Meta-analysis of RCTs supports alpha-blockers after shockwave lithotripsy in children

Meta-analysis · J Pediatr Urol · 2026-11-06. Number 4 in the UrologyWatch Top 5 for November 6, 2026.

Pooling 4 randomized trials (408 pediatric patients), adjunctive alpha-1 blockade (tamsulosin or silodosin) after shockwave lithotripsy improved stone-free outcomes compared with placebo or conservative management.

Why it matters: Supports extrapolating adult-guideline adjunctive alpha-blocker use after shockwave lithotripsy to pediatric patients, an area with previously limited pediatric-specific evidence.

Limitation: Only 4 small RCTs included; pediatric-specific long-term safety data remain limited.

Source: J Pediatr Urol · PubMed 42981863 · DOI 10.1016/j.jpurol.2026.106348

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