Purpose. Urolithiasis in children is a growing concern, necessitating effective non-invasive treatments. This study evaluates the role of α1-adrenergic blockers (tamsulosin and silodosin) in enhancing stone clearance after extracorporeal shock wave lithotripsy (ESWL). The aim of the study was to improve outcome of ESWL in kidneys.
Methods: A prospective comparative study included 200 pediatric patients (2–18 years) after ESWL, divided into a study group (n=50, receiving α1-blockers) and a control group (n=150, standard therapy). Primary endpoints were stone-free rate (SFR) and expulsion time; secondary endpoints included pain dynamics, analgesic use, and safety. Statistical analysis was performed using StatTech v.4.8.3.
Results: The study group showed a 2.111-fold higher SFR (OR = 0.474; 95% CI: 0.229–0.980) and reduced median expulsion time (5 vs. 7 days, p=0.010). ROC analysis identified 6 days as the optimal efficacy threshold (AUC=0.627). Pain intensity decreased significantly by day 2 (p<0.001), with lower analgesic demand (p=0.003). Adverse effects were rare (14%) and mild.
Conclusion: α1-blockers significantly improve after ESWL outcomes in children, accelerating stone expulsion, reducing pain, and demonstrating a favorable safety profile. Optimal efficacy assessment occurs at 6 days.
Keywords: urolithiasis, children, α1-adrenergic blockers, medical expulsive therapy, extracorporeal shock wave lithotripsy
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