Use of sympathetic alpha antagonists in the management of pediatric urologic disorders.
OBJECTIVE
To update the physician regarding the use of alpha-adrenergic antagonists in the management of various pediatric urologic problems.


RESULTS
The use of alpha-adrenergic antagonist for the treatment of pediatric urologic disorders has expanded greatly over the past decade. This review summarizes the current use of these medications in the treatment of pediatric voiding dysfunction, neurogenic bladder, chronic lower urinary tract symptomatology, idiopathic urethritis, and the passage of ureteral calculi.


CONCLUSIONS
Currently alpha antagonist therapy although not useful in the primary treatment of voiding dysfunction is equivalent in potency to biofeedback therapy for the treatment of recalcitrant voiding dysfunction. In the management of neurogenic bladder and chronic lower urinary tract symptomatology, alpha antagonists working alone or in conjunction with anticholinergic medications will improve clinical symptoms, increase bladder compliance, and decrease detrusor instability. In addition, alpha antagonists may decrease the intensity and duration of symptoms in patients with idiopathic urethritis. Compared with placebo, alpha-adrenergic antagonists will also aid significantly in the spontaneous passage of distal ureteral calculi, thereby reducing the need for surgical intervention and analgesia. The findings noted above significantly expand the clinical usefulness of alpha antagonist therapy within the field of pediatric urology.
Husmann
Douglas A
DA
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA. dhusmann@mayo.edu
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000818:Animals; D002648:Child; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D006801:Humans; D009422:Nervous System Diseases / Q000188:drug therapy; D011942:Receptors, Adrenergic, alpha / Q000378:metabolism; D014570:Urologic Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology
D000317:Adrenergic alpha-Antagonists; D011942:Receptors, Adrenergic, alpha