Study of the Effect of Tamsulosin HCl (an Alpha-1 Receptor Antagonist) as a Medical Expelling Agent on Subsequent Ureteroscopic Procedure for Treatment of Lower Ureteric Stones

Abstract
Background: Tamsulosin is an a-1A-specific blocker which induces selective relaxation of ureteral smooth muscle with subsequent inhibition of ureteral spasms and dilatation of the ureteral lumen and facilitates stone expulsion.
Aim of the Study: In this prospective randomized study we aimed to assess the efficacy of use of alpha blocker (tamsulosin Hcl 0.4mg) on the outecome of ureteroscopic lithotripsy for distal ureteric stone.
Patients and Methods: In a prospective study by a rand-omized controlled clinical trial, which was performed from September 2016 to March 2017, about 50 patients underwent ureteroscopic lithotripsy with the pneumatic wolf lithotripsy. The patients were randomly divided into 2 groups: The study group including 25 patients, received tamsulosin with our traditional treatment (hydration and analgesic when required), and the control group with 25 patients who received placebo with traditional treatment. Patients prospectively will be evaluated for stone clearing rate by imaging at morning of URSL and at the end of 2nd week including: (KUB and pelvi abdominal ultrasound)and they will be evaluated for number of colic episodes, analgesic consumption and post-operative complications (haematuria and UTI).
Results: The results showed that tamsulosin treatment group had short time of the procedure, easy extraction of the stone fragments, had low expulsion time, low urinary tract symptoms, least analgesic needs and low adverse effects.
Conclusions: Administration of a-1A-specific antagon istmade the procedure of short time, easy extraction of the stone fragments reduced analgesic dosage and colic episodes, rate of adverse effects after ureteroscopic lithotripsy of lower ureteral stones and decreased gravel expulsion time after URSL.