CLINICAL EVALUATION OF ‘SUSPEND’ TRIAL WITH HERBAL PREPARATION AND TAMSULOSIN: A MEDICAL EXPULSIVE THERAPY FOR UROLITHIASIS

Abstract

Lithiasis occurs in various forms and at various sites in the body and the most common site is urinary tract. Urinary stones are one of the major problems and an important cause of morbidity and end stage renal failure in India. Urolithiasis affects up to 5 % of the population, with a recurrence rate of 50 to 80 %. Males are more frequently affected than the females. The objective of this study is to evaluate and compare the efficacy and safety of Herbal preparation (decoction of Boerhavia diffusa roots and Crataeva nurvala bark) and Tamsulosin in the treatment of patients with ureteric stones. A total of 110 patients with ureteric stones ranged from 4- 10 mm were selected for the trial according to the inclusion and exclusion criteria of this study and were randomized into two groups where the first group (herbal group) included 55 patients treated with decoction of Boerhavia diffusa roots and Crataeva nurvala bark in the dose of 50 ml BD daily, and the second group (tamsulosin group) included 55 patients treated with tamsulosin 0.4 mg/day. All patients were randomly assigned to receive the designed SUSPEND trial (Spontaneous Urinary Stone Passage enabled by Drugs) for a maximum of 6 weeks. The Herbal preparation found statistically significant in increasing the expulsion rate, better control of ureteric pain and reduced expulsion time of ureteric stone impacted in any part of the ureter i.e. the upper, middle and lower ureteric tract and thereby decrease in number of URS procedure performed to remove the stone of unaffected patients. Tamsulosin group results in a better control of ureteric pain and reduced expulsion time of stones which are impacted in only lower ureter.