Do alpha-1 antagonist medications affect the success of semi-rigid ureteroscopy? A prospective, randomised, single-blind, multicentric study

The objective of this study is to assess the efficacy of adjunctive silodosin therapy in improving the success rate of semi-rigid ureteroscopy for removing ureteral stones. Prospective randomised controlled clinical trial performed between July 2016 and September 2016. All the patients underwent ure...

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Bibliographic Details
Published in:Urolithiasis 2018-11, Vol.46 (6), p.567-572
Main Authors: Aydın, Mustafa, Kılınç, Muhammet Fatih, Yavuz, Abdulmecit, Bayar, Göksel
Format: Article
Language:English
Subjects:
Adrenergic alpha-1 Receptor Antagonists - therapeutic use
Adult
Aged
Combined Modality Therapy - adverse effects
Combined Modality Therapy - methods
Female
Humans
Indoles - therapeutic use
Lasers, Solid-State
Lithotripsy, Laser - adverse effects
Lithotripsy, Laser - instrumentation
Lithotripsy, Laser - methods
Male
Medical Biochemistry
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Operative Time
Original Paper
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prospective Studies
Single-Blind Method
Success
Treatment Outcome
Ureteral Calculi - therapy
Ureteroscopes
Ureteroscopy - adverse effects
Ureteroscopy - instrumentation
Ureteroscopy - methods
Urology
Young Adult
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Summary:The objective of this study is to assess the efficacy of adjunctive silodosin therapy in improving the success rate of semi-rigid ureteroscopy for removing ureteral stones. Prospective randomised controlled clinical trial performed between July 2016 and September 2016. All the patients underwent ureteroscopic holmium lithotripsy with a YAG laser. The patients were randomised into one of three groups: those who did not use an alpha-1 blocker (AB) (Group 1, n = 50), those who used an AB for one day (Group 2, n = 50), and those who used an AB for three days (Group 3, n = 47). The following information was recorded for each patient: the side, location, and surface area of the stone; successful access; operative success; complications; and operative time. There were no significant differences between the three groups in terms of demographics, stone location or size, and number of doses of an analgesic drug used. Access to the stone and the stone-free rate were significantly higher in group 3 (95.7, 93.6%) than in group 1 (76, 74%) and group 2 (78, 74%) ( p = 0.018, p = 0.021), respectively. Balloon dilatation and complication rates were significantly lower in group 3 (12.8, 0%) than in group 1 (34, 12%) and group 2 (22, 4%) ( p = 0.045, p = 0.029), respectively. The use of silodosin for 3 days before ureteroscopy for ureteral stones increased the rate of access to all ureter stones and decreased the complication rate.
ISSN:2194-7228
2194-7236
DOI:10.1007/s00240-017-1026-6