Does preoperative tamsulosin facilitate semirigid ureteroscopic management of lower ureteric calculi? A prospective, randomized double-blind study.

IF 1.3 4区 医学 Q4 UROLOGY & NEPHROLOGY
Current Urology Pub Date : 2025-07-01 Epub Date: 2025-05-23 DOI:10.1097/CU9.0000000000000286
Ahmed A Shahat, Ahmad A Elderwy, Mahmoud A Gaber, Nasreldin Mohammed
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引用次数: 0

Abstract

Background: The use of tamsulosin before semirigid ureteroscopy (URS) for proximal ureteral stones increases operative success. Several authors have used α-blockers for dilation of the ureter, and most studies have observed a higher stone-free rate and fewer complications than those with a placebo or no use of drugs. Ureteroscopy is the standard treatment for ureteral stones and has excellent outcomes. This study aimed to assess the effect of preoperative tamsulosin on the intraoperative and postoperative outcomes of URS in the management of lower ureteric stones.

Materials and methods: This was a double-blind randomized placebo-controlled clinical trial. A total of 80 patients were included, 40 in each group. The closed envelope method of randomization was performed at the Assiut Urology and Nephrology Hospital (Urology Department), Faculty of Medicine, Assiut University, Egypt, from December 2019 to November 2021.

Results: Both groups showed no significant differences in age, and the majority of patients in both groups were male. Most patients had a moderate degree of obstruction, and the stones were radiopaque. Both groups showed insignificant differences in stone size (11.93 ± 3.39 vs. 12.40 ± 4.24 mm, p = 0.30). Operative time was significantly shorter in the study group than in the control group (61.50 ± 23.99 vs. 79.80 ± 23.22 minutes, p = 0.001). The control group had a significantly higher frequency of need for dilatation (80% vs. 20%, p < 0.001) and need to stent than the study group (60% vs. 22.5%, p = 0.001).

Conclusions: Preoperative tamsulosin facilitates URS for lower ureteric stones. It decreases operative time, the need for dilation, and the need for postoperative indwelling ureteral stenting. It also increases the success rate but does not significantly affect the complication rate.

术前坦索罗辛是否有助于输尿管下段结石的半硬质输尿管镜治疗?一项前瞻性、随机双盲研究。
背景:输尿管近端结石半硬质输尿管镜检查(URS)前使用坦索罗辛可提高手术成功率。一些作者已经使用α-受体阻滞剂来扩张输尿管,大多数研究发现,与使用安慰剂或不使用药物的患者相比,使用α-受体阻滞剂的输尿管无结石率更高,并发症更少。输尿管镜检查是输尿管结石的标准治疗方法,效果良好。本研究旨在评估术前坦索罗辛对输尿管下段结石尿路治疗术中及术后预后的影响。材料与方法:这是一项双盲随机安慰剂对照临床试验。共纳入80例患者,每组40例。随机分组的封闭信封法于2019年12月至2021年11月在埃及阿西乌特大学医学院阿西乌特泌尿和肾脏科医院(泌尿科)进行。结果:两组患者年龄差异无统计学意义,且两组患者均以男性居多。大多数患者有中等程度的梗阻,结石不透射线。两组结石大小差异无统计学意义(11.93±3.39 vs. 12.40±4.24 mm, p = 0.30)。研究组手术时间明显短于对照组(61.50±23.99分钟vs 79.80±23.22分钟,p = 0.001)。对照组需要扩张的频率(80%比20%,p < 0.001)和需要支架的频率明显高于研究组(60%比22.5%,p = 0.001)。结论:术前坦索罗辛可促进输尿管下段结石的尿路重建。它减少了手术时间,需要扩张,并需要术后留置输尿管支架。它也增加了成功率,但对并发症发生率没有显著影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Urology
Current Urology Medicine-Urology
CiteScore
2.30
自引率
0.00%
发文量
96
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