[Immunological parameters of urine in differential diagnosis of chronic recurrent cystitis in women].

INTRODUCTION: Chronic recurrent cystitis (CRC) is a complex multifaceted problem of modern uroinfectology. OBJECTIVE: To study the immunological parameters of urine in patients with chronic recurrent cystitis depending on the etiological factor. MATERIALS AND METHODS: The prospective study included 71 patients aged 20-45 years who had previously been diagnosed with recurrent lower urinary tract infection: chronic recurrent cystitis (CRC) during an exacerbation period. Based on the results of bacteriological and PCR studies of urine, scraping of the urethra and vagina, depending on the dominant etiological factor, the patients were divided into three groups: group 1 (n=30) - with papillomavirus CRC (PVI-CRC), group 2 (n=30) - with bacterial CRC (B - CRC), group 3 (n=11) - with candida CRC (C - CRC). Analysis of the assessment of immunological parameters of urine was carried out using an enzyme-linked immunosorbent assay (ELISA-BEST). RESULTS: Based on the results of an immunological study of urine in the study groups, characteristic specific changes in the level of interleukins and interferons were identified, which made it possible to determine a protocol for the differential diagnosis of CRC. CONCLUSIONS: Our study shows the advisability of testing interleukins in urine (IL-1 beta, IL-6, IL-8); these indicators can serve as scoring criteria in the differential diagnosis of CRC of various origins. CONCLUSIONS: , it is reasonable to study the level of IFN-2b and IFN; when identifying the functional inferiority of the IFN system in women with CRC, correction of the IFN system is necessary.

[Extended culture study as a keypoint to rethinking antibiotic therapy for chronic bacterial prostatitis].

OBJECTIVE: To juxtapose the microbiological efficacy of standard and targeted antibiotic therapy (ABT) based on the comparison of the results of extended bacteriology of biomaterial in patients suffering chronic bacterial prostatitis (CBP) before and after treatment. STUDY DESIGN: single-centre observational comparative study. Sixty patients with CBP aged 20 to 45 years were included in the study. All patients underwent an initial examination: questioning, Meares-Stamey 4-glass test, extended bacteriology of biomaterial samples, and determination of antibacterial susceptibility (ABS). After the initial examination, the patients were randomly assigned to two groups (30/30 patients). In group (G) 1, antibacterial drugs were prescribed following the EAU guidelines on Urological Infections (monotherapy), in G2, focusing on the results of ABS (mono or combination therapy). Evaluation of the treatment effectiveness and control bacteriology were carried out three months after therapy. RESULTS: In G1 vs G2, nine vs ten aerobes and eight vs nine anaerobes were identified in the expressed prostate secretion, respectively. The microbial load of the samples in more or equal 103 CFU / ml was established in G1 vs G2 for five vs ten aerobes and seven vs eight anaerobes, respectively. The highest ABS of bacteria was determined to moxifloxacin, ofloxacin, and levofloxacin. Cefixime was the most active against anaerobes. After treatment, no significant changes in the bacterial spectrum were observed in both groups. A more reliable decrease in the frequency of microorganism identification and the microbial load of the samples was observed in patients with G2 after the targeted ABT. CONCLUSION: Targeted ABT based on extended bacteriology can be considered an effective alternative to standard guideline-approved ABT for the treatment of CBP.

[Cytological examination of urine in the differential diagnosis of recurrent lower urinary tract infection].

INTRODUCTION: A diagnosis and treatment of recurrent lower urinary tract infection (UTI) in women is still one of the unresolved problems of urology. The proper identification of the etiological factor determines the treatment tactics. Therefore, the most urgent issue of recurrent lower UTI is the differential diagnosis of the causative pathogens. MATERIALS AND METHODS: A cytological study of urine was performed in 151 patients with recurrent lower UTI, who, according to the results of bacteriological and PCR studies of urine, were divided into three groups, depending on the etiological factor. The group 1 (n=70) included women with recurrent lower UTI of bacterial etiology, while in group 2 (n= 70) papillomavirus etiology was found, and in group 3 (n=11) candida species were the causative pathogens. The age of the patients ranged from 20 to 45 years (32.3+/-7.8). RESULTS: In the majority of patients with recurrent lower UTI of bacterial etiology, the cytological features were represented by leukocytes, plasma, epithelial cells and bacteria in combination with actively phagocytic macrophages. In group 3, in addition to a large number of leukocytes (neutrophils) and epithelial cells, Candida mycelium was found. In group 2, signs of bacterial inflammation were minimal, while a predominance of lymphocytes, epithelial cells, and the presence of single neutrophils was seen. With papillomavirus lesions of the bladder, urothelial cell dystrophy with the presence of koilocytes developed. CONCLUSIONS: A cytological examination of urine can confirm the etiology of the recurrent lower UTI and be an evidence-based criterion in the differential diagnosis of bacterial, candidiasis, and papillomavirus infection. Total transformation of the urothelium and vacuolization of urothelial cells, as well as an excess of lymphocytes in the urine in the absence of neutrophils, are the characteristic features of viral recurrent lower UTI.

[The role of electron microscopy of ejaculate in the diagnosis of infertility associated with human papillomavirus infection].

INTRODUCTION: The problem of male infertility is multifactorial. However, in recent years, the question of the involvement of viruses, in particular human papillomaviruses (HPV), in the development of this condition has been actively discussed. PURPOSE OF THE STUDY: To study the role of ejaculate electron microscopy in the diagnosis of infertility associated with human papillomavirus infection. MATERIALS AND METHODS: The analysis of the results of electron microscopic examination of the ejaculate in 51 patients aged 22 to 40 years (mean age 32.3 +/- 6.4) with a diagnosis of infertility and pathospermia, combined with human papillomavirus infection (PVI), but with the absence of other risk factors, was carried out. RESULTS: Various variants of pathozoospermia were found in the ejaculate: asthenozoospermia (35.3%), asthenoteratazoospermia (31.4%), oligoasthenoteratazoospermia (19.6%), oligoasthenozoospermia (13.7%). Among the studied HPV types of high oncogenic risk prevailed (16, 18). More often (88.2%), HPV was registered as part of associations with dominance of types 16 and/or 18 and 33, as well as types 18 and 33. In electron microscopy, in 80.3% of cases, HPV was fixed on spermatozoa with localization on the acrosome (76.4%) and in the sperm plasma (52.9%). CONCLUSIONS: PVI, regardless of the type of HPV and the localization of virions on spermatozoa, significantly impairs the progressive motility and morphology of spermatozoa. The electron microscopy method allows not only to detect HPV in the ejaculate, but also to clarify its localization on the spermatozoon and determine those negative changes in the spermatozoon that are caused by the virus.

[Efficacy of Uronext in chronic recurrent bacterial-viral cystitis with multiple resistance to antibacterial drugs].

Chronic recurrent cystitis (CRC) is one of the most common diseases of the lower urinary tract in the female population. Difficulties in diagnosis and treatment, despite the observance of modern clinical recommendations for CRC, are due to the versatility and polyetiology of the pathogenesis of the disease. The most difficult and discussed section of this problem is the diagnosis and treatment of CRC of papillomavirus (PV) etiology. The article presents its own clinical observation - Diagnosis and treatment of a patient with CRC PV etiology. CRC, in addition to bacterial uropathogens, can be caused by various representatives of a viral infection. Among all viral pathogens, HPV has the widest pathogenic potential. Currently, there is no single etiotropic therapy for PVI of the urinary tract and reproductive organs; there is no systemic treatment of patients with HPV-associated lesions, including the bladder. Nevertheless, an important principle of therapy, which has already become an axiom, is applied - an integrated approach that includes anti-inflammatory,antiadhesive, antiviral and immunoactive therapy.

[Management of lower urinary tract symptoms in patients with benign prostatic hyperplasia during COVID-19. results of an all-russian observational study ATLANT].

BACKGROUND: COVID-19 aggravates lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). The optimal treatment regimen for patients with this disease during the COVID-19 pandemic is still under question. OBJECTIVES: The aim of the All-Russian observational study of Afalaza in the Treatment of LUTS in pAtieNTs with BPH during COVID-19 (ATLANT) was to obtain additional data on the efficacy and safety of Afalaza in this patient group. METHOD: s. The study enrolled 73 men aged 46-65 years with LUTS and diagnosed BPH who suffered from COVID-19. All patients received Afalaza for 16 weeks. The dynamics of BHP indicators, erectile function, and quality of life were assessed after 4, 12, and 16 weeks of treatment. RESULTS: Patients with LUTS/BHP who suffered from COVID-19 had a decrease in the total IPSS score from 21.6+/-8.6 to 6.4+/-2.4 (-70.4%) points after 16 weeks of treatment. There was a direct correlation between COVID-19 duration (and beginning of therapy) and the severity of symptoms after Afalaza treatment. According to the subjective assessment of patients, there was a significant increase in the quality of life and erectile function after 16 weeks of treatment. 9 mild AEs were registered in 12.3% of patients and were unrelated to the study drug. CONCLUSIONS: Results show that Afalaza may be a perspective drug for the treatment of LUTS/BPH in patients with COVID-19 and be used for this urological disease in the current COVID-19 pandemic.

[Serum testosterone and testicular hemodynamics before and after infection with SARS-COV-2 (pilot study)].

INTRODUCTION: The current epidemiological situation dictates a detailed study of the effect of a new coronavirus infection (SARS-CoV-2) on various anatomical, histological, physiological and biochemical parameters of the human body, which has become an integral part of many medical research, including urology, andrology, endocrinology. OBJECTIVE: To study serum testosterone levels and testicular hemodynamics before and after infection with SARS-CoV-2. MATERIALS AND METHODS: 20 patients were examined, before and after suffering SARS-CoV-2 infection (who fell ill at the beginning of 2020). Average age 37.8 years (min=27, max=50). The level of total testosterone (s) in the blood serum and hemodynamic parameters of the testicles (maximum and minimum blood flow velocity and resistance index) were studied. RESULTS: When studying the level of s 3 months after the transferred SARS-CoV-2, its decrease from the initial value was noted (r=0.47; p=0.35), and after 6 months (r=0.98; p<0.007) there was no recovery of the target level of Ts before infection with SARS-CoV-2. Regarding the hemodynamics of the testicles, there was also a decrease in Vmax and Vmin, and an increase in RI, which indicates a deterioration in the blood flow of the testicles (p<0.001). CONCLUSION: SARS-CoV-2 affects the level of Ts in the blood serum and the parameters of the hemodynamics of the testicles. The extent to which SARS-CoV-2 affects patient performance depends largely on the severity of the disease and to a lesser extent on baseline performance.

[Idiopathic infertility and human papillomavirus infection].

INTRODUCTION: Infertility is the complex and urgent problem in reproductology. Now HPV involvement in male infertility is considered proven. OBJECTIVES: of the study: To study the etiological structure of human papillomavirus infection (HPV) in ejaculate in men with infertility, as well as to assess the effect of HPV on the parameters of sperm (motility, quantity, morphology). MATERIALS AND METHODS: The analysis of the results of the examination of 71 patients aged 22 to 44 years with a diagnosis of infertility, combined with PVI, with the absence of other risk factors. The assessment of the fertilizing ability of the ejaculate was carried out in accordance with the data and parameters recommended by the WHO (2010) in the clinical diagnostic laboratory. To identify the type of virus used amplification method of DNA - diagnostics (polymerase chain reaction - PCR). The material for the study was ejaculate. RESULTS: The analysis of the ejaculate: asthenozoospermia was detected in 56% cases, asthenoteratozoospermia - 21%, oligoasthenoterozoospermia - 16%, oligoastenozoospermia - 6%. The most frequent HPV types were 16 (60,7%), 18 (54,9%), 33 (49,3%). The most frequent HPV types combinations were 16 with 18 (33,8%), 16 with 33 (35,2%), 18 with 33 (28,2%). The number of virus types has a statistically significant weak correlation with sperm motility (r=-0.267; p=0.0244). Combinations of types 6 and 11, 11 and 16, 16 and 33, 31 and 33 of HPV types more often than others worsened several sperm parameters rather than one. The combination of 6 and 11 HPV types significantly decreases progressive (6.20+/-4.18% and 10.52+/-5.66, p=0.026) and total (11.10+/-5.95% and 17.90+/-6.92%, p=0.0056) motility compared with other combinations of HPV types. The combination of 31 and 33 HPV types was characterized by a large decrease in the total sperm count (12.78 +/- 8.81 million and 21.82+/-9.92 million, p=0.011) and the count of sperm in 1 ml (29.11+/-21.54 million and 53, 35+/-22.13 ppm, p=0.0052) compared with other combinations of HPV types. CONCLUSIONS: According to the results of the study, patients with idiomatic infertility, combined with PVI, have different variants of pathozoospermia.

[Virusuria as a component of the urine microbiota and its significance for assessing the health of the urinary tract: a descriptive clinical study].

AIM: To determine the frequency of occurrence of oportunistic pathogenic bacterial flora and viral pathogens in the urine of healthy people with the establishment of the association between them. MATERIALS AND METHODS: 40 healthy sexually active women and men were examined, which are divided by gender into equivalent groups: Group I - healthy women (n=19), Group II - healthy men (n=21). The age of the subjects ranged from 20 to 25 years, the average age was 22.4+/-1.2 years. In both groups, the average portion of morning urine was taken for a study after a proper hygienic procedure with self-urination of the subjects in a sterile plastic container (Sterile Uricol for urine sample collection "HiMedia"). In addition to the nutrient media regulated by the Clinical Guidelines, additional HiMedia chromogenic media were used to cultivate facultative anaerobic (FAB) and non-clostridial anaerobic bacteria (NAB). Detection of viruses was performed by PCR with detection in "real time". DNA isolation was carried out by the sorption method using the AmpliPrime DNA-Sorb-B ("NextBio") kit from urine samples, with preliminary concentration. RESULTS: In all 40 cases, normative leukocyturia was detected in the urine. According to the results of bacteriological examination of urine, healthy men and women in all cases found aerobic-anaerobic associations. Coagulase-negative staphylococci (CNS) and Corynebacterium spp. Dominated in the cluster of aerobic taxa of microbiota. (75.0%, 55.0% respectively). The spectrum of CNS was represented by five species: S.epidermidis (30.0%), S.haemolyticus (27.5%), and S.warneri (25.0%), S.saprophyticus and S.lentus (15.0%). Enterococcus spp. were recorded in the urine in 32.5% of cases. Representatives of the Enterobacteriaceae family were represented by 4 taxa: E. coli (10.0%), Klebsiella spp., Proteus spp. (5.0% each), Enterobacter spp., Citrobacter spp. (2.5%). In a cluster of anaerobic bacteria in the urine, Eubacterium spp. (60.0%) and almost half of healthy individuals recorded Lactobacillus spp. and Peptococcus spp. (42.5% each). When analyzing the frequencies of detection of various microbiota taxa, it was found that women significantly more frequently recorded urine Corynebacterium spp., Eubacterium spp. and Lactobacillus spp., as well as Enterococcus spp. and Peptococcus spp. Peptostreptococcus spp. and Veillonella spp. were significantly more often determined (p<0.05) in the urine of men. HHV6 (10.0%), HPV18 and B19 parvovirus (2,5%) were determined in the urine of healthy people. It should be noted that the studied viruses were more often recorded in men, in particular, HPV18 and parvovirus B19 - only in men, and HHV6 more often in men (7.5%), less often in women (2.5%). Significant associations of some genera of microorganisms with the sex of the participants were revealed for E. faecalis and Lactobacillus spp., which were more often found in the urine of healthy women Reliably significant associations were found for three taxa: viruses HPV6, HPV18 and parvoviruses B19 (16.7%) were determined in the presence of Bacteroides spp., Bifidobacterium spp., and Prevotella spp., in urine. Accordingly, in 83.3% of cases, these viruses were detected in the absence of the above-listed taxa of microorganisms in the urine. CONCLUSIONS: The normal urinary microbiota of healthy women and men has differences: Lactobacillus spp and Candida spp are absent in the urine of men while Streptococcus spp in urine of women. HHV6, HPV18, parvoviruses B19 are found in urine of healthy people and more often in men. Data about the virobiota and microbiota of urine in healthy people can highlight on the pathogenesis of urinary tract infections of various localization and develop targeted approaches in personalized therapy of this group of diseases.

[A comparative analysis of the effectiveness of serenoa repens and serenoa repens in combination with urtica dioiccus for lower urinary symptoms suggestive of benign prostatic hyperplasia associated with chronic inflammation in prostate tissue].

INTRODUCTION: Benign prostatic hyperplasia (BPH) is the most common proliferative disease of the prostate gland in the elderly. MATERIALS AND METHODS: The results of an open, randomized comparative study of the effectiveness of Serenoa repens in the combination with Urtica dioiccus (Prostagut-forte) are presented in the article. All patients were divided into two groups, depending on the therapy. In group I (n=51) Serenoa repens in combination with Urtica dioiccus 160/120 mg twice daily for 3 months was given, while in Group II (n=51) patients were prescribed to Serenoa repens 320 mg once a day, for 3 months. RESULTS: According to the results, herbal preparations, like Serenoa repens, are effective for the medical treatment of BPH, which is confirmed by a decrease in LUTS severity, an increase in Qmax, a decrease in postvoid residual urine volume and an intensity of the inflammatory process in the prostatic tissue. However, in patients with BPH associated with chronic inflammation, it is preferable to use Serenoa repens in combination with Urtica dioiccus.

[Microbiota of lower urine tract and genital organs of healthy men and in infertility].

AIM: Study microflora of urine, ejaculate, urethra scrape in normal state and infertility. MATERIALS AND METHODS: 2 groups of men were examined: I (28)--control, conditionally healthy men (20 - 25 years of age), II (26)--infertile patients (25 - 35 years of age). Middle portion of morning urine, ejaculate, urethra scrape were studied in group I, in II--ejaculate. Bacteriologic study of urine and ejaculate was carried out in an extended kit of nutrient media (HiMedia) for facultative- anaerobic (FAB) and non-clostridia anaerobic bacteria (NAB). Urethra scrape and ejaculate were studied by PCR in group I. RESULTS: In urethra scrape and ejaculate a wide spectrum of FAB and NAB was detected in group I. Corynebacterium spp. and coagulase-negative staphylococci (67.9% each) were the dominant cluster of FAB. Eubacterium spp.--in NAB. Bacteriologic study of ejaculate corresponded in PCR with similar results of dominating bacteria. Among FAB the same clusters dominated during bacteriologic study of ejaculate from group II patients, among NAB--Propionibacterium spp., Peptococcus spp. and Peptostreptococcus spp. Quantitative characteristics of ejaculate of group I and II differed insignificantly. CONCLUSION: The frequency of detection of certain genera of FAB and NAB was significantly higher in patients with infertility than in conditionally healthy men, however quantitative parameters of the isolated microorganisms practically did not differ between groups.

[Problems of testosterone deficiency and erectile dysfunction in men (literature review)].

In recent years, treatment of men with testosterone deficiency has become an important part of andrological and urological practice. Clinical manifestations of testosterone deficiency syndrome are usually diverse. Testosterone deficiency and erectile dysfunction often occur against the background of some systemic diseases, and sometimes are markers or predictors of these diseases. It is important that erectile dysfunction and testosterone deficiency syndrome are closely interrelated, and the correction of these conditions requires account of specific treatment of both diseases.

[Some aspects of the treatment of persistent lower urinary tract infections in women].

Chronic recurrent cystitis in women is a major socio-economic problem. In the pathogenesis of recurrent infection, violations of mechanisms of innate immunity of the bladder mucosa, and the persistence of microorganisms play an important role. The study included 43 women (mean age 39.5±1.2 years) with persistent lower urinary tract infection. The mean duration of disease was 6.5±1.8 years. Depending on the therapy, patients were divided into two groups. Patients in Group 1 (n = 20) have received only fosfomycin trimetamol 3 g every 10 days for 3 months, patients in group 2 (n = 23) have received the drug viferon® (rectal suppositories) 1 million IU per rectum 2 times per day at intervals of 12 hours for 20 days in addition to antibiotic therapy at the same dosage. The inclusion of immunomodulator in the complex therapy of persistent lower urinary tract infections contributed to the reduction of relapse rate by 1.5 times, and reduction of the number of patients with relapses by 4 times.

[Unsterile urine in health human--new paradigm in medicine].

The 3-fold urine culture evaluation in healthy women (24) and men (28) was performed. In 100% of cases, various types of multicomponent aerobic-anaerobic microorganism associations were found. Dominant clusters in the urine of women incleded coagulase-negative staphylococci, Corynebacterium sp., Lactobacillus sp., Peptococcus sp., Propionibacterium sp., in men--coagulase negative staphylococci, Corynebacterium sp., Eubacterium sp. For aerobic microorganisms, level of bacteriuria in both groups was 10(2) CFU/ml, for most anaerobes--≥10(3) CFU/ml. Spectrum of microorganisms isolated from the urine was quite wide and variable. In women, number of assiociates in urine ranged from 3 to 10, in men--from 6 to 9, as well as individually--in each subject, the original range of microorganisms was not repeated in any other case.

[The microbial spectrum of urine and bladder bioptic samples in women with chronic recurrent cystitis].

The evaluation of urine and bladder bioptic samples (bacteriological examination and polymerase chain reaction) of 28 women with chronic cystitis was performed. In 85.7% of cases, mixed infections with predominance of nonclostridial anaerobes in the urine was detected. Herpes simplex virus type 1 was detected in 7.1% of cases. In the same manner as in urine, predominance of nonclostridial anaerobes in bladder bioptic samples (85.7%) was observed. Identical bacteria in urine and bladder bioptic samples were revealed in 64.3% of patients. Herpes viruses and papillomaviruses were frequently registered (p < 0.05) in the bioptic samples.

[Treatment of recurrent large external genital warts in men].

The article presents the results of treatment of 51 men with recurrent genital HPV infection in the form of genital warts. Patients were divided into two groups depending on the treatment. Group 1 of patients has received the combination treatment--electrocoagulation + pharmacotherapy (panavir intravenously and topically in the form of a gel), Group 2 of patients--only electrocoagulation. According to the results of follow-up within 6 months, disease recurrence rate was significantly higher in Group 2--39.5% versus 9.6% in the Group 1. Postoperative complications were also more frequently recorded in the Group 2. These findings suggest that the combined treatment of reccurent forms of genital warts is preferred than just using destructive methods of treatment.

[Non-clostridial anaerobic bacteria can cause acute pyelonephritis (an experimental trial)].

Acute obstructive pyelonephritis (PN) caused by Peptococcus niger (Pn), E. coli and mixed infection (Pn + E. coli) was modeled in rabbits. Morphologic examination showed that in animals with peptococcal infection renal lesions were identical to those in escherichial PN. Hemorrhagic infarctions and vasculitis develop in animals with mixed infection. These morphological findings were confirmed bacteriologically. The experimental trial confirms the role of Pn in development of acute obstructive PN in animals.

[Bacterial mixed infection in women with chronic recurrent cystitis].

AIM: To study microbial repertoire of urine in healthy women and patients with chronic recurrent cystitis (CRC) including facultative anaerobic (FA) and non-clostridial anaerobic (NCA) bacteria. MATERIALS AND METHODS. Triple bacteriological study of urine was performed in three groups of women: group I--22 healthy virgin women aged 18- 25 years, group II--24 women aged 18 - 25 years with regular sexual contacts, group III--72 women aged 20 - 60 years with CRC, before antibacterial therapy. Bacteriological method was used to study qualitative and quantitative composition of urine microflora. RESULTS: In all subjects from groups I and II aerobic-anaerobic associations with predomination of coagulase-negative staphylococci (CNS), corynebacteria, peptococci, and peptostreptococci were isolated from urine. Quantity of isolated NCA bacteria was significantly higher than that of FA. In etiologic structure of CRC, NCA bacteria, enterobacteria, and CNS predominated. Spectrum of NCA bacteria isolated from patients with CRC was wider and level of bacteriuria--higher (p < 0.05) compared to groups I and II. Bacteria were identified in aerobic-anaerobic associations. In 85.7% of cases following NCA were identified in biopsy samples: Propionibacterium sp. (41.8%), Peptococcus sp. (35.7%), Eubacterium sp. (28.6%), Peptostreptococcus sp. (14.3%), and Bacteroides sp. (14.3%). Aerobic-anaerobic associations were observed in 7.1% of samples. CONCLUSION: Urine of healthy women is not sterile. Aerobic-anaerobic mixed infections were detected in patients with CRC that should take into account during diagnostics and treatment of this disease.

[Etiological structure and antibiotic sensitivity of uropathogens in chronic recurrent infection of the lower urinary tract].

While acute infections of the lower urinary tract (UT) have been studied in detail and antibiotic therapy of such infections is well known, etiology and choice of antibacterial treatment in recurrent chronic UT infection are not so clear. In our trial we aimed at elucidation of etiological structure of chronic cystitis recurrences by means of microbiological investigation of urine samples from 72 women on extended spectrum of nutrient media. In all the cases urine was infected with both aerobic and non-clostridial anaerobic bacteria. We determined prevalent pathogens and their antibiotic sensitivity and compared them with standard pathogens and their sensitivity in acute lower UT infection. We came to the conclusion that it is necessary to develop new recommendations on antibiotic treatment of recurrent chronic cystitis in women.