Medical expulsive therapy with α1-adrenergic blockers after extracorporeal shock wave lithotripsy for urolithiasis in children

Introduction. The development of medical expulsive therapy options following extracorporeal shock wave lithotripsy (ESWL) in pediatric urolithiasis plays a crucial role in accelerating stone fragment clearance. The aim: evaluation of the efficacy and safety of α1-adrenergic blockers (tamsulosin and silodosin) in pediatric patients with urinary stone disease after ESWL. Materials and Methods. We conducted a prospective comparative study of 200 patients (aged 2-18 years) divided into a study group (n=50, received α1-adrenergic blockers after ESWL) and a control group (n=150, standard therapy). Efficacy endpoints included: stone-free rate, stone fragment expulsion time, pain dynamics, analgesic requirements and α1-blocker adverse effects. Statistical analysis was performed using StatTech v.4.8.3. Results. The use of α1-adrenergic blockers increased the stone-free rate after ESWL by 1.23-fold compared to standard therapy (OR = 0.474; 95% CI: 0.229-0.980). The median stone fragment expulsion time decreased from 7 to 5 days (p=0.010). Pain intensity decreased by the second day of treatment (p<0.001), with reduced analgesic requirements (p=0.003). Adverse effects of α1-blockers were rare (5 cases of nasal congestion, 2 of nausea). Conclusion. The use of α1-blockers in children with urolithiasis after ESWL improves treatment efficacy, reduces expulsion time, and alleviates pain with a favorable safety profile.