[Extract of Serenoa repens in the treatment of benign prostatic hyperplasia and lower urinary tract symptoms].

This literature review focuses on the use of Serenoa repens extracts in the treatment of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Extracts of Serenoa repens produce marked anti-inflammatory, anti-androgenic and antiproliferative effects. Various extracts differ in their activity depending on the concentration of free fatty acids and the method of extract preparation. Extracts of Serenoa Repens from different manufacturers vary considerably in composition, effectiveness and supporting evidence. Evaluation of the effectiveness of Serenoa Repens extracts should be carried out for each extract separately, depending on the method of preparation and brand. The most studied and clinically effective is the hexane lipidosterol extract of Serenoa Repens Permixon. This assessment is supported by a report on Serenoa Repens, issued by the European Medicines Agency. In this report, only Serenoa repens hexanic extract Permixon is considered to be a well-established medical use product for the symptomatic treatment of BPH.

[Quality of life in patients with lower urinary tract symptoms after TURP for benign prostatic hyperplasia].

INTRODUCTION: To date, the gold standard for the surgical management of BPH is transurethral resection of the prostate (TURP). Most patients who undergo TURP for BPH experience immediate effects and complete relief of lower urinary tract symptoms and do not need further urological care. However, some patients after this operation have some level of persistent residual lower urinary tract symptoms, which may require additional therapy. AIM: To investigate voiding function and the need for medical therapy in patients who underwent TURP for LUTS due to BPH. MATERIALS AND METHODS: This study was performed as an anonymous survey among male patients presenting to a urology clinic. During the visit, the patients were offered to fill out I-PSS and SF-36 questionnaires. Also, they were asked about their socio-economic status, history of BPH, their perception of surgery and the postoperative period up to the day of the interview, presence or absence of symptoms of voiding dysfunction and any drug therapy at the time of the interview or after surgery. The patients also rated the severity of the symptoms using the IPSS questionnaire. The study comprised patients after 12 months to 3 years following successful TURP for LUTS due to BPH. A total of 1100 questionnaires were forwarded to researchers for interviewing patients who underwent TURP for prostatic hyperplasia. RESULTS: After collecting and reviewing all the questionnaires, 921 questionnaires were found eligible. The findings of the survey showed that a significant proportion of patients who underwent TURP require a long-term postoperative medical therapy. At the same time, in the Russian Federation, there are no standard approaches to medical management of this category of patients.

[URINARY DISCOMFORTS IN PATIENTS AFTER RADICAL PROSTATECTOMY].

The authors showed the result of complication treatment of lower urinary tracts in 128 patients with localized prostate cancer. The patients underwent radical prostatectomy. Urinary discomforts included enuresis, urinary incontinence in postoperative period. Abnormalities of urine outflow due to urethral stricture were revealed in 6 (4,6%) patients by the 6 month after operation. These complications required surgical treatment. Urinary incontinence was noted in 20 (15,6%) patients in this period. It was stressful urinary incontinence in 16 (12,6%) and urgent - in 4 (3%). Patents with stressful urinary difficulty were advised to use the conservative treatment (pelvic floor muscle training and electrostimulation), but in case of inefficiency - surgical treatment.

[Value of combined urodynamic examination of patients with unsatisfactory outcomes of surgical treatment of prostatic adenoma].

Forty three patients with unsatisfactory outcomes of surgical treatment of benign prostatic hyperplasia (BPH) were examined urodynamically. Thirty five patients complained of daily and nocturnal pollakiuria, incomplete evacuation of urine from the bladder, imperative voiding. Eight patients had postoperative enuresis. Seventeen control patients had satisfactory surgical results. The urodynamic findings showed that postoperative dysuria was caused by detrusor pathology: detrusor hyperactivity (n = 27, 62.8%), contractile hypoactivity (n = 4, 9.3%), infravesical obstruction (n = 4, 9.3%). Diuresis patients had low maximal cystometric capacity of the urinary bladder, detrusor hyperactivity was diagnosed in 5 (62.6%) patients. Enuresis patients had also very low indices of urethral profilometry characterizing function of the sphincter. The urodynamic examination detected true stress urine incontinence in 3 enuresis patients due to sphincter impairment. Five patients had enuresis of mixed nature. Thus, urodynamic examination of patients with unsatisfactory results of surgery determined cause of dysuria. Accurate diagnosis of characteristics and causes of lower urinary tracts dysfunction decides choice of adequate therapeutic policy.

[Diagnosis of infravesical obstruction in patients with benign prostatic hyperplasia].

To improve reliability of the diagnosis of infravesical obstruction (IVO) in patients with benign prostatic hyperplasia (BPH), we examined 80 BPH patients (mean age 58.2 +/- 2.1 years). The examination included evaluation of complaints by IPSS, ultrasound investigation with determination of prostatic size and residual urine, and urodynamic tests: uroflowmetry, miction cystometry. We came to the conclusion that symptoms of BPH, size of the gland, amount of residual urine and maximal volumetric miction velocity not always evidence for IVO. To raise reliability of IVO diagnosis we propose the following formula: D1 = 0.818 x S(max) +0.0006 x S(min) +0.215 x Q(max) - 0.478 x Q(aver), where D1 is a discriminant function; S(max) is a maximal linear size of the prostate; S(min) is a minimal linear size of the prostate; Q(max) is maximal volumetric flow rate; Q(aver) is mean volumetric flow rate. If D1 > or = 2.85, IVO is definite. If D1 < or = 2.85, IVO absence is more probable. Thus, the proposed formula provides more reliable diagnosis of IVO in BPH patients than assessment of clinical indices.

[Urodynamic studies in the diagnosis of infravesical obstruction in men]. / Urodinamicheskie issledovaniia v diagnostike infravezikal'noi obstruktsii u muzhchin.

The authors have performed urodynamic investigations pressure-flow in 39 males (mean age 57.9 +/- 1.8 years) to detect infravesical obstruction. Interpretation of the findings rested upon Abrams-Griffits index (AGI) derived by the formula AGI = PdetQmax - 2xQmax, where Qmax is the maximal speed of urine flow and PdetQmax is detrusor pressure when the maximal urine flow is reached. Definite conclusion on the presence or absence of infravesical obstruction was feasible for 21(53.8%) of 39 examinees, was not possible for 18(46.2%) patients. Statistical processing yielded non-linear relationship between PdetQmax and Qmax (cubic parabola) requiring correction for AGI (coefficient K calculated according to the formula K = 58.7 - 0.00554x(Qmax)3). This correction for nonlinearity K allowed classification of 11 out of 18 patients who were initially indefinite. By standard AGI technique, the uncertainty zone made up 46.2% while correction for nonlinearity reduced this zone to 18.0% (p < 0.008). Thus, the account for nonlinearity of the relationship between PdetQmax and Qmax may contribute to a rise in diagnostic value of urodynamic investigations.

[Prophylactic use of prostatilen in rats prior to exposure to +Gz loads as a way of reducing changes in urogenital organs]. / Profilakticheskoe primenenie prostatilena u krys pered vozdeistviem gravitatsionnykh peregruzok +Gz kak sposob umen'sheniia narushenii v mochepolovykh organakh.

Experimental verification of prostatilen prophylactics of changes in the urogenital organs consequent to g-loads was the idea of the work. The experiment was performed with 37 mongrel white male rats weighing 200-250 g who were exposed to the head-pelvis g-loads (+Gl) at 10 units. Behavior reactions of the rats were assessed with the "open field" technique immediately after centrifugation; weighing coefficients of the urogenital organs (the organ/body mass relation) were determined, and histological and morphometric analyses of prostate, testis and kidney were made. A significant moderating effect of prophylactic prostatilen on the stress-reactions in animals was first revealed; prostatilen was also found to speed up adaptation. This was concluded from normalization of the hemodynamics, a decrease in venous plethora and epithelial dystrophy, absence of basophilia in conjunctive tissue of the urogenital organs. Distention and overfilling of acini by secret and the number of epithelial acinus hulled into the lumen were markedly less in prostate. Spermatogenesis in testis was normalized, too. The histological profile of kidney approached the norm. Results of the experiment showed that prostatilen is a promising preparation from the standpoint of moderation of stress-reactions and counteraction of disorders in the urogenital organs caused by g-loads.

[Effect of a renal peptide complex on experimental acute pyelonephritis]. / Vliianie kompleksa peptidov pochki na techenie éksperimental'nogo ostrogo pielonefrita.

The purpose of the present study was to examine the effects of the animal renal peptide complex renaline obtained via acid extraction on the cause of acute pyelonephritis in the experiment. Renaline was found to be highly effective in treating experimental acute pyelonephritis in rats. This is manifested as improved changes in the parameters of leukocytosis, leukocyturia, rectal temperatures, and bacteriuria along with the regression of abnormal changes and the reduction in renal mass differences, as compared to the similar parameters in untreated animals. The findings indicate that the clinical use of renaline in the combined therapy for acute pyelonephritis.