Urology reports (St. - Petersburg)Urology reports (St. - Petersburg)2225-90742687-1416Eco-Vector869410.17816/uroved8119-25Research ArticleCombined (citrate and herbal) drug uriklar in extracorporeal shock wave lithotripsy and metaphylaxis of urolithiasisShestaevAleksandr Yu.<p>Doctor of Medical Science, Associate Professor, Head of Urology Department</p>paronnikov@mail.ruProtoshchakVladimir V.<p>Doctor of Medical Science, Associate Professor, Deputy Head of Urology Department</p>protoshakurology@mail.ruParonnikovMikhail V.<p>Candidate of Medical Science, Urologist, Urological Clinic</p>paronnikov@mail.ruKiselevArtyem O.<p>Urologist, Urological Clinic</p>paronnikov@mail.ruS.M. Kirov Military Medical Academy1503201881192519042018Copyright © 2018, Shestaev A.Y., Protoshchak V.V., Paronnikov M.V., Kiselev A.O.2018<p><strong>The aim</strong> of the study was to study the clinical efficiency and safety of the drug uriklar in extracorporeal shock wave lithotripsy (ESWL) and early metaphylaxis of urolithiasis.</p>
<p><strong>Materials and methods</strong>. 45 patients were included in the prospective study. The patients were divided into two groups. The main group consisted of 25 patients, they received uriklar 1 capsule three times a day for one month before and three after ESWL. The control group included 20 patients who underwent ESWL only. Uriklar is combined drug with citrate and herbal components.</p>
<p><strong>Results</strong>. The total efficiency of ESWL was 92% in I group versus 75% in control group. Among the patients of the main group, the frequency of renal colic after ESWL was 24% (6 patients), while in the control group colic occurred in 9 patients (45%). The severity of pain syndrome was of 5.12 2.1 in I group and of 7.48 2.2 and in II group (p 0.05). Uriklar in the first group of patients increased the pH of urine and the excretion of citrate significantly and decreased excretion of uric acid. After 3 months, the vast majority of patients (n = 24, 96%) of the main group underwent curing of the urinary tract, and daily diuresis remained at 2.3 0.3 l/day.</p>
<p><strong>Conclusions</strong>. The uriklar taking increases the fragmentation of urinary stones and the elimination of the resulting fragments from the urinary tract, promotes the normalization of metabolic disorders, and effectively eliminates infectious-inflammatory complications of urolithiasis. It is also well-tolerated and has no side effects.</p>urolithiasisextracorporeal shock wave lithotripsyuriklarмочекаменная болезньдистанционная литотрипсияуриклар[1. Авдошин В.П., Андрюхин М.И., Исрафилов М.Н. Комплексное лечение и метафилактика уратного и смешанного уролитиаза: метод. пособие для врачей. – М.: Спецкнига, 2013. [Avdoshin VP, Andrukhin MI, Israfilov MN. Kompleksnoe lechenie i metafilaktika uratnogo i smeshannogo urolitiaza. Moscow: Spetskniga; 2013. (In Russ.)]][2. Каприн А.Д., Аполихин О.И., Сивков А.В., и др. Анализ уронефрологической заболеваемости и смертности в Российской Федерации за период 2002–2014 гг. по данным официальной статистики // Экспериментальная и клиническая урология. – 2016. – № 3. – С. 4–13. [Kaprin AD, Apolikhin OI, Sivkov AV, et al. Analysis of uronephrological morbidity and mortality in the Russian Federation for the period 2002-2014 according to official statistics. Experimental and clinical urology. 2016;(3):4-13. (In Russ.)]][3. Вощула В.И. Мочекаменная болезнь: этиотропное и патогенетическое лечение, профилактика. – Минск: ВЭВЭР, 2006. [Voshhula VI. Mochekamennaya bolezn’: etiotropnoe i patogeneticheskoe lechenie, profilaktika. Minsk: VEVER; 2006. (In Russ.)]][4. Дзеранов Н.К., Бешлиев Д.А., Черепанова Е.В. Цитратная метафилактика в лечении уратного нефролитиаза // Эффективная фармакотерапия. – 2011. – № 2. – С. 24–27. [Dzeranov NK, Beshliev DA, Cherepanova EV. Tsitratnaya metafilaktika v lechenii uratnogo nefrolitiaza. Journal Effective Pharmacotherapy. 2011;(2):24-27. (In Russ.)]][5. Шестаев А.Ю., Паронников М.В., Протощак В.В., и др. Эффективность противорецидивной терапии у больных мочекаменной болезнью и метаболическим синдромом // Вестник Северо-Западного государственного медицинского университета имени И.И. Мечникова. – 2013. – Т. 5. – № 2. – С. 85–89. [Shestaev AYu, Paronnikov MV, Protoshchak VV, et al. A efficiency of preventive treatments for recurrence of patients with urolithiasis and metabolic syndrome. Herald of North-Western State Medical University named after I.I. Mechnikov. 2013;5(2):85-89. (In Russ.)]][6. Skolarikos A, Grivas N, Kallidonis P, et al. The efficacy of Medical Expulsive Therapy (MET) in improving stone-free rate and stone expulsion time, after extracorporeal shock wave lithotripsy (SWL) for upper urinary stones: a systematic review and meta-analysis. Urology. 2015;86(6):1057-1064. doi: 10.1016/j.urology.2015.09.004.][7. Kasote DM, Jagtap SD, Thapa D, et al. Herbal remedies for urinary stones used in India and China: A review. J Ethnopharmacol. 2017;203:55-68. doi: 10.1016/j.jep.2017.03.038.][8. Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016;69(3):468-474. doi: 10.1016/j.eururo.2015.07.040.][9. Neisius A. What is the current status of shock wave lithotripsy? Urologe A. 2017;56(9):1147-1157. doi: 10.1007/s00120-017-0470-9.][10. Ziemba JB, Matlaga BR. Epidemiology and economics of nephrolithiasis. Investig Clin Urol. 2017;58(5):299-306. doi: 10.4111/icu.2017.58.5.299.]