Can alpha blockers facilitate the placement of ureteral access sheaths in retrograde intrarenal surgery?

Özet

Objective: To investigate the effects of alpha blocker treatment on the placement of ureteral access sheaths(UAS) during retrograde intrarenal surgery (RIRS).Material and methods: This study was a retrospective analysis of prospectively collected data. Patientswho underwent RIRS due to renal stones between November 2015 and December 2017 were seperated intotwo groups. Age, gender, body mass index (BMI), stone size, laterality, hydronephrosis degree, and renalstone density were recorded. Tamsulosin (0.4 mg/day) was prescribed to the study group (n=25) 2 weeksbefore the operation. The control group (n=25) underwent the operation without any additional treatment.All the operations were performed using a 7.5 Fr flexible ureteroscope and 9.5/11.5 Fr (Cook, Blooming,USA) UAS.Results: Two patients in the study group were excluded from the study as they suffered from dizziness andretrograde ejaculation. No statistically significant difference was found between the patients in the studygroup (n=23) and control group (n=25) in terms of age, gender, BMI, stone size, laterality, hydronephrosis,and renal stone density (p=0.470, p=0.536, p=0.456, p=0.102, p=0.555, p=0.732, and p=0.317, respectively).The UAS could be successfully placed on the first attempt in 15 (65.2%) patients in the study group and 11(44%) patients in the control group during the first attempt itself. Even though the successful UAS placementrate was higher in the study group, no statistically significant values were observed (p=0.141).Conclusion: The data obtained from the present study showed that the use of alpha blockers prior to RIRSdid not improve the UAS placement rates. It is considered that studies conducted on more patients might beable to achieve significant values.