Modern treatment of urinary stone disease: results improvement in the spotlight

Introduction. The modern sedentery lifestyle, high-calorie diet and comorbidities make new challenges in the renal stone disease management. The best policy to decrease residual stone rate is the combined use of schock wave lithotripsy (SWL), intracorporeal stone treatment and conservative therapy. The aim of the study was the evaluation of stone-free rate after conservative therapy, SWL and ureteroscopic lithotripsy. Materials and methods: Since November 2019 till March 2020 170 patients (82 males and 88 females, age 23-84y.o.) with renal stones were treated at the urological clinic in the Hospital named after D.D. Pletnev. First cohort (n = 27) with the less than 5mm stones were treated conservatively. Second cohort (n = 74) with the 6-10mm stones were managed with SWL and the third one (n = 69) with stone burdens from 11 to 20mm were treated ureteroscopically by means of thulium fiber laser. The diagnosis of stone has been confirmed at CT scan with evaluation of its density and location. The randomization in the each group has been done in relation to the add-on therapy of the herbal dietary supplement Renalof*. The main group took additionally Renalof 1 capsule 3 times daily during 1 month. The control group obtained only routine antiinflammatory treatment 1 month too. The primary end-point was 1 mo. stone-free rates, the secondary were - the level of leucocytes in urine and pH. Results: the Renalof add-on application in all 3 cohorts resulted to the statistically significant decrease of stone residuals rate in main vs. control groups (81,8% vs. 43,7%, 75% vs 54,3% and 84,8% vs. 58,3% respectively). Additionally there were decrease at the levels of WBC in urine and the normalization of pH urine in the main vs. control groups. No drug-related adverse events were found. Conclusion: the add-on application of Renalof* is justified in the complex management of urolithiasis.