COMPARATIVE EFFICACY OF UROSORB PHYTOMEDICINE AND ANALOGUES IN THE TREATMENT OF UNCOMPLICATED CYSTITIS IN WOMEN

Abstract Background: Phytotherapy holds a significant place in the treatment and prevention of cystitis in women. The pharmaceutical market offers numerous herbal preparations with similar indications, necessitating a comparative analysis of their efficacy. This study aimed to evaluate the therapeutic effectiveness of the drug Urosorb compared to analogues (Canephron N, Fitolysin) in treating uncomplicated cystitis in women.

Materials and Methods: A prospective comparative study was conducted involving 120 women with acute uncomplicated cystitis. Patients were randomized into 3 groups of 40: Group 1 received Urosorb, Group 2 received Canephron N, Group 3 received Fitolysin. Treatment duration was 14 days. Dynamics of clinical symptoms, laboratory findings, and treatment tolerability were assessed.

Results: All drugs demonstrated clinical efficacy. The Urosorb group showed faster relief of dysuria — by day 3.2 ± 0.8 compared to day 4.1 ± 1.1 in the Canephron N group (p<0.05) and day 4.8 ± 1.3 in the Fitolysin group (p<0.05). Normalization of urine parameters was achieved in 95% of patients in the Urosorb group, 90% in the Canephron N group, and 87.5% in the Fitolysin group. Urosorb was characterized by better tolerability indicators.

Conclusion: Urosorb is a highly effective treatment for uncomplicated cystitis in women, surpassing analogues in the speed of relieving key symptoms and demonstrating comparable overall efficacy with a better tolerability profile.

Keywords: cystitis, women, phytotherapy, Urosorb, Canephron N, Fitolysin, comparative study, rosemary, centaury, lovage, bearberry.

Introduction

Uncomplicated urinary tract infections (UTIs), particularly acute cystitis, remain one of the most common clinical problems in urological and gynecological practice. According to epidemiological data, up to 50-60% of women of reproductive age experience at least one episode of acute cystitis [1].

Phytotherapy holds a firm position in the treatment and prevention of cystitis due to its comprehensive action, good tolerability, and potential for long-term use. Among the many herbal medicines, "Urosorb," containing standardized extracts of rosemary leaves (Rosmarini officinalis folium), centaury herb (Centaurii herba), lovage root (Levistici radix), and bearberry leaves (Uvae ursi folium), deserves special attention. However, the modern pharmaceutical market contains analogous drugs with similar indications, notably Canephron N and Fitolysin, necessitating comparative studies to determine the optimal therapeutic approach.

The aim of this study was a comparative evaluation of the clinical efficacy and tolerability of Urosorb compared to Canephron N and Fitolysin in the treatment of uncomplicated cystitis in women.

Materials and Methods

Study Design: A prospective, open-label, comparative, randomized study.

Inclusion Criteria: Women aged 18-45 years diagnosed with acute uncomplicated cystitis, with symptom duration less than 48 hours.

Exclusion Criteria: Complicated UTIs, urolithiasis, anatomical abnormalities of the urinary tract, pregnancy, lactation, known hypersensitivity to drug components.

Study Procedure: 120 patients were randomly allocated into 3 groups:

• Group 1 (n=40): Received Urosorb according to the standard regimen for 14 days.

• Group 2 (n=40): Received Canephron N (50 drops 3 times daily) for 14 days.

• Group 3 (n=40): Received Fitolysin (1 teaspoon of paste 3 times daily) for 14 days.

Assessment Methods: Efficacy was evaluated on days 3, 7, and 14 of treatment and included:

1. Analysis of clinical symptom dynamics using urinary diaries and a Visual Analogue Scale (VAS) for pain.

2. Laboratory tests: urinalysis, urine culture.

3. Assessment of therapy tolerability and recording of adverse events.

Statistical Analysis: Performed using SPSS 23.0 statistical software.

Results

Dynamics of Clinical Symptoms: Positive dynamics were observed in all groups; however, the Urosorb group showed a statistically significant faster relief of symptoms (Table 1).

Table 1. Dynamics of Clinical Symptoms (M ± SD)

*Note: * — p<0.05 compared to other groups*

Laboratory Parameters: By day 7 of treatment, normalization of urinalysis parameters was observed in 85% of patients in the Urosorb group, 77.5% in the Canephron N group, and 72.5% in the Fitolysin group. By the end of the treatment course (day 14), these rates were 95%, 90%, and 87.5%, respectively.

Treatment Tolerability: The best tolerability was noted in the Urosorb group — only 2 patients (5%) experienced minor dyspeptic symptoms not requiring drug discontinuation. In the Canephron N group, adverse effects were registered in 4 patients (10%), and in the Fitolysin group — in 7 patients (17.5%), with 2 patients from the Fitolysin group discontinuing the drug due to significant discomfort.

Discussion

This study demonstrates that all investigated phytomedicines are effective in treating uncomplicated cystitis in women but have certain differences in efficacy and tolerability.

Comparative Analysis of Mechanisms of Action:

Urosorb possesses the most balanced composition ensuring synergistic action:

• Bearberry — potent antiseptic action due to arbutin.

• Lovage — pronounced spasmolytic and diuretic effect.

• Rosemary — anti-inflammatory and antioxidant action.

• Centaury — anti-inflammatory and mild antiseptic action.

Canephron N contains centaury, lovage, and rosemary but lacks bearberry, which may explain its slightly less pronounced antiseptic effect.

Fitolysin has the most complex composition (9 components); however, the lack of standardized extracts and the paste form for suspension preparation may impair bioavailability and tolerability.

The faster relief of dysuria in the Urosorb group can be explained by the optimal combination of the spasmolytic action of lovage and the anti-inflammatory effects of rosemary and centaury, complemented by the antiseptic action of bearberry.

Conclusion

1. Urosorb is a highly effective treatment for uncomplicated cystitis in women, demonstrating advantages over analogues in the speed of relieving clinical symptoms.

2. The faster relief of dysuria and pain in the Urosorb group (by day 3 of therapy) indicates an optimal synergy of its components.

3. Urosorb is characterized by better tolerability compared to analogues, which is particularly important when long-term therapy is needed.

4. The comprehensive mechanism of action, including anti-inflammatory, spasmolytic, diuretic, and antiseptic effects, makes Urosorb the phytomedicine of choice for treating cystitis in women.

The obtained results allow recommending Urosorb as an effective and safe alternative to other herbal medicines for the treatment of uncomplicated cystitis in women.