1
|
Zeng G, Zhong W, Chaussy CG, Tiselius HG, Xu C, Turney B, Turk C, Tailly GG, Preminger GM, Akpinar H, Petrik A, Bernardo N, Wiseman O, Farahat Y, Budia A, Jones DK, Beltran Suarez E, De Marco F, Mazzon G, Lv J, Natchagande G, Guven S, Ibrahim TAA, Xu H, Xie L, Ye Z, Sarica K. International Alliance of Urolithiasis Guideline on Shockwave Lithotripsy. Eur Urol Focus 2023; 9:513-523. [PMID: 36435718 DOI: 10.1016/j.euf.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/04/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022]
Abstract
Different international associations have proposed their own guidelines on urolithiasis. However, the focus is primarily on an overview of the principles of urolithiasis management rather than step-by-step technical details for the procedure. The International Alliance of Urolithiasis (IAU) is releasing a series of guidelines on the management of urolithiasis. The current guideline on shockwave lithotripsy (SWL) is the third in the IAU guidelines series and provides a clinical framework for urologists and technicians performing SWL. A total of 49 recommendations are summarized and graded, covering the following aspects: indications and contraindications; preoperative patient evaluation; preoperative medication; prestenting; intraoperative analgesia or anesthesia; intraoperative position; stone localization and monitoring; machine and energy settings; intraoperative lithotripsy strategies; auxiliary therapy following SWL; evaluation of stone clearance; complications; and quality of life. The recommendations, tips, and tricks regarding SWL procedures summarized here provide important and necessary guidance for urologists along with technicians performing SWL. PATIENT SUMMARY: For kidney and urinary stones of less than 20 mm in size, shockwave lithotripsy (SWL) is an approach in which the stone is treated with shockwaves applied to the skin, without the need for surgery. Our recommendations on technical aspects of the procedure provide guidance for urologists and technicians performing SWL.
Collapse
Affiliation(s)
- Guohua Zeng
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
| | - Wen Zhong
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Christian G Chaussy
- University of Munich, Munich, Germany; University of Regensburg, Regensburg, Germany
| | - Hans Göran Tiselius
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Changbao Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ben Turney
- Department of Urology, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Christian Turk
- Department of Urology, Hospital of the Sisters of Charity, Vienna, Austria
| | | | - Glenn M Preminger
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Haluk Akpinar
- Department of Urology, Florence Nightingale Hospitals Group, Istanbul, Turkey
| | - Ales Petrik
- Department of Urology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Norberto Bernardo
- Department of Urology, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
| | - Oliver Wiseman
- Department of Urology, Cambridge University Hospitals, Cambridge, UK
| | - Yasser Farahat
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Alberto Budia
- Department of Urology, La Fe Polytechnic University Hospital, Valencia, Spain
| | - David K Jones
- Department of Pharmacology, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Edgar Beltran Suarez
- Department of Urology, Specialty Hospital La Raza, National Medical Center of the Mexican Institute of Social Security, Mexico City, Mexico
| | - Ferdinando De Marco
- Urology Division, Istituto Neurotraumatologico Italiano-Grottaferrata, Rome, Italy
| | - Giorgio Mazzon
- Department of Urology, San Bassiano Hospital, Vicenza, Italy
| | - Jianlin Lv
- Department of Urology, Jiangning Hospital, Nanjing Medical University, Nanjing, China
| | | | - Selcuk Guven
- Urology Department, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | | | - Hanfeng Xu
- Department of Urology, First Affiliated Hospital of University of South China, Henyang, China
| | - Lei Xie
- Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kemal Sarica
- Department of Urology, Biruni University Medical School, Istanbul, Turkey.
| |
Collapse
|
2
|
Demirelli E, Öğreden E, Tok DS, Demiray Ö, Karadayi M, Oğuz U. Complementary Ureterorenoscopy after extracorporeal Shock Wave Lithotripsy in proximal ureteral stones: success and complications. Rev Assoc Med Bras (1992) 2022; 68:1068-1072. [PMID: 36134836 PMCID: PMC9574975 DOI: 10.1590/1806-9282.20220237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to demonstrate the effect of extracorporeal shock wave lithotripsy application on the success and complications of ureteroscopic lithotripsy in proximal ureter stones. METHODS The data of 87 patients who did not respond to shock wave lithotripsy and underwent ureteroscopic lithotripsy were retrospectively analyzed and classified as group I, and 99 patients who received ureteroscopic lithotripsy as primary treatment were classified as group II. Demographic features, response to treatment, and preoperative and postoperative complications were compared between the two groups. RESULTS There was no difference between the two groups in terms of gender, operation times, stone sizes, and ureteroscope diameters. (p>0.05). Infective complications such as postoperative fever, pyelonephritis, and urosepsis were similar in both groups (p=0.142, p=0.291, and p=0.948). Stone migration was observed in 10 (11.5%) and 6 (6.1%) patients in groups I and II, respectively (p=0.291). Impacted stone was seen in 47 (54%) patients in group I and in 15 (15.2%) patients in group II (p<0.0001). Mucosal laceration occurred in 11 (12.6%) and 3 (3%) patients in groups I and II, respectively (p=0.028). Ureteral perforation was detected in 3 (3.4%) patients in group I and 1 (1%) patient in group II, whereas ureteral avulsion was not observed in either group (p=0.524). CONCLUSIONS It was concluded that the application of shock wave lithotripsy before ureteroscopic lithotripsy in proximal ureter stones did not affect the success. Although the results are similar in terms of postoperative infection, shock wave lithotripsy application has been found to increase the risk of stone impaction into the mucosa and ureteral laceration.
Collapse
Affiliation(s)
- Erhan Demirelli
- Giresun University, Faculty of Medicine, Department of Urology - Giresun, Turkey
| | - Ercan Öğreden
- Giresun University, Faculty of Medicine, Department of Urology - Giresun, Turkey
| | - Doğan Sabri Tok
- Giresun University, Faculty of Medicine, Department of Urology - Giresun, Turkey
| | - Özay Demiray
- Prof. Dr. A. İlhan Özdemir Training and Research Hospital, Department of Urology - Giresun, Turkey
| | - Mehmet Karadayi
- Giresun University, Faculty of Medicine, Department of Urology - Giresun, Turkey
| | - Ural Oğuz
- Giresun University, Faculty of Medicine, Department of Urology - Giresun, Turkey
| |
Collapse
|
3
|
Pricop C, Ivanuta M, Radavoi GD, Toma CV, Cumpanaş A, Jinga V, Bacalbaşa N, Puia D. Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second-line treatment: A clinical study. Exp Ther Med 2021; 23:38. [PMID: 34849153 DOI: 10.3892/etm.2021.10960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/20/2021] [Indexed: 11/06/2022] Open
Abstract
The purpose of the study was to establish whether shock wave lithotripsy (SWL) is a potential harmful first-line treatment for ureteric stones where ureteroscopy (URS) is necessary as a second-line treatment. Medical records of patients with ureteric stones who underwent either URS as the only therapy applied or SWL followed by URS over two years were retrospectively evaluated. In total, 158 patients were included: 79 patients in Group A (no SWL) and 79 in Group B (prior SWL before URS). There was no difference in major complications, Group A had higher stone-free rates, Group B had higher rates of ureteral edema and similar intraoperative ureteral lesions. In conclusion, the failure of SWL for lumbar or pelvic ureteral lithiasis does not appear to have a negative effect on the rate of intraoperative complications or the success rate of semi-rigid retrograde URS for this category of calculi, with the same safety profile as first-line endourological intervention.
Collapse
Affiliation(s)
- Cătălin Pricop
- Department of Urology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania.,Department of Urology, 'C. I. Parhon' Hospital, 700503 Iași, Romania
| | - Marius Ivanuta
- Department of Urology, 'C. I. Parhon' Hospital, 700503 Iași, Romania
| | - George Daniel Radavoi
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Urology, 'Prof. Dr. Theodor Burghele' Clinical Hospital, 050653 Bucharest, Romania
| | - Cristian-Valentin Toma
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Urology, 'Prof. Dr. Theodor Burghele' Clinical Hospital, 050653 Bucharest, Romania
| | - Alin Cumpanaş
- Department of Urology, 'Victor Babeş' University of Medicine and Pharmacy, 300041 Timișoara, Romania.,Department of Urology, 'Pius Brînzeu' County Emergency Clinical Hospital Timiş, 300723 Timișoara, Romania
| | - Viorel Jinga
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Urology, 'Prof. Dr. Theodor Burghele' Clinical Hospital, 050653 Bucharest, Romania
| | - Nicolae Bacalbaşa
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Visceral Surgery, Center of Excellence in Translational Medicine, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Dragoş Puia
- Department of Urology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania.,Department of Urology, 'C. I. Parhon' Hospital, 700503 Iași, Romania
| |
Collapse
|
4
|
Yao F, Jiang X, Xie B, Liu N. Comparison of ureteroscopy (URS) complementary treatment after extracorporeal shock wave lithotripsy failure with primary URS lithotripsy with holmium laser treatment for proximal ureteral stones larger than10mm. BMC Urol 2021; 21:126. [PMID: 34517851 PMCID: PMC8439014 DOI: 10.1186/s12894-021-00892-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background To compare ureteroscopy (URS) complementary treatment following extracorporeal shock wave lithotripsy (SWL) failure with primary URS lithotripsy for proximal ureteral stones > 10 mm, and try to find out acceptable number of SWL sessions followed by safe URS. Methods This was a retrospective study following approval from Medical Ethics Committee of People's Hospital of Chongqing Banan District. Patients (n = 340) who received URS in our hospital for stones > 10 mm from Jan 2015 to June 2020 were divided into two groups according to their previous SWL history. Group 1 consisted of 160 patients that underwent unsuccessful SWL before URS. Group 2 encompassed 180 patients without SWL before URS. Patient’s operative outcomes were compared. A logistic regression and receiver operator characteristics (ROC) were used to identify the acceptable number of SWL sessions prior to URS, regarding the intra-operative complications of URS. Results The group 1 required more surgery time (41.38 ± 11.39 min vs. 36.43 ± 13.36 min, p = 0.01). At the same time, more intra-operative (68.1% VS 22.8%, p < 0.05) and post-operative (35% VS 18.0%, p = 0.001) complications occurred in group 1. Need more hospital stay in group 1 (2.7 ± 1.2 days vs 1.6 ± 1.1 days, p < 0.05). More patients in group 1 need further URS (16.3% VS 8.9%, p = 0.029). After second URS, the SFR of URS in two groups was insignificant differences (82.5% VS 88.9%, p > 0.05). The median (25–75%) of SWL sessions before URS was 2 (1–3) in group 1. According to the results of logistic regression analysis, patients suffered more SWL failure have an increased risk of complications during URS (OR = 1.995, 95% CI: 1.636–2.434). ROC showed that the optimal number of SWL session followed by URS were 0.5, with a sensitivity of 67.7% and specificity of 71.5%. Intra-operative complication rates of URS treatment were higher in patients who suffered > 1 SWL failure (72.6% vs 57.4%, p = 0.047). Conclusion There was no acceptable number of SWL sessions that could be followed by URS with fewer intra-operative complications. Patients who underwent previous SWL were likely to suffer more intra-operative complications, the average operating time, hospitalization time, and needing further treatment, during URS treatment for proximal ureteral stones larger than 10 mm.
Collapse
Affiliation(s)
- Feng Yao
- Department of Urology, People's Hospital of Chongqing Banan District, Chongqing, 401320, China
| | - XiaoLiang Jiang
- Department of Urology, People's Hospital of Chongqing Banan District, Chongqing, 401320, China
| | - Bin Xie
- Department of Urology, People's Hospital of Chongqing Banan District, Chongqing, 401320, China
| | - Ning Liu
- Department of Urology, People's Hospital of Chongqing Banan District, Chongqing, 401320, China.
| |
Collapse
|
5
|
Wang W, Peng L, Di X, Gao X, Wei X. Does previous unsuccessful shockwave lithotripsy influence the outcomes of ureteroscopy?-a systematic review and meta-analysis. Transl Androl Urol 2021; 10:2122-2132. [PMID: 34159093 PMCID: PMC8185663 DOI: 10.21037/tau-21-39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background To determine whether previous unsuccessful shockwave lithotripsy (SWL) influence the outcomes of ureteroscopy (URS). Methods An exhaustive search of PubMed, EMBASE, Web of Science and Cochrane Library were conducted to find eligible studies before October 2020. Result variables consisting stone-free rate (SFR), operation time and postoperative modified Clavien grade I-IV complications were pooled utilizing RevMan 5.3. Results Seven studies with 2413 individuals were included. Pooled results revealed that the salvage URS after failed SWL was similar to URS performed primarily regarding SFR [odds ratio (OR) =0.84, P=0.15] and operation time [weighted mean difference (WMD) =6.79, P=0.19]. Additionally, no statistically significant differences concerning fever (OR: 1.36; P=0.32), hematuria (OR: 0.81; P=0.75), urinary tract infection (OR: 1.57; P=0.28), renal colic (OR: 1.94; P=0.50), ureteral perforation (OR: 1.44; P=0.46), ureteral avulsion (OR: 1.21; P=0.83), stone migration (OR: 0.92; P=0.86) and sepsis (OR: 0.46; P=0.38) were observed between salvage URS and primary URS group. Discussion The success rates and complications of URS were not impacted by previous unsuccessful SWL. The salvage URS is equally effective and safe to primary URS.
Collapse
Affiliation(s)
- Wei Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liao Peng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingpeng Di
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoshuai Gao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
6
|
Irer B, Sahin MO, Erbatu O, Yildiz A, Ongun S, Cinar O, Cihan A, Sahin M, Sen V, Ucer O, Kizilay F, Bozkurt O. Impact of previous SWL on ureterorenoscopy outcomes and optimal timing for ureterorenoscopy after SWL failure in proximal ureteral stones. World J Urol 2019; 38:769-774. [PMID: 31098658 DOI: 10.1007/s00345-019-02809-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/10/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE We aimed to evaluate the impact of previous unsuccessful shock wave lithotripsy (SWL) therapy on ureterorenoscopy (URS) outcomes in proximal ureteral stones and to define whether there is any optimal timing for safe URS after SWL. METHODS The patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were included. Patients were divided into two groups according to previous SWL history; group 1 consisted of patients without SWL before URS for the stone [SWL (-)] and group 2 consisted of patients with a previous SWL for the stone [SWL (+)]. Demographics, operation outcomes and stone characteristics were compared between these two groups. Regarding the complication and success rates, optimal timing for URS after SWL for the stone was calculated with receiver operator characteristics curve analysis. RESULTS Totally 638 patients were included (group 1: 466 patients and group 2: 172 patients). The operation and hospitalization times, rate of ureteral stenting and complications were significantly higher in group 2. Stone free status was similar between the groups. Optimal timing for URS after SWL was calculated as 16.5 days (AUC = 0.657, p = 0.012) with a sensitivity of 68% and specificity of 72%, regarding the complication rates. Complication rates were significantly higher in patients who were operated before 16.5 days (27.7% vs 6.5%, p < 0.001). CONCLUSIONS The optimal timing; 2-3 weeks delay of the URS procedure after unsuccessful SWL may decrease complication rates according to our results.
Collapse
Affiliation(s)
- Bora Irer
- Department of Urology, Izmir Metropolitan Municipality Esrefpasa Hospital, Izmir, Turkey
| | | | - Oguzcan Erbatu
- Department of Urology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Alperen Yildiz
- Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Sakir Ongun
- Department of Urology, Balikesir University School of Medicine, Balıkesir, Turkey
| | - Onder Cinar
- Department of Urology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Ahmet Cihan
- Department of Urology, Nigde Omer Halisdemir University School of Medicine, Nigde, Turkey
| | - Mehmet Sahin
- Department of Urology, Ege University School of Medicine, Izmir, Turkey
| | - Volkan Sen
- Department of Urology, Manisa State Hospital, Manisa, Turkey.
| | - Oktay Ucer
- Department of Urology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Fuat Kizilay
- Department of Urology, Ege University School of Medicine, Izmir, Turkey
| | - Ozan Bozkurt
- Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| |
Collapse
|
7
|
Can intervals in extracorporeal shock wave lithotripsy sessions affect success in the treatment of upper ureteral stones? Wideochir Inne Tech Maloinwazyjne 2018; 13:507-511. [PMID: 30524622 PMCID: PMC6280089 DOI: 10.5114/wiitm.2018.75873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/12/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction Managing upper ureteral stones with shock wave lithotripsy (SWL) has been done for many years. However, no conclusive data have been found on the intervals required between repeated SWL sessions. Aim To identify the most optimal intervals between SWL sessions. Material and methods Between September 2015 and December 2016, 80 patients undergoing elective outpatient lithotripsy who required repeated SWL sessions for ureteral stones were evaluated. These patients were categorised into two groups according to different SWL session intervals. The intervals between SWL sessions (n = 40) for the first group lasted one day, whereas those for the second group (n = 40) lasted 1 week. The data recorded during SWL included visual analogue scale (VAS) scores, total number of shocks, total energy used and number of sessions. The stone clearance rates, number of urinary tract infections, complication rates and VAS scores were compared between the two groups. Results All patients’ clinical outcomes after SWL therapy are shown in Table I. The stone clearance rate for group 1 was 70%, whereas that for group 2 was 72.5% (p = 0.805). Additionally, the number of urinary tract infections, complications and VAS scores were similar for both groups. In group 1, 3 patients had steinstrasse, two suffered from severe renal colic, and one had a urinary tract infection. In group 2, 3 patients endured steinstrasse, and 2 patients experienced severe renal colic during the study. Conclusions Short-interval SWL sessions are safe and effective for treating upper ureteral stones, and such sessions do not increase complication rates.
Collapse
|
8
|
Sokhal AK, Singh K, Goel S, Kumar M, Purkait B, Sain DK, Gupta AK, Sankhwar S. Do Preoperative Alpha Blockers Facilitate Ureteroscope Insertion at the Vesico-Ureteric Junction? An Answer from a Prospective Case-Controlled Study. EUROPEAN MEDICAL JOURNAL 2017. [DOI: 10.33590/emj/10310145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Objective: To evaluate whether alpha blockers facilitate the navigation of the ureteroscope through the ureteric orifice, if administered preoperatively, based on the role of alpha blockers, mainly tamsulosin, in medical expulsive therapy of ureteric calculus.
Methods: A prospective, case-control study of 174 patients who underwent ureteroscopic stone removal for lower or mid ureteral calculi between November 2014 and March 2016 was carried out. We included patients >14 years of age who were planned for ureteroscopic stone removal. We divided the patients into two groups, including those who were not prescribed alpha blockers prior to surgery (Group A: no alpha blocker) and those patients who were started on alpha blockers, tamsulosin 0.4 mg, 3 days prior to surgery (Group B: alpha blocker). We excluded patients with stone size >1 cm, spontaneous stone passage prior to surgery, unable to perform ureteroscopy (URS), and previous history of ureteroscopic intervention.
Results: Our study included 124 patients, among whom 60 patients were prescribed alpha blockers preoperatively (Group B). The mean age of the study population was 37.62+9.74 (15–64 years) and the mean stone burden was 38.92+8.21 (15.94–58.12 mm2). The difference in rate of ureteroscope negotiation through the ureteric orifice between Groups A and B was not statistically significant (p=0.57).
Conclusions: In URS, preoperative administration of alpha blockers failed to improve technical ease and lower complication rate. Further large group, multi-centre studies are required todiscover a definitive role of alpha blockers prior to URS.
Collapse
Affiliation(s)
- Ashok Kumar Sokhal
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Kawaljit Singh
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sunny Goel
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Bimalesh Purkait
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Durgesh Kumar Sain
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Ashok Kumar Gupta
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Satyanarayan Sankhwar
- Department of Urology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|