요관 내시경 수술에서 탐스로신의 요관 확장 및 요관 부목 관련 증상 완화에 미치는 영향: 이중 맹검, 무작위 배정, 위약 대조군 연구

Abstract

Purpose This study aimed to investigate the effect of taking tamsulosin prior to surgery on the successful insertion of a 14 French (F) ureteral access sheath (UAS) during the procedure, as well as the impact of pre- and post-operative tamsulosin use on symptoms related to the ureteral stent.

Materials and Methods This study was a randomized, single-center, double-blinded, placebo-controlled trial of 200 patients undergoing retrograde intrarenal surgery. Patients received either tamsulosin (0.4 mg) or placebo from 1 week before the surgery until stent removal. The patients were randomly assigned to one of four groups: Group 1 received tamsulosin throughout the entire study period, Group 2 received tamsulosin before surgery and placebo after surgery, Group 3 received placebo before surgery and tamsulosin after surgery, and group 4 took placebo before and after surgery. The Ureteral Stent Symptoms Questionnaire was completed between postoperative days 7 and 14 just before the stent removal.

Results In total, 160 patients were included in the analysis. Their mean age was 55.0 ± 11.0 years, and 48 (30.0%) were female. In the group receiving pre-operative tamsulosin, the success rate of 12/14F UAS deployment was significantly higher compared to the pre-operative placebo group (88.0 vs. 75.3%, p=0.038). Pre- and post-operative tamsulosin use did not significantly alleviate symptoms related to the ureteral stent.

Conclusions These results revealed that pre-operative administration of tamsulosin improved the success of larger-sized UAS, while pre- and post-operative tamsulosin use did not significantly alleviate symptoms related to ureteral stents.

Keywords adrenergic alpha-antagonists; tamsulosin; ureteroscopy; lower urinary tract symptoms