Efficacy of medical expulsive treatment with doxazosin in pediatric patients

Abstract

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.

Materials and 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).

Conclusion: 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.