MP10-19 THE USE OF ALPHA-ADRENERGIC ANTAGONISTS IN PEDIATRIC NEPHROLITHIASIS: A SYSTEMATIC REVIEW

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You have accessJournal of UrologyCME1 Apr 2023MP10-19 THE USE OF ALPHA-ADRENERGIC ANTAGONISTS IN PEDIATRIC NEPHROLITHIASIS: A SYSTEMATIC REVIEW Firas Haddad, Beirut, Lebanon, Walid Farhat, and Shannon Taylor Smith Cannon Firas HaddadFiras Haddad More articles by this author , Beirut Beirut More articles by this author , Lebanon Lebanon More articles by this author , Walid FarhatWalid Farhat More articles by this author , and Shannon Taylor Smith CannonShannon Taylor Smith Cannon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003225.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urolithiasis is increasingly common in children, and alpha-adrenergic antagonists are often used as a treatment option. We conducted a systematic review of randomized controlled trials and cohort studies to assess the use of alpha-adrenergic antagonists in the treatment of kidney stones in pediatric patients. METHODS: A search of MEDLINE, PubMed, Cochrane, EMBASE, and Google Scholar was conducted on May 20, 2022. Inclusion criteria included patients <18 years old with any kidney stones treated with alpha-adrenergic antagonists reported in cohort studies and randomized control trials. Outcomes included stone expulsion time, stone passage rate, mean number of pain episodes, and mean need for analgesics. Following deduplication, two reviewers screened the articles with a third reviewer available for adjudication. We performed data extraction of the selected articles, and the results were assimilated and synthesized qualitatively. RESULTS: Nine studies were selected out of 254 articles and 1,039 patients were included, outlined in Table 1. Five of 6 studies measuring stone expulsion time reported a statistically significant decrease in expulsion time in the treatment group compared to the control. Seven studies measured the stone expulsion rate, and 5 reported a statistically significant increased expulsion rate in the treatment group. In assessment of pain, four studies reported a decrease in the mean number of pain episodes in the treatment group and two studies showed a decreased analgesic requirement for treatment compared to control. Two studies assessed the use of alpha-adrenergic antagonists after shock wave lithotripsy, and both found alpha-adrenergic not superior to watchful waiting for spontaneous stone passage. CONCLUSIONS: Our results suggest that alpha-adrenergic antagonists are effective at decreasing the stone expulsion time and increasing the stone passage rate. Limitations included variable reporting of intervention and outcome data. We conclude that alpha-adrenergic antagonists are a useful adjunct therapy to consider in the treatment of pediatric nephrolithiasis. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e121 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Firas Haddad More articles by this author Beirut More articles by this author Lebanon More articles by this author Walid Farhat More articles by this author Shannon Taylor Smith Cannon More articles by this author Expand All Advertisement PDF downloadLoading ...