Effect Of Tamsulosin On Systemic Blood Pressure And Nonneurogenic Dysfunctional Voiding In Children

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health
Article Date: 16 Mar 2009 - 0:00 PST

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UroToday.com - A study by Brian VanderBrink et al. evaluated the effect of tamsulosin on systemic blood pressure in children and non-neuropathic dysfunctional voiding. The group was comprised of 23 children with refractory dysfunctional voiding. They all had uroflows and PVRs along with constipationtreatment if constipation was present.

The children kept voiding diaries. The patients and families were offered tamsulosin once all the run-of-the-mill biofeedback and voiding diary parameters were exhausted. Once tamsulosin was started, repeat voiding diaries showed a significant decrease in voiding and incontinent episodes. Tamsulosin was discontinued at a mean of 9 months after symptomatic improvement in the patients. They also found that no patient experienced a clinically significant alteration of systemic blood pressure. The group felt that tamsulosin offered a safe and effective treatment modality in select children with lower urinary tract symptoms.

In an editorial comment on this article written by Paul Austin, he states that there are several reports in the literature using selective alpha-blocker therapy in treating children with this type of voiding pattern. He states that although orthostatic hypotension was not specifically evaluated, he did agree that the authors did not find any significant alternations in blood pressure measures in these seated patients. The group also did not state that there were any other signs or symptoms of hypotension such as dizziness or syncope.

My experience with alpha-blockers occurs more in our stone patients. I do give them a trial of Flomax to help expel the stone during a trial of passage. I have experienced children complaining of dizziness and there was even one with a syncopal episode while on Flomax. The founding factor in these patients is that the majority are dehydrated which might have led them towards stone formation in the first place.

Vanderbrink BA, Gitlin J, Toro S, Palmer LS
J Urol. 2009 Feb;181(2):817-22
10.1016/j.juro.2008.10.045

Written by UroToday.com Medical Editor Pasquale Casale, MD

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