Efficacy and safety of medical expulsive therapy (MET) after extracorporeal shockwaves lithotripsy (SWL) in pediatric patients.

Purpose: To evaluate the impact of tamsulosin as a post-SWL adjunctive treatment for pediatric urolithiasis.

Patients and methods: A randomized controlled trial (RCT) was carried out for children with renal stones amenable for SWL. Eligible children were randomized into 2 groups. Group 1 received tamsulosin (0.01 mg/kg once daily) for 2 weeks after each SWL session while group 2 served as a control. Stone clearance was defined as no residual fragments by low-dose non-contrast computed tomography (NCCT) at one and three months after last session.

Results: A total of 106 patients were included (53 in each group). Pre-SWL patients and stone criteria were comparable between both groups. Stone clearance was achieved in 43 patients (81.1%) in group 1 and 36 patients (67.9%) in group 2 (P = 0.119). Time to stone clearance was comparable for both groups (P = 0.110). Post-SWL complications were encountered in one patient (1.9%) in group 1 and three patients (5.7%) in group 2 (P = 0.308). Tamsulosin minor adverse effects were observed in 18.9%, but no patients discontinue treatment.

Conclusions: Tamsulosin treatment following SWL for renal stones in children showed trends for increasing SFR and decreasing complications in comparison with control group. However, statistically significant differences were not achieved.