Efficacy of medical expulsive treatment with doxazosin in pediatric patients.
OBJECTIVE
To evaluate the possible efficacy of an α1 blocker (doxazosin) therapy on the management and disease course in pediatric patients with distal ureteral stones.


METHODS
A total of 45 patients (24 boys and 21 girls) with a single lower ureteral stone were included in the study program. Their age range was 3-15 years (mean 6.65 ± 3.78). The children were randomized into 2 main groups: group 1 (n = 21), who received only ibuprofen 20 mg/kg/d divided into 2 equal doses for pain control during follow-up; and group 2 (n = 24), who received, in addition to ibuprofen, 0.03 mg/kg/d doxazosin once daily, before bed.


RESULTS
The stone expulsion rate was 28.5% (6 of 21) in group 1 and 70.8% (17 of 24) in group 2 (P = .001). The number of daily colic attacks and stone expulsion time clearly demonstrated the advantage of doxazosin, with a statistically significant diminished number of pain attacks (P = .04) and shorter stone expulsion period (P = .001). Stones <5 mm were expulsed at greater rates than stones 5-10 mm in group 2 (P = .046). Also children aged <6 years passed the stones with significantly greater rates than children aged ≥7 years (P = .008).


CONCLUSIONS
The use of α-adrenergic blocker agents could have certain advantages in attempts to render children stone free within a shorter period, which would inevitably diminish the number of colic attacks and the need for analgesic usage.
Department of Urology, Gaziantep University, Gaziantep, Turkey.
Sakip
S
Erturhan
Omer
O
Bayrak
Kemal
K
Sarica
Ilker
I
Seckiner
Muharrem
M
Baturu
Haluk
H
Sen
D000293:Adolescent; 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; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000188:drug therapy*
D058668:Adrenergic alpha-1 Receptor Antagonists; D017292:Doxazosin