口服Silodosin促進腎及輸尿管結石在體外震波碎石後結石排出及疼痛緩和之臨床療效評估
Silodosin oral therapy facilitates stone clearance after shockwave lithotripsy for renal and ureteral calculi: a double-blind, randomized placebo-controlled study
Hung-Jen Wang, Chien-Hsu Chen, Wei-Ching Lee
Divisions of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
王弘仁, 陳建旭, 李維菁
高雄長庚紀念醫院外科部 泌尿科
Purpose: We evaluated the effect of the alpha-blocker Silodosin on stone clearance, pain intensity in shock wave lithotripsy for solitary renal and ureteral calculus.
Methods: A prospective, double-blind, randomized placebo controlled study was performed from 2016 to 2018. 54 patients with a single radiopaque non-lower pole renal stone (5-20 mm) or ureter stone (5-15mm) undergoing ESWL will be enrolled. The study group (28) received 4 mg Silodosin twice daily and the control group (26) received placebo twice daily until stone clearance or for a maximum of 28 days. The parameters assessed were stone size, position, clearance time, effect on steinstrasse and analgesic requirement. The study end-points included—primary: success rate; and secondary: speed of fragment elimination, pain intensity.
Results: Totally 44 patients complete the study. The overall stone clearance rate was significant higher in the study group (75%, 18 of 24) compare with the rate in the control group (55%, 11 of 20) (p=0.0047). There was no difference between the time to be stone free in two groups. (15.17 days vs 14.64 days, Silodosin vs placebo, respectively, p=0.91). There was no difference between the 2 groups with regard to age, stone size or location.
Conclusions: Silodosin seemed to facilitate stone clearance, particularly with larger stones during shock wave lithotripsy for renal and ureteral calculus. Silodosin may have a clinical benefit as an adjuvant therapy in shock wave lithotripsy.