How pre-URS tamsulosin use in pediatric patients may reduce repeat procedures

In a recent interview with Urology Times®, Kate H. Kraft, MD, MHPE, FACS, FAAP, discussed a recent study regarding the use of tamsulosin (Flomax) in pediatric patients undergoing ureteroscopy.¹ During the interview, she was asked about the implications of reducing repeat anesthetic exposures in children.

“With regard to anesthesia exposure in the pediatric population, there's been some data in the anesthesiology literature that suggests that there may be an association with neurotoxicity or cognitive development over time, whether it's anesthesia exposure at an early age or repeated anesthesia exposure. And so in pediatric urology and all pediatric surgical fields, we're very cognizant of that, and want to try to reduce exposure as much as possible. Now, [with] the literature essentially, the jury is out. The literature is not very definitive [and] still somewhat controversial, but I think if we can minimize anesthesia exposure for our patients, that is certainly the best for them. That’s where I think the findings of our study are really exciting, because if we can do a simple prescribing practice to be able to minimize return trips to the operating room for ureteroscopic access, I think that would really benefit our patients,” said Kraft, chief of Pediatric Urology, Mark C. McQuiggan, MD, and Carolyn A. McQuiggan Research Professor, and professor of urology at the University of Michigan, Ann Arbor.

Asked for the take-home message of the study, Kraft commented, “I would say the take-home message for this study is that prescribing tamsulosin for a week prior to an anticipated surgery that involves flexible ureteroscopy is a very simple practice that certainly is within standard of care within pediatric urology. It’s easy for patients to take. If they don't swallow pills, they can sprinkle the capsule contents on some food and easily take it on a daily basis. It's a once-daily medication, so it's not too cumbersome. It has minimal [adverse events], and has been shown to be very safe and effective for children, even as young as in the toddler range. So simply, just adding this to one's daily practice might save the patient return trips to the operating room, afford more successful outcomes and make our lives easier too, so that we can have successful treatment in 1 fell swoop, in a single surgery.”

REFERENCE

1. Meyer KM, Asantey K, Ellison JS, et al. The effect of preoperative tamsulosin on pediatric ureteroscopic access: A multi-institutional experience. Urol Pract. 2025 Feb 5:101097UPJ0000000000000793. doi:10.1097/UPJ.0000000000000793