OBJECTIVES:
Tamsulosin is proved to promote spontaneous passage of distal ureteral and juxtavesical calculi. Our aim is to prospectively evaluate the role of neoadjuvant tamsulosin during ureteroscopic treatment of lower ureteric stone.
METHODS:
One hundred thirty-eight adult patients with lower ureteral calculi underwent ureteroscopic management. Stone length varied from 7 to 12 mm. Before treatment, the patients were randomly divided into 2 groups; the study group (n = 70) received tamsulosin 0.4 mg once daily for 3-6 weeks and the control group (n = 68) received standard analgesia only. Preoperative medications were blinded to the endourologists. The primary endpoint was the need for intraoperative ureteral dilatation. Postoperative complications were recorded for both groups.
RESULTS:
Of the 120 patients available for follow up, the need for intraoperative ureteral dilatation was 30% in the study group, compared with 86.7% in the control group (p<0.001). Of the control group, 5% had postoperative pyelonephritis episodes, in contrast to only 1.7% of the study group (p=0.619).
CONCLUSIONS:
Preopertive tamsulosin simplifies ureteroscopic management of lower ureteric calculi. To the best of our knowledge, this is the first study to show the value of neoadjuvant tamsulosin in ureteroscopic management of distal ureteric calculi