The Efficacy and Safety of Adjunctive Alpha-Blocker Therapy before Flexible Ureteroscopy in the Management of Upper Ureteric Stones in Pediatrics Group

Abstract Background The incidence of pediatric urolithiasis has risen dramatically over the past few decades, with a reported rate of 4% per year. A unique aspect of children is the smaller ureteral diameter, which often results in failure to access the ureter during an initial URS (either Flexible or Rigid) attempt to be able to perform the intended procedure. Aim of the Work To evaluate efficacy adjunctive alpha-blocker therapy before Flexible ureteroscopy in the management of Upper ureteric stones (ranging from 5:10 mm) in children as regard facilitating ureteric orifice navigation and ureteral dilatation. Patients and Methods This was a prospective randomized control study that was conducted at Urology Department, Faculty of Medicine, Ain Shams University on 80 patients they were divided into 2 groups. Group A (random): 40 Children received Tamsulosin 0.4 mg capsule for 5 days prior to Flexible ureteroscopy. Group B (random): 40 Children didn’t receive Tamsulosin 0.4 mg capsule prior to Flexible ureteroscopy. Results There were 60 child were male and 20 were female and their ages ranged from 5 to 18 years (mean 10.66 years). There was no statistically significant difference between Group A and Group B regarding age (Years), gender, Body mass index (kg/m2) and Side. Successful stone access occurred in 34 of 40 patients (85%) who had received tamsulosin and 30 of 40 (75%) who had not (p = 0.264). There was no statistically significant difference between Group A and Group B regarding stone burden (mm2), successful access and stone free rate. There was no statistically significant difference between Group A and Group B regarding complication (P < 0.05). Conclusion Adjunctive alpha-blocker therapy (Tamsulosin) before flexible ureteroscopy in the management of upper ureteric stone in school age children failed to show a statistically significant difference for successful ureteral orifice navigation, ureteral dilatation, stone free rete and complication.