ureter or vesico-ureteric junction (VUJ; p= 0.036). None of the patients who underwent negative URS had a postoperative stent inserted or any complications. CONCLUSION Although the rates of negative URS should be as low as possible, it seems to be safe and reassures patients with on-going symptoms. Based on our data, patients with small distal ureteric or VUJ stones should undergo a repeat imaging to avoid this unnecessary procedure. Informed consent, patient counseling, and appropriate up-to-date imaging seem to be key to minimizing negative diagnostic URS.
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Affiliation(s)
- Sarah Prattley
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Patrick Rice
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Amelia Pietropaolo
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Robert Geraghty
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Omikunle Babawale
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom, .,Department of PCPS, University of Southampton, Southampton, United Kingdom,
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Abstract
PURPOSE OF REVIEW While ureteroscopy (URS) is a common procedure for ureteric stones, this window between diagnosis and treatment leaves the possibility for a 'negative', 'stoneless' or 'diagnostic' URS. We perform a systematic review to look at the rate of 'negative ureteroscopy' and risk factors associated with it. RECENT FINDINGS From a total of 3599 articles and 68 abstracts, 4 studies (1336 patients) were selected. The negative URS rate varied from 4 to 14%. Common predictors seem to be female gender, small stones, radiolucent stones and distal ureteric stones. Although infrequent, negative ureteroscopy should be avoided in patients with ureteric stones by performing a low-dose CT scan on the day of surgery. This should especially be performed for females and those with smaller, radiolucent or distal ureteric stones.
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Affiliation(s)
- Patrick Rice
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Sarah Prattley
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK. .,University of Southampton, Southampton, SO16 6YD, UK.
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Tyson M, Grimes N, McAuley L, Hennessy D, Pahuja A, Young M. Renal and Ureteric Stone Composition: A five year retrospective study for Northern Ireland. Ulster Med J 2019; 88:21-4. [PMID: 30675074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The study aimed to present the types of renal and ureteric stones (calculi) present in the population of Northern Ireland. The data may help in future planning treatment of stone services, patient education and prevention. METHODS Consecutive retrospective renal and ureteric stones analysed over 5.75 years (January 2008 - September 2013) in Northern Ireland. Exclusions included patients < 16 years, and calculi listed as bladder stone. RESULTS Total of 1618 stones analysed. Male to female calculi ratio 1.93: 1. Age range 16 - 94 years (52.2 mean), most common age for stone analysis 31-60 years. From 2008 to 2012 the number of stones analysed increased by 132.9%. Calcium was demonstrated in 94.5% (1529) of stones, of which 2.5% (40) pure calcium oxalate. Calcium oxalate and phosphate 72.9% (1182) of all stones, male to female ratio 2.4:1. Stones containing uric acid 9.6% (156), with uric acid male to female ratio 4.83:1. Struvite 13.7% (222), male to female ratio 1:1.6. Pure cystine 1.1% (18) of stones, male to female ratio 1:1.3. CONCLUSION There is a high proportion (94.4%) of stones containing calcium oxalate in Northern Ireland; these patients should be aiming to produce 2L of urine a day to aid prevention. Most common age for stone analysis (31-60) is in keeping with most common age for presentation. The steep increase in calculi analysis of 132.9% must be met with personalised stone treatment and prevention strategies.
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Raassen TJIP, Ngongo CJ, Mahendeka MM. Diagnosis and management of 365 ureteric injuries following obstetric and gynecologic surgery in resource-limited settings. Int Urogynecol J 2017; 29:1303-1309. [PMID: 29022054 PMCID: PMC6132689 DOI: 10.1007/s00192-017-3483-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 09/09/2017] [Indexed: 11/26/2022]
Abstract
Introduction Ureteric injuries are among the most serious complications of pelvic surgery. The incidence in low-resource settings is not well documented. Methods This retrospective review analyzes a cohort of 365 ureteric injuries with ureterovaginal fistulas in 353 women following obstetric and gynecologic operations in 11 countries in Africa and Asia, all low-resource settings. The patients with ureteric injury were stratified into three groups according to the initial surgery: (a) obstetric operations, (b) gynecologic operations, and (c) vesicovaginal fistula (VVF) repairs. Results The 365 ureteric injuries in this series comprise 246 (67.4%) after obstetric procedures, 65 (17.8%) after gynecologic procedures, and 54 (14.8%) after repair of obstetric fistulas. Demographic characteristics show clear differences between women with iatrogenic injuries and women with obstetric fistulas. The study describes abdominal ureter reimplantation and other treatment procedures. Overall surgical results were good: 92.9% of women were cured (326/351), 5.4% were healed with some residual incontinence (19/351), and six failed (1.7%). Conclusions Ureteric injuries after obstetric and gynecologic operations are not uncommon. Unlike in high-resource contexts, in low-resource settings obstetric procedures are most often associated with urogenital fistula. Despite resource limitations, diagnosis and treatment of ureteric injuries is possible, with good success rates. Training must emphasize optimal surgical techniques and different approaches to assisted vaginal delivery.
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Oliver R, Wells H, Traxer O, Knoll T, Aboumarzouk O, Biyani CS, Somani BK. Ureteric stents on extraction strings: a systematic review of literature. Urolithiasis 2016; 46:129-136. [PMID: 27324264 PMCID: PMC5852195 DOI: 10.1007/s00240-016-0898-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 06/09/2016] [Indexed: 11/24/2022]
Abstract
Short-term ureteric stents are commonly placed after ureteroscopy. The removal usually entails having a cystoscopy, but recently, endourologists have been using stents with extraction strings attached to them for ease of removal. We wanted to conduct a systematic review of literature looking at the outcomes of ureteric stents with extraction strings attached to them. Our objective was to investigate the use, morbidity, tolerability, complications, associated cost, and patient preference of stents with extraction strings attached to them. All studies in English language (between 1990 and 2015) where stents on extraction strings were either self-removed by patients or removed by physician were included. A total of eight studies (1279 patients) were included, of which 483 (38 %) patients had extraction strings for removal. There seemed to be no overall difference in pain scores or urinary symptoms between patients with and without extraction strings, but nearly 10 % of patients suffered stent dislodgement in the group with extraction strings attached. Overall stent dwell time was lower in patients who had their stents removed via extraction strings, and majority of them were able to remove their stents at home. Our study suggests that stents with extraction strings are easy for patient self-removal and can reduce the stent dwell time for patients, thus reducing the duration of morbidity and physical and financial burden to patients. However, this must be balanced against a risk of stent dislodgement and, hence, may not be a good option in all patients.
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Affiliation(s)
- Rachel Oliver
- Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Hannah Wells
- Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, University Pierre and Marie Curie, Paris, France
| | - Thomas Knoll
- Department of Urology, Klinikum Sindelfingen-Böblingen, Sindelfingen, Germany
| | - Omar Aboumarzouk
- Urology Fellow, Bristol Urological Institute, Bristol, UK
- EAU Young Academic Urologists Group, Arnhem, The Netherlands
| | | | - Bhaskar K Somani
- Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
- EAU Young Academic Urologists Group, Arnhem, The Netherlands.
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Elgalaly H, Sakr A, Fawzi A, Salem EA, Desoky E, Shahin A, Kamel M. Silodosin vs tamsulosin in the management of distal ureteric stones: A prospective randomised study. Arab J Urol 2015; 14:12-7. [PMID: 26966587 PMCID: PMC4767790 DOI: 10.1016/j.aju.2015.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 11/02/2015] [Accepted: 11/26/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To compare the efficacy of silodosin (8 mg) vs tamsulosin (0.4 mg), as a medical expulsive therapy, in the management of distal ureteric stones (DUS) in terms of stone clearance rate and stone expulsion time. PATIENTS AND METHODS A prospective randomised study was conducted on 115 patients, aged 21-55 years, who had unilateral DUS of ⩽10 mm. Patients were divided into two groups. Group 1 received silodosin (8 mg) and Group 2 received tamsulosin (0.4 mg) daily for 1 month. The patients were followed-up by ultrasonography, plain abdominal radiograph of the kidneys, ureters and bladder, and computed tomography (in some cases). RESULTS There was a significantly higher stone clearance rate of 83% in Group 1 vs 57% in Group 2 (P = 0.007). Group 1 also showed a significant advantage for stone expulsion time and analgesic use. Four patients, two in each group, discontinued the treatment in first few days due to side-effects (orthostatic hypotension). No severe complications were recorded during the treatment period. Retrograde ejaculation was recorded in nine and three patients in Groups 1 and 2, respectively. CONCLUSION Our data show that silodosin is more effective than tamsulosin in the management of DUS for stone clearance rates and stone expulsion times. A multicentre study on larger scale is needed to confirm the efficacy and safety of silodosin.
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Affiliation(s)
| | | | | | | | | | | | - Mostafa Kamel
- Corresponding author at: Zagazig University Hospital, Department of Urology, El Mohafza Street, Zagazig, Egypt. Tel./fax: +20 552 300150.Zagazig University HospitalDepartment of UrologyEl Mohafza StreetZagazigEgypt
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