Rasim GÜZEL, Laurian DRAGOS, Ümit YILDIRIM, Bilal ERYILDIRIM, Kemal SARICA

Bitkisel bir ajan “Tutukon®”un üreter taşlarının spontan pasaj oranlarına etkisi

Amaç: Bu çalışmanın amacı, bir bitkisel ajan olan Tutukon®’ un 5-10 mm üreter taşlarının spontan geçiş oranları üzerindeki etkinliğini değerlendirmektir. Gereç ve Yöntem: 5-10 mm çapında, tek radyoopak üreter taşı olan 96 hasta randomize olarak iki gruba ayrıldı. Grup 1'e (n=51) konservatif yaklaşıma ek olarak 45 mg/gün (üç kez) Tutukon®, Grup 2'deki hastalar (n=45) ise 4 haftalık takip süresince klasik konservatif yaklaşımla takip edildi. Taş geçiş oranları, taş çıkarma süreleri, haftalık kolik ataklarındaki değişim ve kolik ağrısı nedeniyle hastaneye yeniden başvuru oranları karşılaştırıldı. Sonuçlar: Taş çıkarma oranları iki grup arasında istatistiksel olarak anlamlı farklılık gösterdi (%66.7'ye karşı %46.7, p = 0.048). Ek olarak, Tutukon® alan vakalarda, sadece konservatif önlemler alan Grup 2 hastaları ile karşılaştırıldığında, taşların spontan geçişi için gereken ortalama süre anlamlı olarak kısaydı (sırasıyla 5,79 ± 2,39 ve 8,82 ± 3,48 gün) (p = 0,001). Benzer şekilde, takip süresi boyunca ortalama renal kolik atakları Grup 1 hastalarında önemli ölçüde azaldı (sırasıyla %66,6'ya karşı %36, p = 0,001). Son olarak Grup 1'de kolik ağrı ataklarının daha az olduğu görüldü ve “Tutukon®”un bir diğer avantajı da taşların üreterin daha distal kısmına yer değiştirmesiydi (%35.2'ye karşı %4). Sonuç: Üreter taşlarının medikal tedavisinde Tutukon® kullanımı, taşların spontan düşüş oranlarını hızlandırabilir ve aynı zamanda üreterin daha alt seviyelerine geçişini hızlandırabilir.

Anahtar Kelimeler:

bitkisel ajanlar, medikal terapi, spontan pasaj, üreter taşları

The effect of an herbal agent “Tutukon®” on the spontaneous passage rates of ureteric stones

Objective:: The objective of this study is to assess the efficacy of an herbal agent (Tutukon®) on the spontaneous passage rates of ureteral calculi 5-10 mm. Materials and Methods: 96 patients having a single radio-opaque ureteral stone 5-10 mm were randomized into two groups. Group 1 (n = 51) received Tutukon®, 45 mg/day (three times) in addition to conservative approach and Group 2 patients (n = 45) were followed with classical conservative approach during 4 weeks follow-up. The stone passage rates, stone expulsion time, change in weekly colic episodes and hospital readmission rates for colicky pain were compared. Results: Stone expulsion rates showed statistically significant difference between the two group (66.7 % vs 46.7 %, p = 0.048). Additionally mean time period required for the spontaneous passage of the calculi was meaningfully short in those cases receiving Tutukon® when compared with Group 2 patients undergoing conservative measures only (5.79 ± 2.39 vs 8.82 ± 3.48 days, respectively) (p = 0.001). Similarly, the mean renal colic episodes during follow-up period were significantly diminished in Group 1 patients (66.6 vs 36%, p = 0.001, respectively). Lastly, colic pain attacks were noted to be less in Group 1 and another advantage of“Tutukon®” was the relocation of the stones to a more distal part of ureter (35.2 vs 4 %). Conclusion: Use of Tutukon® in the medical management of ureteral calculi can accelarate the spontaneous passage rates and also relocate them into the lower portion of the ureter.

Keywords:

herbal agents, medical therapy, spontaneous passage, ureteral stones,

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