Do you prescribe tamsulosin after ureteroscopy in a patient with residual stone fragments on postoperative imaging to assist with stone passage?

I use alpha blockers after ureteroscopy for stent pain or if there is no stent to help with transient colic or dust passing. I don’t obtain routine imaging after URS - I am selective for those with impacted stones, complicated URS, or symptoms. (Adiyat et al., PMID 19100606)

If this imaging showed ureteral fragments, then I would use an alpha blocker. If residual fragments are in the kidney, I would discuss observation vs reintervention.