Effect of perioperative selective alpha-1 blockers in non-stented ureteroscopic laser lithotripsy for ureteric stones: a randomized controlled trial

Abstract

Introduction The aim of this studywas to assess the efficacy of perioperative alpha-1 blockers on improving the success rate and decreasing complications of non-stented ureteroscopic laser lithotripsy for ureteric stones. Material and methods A randomized control trial was conducted at two high volume urological centers from September 2017 to December 2018. We enrolled 150 patients with lower ureteric stones. They were randomly divided into two groups. Patients in group A, underwent non-stented ureteroscopy using Ho-YAG laser for stone disintegration and received alpha-1 blockers for one week preoperatively and another two weeks postoperatively. Patients in group B, underwent non-stented ureteroscopy and laser and received a placebo. Results One hundred and twenty patients were available for analysis at the end of our study. There was no statistically significant difference found between both groups regarding demographic data and stone parameters. The need for intraoperative ureteric dilatation was 32.7% and 51.6% for both groups A and B respectively with a statistically significant difference. The incidence of lower urinary tract symptoms (LUTS) and the need for analgesics were higher in group B with a statistically significant difference. Conclusions Administration of perioperative tamsulosin seems to not only to significantly decrease the need for intra-operative dilatation and hence operative time, but also leads to a significant decrease in the development of postoperative LUTs, postoperative pain and the need for analgesia and hospital stay.

Surgery and Postoperative Care of Patients Undergoing Percutaneous Nephrolithotomy under the Guidance of B-Ultrasound Based on Smart Internet of Things

“…After adopting the Split Bregman algorithm, the quality of the obtained image will be significantly improved, and the information degree of the image will be guaranteed, and the pixel distribution will be uniform and have better contrast. Finally, simulation experiments verify the feasibility and effectiveness of the algorithm [ 16 ]. A new fidelity term model is proposed to process medical images in B-mode: …”

Effect of preoperative alpha‐blockers on ureteroscopy outcomes: A meta‐analysis of randomised trials

“…The systematic review identified 15 RCTs [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] with 1653 patients (844 alpha-blockers; 809 controls) included in the meta-analysis (Figure S1). Preoperative alpha-blocker therapy involved tamsulosin S2).…”

“…The systematic review identified 15 RCTs 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 with 1653 patients (844 alpha‐blockers; 809 controls) included in the meta‐analysis (Figure S1 ). Preoperative alpha‐blocker therapy involved tamsulosin (11 studies) or silodosin (four studies) administered over 1 to 56 days before URS (median 7 days).…”

Does preoperative silodosin administration facilitate ureteral dilatation during flexible ureterorenoscopy? A randomized clinical trial

“…To our knowledge, there is a lack of studies demonstrating the effectiveness of silodosin in reducing ureteral wall injury during UAS insertion. According to the explanation, silodosin has the potential to be more effective than other alpha-blockers in dilating the ureter [17]. In the study conducted by Kim et al, it was found that premedication with silodosin resulted in reduced insertion force and decreased damage to the ureteral wall, even after 2-3 days of taking the medication.…”