Effect of Silodosin and Deflazacort Combination in Reducing Symptoms Related to Indwelling Ureteric Stent: A Randomised, Double-Blind TrialCorrespondence Address :
Dr. Daisy Karan,
IMS and SUM Hospital, Bhubaneswar, Odisha, India.
Introduction: Endoscopic stent placement is an eminent procedure in urological practice and it substantially helps in reducing severe symptoms of ureteral obstruction. However, there may be few adverse events which may significantly affect the Quality of Life (QoL) of patients. These include stent related pain, sexual dysfunction, and Lower Urinary Tract Symptoms (LUTS). Appropriate therapy will reduce LUTS and improve QoL.
Aim: To assess the effect of silodosin and deflazacort combination, when compared to silodosin alone, in improving symptoms and QoL in patients with indwelling Double J (DJ) ureteral stents.
Materials and Methods: A randomised, controlled trial was conducted at the Department of Urology of a Tertiary Care Hospital, in Eastern India between August 2018 and December 2018; in patients with insertion of DJ stent after ureteroscopy and percutaneous stone removal. Patients were randomised into; Group A, silodosin (8 mg) once daily for two weeks and Group B, silodosin (8 mg) and deflazacort (30 mg) once daily for two weeks. Outcomes including pain, voiding flank pain, storage symptoms (frequency, urgency, nocturia), QoL were determined. Studentâ€™s t-test was used for comparison of Visual Analogue Scale (VAS) and International Prostate Symptom Scale (IPSS) scores.
Results: Total 144 patients were analysed in the study and were divided into group A (n=72) and group B (n=72). The mean age was 50.93 and 50.91 years; with 60 and 58 males in Group A and B, respectively. The mean VAS for pain was 1.05 and 2.01 for group B and A (p<0.05), respectively; similarly, voiding flank pain was also significantly lower in group B (1.56) than group A (2.80) (p<0.05). Mean score for frequency and urgency were significantly lower in group B (2.16 and 1.64) than group A (3.08 and 2.85); while, score for nocturia were similar between both the groups (p=0.87). The QoL score was significantly better in group B than in group A (1.44 vs. 2.81: p<0.05).
Conclusion: Combination therapy with silodosin and deflazacort, instead of monotherapy with silodosin alone, was safe and effective in alleviating stent related LUTS and improving QoL.
Alpha blocker, Anti-inflammatory, Double J stent, Lower urinary tract symptoms, Steroid, Ureteroscopy
Date of Submission: Nov 24, 2019
Date of Peer Review: Dec 23, 2019
Date of Acceptance: Jan 09, 2020
Date of Publishing: Feb 01, 2020
• Financial or Other Competing Interests: No
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Nov 25, 2019
• Manual Googling: Jan 09, 2020
• iThenticate Software: Jan 30, 2020 (15%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)