Purpose: We assessed the effect of tamsulosin as an adjunctive therapy after
shock wave lithotripsy for pediatric single renal pelvic stones.
Materials and 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 ¼ 0.81) and complications rates (p ¼ 0.432) in either group. On multivariate
analysis using logistic regression smaller stone size (p ¼ 0.016) and radiopaque
stones (p ¼ 0.019) were the only predictors of stone clearance at a single shock
wave lithotripsy session. Tamsulosin therapy did not affect stone clearance
(p ¼ 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.NULL