Effect of Preoperative Alpha-Blocker in Ureteroscopy for Ureteral Stones: A Case-Control Study
Al- Anbar Medical Journal,
2022, Volume 18, Issue 1, Pages 10-14
AbstractBackground: Urothethiasis is the most common urinary tract disease with a global prevalence
rate of 2-20%. Alfa-blocker has a relaxation effect on the smooth muscles of the ureter making the
removal of ureteric stone easier during the ureteroscopic procedure.
Objectives: To evaluate the effect of preoperative -adrenoreceptor antagonists therapy (tamsulosin) in the treatment of ureteral stone using a ureteroscope regarding operative time, access to
the ureter, and the complication rate.
Materials and methods: A prospective case-control study was conducted at Al-Jamhory
Teaching Hospital, Mosul, Iraq. During the period from June 2019 to August 2020. Subjectts with
ureteral stones (7-15 mm) scheduled for ureteroscopic intervention were enrolled in the study. The
patients were classified into two groups, the first group was received a pre-operative alpha-blocker
(tamsulosin 0.4 mg capsule per day for 7 days), and the second group (Control) did not receive
further medication. The operative time, uretric access, and intra- and postoperative complications
were registered for both groups.
Results: There was a matching between the two groups regarding the age, gender, and side, size,
and location of the ureteric stones. There was a statistically significant difference between the two
groups regarding the operative time (23.2 ± 4.569 minute in the treated group vs. 25.48 ± 4.904
minute in the control group) (P-value = 0.009). Besides, the ureteroscopic operation was easier
(P-value = 0.031) in treated group (n = 51 easy case, 85%) than the control group (n=41, 68.33%
easy case). The intraoperative and postoperative complications were mucosal injury, perforation,
bleeding, pain, hematuria, and fever. The total number of complicated cases was 14 (23.33%) in
the treated group and 25 (41.66%) in the control group, and there was a significant difference
between the two groups (P-value = 0.032).
Conclusion: The study revealed that the preoperative alpha-blocker tamsulosin was improved the
outcome of ureteroscopy (shorter operative time, easier access to the ureter, and low complication
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