Al- Anbar Medical Journal

Effect of Preoperative Alpha-Blocker in Ureteroscopy for Ureteral Stones: A Case-Control Study

Document Type : Original articles

Authors

Department of Surgery (Urology), Al-Jumhory Teaching hospital, Nineveh Health Directorate, Mosul, Nineveh, Iraq.

Abstract

Background: 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 α-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 rate).

Keywords

References
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Al- Anbar Medical Journal
Volume 18, Issue 1
June 2022
Page 10-14
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