Alfuzosin vs. Silodosin in the Improvement of Ureteral Stent-Related Symptoms after Endoscopic Surgical Treatment of Urolithiasis: A Retrospective Comparison

Abstract

Abstract Purpose In this study, we aimed to compare the efficacy of two α-blockers, alfuzosin and silodosin, which have different pharmacological properties despite being uroselective, in the treatment of double-J stent (DJS)-related symptoms.Material and methods Fifty male patients who underwent DJS implantation after ureterorenoscopy/retrograde intrarenal surgery were included in the study. The patients’ demographic and characteristic data were analyzed. All patients were asked to complete the validated Turkish version of the Ureteral Stent Symptom Questionnaire (USSQ), international prostate symptom score (IPSS), and international index of erectile function-5 (IIEF-5) the day before stent removal and again one month after stent removal. Statistical analysis of these variables was performed in the alfuzosin and silodosin groups, and a value of p < 0.05 was considered statistically significant.Results Whereas no side effects were observed in the alfuzosin group (Group A), retrograde ejaculation was observed in 8 (25.2%) patients in the silodosin group (Group S) (p = 0.006). Significant decreases in IPSS, IPSS-quality of life, and USSQ scores were observed in both Group A and Group S one month after stent removal (i.e., without stent) compared with before stent removal (i.e., with stent) (p < 0.05). Furthermore, a statistically significant increase in IIEF-5 score was observed in both groups after stent removal compared with IIEF-5 score with stenting (p < 0.05).Conclusion The DJS has a significant impact on patients’ quality of life and should only be used when indicated, not routinely after every endoscopic stone procedure. Considering that silodosin may cause more ejaculation problems than alfuzosin, we believe that both drugs can be used in male patients to resolve DJS-related symptoms.