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Kim DH et al, 2014: The effect of terpene combination on ureter calculus expulsion after extracorporeal shock wave lithotripsy

Kim DH, Goh HJ, Lee HW, Kim KS, Kim YT, Moon HS, Lee SW, Park SY
Department of Urology, Hanyang University College of Medicine, Seoul, Korea


Abstract

PURPOSE: Terpene combination (Rowatinex) is known to help with the expulsion of urinary stones. The aim of this study was to determine how Rowatinex affects the expulsion of remnant stones after shock wave lithotripsy (SWL).

MATERIALS AND METHODS: Clinical data were collected retrospectively from 499 patients with a diagnosis of ureteral stones who underwent SWL from January 2009 to August 2012. Ureteral stones were diagnosed in all patients by kidney, ureter, and bladder x-ray and abdominal computed tomography (CT). The progress of patients was documented every 2 weeks to confirm remnant stones after SWL. The patients with remnant stones underwent SWL again. Group 1 consisted of patients who were prescribed an analgesic, Tamsulosin 0.2 mg, and Rowatinex. Group 2 consisted of patients who were prescribed only an analgesic and Tamsulosin 0.2 mg. The expulsion rate of urinary stones was compared between groups.

RESULTS: The expulsion rate of urinary stones was not significantly different between the two groups after 2 weeks. However, after 4 weeks, group 1 had a significantly higher expulsion rate (72.2% compared with 61.1%, p=0.022). Fifteen patients (10.2%) in group 1 and 40 (11.4%) in group 2 had to undergo ureteroscopic removal of the stone (p=0.756). Acute pyelonephritis occurred in one patient (0.7%) in group 1 and in one patient (0.3%) in group 2 (p=0.503).

CONCLUSIONS: The long-term administration of Rowatinex for 4 weeks increased the expulsion rate of urinary stones after SWL.

Korean J Urol. 2014 Jan;55(1):36-40. doi: 10.4111/kju.2014.55.1.36. Epub 2014 Jan 15.
PMID:24466395[PubMed]
PMCID:PMC3897628

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Comments 1

Hans-Göran Tiselius on Monday, 10 March 2014 13:55

I do not know how wide-spread the use of Rowatinex is in the world. Although the authors conclude that fragment expulsion was slightly but significantly higher in patients treated with Rowatinex, it is important to note that this was a retrospective and not randomized study. Moreover, it is of note that no difference was recorded after 2 weeks.

Rowatinex is ascribed a number of properties that might be of interest in the treatment of patients with urolithiasis, but when all patients also are given advice of high fluid intake and exercise as well as Tamsulosin (that also has expulsive properties) conclusions are difficult. It is recommended that the authors carry out studies in larger groups of patients not given Tamsulosin.

Hans-Göran Tiselius

I do not know how wide-spread the use of Rowatinex is in the world. Although the authors conclude that fragment expulsion was slightly but significantly higher in patients treated with Rowatinex, it is important to note that this was a retrospective and not randomized study. Moreover, it is of note that no difference was recorded after 2 weeks. Rowatinex is ascribed a number of properties that might be of interest in the treatment of patients with urolithiasis, but when all patients also are given advice of high fluid intake and exercise as well as Tamsulosin (that also has expulsive properties) conclusions are difficult. It is recommended that the authors carry out studies in larger groups of patients not given Tamsulosin. Hans-Göran Tiselius
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