title: [Our experience with the use of alpha-lithic therapy in the treatment of voiding dysfunction].
abstract: BACKGROUND
  Dysfunctional voiding (DV) is due to a dysfunction in the pelvis floor muscles caused by hyperactivity of the urethral sphincter and the musculature of this zone during the voiding phase of the micturition cycle. The treatments used are recommending correct micturition habits, biofeedback and pelvic relaxation exercises. Currently, drugs are also used, such as alpha lithic drugs and injection of botulinic toxin, however its experience in children is limited.
  
  
  OBJECTIVE
  Show our experience with the use of alpha-lithics in patients with DV.
  
  
  METHODS
  Review of patients with DV treated with alpha-lithics in our institution.
  
  
  RESULTS
  6 patients with DV were treated with alpha-lithics (Alfuzosin or Doxazosin). Girl (12 years) with Wolfram Syndrome with significant post-void residual urine, who initially rejected intermittent catéter. Residual urine decreases slightly with treatment, but isn't enough. Boy (7 years) with uretral duplicity and difficulty urine flow without observable stenosis. He had initial improvement but then required continent bladder diversión and vasectomy due to recurrent orchiepididymitis. Boy (5 years) with ureteral-bladder stenosis and ureteral reimplantation with urinary tract infection and vesico-ureteral reflux that did not improve (an anatomic obstruction was subsequently found). Boy (12 years) with tethered cord and pyelonephritis, who rejected intermittent catheter. He hadn't improvement and he required continent bladder diversión. Boy (7 years) with Syringomyelia, operated in another center for vesico-ureteral reflux with ureteral reimplantation, with recurrent urine infections, who hadn't improvement and required continent bladder diversion. Boy (10 years) with resected urethra valves and normal cystoscopy, with episodes of urine retention, without improvement with treatment.
  
  
  CONCLUSIONS
  The role of alpha-lithics in the treatment of dysfunctional voiding in children is limited and of doubtful efficacy. It may be useful in patients with significant post-micturition residue.
authors.affiliation: Servicio de Cirugia Pediátrica, Hospital Infantil Universitario Miguel Servet, Zaragoza. reyesdelgado@yahoo.es
authors.forename: R
authors.initials: R
authors.lastname: Delgado Alvira
authors.forename: E
authors.initials: E
authors.lastname: Calleja Aguayo
authors.forename: M A
authors.initials: MA
authors.lastname: Rihuete Heras
authors.forename: M
authors.initials: M
authors.lastname: Ruiz de Temiño Bravo
authors.forename: J
authors.initials: J
authors.lastname: Gracia Romero
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017292:Doxazosin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011799:Quinazolines / Q000627:therapeutic use*; D012189:Retrospective Studies; D014555:Urination Disorders / Q000188:drug therapy*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D011799:Quinazolines; C047638:alfuzosin; D017292:Doxazosin