Does Preoperative Alpha-Blocker Use Affect the Results of Flexible Ureterorenoscopy?

Objective: To evaluate the effect of alpha-blocker therapy during flexible ureterorenoscopy (F-URS) on the treatment of upper urinary tract stones. Methods: A retrospective analysis was conducted on 476 patients who underwent F-URS at the Department of Urology between January 2010 and January 2017. Data collected included alphablocker use, stone size, stone location, patient age and gender, success or failure of ureteral access sheath (UAS) placement, ability to reach the stone during the procedure, postoperative stone-free status, and complication rates. Patients were divided into two groups: alpha-blocker users (n = 90, 18.9%) and non-users (n = 386, 81.1%). Results: No significant differences were observed in gender distribution (p = 0.86) or stone size (p = 0.21) between the two groups. Alpha-blocker users had a lower complication rate (p = 0.022), a higher rate of successful stone access during the procedure (p = 0.007), and a higher postoperative stone-free rate (p = 0.01) compared to non-users. Among alpha-blocker users, tamsulosin and silodosin were associated with higher stone clearance rates (p = 0.046 and p = 0.037, respectively). Conclusions: Alpha-blocker therapy during F-URS for upper urinary tract stones is associated with improved outcomes, including higher stone access rates, reduced complications, and increased stone-free rates. These findings suggest that alpha-blockers, particularly tamsulosin and silodosin, may enhance the efficacy and safety of F-URS. (c) 2025 AEU. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.