Investigating the Influence of Tutukon and Alfuzosin on Stone Expulsion After Retrograde Intrarenal Surgery

Yıl 2024, Cilt: 16 Sayı: 1, 8 - 16, 31.01.2024

Muharrem Baturu , Ömer Bayrak , Mehmet Öztürk , Özcan Sevim , Haluk Şen , İlker Seçkiner

https://doi.org/10.54233/endourologybull-1390903

Öz

Objective: To compare the effects of an alpha-blocker (alfuzosin) versus a herbal agent, “Tutukon®,» on stone-free rates in patients who underwent retrograde intrarenal surgery (RIRS).
Material and Methods: We evaluated seventy-five patients who underwent RIRS prospectively consecutively and reported retrospectively between January 2020 and June 2020. Patients were divided into three groups to analyze the effect of medications on stone-free rates after RIRS. “Tutukon®» was prescribed to the first group, alfuzosin 10 mg to the second group, and only dexketoprofen to the third group as the control group. The patients were re-evaluated for stone-free rates after the fourth week of surgery.
Results: Among the groups (Tutukon®/Alfuzosin/Control), no differences were observed in terms of age (44.4±15.71/43.16±14.05/46.00±14.43), stone size, stone location and extracorporeal shock wave lithotripsy (ESWL) history (p>0.05). Complete stone-free rates at the fourth postoperative week; Group 1 (Tutukon®) was 96%, group 2 (alfuzosin) 84%, and group 3 (control) 76% (p=0.163), and the stone-free rate in Group 1 was significantly higher than that in the control group (Group 1 vs. 3; p= 0.044, Group 2 vs. 3; p=0.363). Evaluation of completely stone-free patients and patients with clinically insignificant residual stones showed no difference between the groups (p=0.234).
Conclusion: The data obtained from the use of Tutukon® have similar results to the use of alfuzosin in medical expulsive therapy, suggesting that it may be a preferred phytotherapy method for fragment expulsion after endoscopic stone surgery.

Anahtar Kelimeler

Medical expulsive treatment, urolithiasis, herbal agent, alfa blocker, and retrograde intrarenal surgery

Tutukon ve Alfuzosin’in Retrograd İntrarenal Cerrahi Sonrası Taş Ekspulsiyonu Etkisinin Araştırılması

Öz

Amaç: Retrograd intrarenal cerrahi (RIRC) uygulanan hastalarda bir alfa-bloker (alfuzosin) ile bitkisel bir ajan olan “Tutukon®»un taşsızlık oranları üzerindeki etkilerini karşılaştırmak.
Gereç ve Yöntemler: Ocak 2020 ve Haziran 2020 tarihleri arasında RIRC uygulanan yetmiş beş hasta prospektif olarak değerlendirildi ve retrospektif olarak raporlandı. RIRC sonrası ilaçların taşsızlık oranları üzerindeki etkisini analiz etmek için hastalar üç gruba ayrıldı. Birinci gruba “Tutukon®», ikinci gruba alfuzosin 10 mg ve üçüncü gruba kontrol grubu olarak sadece deksketoprofen reçete edilmiştir. Hastalar ameliyatın dördüncü haftasından sonra taşsızlık oranları açısından tekrar değerlendirildi.
Bulgular: Gruplar (Tutukon®/Alfuzosin/Kontrol) arasında yaş (44.4 ±3.14/43.16 ±2.81/46.00±2.88), taş boyutu, taşın yeri ve ekstrakorporeal şok dalga litotripsi (ESWL) öyküsü açısından fark gözlenmedi (p>0.05). Ameliyat sonrası dördüncü haftada tam taşsızlık oranları; Grup 1 (Tutukon®) %96, grup 2 (alfuzosin) %84 ve grup 3 (kontrol) %76 (p=0.163) olup, Grup 1’deki taşsızlık oranı kontrol grubuna göre anlamlı derecede yüksekti (Grup 1 vs. 3; p= 0.044, Grup 2 vs. 3; p=0.363). Tamamen taşsız hastalar ve klinik olarak önemsiz rezidüel taşları olan hastalar değerlendirildiğinde gruplar arasında fark saptanmadı (p=0.234).
Sonuç: Tutukon® kullanımından elde edilen veriler, alfuzosinin tıbbi eksülsif tedavide kullanımına benzer sonuçlara sahip olup, endoskopik taş cerrahisi sonrası fragman atılmasında tercih edilebilecek bir fitoterapi yöntemi olabileceğini düşündürmektedir.

Anahtar Kelimeler

medikal ekspulsif tedavi, ürolitiyazis, bitkisel ajan, alfa bloker, retrograd intrarenal cerrahi

Kaynakça

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