title: What is the best option for 10-20mm renal pelvic stones undergoing ESWL in the pediatric population: stenting, alpha blockers or conservative follow-up?
abstract: OBJECTIVE
  In this study we aimed to identify the effect of three different modalities (stenting, doxazosin and conservative follow-up) on stone free rates and complication rates for 10-20mm renal pelvic stones in pediatric patients who underwent shock wave lithotripsy.
  
  
  METHODS
  In this study data from 241 renal units (RUs) of 195 consecutive patients with 10-20mm renal pelvis stones were analyzed retrospectively. There were 3 groups in the study; 56 (23.2%) RUs with ureteral stenting were categorized as group 1, and 39 (16.2%) RUs that received doxazosin were categorized as group 2. The remaining 146 (60.6%) RUs without history of ureteral stenting or alpha-blockers usage were categorized as group 3. Patient demographics, stone characteristics, stone free rates (SFRs), time to stone expulsion and complications were documented and compared in each group.
  
  
  RESULTS
  Mean age of the population was 6.6 years and mean stone size was 13.8 ± 2.9 mm. Demographic characteristics of the 3 groups were not significantly different. SFRs of the three groups were 89.2%, 87.1% and 82.1% (p = 0.275). Mean time to stone expulsion for groups 1 and 2 were 17.4 and 21.8 days respectively and significantly lower than that in group 3 (31.3 days).
  
  
  CONCLUSIONS
  Ureteral stenting or doxazosin for shockwave lithotripsy (SWL) is not superior to watchful waiting in terms of SFR and complications however both modalities shorten the stone expulsion time for 10-20mm renal pelvis stones in the pediatric population.
authors.affiliation: Ankara University, School of Medicine, Department of Pediatric Urology, Ankara, Turkey. Electronic address: onurtelli@yahoo.com.
authors.forename: Onur
authors.initials: O
authors.lastname: Telli
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Mehmet Ilker
authors.initials: MI
authors.lastname: Gokce
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Ozturk
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Suer
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Mermerkaya
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Faraj
authors.initials: F
authors.lastname: Afandiyev
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Cihat
authors.initials: C
authors.lastname: Ozcan
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Adil Gucal
authors.initials: AG
authors.lastname: Guclu
authors.affiliation: Ankara University, School of Medicine, Department of Pediatric Urology, Ankara, Turkey.
authors.forename: Tarkan
authors.initials: T
authors.lastname: Soygur
authors.affiliation: Ankara University, School of Medicine, Department of Pediatric Urology, Ankara, Turkey.
authors.forename: Berk
authors.initials: B
authors.lastname: Burgu
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D017292:Doxazosin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D057832:Watchful Waiting
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D017292:Doxazosin
keywords: Extracorporeal shock wave lithotripsy; Pediatrics; Renal stones; Stents