The objective of this study is to assess the efficacy of adjunctive silodosin therapy in improving the success rate of semi-rigid ureteroscopy for removing ureteral stones. Prospective randomised controlled clinical trial performed between July 2016 and September 2016. All the patients underwent ureteroscopic holmium lithotripsy with a YAG laser. The patients were randomised into one of three groups: those who did not use an alpha-1 blocker (AB) (Group 1, n = 50), those who used an AB for one day (Group 2, n = 50), and those who used an AB for three days (Group 3, n = 47). The following information was recorded for each patient: the side, location, and surface area of the stone; successful access; operative success; complications; and operative time. There were no significant differences between the three groups in terms of demographics, stone location or size, and number of doses of an analgesic drug used. Access to the stone and the stone-free rate were significantly higher in group 3 (95.7, 93.6%) than in group 1 (76, 74%) and group 2 (78, 74%) (p = 0.018, p = 0.021), respectively. Balloon dilatation and complication rates were significantly lower in group 3 (12.8, 0%) than in group 1 (34, 12%) and group 2 (22, 4%) (p = 0.045, p = 0.029), respectively. The use of silodosin for 3 days before ureteroscopy for ureteral stones increased the rate of access to all ureter stones and decreased the complication rate.

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Objective: The main objective of this study was to evaluate the efficacy of tamsulosin or mirabegron on ureteral stent-related symptoms. Patients and methods: This was a prospective, randomized, controlled, and singleblinded study. In total, 180 patients who had undergone ureterolithotripsy and ureteral stent insertion were included. Patients were randomly divided into three groups as follows: Group 1 was the control group taking placebo; group 2 was administered tamsulosin (0.4 mg) once a day; and group 3 received mirabegron (50 mg) once a day. The Turkish version of the ureteral stent symptom questionnaire was filled out after 4 weeks. Results: After excluding patients who were lost to follow-up, 161 patients were included in the final analysis. Analgesic usage doses were lower in the tamsulosin (5.1 ± 1.8) and mirabegron (4.5 ± 1.4) groups than in the control group (5.9 ± 2.1; P < .001). The urinary symptoms score was lower in tamsulosin group than it was in the control group (22.1 vs 27.8; P = .001); however, the other scores (body pain, general health, work performance, sexual matters, and other problems) were similar between the groups. Conclusions: Tamsulosin improves only urinary symptoms due to the ureteral stent and decreases the need for analgesics. Mirabegron has no effect on ureteral stentrelated symptoms, but it decreases analgesic need. K E Y W O R D S lower urinary tract symptoms, mirabegron, tamsulosin, ureteral stent 1 | INTRODUCTION Ureteral stents (USs) are widely used in urology practice to resolve obstruction, to help recovery of ureteric injury, or are routinely inserted after surgery. 1 However, about 80% of patients experience stent-related pain, and more than half of them have lower urinary tract symptoms (LUTSs; frequency, urgency, dysuria, and incomplete emptying). 2-4 For these patients, their working capacity decreases and sexual health deteriorates; thus, their quality of life is adversely affected due to pain and urinary symptoms. 5 Two main mechanisms are blamed for causing all these disorders: The first is high pressure transmitted to the renal pelvis during urination from the bladder by reflux; the second is a distal ureter (even whole ureter) and bladder spasms due to irritation from the US. 6,7 Tamsulosin is a selective inhibitor of alpha-1a (minimal 1d) adrenergic contraction; alpha-1a is present in the smooth muscles of the distal ureter, trigone, and bladder neck. 8 Tamsulosin has also long been used for pain and US-related symptoms. 9-12 Mirabegron is a beta-3 adrenergic receptor agonist that is currently available for treatment of overactive bladder symptoms. 13 Beta-3 adrenergic receptors