Journal of Clinical and Diagnostic Research (Feb 2020)
Effect of Silodosin and Deflazacort Combination in Reducing Symptoms Related to Indwelling Ureteric Stent: A Randomised, Double-Blind Tria
Abstract
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. Student’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.
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