beta-escin and Ureteral-Calculi

To evaluate the efficacy and safety of aescin compared to prednisolone in the management of symptomatic distal ureteral stones.. The prospective comparative study was conducted from April 2016 to December 2019 at Al-Yarmouk teaching hospital, Baghdad after approval from the Iraqi Board of Urology and the Iraqi Urological Association, Iraq. It comprised patients with distal ureteral calculi presenting with acute ureteric colic who were managed in an outpatient setting. The sample was randomised into aescin group 1, prednisolone group 2 and placebo group 3. The treatment course lasted 10 days in each group. The treatment outcomes were pain relief, disappearance or decrease of upper tract dilatation, stone expulsion rate and adverse effects of the medications used.. Of the 360 patients, there were 220(61%) males and 140(39%) females. The overall mean age was 39.33±8.54 years (range: 19-60 years). Each of the 3 groups had 120(33.3%) patients. Gender, stone size and calyceal system dilatation were not significantly different among the groups (p>0.05), but age was significantly higher in group 3 (p<0.05). Post-treatment, groups 1 and 2 showed significantly better outcomes compared to the placebo group 3 (p<0.00001), while group 1 was more effective than group 2 (p<0.05). In terms of stone expulsion rates, the difference was significant between the treatment and placebo groups (p<0.05), but not between the two treatment groups (p>0.05). Drug side effects were only reported in the prednisolone group 13(11%).. Aescin was found to be effective and may even be used as a substitute for steroids as medical expulsive therapy.

Topics: Adult; Escin; Female; Humans; Male; Middle Aged; Prednisolone; Prospective Studies; Tamsulosin; Treatment Outcome; Ureteral Calculi

To evaluate the efficacy of the addition of tamsulosin to our standard expulsive pharmacologic therapy for the treatment of distal-ureteral stones.. A series of 96 patients referred to our department for the management of symptomatic distal-ureteral calculi were randomly divided into group 1 (N = 46) who received diclofenac (100 mg/daily) plus aescin (80 mg/daily) and group 2 (N = 50) who received the same therapy plus tamsulosin (0.4 mg/daily) for a maximum of 2 weeks. There were no differences between the groups with respect to age, sex, or stone size. The primary endpoint was the expulsion rate. Expulsion time, need for analgesics, need for hospitalization, and drug side effects were the secondary endpoints.. The expulsion rate was significantly higher in group 2 (90%) than in group 1 (58.7%; P = 0.01), and group 2 achieved stone passage in a shorter time (mean 4.4 v 7.5 days, respectively; P = 0.005). Lower analgesic use was found in group 2 (P = 0.003), as well as significantly fewer hospitalizations for recurrent colic (P = 0.01). Both groups experienced few side effects associated with expulsive therapy.. A conservative approach should be considered as an option in the management of uncomplicated distal-ureteral stones. Even if the best pharmacologic expulsive regimen remains to be established, the use of the selective alpha-blocker tamsulosin is recommended in this setting.

Topics: Adrenergic alpha-1 Receptor Antagonists; Adrenergic alpha-Antagonists; Adult; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Drug Therapy, Combination; Escin; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Sulfonamides; Tamsulosin; Treatment Outcome; Ureteral Calculi

It has recently been demonstrated that specific adrenoceptors subtypes (alpha(1A)/alpha(1D)) are prevalent in the distal part of the ureter, a finding supporting the interesting results obtained by different groups with the use of tamsulosin in the treatment of distal ureteral calculi. We performed a prospective randomized study to evaluate the effects of the addition of tamsulosin on our standard pharmacological therapy for the treatment of selected ureteral stones. A total of 64 patients referred to our department for the management of symptomatic ureteral calculi were considered. Patients were randomly divided into two treatment groups: group A (n=32) who received diclofenac (100 mg/daily) plus aescin (80 mg/daily) and group B (n=32) who received the same therapy plus tamsulosin (0.4 mg/daily) for a maximum of 2 weeks. No significant differences were found between the groups for age, gender distribution and mean stone size measured in the single largest dimension at presentation. The stone expulsion rate was 60% (19/32 patients) for group A and 88% for (28/32) for group B with a mean expulsion time of 7.4+/-2.2 (range 3.5-12) and 4.8+/-2.7 days (range 1.8-10.5), respectively. Group B showed a significant advantage in terms of both expulsion rate (P=0.01) and expulsion time (P=0.005). Different analgesics from those used in the standard treatment regimen were required in ten patients in group A (31%) but only three patients in group B (9%). This difference was significant (P=0.003). Hospitalization for recurrent colic was needed in 21% of patients in group A (7/32) and in 9% in group B (3/32) (P=0.01). Only two patients in each group (6%) experienced minor side effects associated with the expulsive therapy. Our data confirm the efficacy of tamsulosin in the treatment of distal ureteral stones up to 1 cm. This selective alpha-blocker should therefore be included in the pharmacological regimen of patients when a conservative approach is considered in the treatment of ureteral lithiasis.

Topics: Adrenergic alpha-Antagonists; Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Escin; Female; Humans; Male; Middle Aged; Prospective Studies; Sulfonamides; Tamsulosin; Ureteral Calculi

A multicentric randomised and prospective study on conservative treatment of ureteric calculi had been performed. The frequency and transit time of spontaneously passing of the stones, side effects and cost of treatment have been compared under classic spasmoanalgetic therapy and a phytotherapeutic medicament (Urol). In the group with spasmoanalgetic therapy 85.5% of the stones passed spontaneously, in the group with Urol medication 89.3% of the stones. There was no significant difference concerning the transit time of stones between the two groups, but side effects and costs were less in the Urol-group.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Drug Combinations; Escin; Female; Humans; Male; Middle Aged; Parasympatholytics; Plant Extracts; Prognosis; Saponins; Ureteral Calculi

Topics: Adult; Clinical Trials as Topic; Drug Combinations; Escin; Female; Humans; Kidney Calculi; Male; Middle Aged; Plant Extracts; Saponins; Ureteral Calculi