Lithokinetic therapy after SWL: the possibilities of natural terpenes in combination with vitamin E
Authors:   N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation, Prosyannikov M.Yu. ,   Moscow, Russia, Zolotukhin O.V. ,   Voronezh regional hospital №1, Konstantinova O.V ,   N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia, Madykin Yu.Yu. ,   VGMU of. N. N. Burdenko, Voronez, Russia, Voytko D.A. ,   N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia, Anokhin N.V. ,   N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia, Sivkov A.V. ,   N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia
Published: April 2021

Introduction. Lithokinetic therapy after remote shock wave uretero lithotripsy (SWL) is an obligatory stage in the postoperative management of patients with urolithiasis. In the postoperative period, it is extremely important to correctly determine the required drug, its dosage and frequency of administration. According to clinical guidelines, it is customary to use standard schemes of lithokinetic therapy, including non-steroidal anti-inflammatory drugs (NSAIDs) in combination with α-blockers. However, the effectiveness of this therapy does not always lead to success. In this regard, the use of herbal remedies is additionally recommended. One of the phytopreparations is the biologically active additive Renotinex, which is a combination of essential oil (anethole), 6 natural terpenes and an oil solution of vitamin E. Materials and methods. The study involved 100 patients with 4-10 mm ureteral stones after an SWL session. Patients were randomized into 2 groups: study and control, which included 50 patients each. The treatment was carried out for 28 days. Unlike patients in the control group, the patients of the main group, along with standard lithokinetic therapy (diclofenac, 1 suppository (50 mg) for pain, tamsulosin, 1 capsule (0.4 mg) in the morning), additionally received renotinex, 2 capsules 3 times a day. The effectiveness of the treatment was assessed 2 and 4 weeks after the start of therapy according to the data of ultrasound and X-ray research methods: by the presence of calculus its average size and the expansion of the pelvicellular system. As part of laboratory diagnostics, a general blood test was performed with an assessment of 3 parameters, such as: hemoglobin level, erythrocytes, leukocytes; general urine analysis with an assessment of 2 parameters (erythrocyturia and leukocyturia). For statistical analysis, Student's t test and Fisher's angular transformation method were used. Results. The efficacy of combination therapy with renotinex after SWL of ureteral stones was 24% higher than that of standard lithokinetic therapy with NSAIDs and alpha-blockers; the significance of differences was obtained only after 4 weeks of therapy. Сconclusions. The effectiveness of lithokinetic combination therapy in combination with renotinex after SWL of ureteral stones is higher than standard therapy, including NSAIDs and alpha-blockers.