PCRRT Protocol: Perioperative Cardiac Risk Reduction Therapy Art Wallace, M.D., Ph.D. 1. All patients who either have coronary artery disease (CAD), peripheral vascular disease (PVD), or two risk factors for coronary artery disease (age > 60, cigarette smoking, diabetes, hypertension, cholesterol > 240 mg/dl) should be on perioperative beta blockade unless they have a specific intole
Tamsulosin and terpenes in the treatment of ureteral stones
S.S. Kariev, B.S. Tursunov, A.A. Gaybullaev, S.O. Kasimov
Department of Urology, Postgraduate Medical Education Institute, Tashkent, Uzbekistan
Introduction: Medical expulsion therapy (MET) facilitates ureteral stone passage in patients who have a newly
diagnosed ureteral stone <10 mm and whose symptoms are controlled. However, large-scale trials and the
investigation of promising new substances are still needed to optimize the role of MET. Some medicinal plants
contain Terpenes, which help in ureteral stone expulsion. Urolesan (complex phytodrug manufactured by
Galichpharm, Ukraine) is one of them.
Our aim was to examine Urolesan as one of components MET in the treatment of ureteral stones.
Material and Methods: Fifty one patients (26 men and 25 women) who were referred to our city center with
acute renal colic and definite evidence of ureteral stones were included in the study.
The patients with distal ureteral and middle ureteral stones (<10 mm) were randomized into two groups. After
randomization, they were followed for stone expulsion.
We compared the efficacy of treatment and spontaneous stone expulsion rate among two groups: group 1 –
Urolesan + Tamsol (tamsulosin) + NSAID (Diclofenac sodium) and group 2 (standard treatment group) – Tamsol
(tamsulosin) + NSAID (Diclofenac sodium).
Results: The collected data of the investigation demonstrate significantly higher rates of treatment success in the
Urolesan group compared to standard treatment group (75.9% vs 63.6%), despite a larger stone diameter in the
Urolesan group (5.14 vs 3.66 mm). The mean time to stone expulsion was shorter in the Urolesan group (13.9
days vs 15.2 days). The need for additional analgesic drugs was reduced in the 1st group in comparison with the
2nd group (4.24 vs 8.93). The significant difference was detected in terms of the incidence of renal or ureteral colic
among the two groups (8.48 vs 13.6).
The documented adverse effects include retrograde ejaculation, stuffy nose, trouble sleeping and weakness. The
numbers of these events were equai in both groupsand we have suggested that they are more characteristic for
Conclusion: Obtained data of the investigation allow concluded that Urolesan has advantages in overall stone-free
status and the treatment with Urolesan may lead to accelerated stone expulsion and to control symptoms that
reduce the need of additional analgesic drugs.Therefore, MET with α-blocker (Tamsol) and Urolesan resulted in
accelerated and higher expulsion rates compared with a control (standard treatment) group. These findings allow
concluded that Urolesan may be used as a supportive drug in stone expulsive therapy.
As published in the Supplement of AFJU, Volume 18 (2012), 1st ESD “Experts in Stone Disease” Conference (page 73)
Focused crawling for both relevance and quality of medical information ∗ ABSTRACT tion Search and Retrieval—information filtering, retrievalSubject-specific search facilities on health sites are usuallybuilt using manual inclusion and exclusion rules. These canbe expensive to maintain and often provide incomplete cov- General Terms erage of Web resources. On the other hand, health