Efficacy and safety of medical expulsive therapy (MET) after extracorporeal shockwaves lithotripsy (SWL) in pediatric patients.

PURPOSE: To evaluate the impact of tamsulosin as a post-SWL adjunctive treatment for pediatric urolithiasis.

PATIENTS AND

METHODS

A randomized controlled trial (RCT) was carried out for children with renal stones amenable for SWL. Eligible children were randomized into 2 groups. Group 1 received tamsulosin (0.01 mg/kg once daily) for 2 weeks after each SWL session while group 2 served as a control. Stone clearance was defined as no residual fragments by low-dose non-contrast computed tomography (NCCT) at one and three months after last session.

RESULTS

A total of 106 patients were included (53 in each group). Pre-SWL patients and stone criteria were comparable between both groups. Stone clearance was achieved in 43 patients (81.1%) in group 1 and 36 patients (67.9%) in group 2 (P = 0.119). Time to stone clearance was comparable for both groups (P = 0.110). Post-SWL complications were encountered in one patient (1.9%) in group 1 and three patients (5.7%) in group 2 (P = 0.308). Tamsulosin minor adverse effects were observed in 18.9%, but no patients discontinue treatment.

CONCLUSIONS

Tamsulosin treatment following SWL for renal stones in children showed trends for increasing SFR and decreasing complications in comparison with control group. However, statistically significant differences were not achieved.