Login to Access Video or Poster Abstract: MP75-14
Sources of Funding: None

Introduction

Use of an ureteral access sheath (UAS) has been shown to decrease operative time, improve stone free rates, and lower intrarenal pressures during ureteroscopy. With a bigger UAS, the larger dual lumen ureteroscopes can be passed and stone fragments up to 4 mm can be retrieved. We hypothesized that facilitating ureteral relaxation might aid placement of the 16F UAS. In late 2016, two surgeons (JL and RVC) began to routinely pre-treat patients undergoing percutaneous nephrolithotomy (PCNL) or ureteroscopy (URS) for 1-week with tamsulosin._x000D_

Methods

A retrospective chart review was conducted on 84 patients who underwent PCNL or URS in non-stented ureters between January 2015 and September 2016. Demographic data, tamsulosin usage, UAS size (11F, 14F, and 16F), deployment failure, and occurrence of ureteral injuries were reviewed. We performed a univariate and multivariate analysis to assess the impact of tamsulosin administration on the size of the UAS deployed._x000D_

Results

There was no difference between the tamsulosin group and non-tamsulosin group with regard to age, sex, BMI, or side of ureter treated (Table 1). The tamsulosin group had a higher percentage of 16F deployment 83% vs 39% (p<.001), and no significant difference in ureteral injuries (4% vs 3%). Univariate and multivariate analysis (Table 2) revealed that tamsulosin pre-treatment statistically significantly increased the odds ratio (16.0 and 22.9, respectively) for successful passage of a 16F UAS vs 14F UAS. _x000D_

Conclusions

In this retrospective study, one week of pre-operative tamsulosin was associated with an increase in the successful deployment of a 16F UAS. _x000D_

Funding

None