الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Alpha blockers decrease peristalsis above and below the stone, which increases the urine bolus and intraureteral pressure above it and lowers intraureteral pressure below it in association with the decrease in basal and micturition pressure, even at the bladder neck; thus, it increases the chance of stone expulsion. We aim to evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Since our aim in ureteroscopic treatment of upper ureteric stones is laser dusting rather than stone retrieval, its possible that alpha blockers can improve the access to upper ureter and clearance of fragmented stones.
This study aim was to evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance.
This prospective, randomized, multicenter study included 60 patients divided into two groups (30 patients receiving peri-operative tamsulosin and the other 30 patients didn’t receive tamsulosin) and carried out between March 2018 and December 2018 in Police hospital Nasr City and Ain Shams University Hospitals included adult patients (at least 15 years) with proximal ureteral stones (≥ 5mm) scheduled for URS lithotripsy.
In this study, failure of the procedure was due to the difficulty experienced in advancing the ureteroscope. We should mention that this technical problem was less reported in patients receiving pre-URS tamsulosin. The mean operative time was significantly shorter in tamsulosin group compared to control group. At follow-up 4 weeks after URS, stone free rate was higher in tamsulosin group compared to control group.
Our study revealed that peri-operative tamsulosin therapy prior to laser-assisted semirigid URS for the management of proximal ureteral stones reduces the operative time significantly, improves ureteroscopic access and improves the SFR, but does not reach statistical significance with an acceptable complication rate.