Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
Pediatric Urology Section, Urology Department, Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.
J Urol. 2016 Apr;195(4 Pt 2):1284-8. doi: 10.1016/j.juro.2015.11.021. Epub 2016 Feb 28.
We assessed the effect of tamsulosin as an adjunctive therapy after shock wave lithotripsy for pediatric single renal pelvic stones.
A total of 120 children with a unilateral single renal pelvic stone were included in a prospective randomized, controlled study. All children were randomized to 2 equal groups. Group 1 received tamsulosin (0.01 mg/kg once daily) as adjunctive therapy after shock wave lithotripsy in addition to paracetamol while group 2 received paracetamol only. Stone clearance was defined as no renal stone fragments or fragments less than 3 mm and no pelvicalyceal system dilatation.
Our study included 69 boys and 51 girls with a median age of 3.5 years and a median stone size of 1.2 cm. There was no statistically significant difference between groups 1 and 2 in stone or patient criteria. Of the children 99 (82.5%) achieved stone clearance after the first session, including 50 in group 1 and 49 in group 2. All children in each group were cleared of stones after the second session. The overall complication rate was 14.2%. There was no statistically significant difference between single session stone clearance rates (p = 0.81) and complications rates (p = 0.432) in either group. On multivariate analysis using logistic regression smaller stone size (p = 0.016) and radiopaque stones (p = 0.019) were the only predictors of stone clearance at a single shock wave lithotripsy session. Tamsulosin therapy did not affect stone clearance (p = 0.649).
Tamsulosin does not seem to improve renal stone clearance. Smaller and radiopaque renal stones have more chance of clearance after shock wave lithotripsy for pediatric single renal pelvic stones.
我们评估坦索罗辛作为辅助治疗在冲击波碎石术治疗小儿单一肾盂结石后的效果。
本前瞻性随机对照研究共纳入 120 例单侧单一肾盂结石患儿。所有患儿均随机分为 2 组。1 组在冲击波碎石术后加用坦索罗辛（0.01mg/kg，每日 1 次）辅助治疗，同时加用扑热息痛；2 组仅用扑热息痛。结石清除定义为无肾石碎片或碎片小于 3mm 且无肾盂积水。
本研究共纳入 69 例男孩和 51 例女孩，中位年龄 3.5 岁，中位结石大小 1.2cm。1 组和 2 组在结石或患者标准方面无统计学差异。首次治疗后 99 例（82.5%）患儿结石清除，其中 1 组 50 例，2 组 49 例。每组所有患儿均在第二次治疗后清除结石。总并发症发生率为 14.2%。单次碎石术结石清除率（p=0.81）和并发症发生率（p=0.432）在两组间无统计学差异。多变量 logistic 回归分析显示，单次冲击波碎石术结石清除的唯一预测因素是结石较小（p=0.016）和结石不透射线（p=0.019）。坦索罗辛治疗并未影响结石清除（p=0.649）。
坦索罗辛似乎不能提高肾结石清除率。对于小儿单一肾盂结石，较小和不透射线的肾结石在冲击波碎石术后更有可能清除。
