Login to Access Video or Poster Abstract: MP90-18
Sources of Funding: None

Introduction

Silodosin, a selective ?1-blocker,has been proposed for medical expulsive therapy (MET) instead of tamsulosin in adulthood urolithiasis with promising outcomes but studies comparing these substances for MET in children are lacking._x000D_ _x000D_ The aim of this study was to verify the safety and efficacy of silodosin (8 mg) compared with tamsulosin (0.4 mg) and placebo as a MET for distal ureteral stones in children._x000D_

Methods

A prospective randomized placebo-controlled study including 90 children diagnosed with unilateral, single, radio-opaque distal ureteral stones < 10 mm in size was conducted. Age ranged between 5.8 and 18 years old. Patients were randomized into three groups; silodosin group (n = 30) received 8 mg silodosin daily, tamsulosin group (n = 30) received 0.4 mg tamsulosin daily and placebo group (n = 30) were not given any of the above medications. _x000D_ Patients were offered a closely monitored trial for spontaneous stone passage in the 4-week period prior to definitive therapy. The stone clearance rate, time to stone clearance, number of pain episodes, need for analgesia and potential side effects of medications were observed._x000D_

Results

The stone clearance rates for silodosin, tamsulosin and placebo groups were 78.5, 66.6 and 53.3 %, respectively. The time to stone clearance was significantly shorter in silodosin and tamsulosin groups than in placebo group (p = 0.006 and 0.035, respectively). Patients taking silodosin and tamsulosin had fewer pain attacks and lesser analgesic requirement than placebo group patients.

Conclusions

The current study showed the use of ?-blockers for MET of lower ureteric stones in children to be effective, however, the use of silodosin was associated with higher stone clearance rates and shorter time to stone clearance as compared to tamsulosin. Both of these medications demonstrated a good safety and tolerability profile for MET in children with uncomplicated ureteral stones.

Funding

None