Category: Clinical Stones: Equipment (stents, lasers, guidewires, sheaths)

MP27-6 - Is there any difference between Silodosin, Darifenacin and their combination in controlling ureteral stent related symptoms?

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective : Routine use of ureteral stent after endourologic procedures is a daily practice despite many related bothersome symptoms. Ureteral Stent Symptoms Questionnaire (USSQ) was developed as a good tool for assessment of stent related symptoms and provide qualitative and quantitative method for evaluation of effect of postoperative medication on stent bothersome. An Arabic validated version of USSQ was tested for use in Arabic tongue nations.We aimed to know whether is there any additional benefits of combined Silodosin and Darifenacin over either of them alone in controlling ureteral stent related symptoms


Methods : This study included 372 patients with a unilateral ureteral JJ stent placed post ureteroscopy for stone ureter. Patients were randomized  into 4 parallel arms at 1:1:1:1 ratio. Control arm received placepo, Silodosin  arm received Silodosin 8mg caps. Once daily, Darifenacin arm received Darifenacin 7.5mg tab. Once daily and Combination arm received combination of Silodosin and Darifenacin. Ureteral related symptoms were assessed at the end of the 1st and 4th postoperative weeks before stent removal using Arabic validated version of USSQ, here both cases and the principle investigator were blinded and compliance to medication regimen was assured by “Empty for Full” policy


Results : There were no statistically significant differences regarding patient demographics and stone characteristics, regardless the success of the procedures, there was a statistically significant difference for the favor of Silodosin, Darifenacin and combination group over control group with respect to total USSQ score at the 1st and 4th weeks postoperatively (p=0.001), However none of Silodosin, Darifenacin and Combination groups showed statistically significant advantages over each other in improving total USSQ score at the 1st and 4th weeks after stenting, further analysis revealed statistical significant improvement of urinary symptom domain and body pain domain of USSQ for the favor of Silodosin (p=0.001), Darifenacin (p=0.001) and combination groups (p=0.001) over control group. However, no statistically significant advantages for any of study groups regarding general health, Working performance, sexual and additional matters domains of USSQ at the 1st and 4th weeks after the procedure


Conclusions : Silodosin and Darifenacin dual therapy has no benefit over Silodosin or Darifenacin alone in controlling ureteral stent related symptoms. Also, neither Silodosin nor Darifenacin alone showed any benefit over each other regarding total score of USSQ, despite that Darifenacin alone showed  more significant improvement of urinary symptom domain of USSQ

Tarek Fathelbab

Ass.Professor
Faculty of Medicine,Minia University
El Minia, Al Minya, Egypt

Ehab Tawfiek


Minia, Al Minya, Egypt

Ehab Rifat Tawfiek
MD in Urology
Endourology Fellowship at Thomas Jefferson University
(USA) with professor Demetrius Bagley
Chairman Urology Department Minia University
Director of Minia University Urology and Nephrology Hospital
X President of Endourology section Egyptian Urological Association

Amr Abdelhamid


Minia, Al Minya, Egypt

Ehab Galal

Assistant professor of urology
Minia university
Minia, Al Minya, Egypt

Dr Ehab Galal, assistant professor of urology,Minia University,Egypt

I have been graduated in 1995 from Minia university and worked as resident of urology then assistant lecture

In 2008 i graduated for M.D. urology then work as assistant professor since 2016 till now

Also i am worked as a consultant of urology,Aljazerra hospital,KSA

I am interested in endourology and have many reserches at this point

Ahmad Anwar


Minia, Al Minya, Egypt

Ahmad Ali


Minia, Al Minya, Egypt

Ahmad Fawzy


Minia, Al Minya, Egypt