Tawfeek A M, Abdelwahab M S, Higazy Ahmed, Radwan Ahmed, Swar Sh A, Shaker Hassan, Farouk Ahmed
Ain Shams University Hospitals, Department of Urology, Cairo, Egypt.
National Institute of Urology and Nephrology, Cairo, Egypt.
Cent European J Urol. 2020;73(4):520-525. doi: 10.5173/ceju.2020.0258. Epub 2020 Dec 14.
The aim of this studywas to assess the efficacy of perioperative alpha-1 blockers on improving the success rate and decreasing complications of non-stented ureteroscopic laser lithotripsy for ureteric stones.
A randomized control trial was conducted at two high volume urological centers from September 2017 to December 2018. We enrolled 150 patients with lower ureteric stones. They were randomly divided into two groups. Patients in group A, underwent non-stented ureteroscopy using Ho-YAG laser for stone disintegration and received alpha-1 blockers for one week preoperatively and another two weeks postoperatively. Patients in group B, underwent non-stented ureteroscopy and laser and received a placebo.
One hundred and twenty patients were available for analysis at the end of our study. There was no statistically significant difference found between both groups regarding demographic data and stone parameters. The need for intraoperative ureteric dilatation was 32.7% and 51.6% for both groups A and B respectively with a statistically significant difference. The incidence of lower urinary tract symptoms (LUTS) and the need for analgesics were higher in group B with a statistically significant difference.
Administration of perioperative tamsulosin seems to not only to significantly decrease the need for intra-operative dilatation and hence operative time, but also leads to a significant decrease in the development of postoperative LUTs, postoperative pain and the need for analgesia and hospital stay.
本研究的目的是评估围手术期使用α-1受体阻滞剂对提高无支架输尿管镜激光碎石术治疗输尿管结石的成功率及降低并发症的疗效。
2017年9月至2018年12月在两个大型泌尿外科中心进行了一项随机对照试验。我们纳入了150例输尿管下段结石患者。他们被随机分为两组。A组患者接受使用钬激光的无支架输尿管镜检查以粉碎结石，并在术前一周及术后两周接受α-1受体阻滞剂治疗。B组患者接受无支架输尿管镜检查及激光治疗，并接受安慰剂。
在我们的研究结束时，有120例患者可供分析。两组在人口统计学数据和结石参数方面未发现统计学上的显著差异。A组和B组术中输尿管扩张的需求分别为32.7%和51.6%，差异有统计学意义。B组下尿路症状（LUTS）的发生率和镇痛药物的需求更高，差异有统计学意义。
围手术期使用坦索罗辛似乎不仅能显著减少术中扩张的需求，从而缩短手术时间，还能显著降低术后LUTS的发生率、术后疼痛以及镇痛药物的需求和住院时间。
