Pooled analysis of the efficacy and safety of adjunctive alpha-blocker therapy before ureteroscopy in the management of ureteral stones

Tan, Hailin; Li, Yanjiang; Zhang, Xiaofei; Mao, Xin

doi:10.1177/0300060520923878

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…However, in this analysis, contrary to our findings, no significant difference in the operation time between the two groups was found. 18 In 2018, Mohey et al, published a study, 19 that showed the results that were comparable to ours in which pre-operative alpha blockade was achieved with 8mg of Silodosin. During URS, the group that received Silodosin was found that advancement of ureteroscope was much easier which made access to the stone also easier.…”

Section: Discussionsupporting

confidence: 79%

Role of Alpha Blocker in Ureterorenoscopy.

Nadeem

Anwar

Ahmed

et al. 2021

PAFMJ

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Objective: To determine the efficacy of alpha blockers in successful management of lower and mid ureteral stones by ureterorenoscopy. Study Design: Comparative prospective study. Place and Duration of Study: Department of Urology, Combined Military Hospital Quetta Pakistan, from Jul 2018 to Dec 2019. Methodology: Total of 150 patients having mid and lower ureteric calculi requiring ureterorenoscopy were divided into two groups. Group A included patients without pre-treatment with alpha blocker was administered before they were subjected to ureterorenoscopy. Study group B included patients who received daily oral dose of alpha blocker, Tamsulosin 0.4 mg twice daily, for 1 week before ureterorenoscopy. Per-operative findings in both the groups were recorded. Results were analyzed by comparing the outcome between both groups in terms of ease of performing procedure, duration of procedure, complications, duration of hospital stay and need for stent placement. Results: Mean operative time was significantly shorter in group B as compared to group A, (15.9 ± 3.81 min vs. 21.9 ± 3.63 min; p≤0.001). Demographic and stone characteristics were comparable between the both groups. Success rate was 74 (98.7%), in group B as compared to 68 (90.7%) in group A, with statistically significant difference (p=0.020). Complications in group B were less frequent 1 (1.3%) vs 7 (9.3%) in group A (p-value=0.027). Conclusion: Use of alpha blockers for one week before performing ureterorenoscopy resulted in fewer complications and made the procedure easier to perform as well.

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Section: Discussionsupporting

confidence: 79%

Role of Alpha Blocker in Ureterorenoscopy.

Nadeem

Anwar

Ahmed

et al. 2021

PAFMJ

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“…12 It is challenging and risky to advance a ureteroscope into the non-dilated ureter; failure to do might result in the procedure's failure. 13 A systematic review by Rob S, et al showed equally high SFRs and safety profiles of URS in pediatrics may be attained by medium-volume centers as well as large-volume centers, hence encouraging expanded URS use in facilities that do fewer operations annually. 14 According to meta analysis from Ziaeefar, using medical compulsive therapy (MET) enhances stone expulsive rate while decreasing stone expulsive time.…”

Section: Discussionmentioning

confidence: 99%

“…When compared to the placebo group, the adjunctive alpha-blocker medication was linked to a considerably reduced risk of all these complications. 13 A meta analysis by Sesari SS, et al showed that administration of adjunctive alpha blocker also minimizes colic episodes. 23 In children, the lumens of the ureters are narrow, making ureteroscopy has many failures compared to adults, thus providing a more complex challenge.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Preoperative Tamsulosin on Ureteroscopy Access in Pediatrics: A Systematic Review and Meta-Analysis

Singgih,

Oktaviani,

Pranowo Sampurno Secodiningrat

et al. 2023

Siriraj Med J

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Objective: The incidence of urolithiasis in pediatrics increases to 4-10% annually. One of the methods for treating urolithiasis is ureteroscopy (URS). The small anatomy in pediatrics often makes the initial URS unsuccessful. Alpha blockers, a drug that can relax the ureteral muscles, is a therapy that can be considered before URS is carried out. The objective of this study is to evaluate the efficacy of preoperative tamsulosin for URS access in pediatrics. Materials and Methods: We conducted a search using four databases, including PubMed, EBSCO, Cochrane Library, and ProQuest. This study includes randomized controlled trials (RCTs), retrospective and prospective studies, which compared the efficacy of preoperative alpha blockers and placebo or non-placebo controls in pediatrics undergoing ureteroscopy. The outcome of interest was the success rate of URS access and the duration of surgery. Results: A total of 120 studies were identified from a database search. There were 3 studies included in this review involving 235 patients. The meta-analysis was conducted using a random-effects model. The results of the meta-analysis showed that alpha blockers provided a successful rate of ureteroscopy access in pediatric patients (Odds ratio (OR) 2.73; 95% confidence interval (CI) 1.52 up to 4.91; p=0.0008). Duration of surgery did not show significant results (Mean difference (MD) 3.46; 95% CI -3.59 up to 10.50; p=0.34).

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“…10 Medical expulsive therapy (MET) should be considered for ureterolithiasis with positive outcomes for ureteroscopy following preoperative alpha-blockers showing significant reduction for the need of ureteral orifice dilation 11 and higher rate of access to stones. 12 None have evaluated medication use in material entrapment as it is a rare situation. In our case, patient did not receive alpha-blockers prior to surgery.…”

Section: Discussionmentioning

confidence: 99%