MP26-19 TAMSULOSIN INCREASES SPONTANEOUS PASSAGE OF URETERAL STONES IN CHILDREN

Abstract

You have accessJournal of UrologyPediatrics: Testis, Varicocele & Stones1 Apr 2014MP26-19 TAMSULOSIN INCREASES SPONTANEOUS PASSAGE OF URETERAL STONES IN CHILDREN Janelle Fox, Nicholas Cost, Candace Granberg, Jose Pulido, Marcelino Rivera, Zeyad Schwen, Marion Schulte, and Gregory Tasian Janelle FoxJanelle Fox More articles by this author , Nicholas CostNicholas Cost More articles by this author , Candace GranbergCandace Granberg More articles by this author , Jose PulidoJose Pulido More articles by this author , Marcelino RiveraMarcelino Rivera More articles by this author , Zeyad SchwenZeyad Schwen More articles by this author , Marion SchulteMarion Schulte More articles by this author , and Gregory TasianGregory Tasian More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.907AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The effect of tamsulosin on the spontaneous passage rate in children with ureteral stones is uncertain. We compared the passage rates of ureteral stones in children who received tamsulosin with those who received analgesics alone. METHODS We performed a multi-institutional retrospective cohort study of children ≤ 18 years who presented to the Emergency Department, outpatient Urology clinic, or the Urology inpatient hospital consult service with a ureteral stone ≤ 10 mm between 2007 and 2012 who were managed with tamsulosin 0.4mg po daily versus oral analgesics alone. We excluded patients with a history of ureteropelvic or ureterovesical junction obstruction, ureteral stricture, those who underwent surgical intervention within 24 hours of presentation, and those with urinary tract infection, immunocompromised status, and/or contraindication to tamsulosin (e.g., sulfa allergy). The outcome was spontaneous passage of the stone. Passage was defined as radiographic clearance and/or patient report of passage. Multivariate hierarchical logistic regression models were used to estimate the association between tamsulosin and spontaneous passage of ureteral stones, adjusting for age, gender, and height of the patient, as well as stone size and location. RESULTS Complete data were available for 273 children from 4 institutions (99 tamsulosin; 174 analgesics alone). The median age of children in the tamsulosin and control cohorts were 14.4 years and 12.1 years, respectively (p < 0.001). Fifty-two percent of patients in the tamsulosin cohort and 40% in the control cohort were male (p = 0.06). Presenting symptoms and stone location were similar in both groups. Median stone size was 4mm in the tamsulosin and analgesic groups. The spontaneous passage rate of ureteral stones was 59% in the tamsulosin cohort and 41% in the analgesics alone cohort (p = 0.006). In multivariate analysis, tamsulosin was associated with spontaneous passage of ureteral stones (OR 1.89; 95% CI 1.03-3.44). Smaller stones and stones in more distal locations were more likely to pass spontaneously. Age, gender, and height were not associated with spontaneous passage of stones. No adverse reactions to tamsulosin were observed. CONCLUSIONS Tamsulosin increased the spontaneous passage of ureteral stones in children. A randomized controlled trial should be performed to validate these observations. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e258-e259 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Janelle Fox More articles by this author Nicholas Cost More articles by this author Candace Granberg More articles by this author Jose Pulido More articles by this author Marcelino Rivera More articles by this author Zeyad Schwen More articles by this author Marion Schulte More articles by this author Gregory Tasian More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...