Urocrush

Correspondence to:

1Professor Dr. U Khin Tun 
M.B.,B.S., M.Med.Sc.(Surgery), F.R.C.S. (Edin.), F.I.C.S. (Urology)
Professor of Urosurgery, Institute of Medicine (2),
Thingungyun Sanpya Hospital, Yangon

2Dr. Khin Maung Lwin
M.B.,B.S., Ph.D. (Alternative Medicine)(UK), D.B.A.(USA)
Managing Director, FAME Pharmaceutical Enterprise,
Hlaing Tharyar Industrial Zone (3), Yangon.

INTRODUCTION

Urolithiasis is one of the oldest disease which has affected the mankind. Occurrence of urinary stones were discovered in ancient Egyptian mummies and in fact the operation of stone was mentioned in the Hippocratic oath. In Myanmar, urolithiasis is not uncommon in hospital practice. Out of 620 patients attending the Thingangyun Sanpya Hospital during 2002, a total of 111 patients (17.9%) were recorded as patients with urolithiasis (Table 1).

There are many treatment modalities for urolithiasis; basically conservative treatment and surgical treatment. The conservative treatment consisted of high fluid intake, stone solvents, urinary antiseptic and other conventional therapy. 

In the surgical treatment, open surgery or open operations for urinary stones were the mainstay of treatment in the early 1970s. At present, with the advanced technology, minimal invasive surgery like Per Cutaneous Nephro Lithotomy (PCNL), Ureteroscopic Lithotripsy (URS) and non invasive surgery like Extracorporeal Shock Wave Lithotripsy (ESWL) are available.

There also been many imported medicines in the treatment of urolithiasis. Therefore a pilot study is initiated to observe the efficacy of Myanmar traditional medicinal plants formulation in the treatment of patients with urilithiasis with the aim to save foreign currency.

MATERIALS AND METHODS

Design and subjects: A total of 32 subjects (21 males and 11 females) with urinary calculi in whom surgery was not indicated in view of size and site and some of them refuse for surgery. The selected subjects were briefly explained about the clinical study and the consent form is distributed among them. The study design is a prospective clinical and laboratory design (pre- and post-treatment).

Selection criteria included subjects above 2 years of age, both sexes. Subjects with preference to western medicine, pregnant women and lactating mothers were not included in the study. Withdrawal from the trial were made on subject’s request, allergic and hypersensitive to our traditional medicinal plant formulations. 

Traditional Medicinal formulation: Trade name “Urocrush” was formulated by FAME Pharmaceutical Enterprise using the combinations of three reputed Myanmar medicinal plants, namely (i) Asystasia gangetica (Myanmar name: kyauk-kwe), (ii) Alysicarpus vaginalis (Myanmar name: Than-manaing-kyauk-manaing), and Arundo donax (Myanmar name: Alokyu). The above three plants were reputed for the control in urinary composition, maintaining crystalloid-colloid balance, strengthening mucosal integrity, increasing urine out put and eliminating urinary sediments and enhancing the urethral stones to dissolve^1,2. “Urocrush” capsule contains 300mg (100mg each plant) of total plant extracts. The dosage regimen was one to two capsules (depending on age) three times daily before meal. 

Baseline Examinations: Standard history taking, clinical examinations, and appropriate laboratory investigations were carried out on all selected subjects before performing the clinical trial with “Urocrush”.        The screening examinations consisted of (i) urine for routine examinations,  (ii) blood urea,(iii) serum creatinine, (iv) serum uric acid, (v) serum Calcium, (vi) serum Phosphate, (vii) X’Ray for KUB, (viii) USG abdomen, and (ix) IVU in some instances. The above laboratory and radiological examinations were made at 1 ½ month intervals.

Clinical Assessment: The subjects were followed up weekly for two consecutive weeks at first, then every fortnightly for one month and every month for three consecutive months.

RESULTS

Annual admission of subjects with urolithiasis during 2002 is shown in Figure 1 and 2. Figure 1 represents the male subjects and Figure 2 represents the female subjects. All subjects were classified according to the sites (locations) of the stone along the urinary tract. Annually, there were 35 subjects with renal stones (22 males and 13 females), 33 subjects with ureteric stones (16 males and 17 females), 35 subjects with vesical stones (28 males and 7 females), and 8 subjects with urethral stones (6 males and 2 females). 

Out of 32 subjects, 17 subjects were not completed for the trial. They were either drop outs or not willing to participate anymore (Table 2). Out of 15 cases completed for the trial with “Urocrush”, 3 (2 males and one female) showed radiological disappearance of stones, 3 (all females) showed reduction of size, 5 (3 males and 2 females) revealed relief in symptoms of colic pain, and 4 (all males) observed to pass stones in their urine.

It was also found that the blood urea and creatinine levels in the patients undergoing the trial showed no changes before and after “Urocrush” therapy.

DISCUSSION

Globally, urolithiasis is one of the common disorders in urological medicine. In Myanmar, the incidence of urolithiasis showed higher incidence and it is the major workload for urosurgical units of specialist hospitals. The main aim of this study is to find out the efficacy of “Urocrush” in the treatment of subjects with urolithiasis without major iatrogenic disturbances.

This preliminary study on the effectiveness of “Urocrush” will highlights the role of Myanmar traditional medicines as alternative treatment. On the other hand, cost-effective new traditional medicine for the prevention and treatment of urolithiasis will be produced.

REFERENCES

1. Burmese Medicinal Plants
2. Ashin Ngagathein's Dictionary for Medicinal Plants

Table 1. The efficacy of "Urocrush" therapy on the male and female subjects with urinary stones

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