title: Is Tamsulosin Effective after Shock Wave Lithotripsy for Pediatric Renal Stones? A Randomized, Controlled Study.
abstract: OBJECTIVE
  We assessed the effect of tamsulosin as an adjunctive therapy after shock wave lithotripsy for pediatric single renal pelvic stones.
  
  
  METHODS
  A total of 120 children with a unilateral single renal pelvic stone were included in a prospective randomized, controlled study. All children were randomized to 2 equal groups. Group 1 received tamsulosin (0.01 mg/kg once daily) as adjunctive therapy after shock wave lithotripsy in addition to paracetamol while group 2 received paracetamol only. Stone clearance was defined as no renal stone fragments or fragments less than 3 mm and no pelvicalyceal system dilatation.
  
  
  RESULTS
  Our study included 69 boys and 51 girls with a median age of 3.5 years and a median stone size of 1.2 cm. There was no statistically significant difference between groups 1 and 2 in stone or patient criteria. Of the children 99 (82.5%) achieved stone clearance after the first session, including 50 in group 1 and 49 in group 2. All children in each group were cleared of stones after the second session. The overall complication rate was 14.2%. There was no statistically significant difference between single session stone clearance rates (p = 0.81) and complications rates (p = 0.432) in either group. On multivariate analysis using logistic regression smaller stone size (p = 0.016) and radiopaque stones (p = 0.019) were the only predictors of stone clearance at a single shock wave lithotripsy session. Tamsulosin therapy did not affect stone clearance (p = 0.649).
  
  
  CONCLUSIONS
  Tamsulosin does not seem to improve renal stone clearance. Smaller and radiopaque renal stones have more chance of clearance after shock wave lithotripsy for pediatric single renal pelvic stones.
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shahat
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Elderwy
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt. Electronic address: assafwat@gmail.com.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Safwat
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Islam F
authors.initials: IF
authors.lastname: Abdelkawi
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Reda
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Abdelsalam
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sayed
authors.affiliation: Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
authors.forename: Hisham
authors.initials: H
authors.lastname: Hammouda
mesh_terms: D000293:Adolescent; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin
keywords: kidney; lithotripsy; nephrolithiasis; tamsulosin; ureter