Номер №4, 2018 - page 64-73

The role of phytotherapy in metaphylaxis of urolithiasis after extracorporeal lithotripsy

Davidov M.I., Igoshev A.M.
Information about authors:
  • Davidov M.I. – PhD., associate professor of the Department of Faculty Surgery with a course of urology of Perm State Medical Universitynamed of acad. E.A. Wagner; e-mail: midavidov@mail.ru
  • Igoshev A.M. – assistant of the Department of Faculty Surgery with a course of urology of Perm State Medical Universitynamed of acad. E.A. Wagner; e-mail: rector@psma. ru

Introduction. Urolithiasis is one of the most common diseases in urology. The percentage of incidence varies greatly in the world: from 1-5% to 13-20%. Extracorporeal lithotripsy (EL) does not cure the disease and the frequency of kidney stone recurrence reaches 15-80%

The aim of our study was to assess the efficacy of the phytodrug Canephron N use in the early and long-term complex metaphylaxis of urolithiasis after EL.

Materials and methods. The prospective study comprised 642 patients with kidney and ureteral stones, which underwent EL on the «Dornier Compact Delta II». Complete calculus disintegration was achieved in 598 patients, who were randomly divided into 2 groups at the first stage of the study. In the first group, patients received 2 tablets of Canephron N 3 times a day for 90 days; in the second group, only water load test was performed. The timescale and completeness of the stone fragments discharge and the immediate complications of the EL as regards early metaphylaxis of urolithiasis recurrence were studied. At the second stage of the research, the long-term results of EL were investigated for 4 years to detect kidney stone recurrence in 584 patients, which were divided into three groups Group A consisted of 245 patients, who took Canephron N for 90 days after EL and then got three 30-day courses of that drug each year in addition to standard metaphylactics. Group B comprised 242 people who received standard urolithiasis metaphylaxis depending on the stone composition. Group C consisted of 97 patients who refused to take metaphylaxis.

Results. At the first stage of the study, the best results were obtained in group 1, where the use of Canephron N after EL allowed achieving the rapid and complete removal of disintegrated stones fragments as well as reduction in numbers of complications and urinary tract rehabilitation in most patients. At the second stage, the worst results were obtained in group C, where 30.9% of patients had recurrent kidney stones within 4 years. In group B, recurrences were recorded in 12.4% of patients. The best results were achieved in group A, where kidney stone recurrences were observed only in 6.1% of cases (p <0.05). Canephron N was particularly effective in preventing calcium oxalate and uric acid stones, and also reduced the number of mixed and infected stones recurrences. The main mechanisms of urolithiasis metaphylaxis with Canephron N were revealed: the increase in diuresis, the improvement of kidney function, the urinary tract rehabilitation, the urine pH stabilization in the range of 6.2-6.8, the elimination of hypercalciuria, the uric acid reduction in the blood and urine.

Conclusion. The introduction of Canephron N annual preventive courses in the standard metaphylactic treatment programme after EL reduces the risk of calculus recurrence by 50.8%.

Authors declare lack of the possible conflicts of interests.

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urolithiasis, metaphylaxis, recurrence of kidney stones, extracorporeal shock wave lithotripsy lithotripsy, phytotherapy, canephron N

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