Microsoft powerpoint - postaereau08milan.ppt

Prospective study comparing Rowatinex, Alfuzosin and treatment with
both for lower ureteral stones
Faragi G.(1), Mullerad M. (1,2), Rub R. (1), Gremitsky A. (1), Jolkowsky E. (1), Marazka H. (1), Erlich N. (1)
1- Hillel Yaffe Medical Center, Dept. of Urology, Hadera, Israel; 2- Laniado Hospital-Sanz Medical Center,
Urology Service, Dept. of Surgery, Netanya, Israel
Background
Materials and Methods
Conservative treatment of lower ureteral stones is a Between the years 2004-2007, 67 patients (average and mean Stone expulsion rate was 84% at one month (56 patients). preferred option for small non obstructing or impacted age 44 and 43 years, 55 men, 12 women) diagnosed with Kaplan Meier curve demonstrated a significant better stone stones. Pharmacotherapy aimed to enhance stone expulsion expulsion rate in the combined treatment arm (log rank test rates had been previously studied. Alpha-blockers can be Institutional review board approved the study. All patients P=0.002). Multivariate analysis found only the type of used as muscle relaxants for the lower urinary tract. signed an informed consent. Patients were assigned to one of pharmaceutical treatment and stone size to be associated Alpha1-adrenergic receptor antagonist have been shown to 3 study arms a. Rowatinex- 12 capsules a day [Pinene with a stone expulsion event (Cox regression analysis; greatly increase urinary flow rates for patients with 31%,Camphene 15%,Borneol10%,Ayhenol 4%,Fenchone symptomatic prostatic hyperplasia. Studies have shown the 4%, Cineol 3%] ; b. Alfuzosin 10 mg a day; c. Combined presence of alpha1-adrenergic receptors in the distal ureter and ureterovesical junction, where antagonists are able to Each patient was followed for one month or until stone inhibit basal muscle tone, reduce peristaltic frequency, and expulsion. Confirmation for stone status at the end of follow- weaken ureteral contractions in the distal and intramural up was done by the imaging utility that diagnosed the stone. ureter. Previous studies demonstrated 30% increased Using student T test we found patients treated with spontaneous stone passage rates in patients treated with Rowatinex had significantly smaller stones than patients Alpha1-adrenergic receptor antagonist for ureterovesical treated with Alfuzosin. No other significant differences and distal ureteral stones. Other agents used to facilitate between the study arms were found (table 1). Kaplan Meier stone expulsion rates are terpenes. Terpenes are curves and Log rank analysis compared between the study hydrocarbon compounds remedies based on herbal essential arms. Cox regression analysis allowed identification of oils extracts. In our study we used the Rowatinex® different factors associated with stone expulsion rate (Age, formulation which was previously studied as a treatment for sex, stone location, stone size, and type of pharmaceutical treatment). A P value of 0.05 or less designated statistical Objectives
Conclusion
Prospective study to compare the lower ureteral stone expulsion rate of patients treated with either Trepenes (Rowatinex) ; Alpha1-adrenergic receptor antagonist Combined treatment with Alfuzosin and Rowatinex is more (Alfuzosin) and combined treatment with both drugs.
effective in achieving lower ureteral stone expulsion than treatment with only one drug. Further studies are needed to compare this combination treatment in larger populations.
Figure-1

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