EFFICACY OF ALPHA-ADRENERGIC RECEPTOR ANTAGONISTS IN THE TREATMENT OF DISTAL URETERIC STONES: A PAEDIATRIC STUDY
AbstractBackground: European association of urology (EAU) recommended α- blockers for managing distal ureteric stones in the paediatric population. This paper will help to understand the efficacy of Silodosin as a medical expulsive agent for distal ureteric stones in children, along with the required time duration of stone expulsion. Methods: Forty participants were enrolled and evaluated for complaints, pain severity, associated symptoms, and ultrasound was done to confirm the position and size of the distal stone. Follow-ups were scheduled after every 7 days (1 week) for redo ultrasound and assessment of the stone position. Data was entered and analyzed in the SPSS version 23. To evaluate the significance of data chi-square test was performed, p-value <0.005 was considered significant. Results: The minimum and maximum age limits recorded are 3 years and 18 years respectively with a mean age of 9.5±4.5 years and mean stone size was measured as 0.6±0.1 cm. Distribution of stone size indicated the minimum size of 0.4 cm and maximum of 1.0 cm stone in study subjects. Maximum stone expulsion was reported within 14 days or an initial 2 follow-up scans. Conclusion: The efficacy of Silodosin and medical expulsive therapy evaluated the effect on pain management as pain episodes declined with Silodosin treatment and spontaneous passage of stones were increased within the first 14 days of treatment. This study will be a beneficial contribution in literature especially in a developing country population where paediatric urolithiasis is on expansion and ongoing
Rehman I, Khan H, Farooq A, Mahmood A, Din QAM, Habib B. Study on Uroliths Composition in Tertiary Care Hospital of Pakistan. Pak J Med Health Sci 2021;15(7):1818–21.
Samotyjek J, Jurkiewicz B, Krupa A. Surgical treatment methods of urolithiasis in the paediatric population. Dev Period Med 2018;22(1):88–93.
Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2016;69(3):475–82.
Iqbal N, Hussain I, Waqar S, Sadaf R, Tashfeen R, Nabil N, et al. Ureteroscopy for management of ureteric stones in children-a single centre experience. J Coll Physicians Surg Pak 2016;26(12):984–8.
Campschroer T, Zhu X, Vernooij RWM, Lock MT. Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev 2018;4(4):CD008509.
Elmacı AM, Dönmez Mİ, Akın F, Çetin B, Gündüz M. What predicts spontaneous passage of ≤ 1 cm ureteral stones in children? J Pediatr Surg 2020;55(7):1373–6.
Jendeberg J, Geijer H, Alshamari M, Cierzniak B, Lidén M. Size matters: The width and location of a ureteral stone accurately predict the chance of spontaneous passage. Eur Radiol 2017;27(11):4775–85.
Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint S, Wei JT, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006;368(9542):1171–9.
Gur M, Ulu MB, Caliskan ST, Ozturk K, Akdeniz E. Dexketoprofen vs. tamsulosin vs. silodosin vs. tadalafil as medical expulsive therapy for distal ureteral stones in men. J Coll Physicians Surg Pak 2021;31(8):947–52.
Huang W, Xue P, Zong H, Zhang Y. Efficacy and safety of silodosin in the medical expulsion therapy for distal ureteral calculi: A systematic review and meta-analysis. Br J Clin Pharmacol 2016;81(1):13–22.
Li JK, Qiu S, Jin K, Zheng XN, Tu X, Bi SW, et al. Efficacy and safety of phosphodiesterase type 5 inhibitors for the treatment of distal ureteral calculi of 5 to 10 mm in size: A systematic review and network meta-analysis. Kaohsiung J Med Sci 2019;35(5):257–64.
Rajpar ZH, Memon II, Soomro KQ, Hussain SA, Mughal SA, Soomro N. Comparison of the Efficacy of Medical Expulsive Therapy for the Treatment of Distal Ureteric Stones with and without Mirabegron. J Liaquat Univ Med health Sci 2022;21(1):11–5.
Taguchi K, Cho SY, Ng ACF, Usawachintachit M, Tan YK, Deng YL, et al. The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol 2019;26(7):688–709.
Fulgham PF, Assimos DG, Pearle MS, Preminger GM. Clinical effectiveness protocols for imaging in the management of ureteral calculous disease: AUA technology assessment. J Urol 2013;189(4):1203–13.
Singh A, Alter HJ, Littlepage A. A Systematic Review of Medical Therapy to Facilitate Passage of Ureteral Calculi. Ann Emerg Med 2007;50(5):552–63.
Capitanio U, Salonia A, Briganti A, Montorsi F. Silodosin in the management of lower urinary tract symptoms as a result of benign prostatic hyperplasia: Who are the best candidates. Int J Clin Pract 2013;67(6):544–51.
Elgalaly H, Eliwa A, Seleem M, Salem E, Omran M, Shello H, et al. Silodosin in the treatment of distal ureteric stones in children: A prospective, randomised, placebo-controlled study. Arab J Urol 2017;15(3):194–8.
Mokhless I, Zahran AR, Youssif M, Fahmy A. Tamsulosin for the management of distal ureteral stones in children: A prospective randomized study. J Pediatr Urol 2012;8(5):544–8.
Aydogdu O, Burgu B, Gucuk A, Suer E, Soygur T. Effectiveness of Doxazosin in Treatment of Distal Ureteral Stones in Children. J Urol 2009;182(6):2880–4.
Saeed ZI, Hussain SA. Chronic kidney disease in Pakistan: An under-recognized public health problem. Kidney Int 2012;81(11):1151.
Shin HJ, Choi WS, Lee SH, Lee AG, Kim A, Park HK, et al. Improvement in near vision following silodosin treatment in patients with lower urinary tract symptoms. Int Neurourol J 2021;25(2):164–71.
Campschroer T, Zhu X, Vernooij RWM, Lock TMTW. α-blockers as medical expulsive therapy for ureteric stones: a Cochrane systematic review. BJU Int 2018;122(6):932–45.
Sharma G, Pareek T, Kaundal P, Tyagi S, Singh S, Yashaswi T, et al. Comparison of efficacy of three commonly used alpha-blockers as medical expulsive therapy for distal ureter stones: A systematic review and network meta-analysis. Int Braz J Urol 2021;47:1–18.