- 2026-04
- International braz j urol : official journal of the Brazilian Society of Urology 52(2)
- Hao Dong
- Pan Song
- Zhihua Li
- Xiang Wang
- Kunlin Yang
- Xuesong Li
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 960
- Population
- patients undergoing URS for ureteral stones
- Methods
- systematic review and meta-analysis; PubMed, EMBASE and Cochrane Central were systematically searched for studies comparing preoperative silodosin with placebo or 'no preoperative silodosin'
Purpose
To perform a systematic review and meta-analysis evaluating the efficacy and safety of preoperative silodosin in improving ureteroscopy (URS) outcomes for ureterolithiasis.Materials and methods
PubMed, EMBASE and Cochrane Central were systematically searched for studies comparing preoperative silodosin with placebo or 'no preoperative silodosin' in patients undergoing URS for ureteral stones. Primary outcomes included ureteral wall injury, analgesia use, fever, haematuria, stone-free rate (SFR), operative time, and complications. Statistical analysis was performed using Review Manager 5.1.7. Study quality and risk of bias were assessed per Cochrane guidelines.Results
Nine studies, including eight randomized clinical trials, including 960 patients were analysed; 450 (46.8%) received silodosin. Compared to controls, silodosin significantly reduced ureteral injuries (RR 0.30; 95% CI: 0.18-0.49; p < 0.00001) and operative time (MD -17.72 minutes; 95% CI: -24.72 to -10.72; p < 0.00001). It also lowered analgesia needs (RR 0.35; 95% CI: 0.16-0.75; p = 0.007), with trends toward reduced fever (RR 0.67; 95% CI: 0.36-1.22; p = 0.19) and haematuria (RR 0.57; 95% CI: 0.32-1.02; p = 0.06). In studies with ≥10 days of preoperative use, silodosin significantly improved SFR (RR 1.17; 95% CI: 1.10-1.26; p < 0.00001).Conclusions
Preoperative silodosin reduces ureteral injuries, operative time, and complications, supporting its use to improve safety and efficiency of URS for ureterolithiasis.