Evaluation of the Role of Preoperative Pharmacological Ureteral Dilatation in Ureteroscopic Stone Surgery

Abstract

Abstract Background Urinary stone disease is very common, with an estimated prevalence among the general population of 2% to 3% and an estimated lifetime risk of 1 in 8 for white males and 5% to 6% for white females, with men forming stones three times as often as women. Aim of the Work To compare the effectiveness of antispasmodics (hyoscine-N- butylbromide), α-blockers (tamsulosin), placebo as control (in the form of multivitamins), as preoperative medications for ureteral dilatation prior to semirigid ureteroscopic stone surgery. Patients and Methods This prospective randomized control clinical study conducted on 90 patients admitted from Urology department, Faculty of Medicine, Ain Shams University hospitals in a period of 6 months starting from March 2022 till September 2022; they were randomized into 3 groups 30 patients per group: Group (A) received Tamsulosin 0.4 mg once daily for 7 days, Group (B) received Hyoscine-N- butylbromide 10 mg three times per day for 7 days, Group (C) received Placebo. Results The operation time and the need of double J stent insertion significantly decrease with Tasmulosin or Hyoscine-N-butylbromide versus Placebo. Operative and postoperative complications significantly decrease while using Tamsulosin or Hyoscine- N-butylbromide versus Placebo. Conclusion The administration of adjunctive alpha-blockers and/or antispasmodics prior to ureteroscopic management of lower ureteric stones seems to be associated with better advancing of the ureteroscope to access the stone, shorter procedure time, higher stone-free rate, lower incidence of intra- and postoperative complications and lesser need for postoperative analgesia.