Effects of Tamsulosin and Silodosin on the Success Rate of Ureteral Access Sheath Insertion and Postoperative Complications

Corresponding author: Long Jian Hua, alexseeking2000@163.com

DOI: 10.12201/bmr.202603.00119

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  Abstract: Objective To investigate the effects of perioperative tamsulosin and silodosin on the success rate of primary ureteral access sheath insertion and postoperative complications during flexible ureteroscopic lithotripsy. Methods A total of 130 patients with upper ureteral calculi or renal calculi who underwent flexible ureteroscopic laser lithotripsy at Beijing Chuiyangliu Hospital between January 2024 and December 2025 were retrospectively enrolled. According to different perioperative interventions, the patients were divided into control group A (n=45, no special intervention), experimental group B (n=42, oral tamsulosin sustained-release capsules 0.2 mg once daily for 7 days), and experimental group C (n=43, oral silodosin capsules 4 mg twice daily for 7 days). Preoperative baseline data, operation time, success rate of primary ureteral access sheath insertion, and postoperative complications were compared among the three groups, with pairwise comparisons between groups. Results There were significant differences in the success rate of primary ureteral access sheath insertion and the incidence of postoperative lower urinary tract symptoms among the three groups (P<0.05). The success rates of primary ureteral access sheath insertion in group B (88.1%) and group C (90.7%) were significantly higher than that in group A (66.7%) (P<0.05). The incidences of postoperative lower urinary tract symptoms in group B (16.7%) and group C (14.0%) were significantly lower than that in group A (35.6%) (P<0.05). No significant differences were observed in operation time, postoperative fever, postoperative analgesic use, or postoperative hematuria among the three groups (P>0.05). There were no significant differences between group B and group C in the success rate of primary ureteral access sheath insertion or the incidence of postoperative lower urinary tract symptoms (P>0.05). Conclusion Perioperative oral administration of tamsulosin or silodosin for 7 days can significantly improve the success rate of primary ureteral access sheath insertion and reduce the incidence of postoperative lower urinary tract symptoms during flexible ureteroscopic lithotripsy compared with no intervention. However, it shows no significant effect on shortening operation time or improving postoperative fever, analgesic requirement, or hematuria. Tamsulosin and silodosin have similar efficacy in improving the success rate of primary ureteral access sheath insertion and reducing the incidence of postoperative lower urinary tract symptoms, with no significant difference between the two agents.

  Key words: Renal calculi; Ureteral calculi; Tamsulosin; Silodosin; Flexible ureteroscopic lithotripsy; Ureteral access sheath

  Submit time: 30 March 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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