Role of Alpha Blocker in Ureterorenoscopy.

Abstract

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.

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).…”