title: Semi-Rigid Ureteroscopy for Proximal Ureteral Stones: Does Adjunctive Tamsulosin Therapy Increase the Chance of Success?
abstract: OBJECTIVE
  To assess the efficacy of adjunctive tamsulosin therapy in improving the success rate of laser-assisted semi-rigid ureteroscopy (URS) for removing proximal ureteral stones.
  
  
  METHODS
  This prospective study included 165 patients with proximal ureteral stones ≥10 mm. The patients were randomly assigned to a tamsulosin group (Group I, n = 81) receiving tamsulosin 0.4 mg daily for 1 week pre-URS and a control group (Group II, n = 84) without tamsulosin therapy. Treatment consisted of URS using a semi-rigid ureteroscope (7.5 Fr), followed by intracorporeal holmium: YAG laser lithotripsy. The patients were followed up regularly for 8 weeks after URS.
  
  
  RESULTS
  The operative time was 43.4 and 49.6 min in Groups I and II, respectively (p < 0.001). Scope to stone access rate was 93.8 and 82.1% in patients of Groups I and II, respectively (p = 0.022). The stone-free rate was significantly higher in Group I compared to Group II (74/81; 91.4% vs. 67/84; 79.8%; p = 0.035). The complication rate was significantly lower in Group I compared to Group II (17.3 vs. 38.1%, p = 0.003). Only minor complications were encountered and were managed conservatively.
  
  
  CONCLUSIONS
  Tamsulosin therapy prior to semi-rigid URS improved ureteroscopic access to proximal ureteral stones, thus leading to an increased success rate and low morbidity.
authors.affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt.
authors.forename: Abul-Fotouh
authors.initials: AF
authors.lastname: Ahmed
authors.forename: Aref
authors.initials: A
authors.lastname: Maarouf
authors.forename: Essam
authors.initials: E
authors.lastname: Shalaby
authors.forename: Saad
authors.initials: S
authors.lastname: Alshahrani
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Feky
authors.forename: Sabri
authors.initials: S
authors.lastname: Khaled
authors.forename: Abdullah
authors.initials: A
authors.lastname: Daoud
authors.forename: Ahmed
authors.initials: A
authors.lastname: Soliman
authors.forename: Esam
authors.initials: E
authors.lastname: Desoky
authors.forename: Hisham
authors.initials: H
authors.lastname: El-Helaly
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011336:Probability; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D013997:Time Factors; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000188:drug therapy* / Q000601:surgery*; D020709:Ureteroscopes; D018666:Ureteroscopy
chemical_list: D013449:Sulfonamides; D000077409:Tamsulosin
keywords: Stone; Tamsulosn; Ureter; Ureteroscopy