Thesis (M.Sc.) -Cairo University, 2024.

Bibliography: pages 94-109.

Background: Studies have shown that alpha-blockers facilitate the more natural
passage of ureteral stones and lessen pain intensity and frequency, with the latter
effect being particularly pronounced in cases of distal ureteral stones. Enabling
relaxation and reducing intramural ureteral resistance in ureteral smooth muscles is
a significant factor in the rise in the spontaneous passage of ureteral stones guided
by alpha-blockers. This study investigated whether or not intramural ureteral
resistance may be decreased, and whether or not alpha-blockers can facilitate the
implantation of UAS.
Objective: The purpose of this study was to compare the effect of alpha-blocker
silodosin versus placebo treatment on the deployment of ureteral access sheaths
(UAS) during retrograde intrarenal surgery (RIRS).
Methodology: This study was an interventional, double-blinded, prospective,
comparative, randomized clinical trial. This study involved patients scheduled for
RIRS procedures between March, and November 2023. Patients were signed
informed consent forms before the procedure. This study involved sixty patients of
both genders, age above 18 years. They divided into two groups: group A (n=30),
and group B (n=30). Two weeks before the operation, group A patients received 8
mg of silodosin per day. For a comparable amount of time as group A, group B
patients received a placebo (a pill without an active component).
Outcome Parameters: The 11/13 F ureteral access sheath entering the proximal
ureter or ureteropelvic junction would be considered a successful deployment if it
is achieved. Complications such as ureteral injury, postoperative fever, or UTI will
be recorded.
Results: 27 patients of group A ;( 90 %), had Success of Ureteral Access Sheath
11/ 13 Fr deployment into the ureter from the first attempt, while 18 patients ;( 60
%) of group B, had Success of Ureteral Access Sheath deployment from the first
attempt. (P-value less than 0.001).
Perioperative complications, stone-free status, postoperative problems, and overall
hospital stay did not significantly differ between the two groups.
Conclusion: This study demonstrated that, in terms of the success rate of UAS
deployment during retrograde intrarenal surgery, silodosin is superior to placebo.
Ejaculatory disorders, however, are thought to be problematic for sexually active
people.

هو أكتشاف دور محاصرات ألفا -1 الأدينالين فى زيادة معدل نجاح وضع غمد الوصول الى الحالب من عدمة .وقد تم أجراء هذا البحث على ستون مريض ، بقسم جراحة المسالك البولية والتناسلية – بكلية طب قصر العينى – جامعة القاهرة .
تم تقسيم المرضى على مجموعتين ، المجموعة ( أ)= 30 مريض ، والمجموعة (ب)= 30 مريض، وتم أعطاء مرضى المجموعة الأولى (أ) عقار سلدوسين 8 مجم من محاصرات ألفا -1 مرة واحدة قبل النوم، ولمدة أسبوعين قبل العملية ، بينما مرضى المجموعة (ب) حصلوا على علاج وهمى ولمدة مماثلة لمرضى المجموعة (أ).
وقد تبين لنا نجاح وضع غمد الوصول الى الحالب فى 27 حالة ( بنسبة 90%) من مرضى المجموعة (أ) ،بالمقارنة بمعدل نجاحه فى عدد 18 حالة (بنسبة 60 %) من مرضى المجموعة (ب)، بدلالة أحصائية 0.001 > ، وهذا الفارق الأحصائى له دلاله أكلينيكيه ، مما يؤكد فاعلية دواء سلدوسين فى زيادة معدل نجاح وضع غمد الوصول الى الحالب .

Issued also as CD

Text in English and abstract in Arabic & English.