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Tamsulosin Use in 250 Male and Female Children with Voiding Dysfunction
Pharto Chanda, BS1, Jordan L. Mendelson, MD2, Jordan Gitlin, MD2, Chino Eke, BS3, Hadis Askari, BS4, Katherine Bascobert, BS2, Ronnie Fine, MD2, Mark Horowitz, MD2, Israel Franco, MD5.
1SUNY Downstate Health Sciences University College of Medicine, Brooklyn, NY, USA, 2NYU Langone Hospital-Long Island, Mineola, NY, USA, 3Warren Alpert Medical School of Brown University, Providence, RI, USA, 4Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA, 5University of Tennessee Medical College-Chattanooga, Chattanooga, TN, USA.
BACKGROUND: Despite tamsulosin’s longstanding use in pediatric urology, a review of the literature reveals only two small studies that have looked at its usage in treating non-neurogenic voiding issues in children (n = 23 and 50). In this study, we set out to evaluate its efficacy and safety in a much larger patient population.
METHODS: We retrospectively reviewed all pediatric patients (both male and female) who were treated with tamsulosin for lower urinary tract symptoms (LUTS) at one institution between January 2007 and January 2024. Data were collected on specific voiding symptoms (e.g. urinary frequency, urgency, straining, retention), pre- and post-treatment uroflowmetries, adverse events, reasons for treatment termination, and instances of alternative/additional alpha-blocker usage. Results were stratified based on the type of LUTS. SPSS was used to compare pre- and post- treatment uroflowmetry metrics via Bayesian factors for related-sample T-tests.
RESULTS: 250 total patients were treated with tamsulosin within the timeframe specified and were thus included in this study. 78% of these patients reported a general subjective improvement in symptoms. Females with outlet obstruction were demonstrated to have an increase in the maximum and average urine flow rate indices (Q
max Fi and Q
avg Fi), with a mean difference of 0.24 ± 0.25 and 0.32 ± 0.38, respectively. Alternatively, males with outlet obstruction did not show evidence of improved flow, but did show a marked reduction in their post-void residual (PVR), by an average of 24.63 ± 29.93 mL. Adverse effects were uncommon, with just 23/250 patients complaining of a total of 26 instances of adverse events (most commonly dizziness, headaches, incontinence, and fatigue).
CONCLUSIONS: In a much larger series than previously published, alpha-blockers were again shown to be well tolerated in pediatric patients with LUTS. Most patients reported a subjective improvement in symptoms. Females with symptoms related to outlet obstruction showed improved flow rates, while males with similar complaints had improved PVRs after treatment with tamsulosin. To our knowledge, this is the first large study to show that both male and female pediatric patients with LUTS respond well to tamsulosin.
Descriptive Statistics and Adverse Events | | | |
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