Shahat Ahmed A, Elderwy Ahmad A, Gaber Mahmoud A, Mohammed Nasreldin
Urology Department, Faculty of Medicine, Assuit University Hospital, Assiut, Egypt.
Curr Urol. 2025 Jul;19(4):253-256. doi: 10.1097/CU9.0000000000000286. Epub 2025 May 23.
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.
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.
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, = 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, = 0.001). The control group had a significantly higher frequency of need for dilatation (80% vs. 20%, < 0.001) and need to stent than the study group (60% vs. 22.5%, = 0.001).
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.
在半硬性输尿管镜检查（URS）治疗近端输尿管结石前使用坦索罗辛可提高手术成功率。几位作者使用α受体阻滞剂扩张输尿管，大多数研究观察到与使用安慰剂或不使用药物相比，结石清除率更高且并发症更少。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URS治疗下段输尿管结石术中及术后结果的影响。
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。2019年12月至2021年11月，在埃及阿斯尤特大学医学院阿斯尤特泌尿外科和肾脏病医院（泌尿外科）采用封闭信封随机法。
两组在年龄上无显著差异，两组大多数患者为男性。大多数患者有中度梗阻，结石不透X线。两组结石大小无显著差异（11.93±3.39 vs. 12.40±4.24 mm，P = 0.30）。研究组手术时间显著短于对照组（61.50±23.99 vs. 79.80±23.22分钟，P = 0.001）。对照组扩张需求频率（80% vs. 20%，P < 0.001）和留置支架需求频率显著高于研究组（60% vs. 22.5%，P = 0.001）。
术前坦索罗辛有助于URS治疗下段输尿管结石。它可减少手术时间、扩张需求和术后输尿管留置支架的需求。它还可提高成功率，但对并发症发生率无显著影响。
