WOFAPS 2025 8th World Congress of Pediatric Surgery

Ibragim Kiarimov, Sergey Zorkin, Alexandra Galuzinskaya, Rimir Bayazitov, Dmitriy Shakhanovsky

National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health

Purpose. Urolithiasis in children is a growing concern, necessitating effective non-invasive treatments. This study evaluates the role of α1-adrenergic blockers (tamsulosin and silodosin) in enhancing stone clearance after extracorporeal shock wave lithotripsy (ESWL). The aim of the study was to improve outcome of ESWL in kidneys.

Methods: A prospective comparative study included 200 pediatric patients (2–18 years) after ESWL, divided into a study group (n=50, receiving α1-blockers) and a control group (n=150, standard therapy). Primary endpoints were stone-free rate (SFR) and expulsion time; secondary endpoints included pain dynamics, analgesic use, and safety. Statistical analysis was performed using StatTech v.4.8.3.

Results: The study group showed a 2.111-fold higher SFR (OR = 0.474; 95% CI: 0.229–0.980) and reduced median expulsion time (5 vs. 7 days, p=0.010). ROC analysis identified 6 days as the optimal efficacy threshold (AUC=0.627). Pain intensity decreased significantly by day 2 (p<0.001), with lower analgesic demand (p=0.003). Adverse effects were rare (14%) and mild.

Conclusion: α1-blockers significantly improve after ESWL outcomes in children, accelerating stone expulsion, reducing pain, and demonstrating a favorable safety profile. Optimal efficacy assessment occurs at 6 days.