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Introduction: Symposium on “Terpenes in Urolithiasis,” Düsseldorf, Germany, September 2010

  • Thomas Knoll
    Correspondence
    Corresponding author. Department of Urology, Sindelfingen-Boeblingen Medical Center, University of Tübingen, Arthur-Gruber-Str. 70, 71065 Sindelfingen, Germany. Tel. +49 7031 98 12501; Fax: +49 7031 815307.
    Affiliations
    Department of Urology, Klinikum Sindelfingen-Boeblingen, University of Tübingen, Germany
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  • Imre Romics
    Affiliations
    Department of Urology, Semmelweis University, Budapest, Hungary
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      Urolithiasis shows a worldwide increasing prevalence and incidence [
      • Hesse A.
      • Brändle E.
      • Wilbert D.
      • Köhrmann K.-U.
      • Alken P.
      Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000.
      ]. Consequently, urinary stone disease has a significant medical and economic impact. Extracorporeal shock wave lithotripsy (ESWL) remains the recommended first-line treatment for most stones [
      • Tiselius H.G.
      • Ackermann D.
      • Alken P.
      • Buck C.
      • Conort P.
      • Gallucci M.
      Guidelines on urolithiasis.
      ]. However, after disintegration is achieved, the fragments have to pass the upper urinary tract for complete clearance. Such fragments may cause renal colic or remain within the renal collecting system as residual stones, limiting the overall success of ESWL [
      • Osman M.M.
      • Alfano Y.
      • Kamp S.
      • et al.
      5-year-follow-up of patients with clinically insignificant residual fragments after extracorporeal shockwave lithotripsy.
      ].
      Several medical attempts have been evaluated in recent years to improve spontaneous stone passage, with the most promising data for α-adrenoreceptor antagonists such as tamsulosin (medical expulsive therapy [MET]). The American Urological Association/European Association of Urology working group for ureteral calculi recommends the use of MET for uncomplicated, well-controlled calculi of <10 mm in size [
      • Losek R.L.
      • Mauro L.S.
      Efficacy of tamsulosin with extracorporeal shock wave lithotripsy for passage of renal and ureteral calculi.
      ]. Rowatinex, a terpene mixture, is well known for treatment of urinary stone-related symptoms all over the world. Recently, a randomized controlled trial (RCT) demonstrated a beneficial effect of Rowatinex application on stone passage after ESWL. This approach could offer patients the interesting therapeutic option of an herbal, well-tolerated treatment.
      This supplement summarizes the contributions made at a symposium held in Düsseldorf, Germany, on September 21, 2010, by European urologists with particular experience and expertise in the field of urolithiasis, including Professor Romics, who performed the RCT on Rowatinex. The objective of the meeting was to achieve a state-of-the-art overview of urinary stone disease and noninterventional treatment modalities.
      After an overview on epidemiology and pathophysiology of urinary stone disease by Professor Knoll (Sindelfingen, Germany), in his capacity as a meeting chairman, Dr. Bach (Hamburg, Germany) reported the available data for Rowatinex and the supposed principles of action. Dr. Seitz (Vienna, Austria) presented the current evidence supporting the application of medical expulsive therapies including data from recent meta-analyses. Professor Romics (Budapest, Hungary) presented the clinical data from his RCT on Rowatinex treatment after ESWL.

      Conflicts of interest

      in recent years, the authors have received consultancy or lecturer honoraria from rowa pharmaceuticals.

      References

        • Hesse A.
        • Brändle E.
        • Wilbert D.
        • Köhrmann K.-U.
        • Alken P.
        Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000.
        Eur Urol. 2003; 44: 709-713
        • Tiselius H.G.
        • Ackermann D.
        • Alken P.
        • Buck C.
        • Conort P.
        • Gallucci M.
        Guidelines on urolithiasis.
        Eur Urol. 2001; 40: 362-371
        • Osman M.M.
        • Alfano Y.
        • Kamp S.
        • et al.
        5-year-follow-up of patients with clinically insignificant residual fragments after extracorporeal shockwave lithotripsy.
        Eur Urol. 2005; 47: 860-864
        • Losek R.L.
        • Mauro L.S.
        Efficacy of tamsulosin with extracorporeal shock wave lithotripsy for passage of renal and ureteral calculi.
        Ann Pharmacother. 2008; 42: 692-697