[Spermoprotective properties of Prostatex in patients with chronic abacterial prostatitis].

AIM: To study the effect of Prostatex therapy on spermatogenesis in patients with infertility that developed due to chronic abacterial prostatitis. MATERIALS AND METHODS: A total of 60 men with infertility in marriage and chronic abacterial prostatitis were included in the study. All patients received therapy with Prostatex rectal suppositories 10 mg 1 time per day. The duration of treatment was 30 days. After taking the drug, patients were observed for 50 days. The study was carried out for 80 days and included 3 visits at 1, 30 and 80 days. The study showed that the use of Prostatex rectal suppositories 10 mg had a positive effect on the main indicators of spermatogenesis, as well as on the subjective and objective symptoms of chronic abacterial prostatitis. Based on these results, we recommend Prostatex rectal suppositories to patients with chronic abacterial prostatitis, accompanied by impaired spermatogenesis, according to the scheme: 1 suppository 10 mg 1 time per day for 30 days.

[Spontaneous rupture of kidney tumor. Successful surgical treatment].

A clinical case of spontaneous rupture of the kidney lesion that occurred after physical exercise is presented in the article. During the examination (ultrasound, multi-slice computed tomography of the kidneys), the diagnosis was unclear, and therefore, the patient underwent surgical treatment. Given the risks of complications and impossibility to exclude the malignancy, a decision was made to perform nephrectomy. The diagnosis was clear cell adenocarcinoma. We consider the prompt nephrectomy in this clinical situation as a success.

[Thrombosis of the inferior vena cava and right atrium in a neonate with thrombophilia: diagnosis, treatment, result]. / Tromboz nizhnei poloi veny i pravogo predserdiia u novorozhdennogo s trombofiliei: diagnostika, lechenie, rezul'tat.

Hereditary thrombophilia is rare pathology giving rise to a ninefold increase in the risk for the development of thromboembolism in infants. The problem is multifactorial and characterized by high mortality, especially in neonates. Infants who develop thrombosis, particularly those with no family history, are often subjected to testing for hereditary thrombophilia. However, genetic testing for thrombophilia does not change the plan of treatment but makes it possible to perform prevention of thrombosis within the risk periods for the patient. Poor awareness of paediatricians, the complexity of carrying out genetic testing, the absence of approaches supported by evidence-based medicine due to shortage of high-quality clinical trials and no guidelines on prevention of thromboembolism in infants, as well as the frequent occurrence of diversified causes and diseases in different age groups make the problem significant for modern medicine. Further studies are needed to address many unanswered as yet questions.

First Experience of Sutureless Redo on Mitral Valve Using Valve-in-Valve Technique: Two-Stage Implantation on a Large Animal.

Sutureless implantation of the mitral valve bioprosthesis using the valve-in-valve method was performed on a large animal (sheep). According to the results of a two-stage implantation (primary implantation of a xenopericardial 26-mm framed bioprosthesis and reimplantation of the developed 23-mm bioprosthesis), minor changes in quantitative indicators were revealed: an increase in the transprosthetic gradient by 1.3 mm Hg and a decrease in the area of the mitral orifice by 21.6%. Considerable reduction in the intervention time by 18 min was achieved (by 40% in comparison with the primary prosthesis). The absence of adverse events in the animal and complications in the post-operative period, as well as physiological hemodynamic indicators indicate the safety of the developed medical device.

[Afalaza in the management of patients with chronic pelvic pain syndrome].

INTRODUCTION: Currently, chronic pelvic pain syndrome (CPPS) is one of the most prevalent urological diseases, but due to the multifactorial nature of the disease and the lack of consensus on its pathogenesis, the issue of adequate therapy remains open. Since the vascular factor plays the major role in the pathogenesis of CPPS, we hypothesized that this category of patients has microcirculatory disturbances of the prostate. AIM: Detection of microcirculatory disturbances of the prostate, their correction, and evaluation of the effect on the course of CPPS. MATERIALS AND METHODS: The study comprised 60 healthy, sexually active men with clinical manifestations of CPPS lasting from 6 months to 5 years. After a comprehensive examination, all patients received Afalaza 2 tablets twice daily for 16 weeks. At the end of week 16, patients were re-examined. RESULTS: In patients with CPPS, therapy with Afalaza resulted in a significant improvement in microcirculation in the prostate thus leading to the reduction of the severity of disease manifestations.

[Acute uncomplicated cysititis: do we follow the guidelines?]

INTRODUCTION: Lower urinary tract infection are a common urologic disease, but a therapy is not always optimal. AIM: to evaluate the compliance of prescriptions made by urologists in treatment of patients with lower urinary tract infection, in particular with acute uncomplicated cystitis. MATERIALS AND METHODS: A specially designed questionnaire was filled out by 161 urologists from Novosibirsk, Barnaul and Krasnoyarsk, as well as participants of VII Congress of urologists of Siberia. RESULTS: The survey showed that 34.8%, 27.9%, 22.4% and 14.9% of urologists had 6-10, 11-20, 1-5 and more than 20 patients with acute uncomplicated cystitis a month, respectively. According to results, 91.9% of urologists are familiar to National guidelines on treatment of lower urinary tract infections and 91.2% of doctors consider them to be reasonable. Among those surveyed, 29.2% of urologists believe that National Guidelines differ from European Guidelines; 95.7% of participants adhere to recommendations, but only 47.4% respect it almost always, 16.9% do it in half of cases and the remaining 35.7% comply with them in less than 40% cases. Moreover, 86.4% of urologists started a treatment of acute cystitis with antimicrobial therapy and preferred fosfomycin in 41.0%, nitrofurans in 20.9%, fluoroquinolones in 21.6% and cephalosporins in 16.5% cases, respectively. Almost all respondents (93.8%) are convinced that antibiotic therapy should be accompanied by phytotherapy, and 71.5% of urologists administer Canephron. CONCLUSION: In the urologic community there are controversies in the treatment of patients with acute uncomplicated cystitis. The choice of therapy is not always optimal.