Mp26-08 Obstetric and Neonatal Outcomes in Pregnant Women Prescribed Tamsulosin for Medical Expulsive Therapy

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP26)1 May 2024MP26-08 OBSTETRIC AND NEONATAL OUTCOMES IN PREGNANT WOMEN PRESCRIBED TAMSULOSIN FOR MEDICAL EXPULSIVE THERAPY Louisa Ho, Sailakshmi Senthil Kumar, Cyrus Chehroudi, Madison Lyon, Alec Sun, Anup Shah, Natalia Llarena, Carrie Bennet, Sri Sivalingam, Anna Zampini, and Smita De Louisa HoLouisa Ho , Sailakshmi Senthil KumarSailakshmi Senthil Kumar , Cyrus ChehroudiCyrus Chehroudi , Madison LyonMadison Lyon , Alec SunAlec Sun , Anup ShahAnup Shah , Natalia LlarenaNatalia Llarena , Carrie BennetCarrie Bennet , Sri SivalingamSri Sivalingam , Anna ZampiniAnna Zampini , and Smita DeSmita De View All Author Informationhttps://doi.org/10.1097/01.JU.0001009408.66023.77.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tamsulosin is commonly used for medical expulsive therapy (MET) in patients with ureteral stones. The off-label use of tamsulosin (FDA Category B) in pregnant women with symptomatic urolithiasis is controversial. We aimed to evaluate obstetric and neonatal outcomes for pregnant women prescribed tamsulosin as MET for suspected renal colic. METHODS: A retrospective review of pregnant patients with suspected symptomatic urolithiasis at our institution from 2009 to 2021 was performed. All patients who underwent surgical intervention (stent, nephrostomy tube, or ureteroscopy) were included, along with a similar number of the most recent patients who matched criteria and were managed expectantly. Symptomatic urolithiasis was defined as flank pain with documented hydronephrosis and one of the following: microscopic or gross hematuria, stone crystals on urinalysis, pyuria, absent ureteral jets, or definitive stones on imaging. Obstetric outcomes included preterm labor and time from initial presentation to first surgical intervention. Neonatal outcomes included APGAR scores and severe neonatal complications. RESULTS: We identified 196 women with suspected urolithiasis during pregnancy of whom 89 received tamsulosin and 107 did not (control). There was no significant difference in mean gestational age (GA) at initial presentation between groups. Mean duration of tamsulosin prescription was 26 days (range 1 to 175), occurring during the first, second, and third trimester in 15 (8%), 97 (49%), and 84 (43%) patients, respectively. Among patients who required intervention, there was a longer time to intervention in those who were prescribed tamsulosin (mean 2.1 vs. 7.9 days, p=.01), with no difference in narcotic utilization. Conversely, patients who did not require a procedure and were prescribed tamsulosin were more likely to be prescribed narcotics as well during the stone event (82% vs. 37%, p<.0001). There was no difference in preterm labor rates between the tamsulosin and control groups (11% vs. 12%). No significant differences in neonatal outcomes were identified including APGAR scores, GA at delivery, neonatal intensive care unit admission, respiratory distress syndrome, and intraventricular hemorrhage. CONCLUSIONS: In pregnant women with renal colic, use of tamsulosin was not associated with adverse maternal or neonatal outcomes in this cohort. In those requiring a procedure, use of tamsulosin was associated with prolonged time to intervention. Patients managed non-surgically using tamsulosin were more likely to be co-prescribed a narcotic. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e416 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Louisa Ho More articles by this author Sailakshmi Senthil Kumar More articles by this author Cyrus Chehroudi More articles by this author Madison Lyon More articles by this author Alec Sun More articles by this author Anup Shah More articles by this author Natalia Llarena More articles by this author Carrie Bennet More articles by this author Sri Sivalingam More articles by this author Anna Zampini More articles by this author Smita De More articles by this author Expand All Advertisement PDF downloadLoading ...