Efficacy of Medical Expulsive Treatment With Doxazosin in Pediatric Patients

Abstract

To evaluate the possible efficacy of an α1 blocker (doxazosin) therapy on the management and disease course in pediatric patients with distal ureteral stones. 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. 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<5mm were expulsed at greater rates than stones 5-10mm in group 2 (P= .046). Also children aged<6 years passed the stones with significantly greater rates than children aged≥7 years (P= .008). 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.