Short Course of α-Blockers May Facilitate Successful URS

Background: Ureteroscopy (URS) is an effective treatment for ureteral and renal stones, although access challenges, residual fragments, and complications remain concerns. Preoperative α-blockers may facilitate ureteral access by relaxing smooth muscle, but their impact on URS outcomes has not been fully defined. Objective: To evaluate the efficacy and safety of preoperative α-blocker therapy on URS outcomes. Design: Systematic review and meta-analysis of randomized controlled trials. Methods: MEDLINE, EMBASE, and Cochrane databases were searched through April 2023 for trials comparing URS with or without preoperative α-blockers. Outcomes included ureteral dilatation, stone access failure, procedure time, residual stone rate, hospital stay, and complications. Random-effects meta-analysis and Grading of Recommendations Assessment, Development and Evaluation assessment were performed. Results: 15 randomized trials (n=1653) were included. Preoperative α-blockers significantly reduced ure more...