Presentation Authors: Goksel Bayar*, Istanbul, Turkey, Muhammet Fatih Kilinc, Ankara, Turkey, Abdulmecit Yavuz, Mersin, Turkey, Mustafa Aydin, Samsun, Turkey
Introduction: To evaluate efficiency of tamsulosin or mirabegron as adjunctive therapy for ureterolithotripsy.
Methods: The study is prospective, randomized, single blind and multicentric. The patients, not-pregnant and aged between 18-75, whom ureteroscopy was planned for ureter stones were invited to study. Patients divided three groups with equal randomization. Group 1 is control group, group 2 has taken silodosin tamsulosin 0.4 mg and group 3 mirabegron 50 mg once daily. Operations were performed after seven days from beginning the drugs administration. Laser was used for lithotripsy. Successful access was defined as the ureteroscope entered the ureter and the stone access was achieved. Successful operation was defined as the stone was completely fragmented and removed or broken into small pieces during the operation and residual stone was not observed four weeks later in computed tomography. Comparison of numerical data was completed with one-way ANOVA analysis and non-numerical with Pearson chi-square test. A p value of less than 0.05 was accepted as statistical significance.
Results: All in, 186 patients were included final analyze. Control group has 63, tamsulosin 61 and mirabegron 62 patients. Stone access was not achieved on 17 (9.1%) patients, ureteroscope could not passed intramural ureter portion on 10 and middle or proximal portion on 7 patients. Additionally, stone was fragmented total or partial, but not taken out from ureter at the end of 4th week on 6 patients, so stone free could not achieved on 23 (12.4%) patients. Balloon dilatation needing was higher in control (23.8%) than tamsulosin (8.2%) and mirabegron (6.5%) groups (p= 0.006). Successful access rate was lower in control (81%) than tamsulosin (96.7%) and mirabegron (95.2%) groups (p= 0.003). Complication rate and mean operation time were similar between groups. In sub analysis, proximal or middle (p= 0.028) and distal ureter localization (p= 0.02) showed statistical significance between groups.
Conclusions: Tamsulosin or mirabegron administration one week before semirigid ureterolithotripsy improved stone access and free rate in all ureter stone localization.