Do alpha-1 antagonist medications affect the success of semi-rigid ureteroscopy? A prospective, randomised, single-blind, multicentric study

The objective of this study is to assess the efficacy of adjunctive silodosin therapy in improving the success rate of semi-rigid ureteroscopy for removing ureteral stones. Prospective randomised controlled clinical trial performed between July 2016 and September 2016. All the patients underwent ureteroscopic holmium lithotripsy with a YAG laser. The patients were randomised into one of three groups: those who did not use an alpha-1 blocker (AB) (Group 1, n = 50), those who used an AB for one day (Group 2, n = 50), and those who used an AB for three days (Group 3, n = 47). The following information was recorded for each patient: the side, location, and surface area of the stone; successful access; operative success; complications; and operative time. There were no significant differences between the three groups in terms of demographics, stone location or size, and number of doses of an analgesic drug used. Access to the stone and the stone-free rate were significantly higher in group 3 (95.7, 93.6%) than in group 1 (76, 74%) and group 2 (78, 74%) (p = 0.018, p = 0.021), respectively. Balloon dilatation and complication rates were significantly lower in group 3 (12.8, 0%) than in group 1 (34, 12%) and group 2 (22, 4%) (p = 0.045, p = 0.029), respectively. The use of silodosin for 3 days before ureteroscopy for ureteral stones increased the rate of access to all ureter stones and decreased the complication rate.