[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.

[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.

[Possibilities of monotherapy with Prostatex in patients with chronic abacterial prostatitis].

AIM: To study the efficiency of the treatment of patients with chronic abacterial prostatitis using the drug Prostatex. MATERIALS AND METHODS: A total of 72 patients aged 22 to 43 years with chronic abacterial prostatitis were included in the study. All patients received Prostatex in the form of suppositories 10 mg QD within 20 days. The duration of the follow-up was 1 month. RESULTS: By the third visit from the start of treatment, there were almost no symptoms of the disease, according to the NIH-CPSI and IPSS questionnaires. In 67 (93.1%) patients, the prostate became an elastic, while in 69 (95.8%) men it was painless at palpation. In addition, a decrease in the prostate size, volume of residual urine and an improvement in urine flow rate were seen. CONCLUSION: Our results showed that monotherapy with Prostatex in patients with chronic abacterial prostatitis was effective and had pathogenetic rationale. This drug has a positive effect on the main symptoms of the disease, significantly reduces pain, urination disturbances, helps to reduce the prostate size and the volume of residual urine, improves prostate microcirculation and can be recommended for this category of patients.

[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.

[Treatment and prevention of chronic cystitis in women].

AIM: to evaluate the efficiency of the dietary supplement NefroBest in women with chronic cystitis. MATERIALS AND METHODS: On the basis of the Department of Urology and Nephrology of the Altai State Medical University and the urological department of the NUZ CH "RJD Medicine", Barnaul, from September 2019 to August 2020 a total of 40 women with chronic cystitis were treaeted. Depending on the type of treatment, all women were divided into the main and control groups, each of 20 people. In the main group, patients received standard therapy and dietary supplements NefroBest. In the control group, patients were prescribed only to standard therapy. RESULTS: The results were evaluated one and two months after the start of therapy. In the main group a more rapid resolution of symptoms and laboratory abnormalities were seen, as well as an improvement of the endoscopic picture and urodynamic parameters. CONCLUSION: The complex of biologically active substances in the dietary supplement NefroBest has an antimicrobial, anti-inflammatory and antispasmodic effect, and reduces the risk of recurrence of chronic cystitis. Thus, the dietary supplement NefroBest can be recommended as a component of the complex therapy of recurrences of chronic cystitis, as well as a prophylactic treatment during relapse-free period.

[Possibilities of using sildenafil in patients with cardiovascular comorbidities who underwent transurethral resection of the prostate].

AIM: To study the efficacy and safety of using sildenafil in patients with erectile dysfunction (ED) and concomitant cardiovascular diseases (CVD) who underwent transurethral resection of the prostate (TURP). MATERIAL AND METHODS: A total of 59 patients (age from 50 to 75 years) with a diagnosis of benign prostatic hyperplasia (BPH), requiring surgical treatment due to inefficiency of drug therapy, I-PSS score more than 20 points), who were sexually active, but had erectile dysfunction (IIEF score < 21), coronary heart disease (NYHA class I) and stage 1-2 hypertension with stable blood pressure. All patients underwent bipolar TURP. From the first day after the TURP, therapy was prescribed as following: tamsulosin 0.4 mg once a day for 90 days, ciprofloxacin 500 mg twice a day for 10 days. In addition, the patients received treatment for comorbidities. In the main group (n=30), men additionally received sildenafil (EFFEX Sildenafil Evalar) 50 mg daily for 60 days, starting from the 30th day postoperatively. We have chosen this drug from an economic standpoint. RESULTS: At baseline, all patients in both groups had hemodynamic and microcirculatory disorders in the prostate, which got worse in the early postoperative period. During the long-term follow-up, hemodynamic and microcirculatory impairments decreased. This effect was more pronounced in patients who received sildenafil. In addition, patients had an improvement in sexual function. During follow-up, there was no adverse effects of sildenafil on hemodynamic parameters (blood pressure, heart rate). CONCLUSION: Our results allow to recommend sildenafil in order to restore sexual function postoperatively in patients with BPH, including those with concomitant cardiovascular disorders.

[The influence of proteolytic enzymes on the antioxidant defensive system in infertile married men].

The causes of male infertility remain unclear in 30-75% cases and are considered idiopathic. The study of influence of free oxygen radicals on the male reproductive function is of outmost interest. Given the important role of hyaluronidase in the penetration of sperm into the egg, we decided to evaluate the drug Longidaza, which has long-acting enzymatic (proteolytic) activity. A total of 48 men with idiopathic infertility were included in the study. All patients were divided into two groups (24 men each). In Group 1 there was a recommendation to attempt to conceive for 1 year without additional treatment. In Group 2, patients were prescribed Longidaza according to the proposed scheme. During the follow-up, there was a significant improvement in the antioxidant defense system of the ejaculate in Group 2, which was accompanied by an increase in the fertilizing ability of the ejaculate and an increase in number of conceptions by 29.1.

[The preparation of patients with urinary stone disease to extracorporeal shock-wave lithotripsy].

The treatment of urinary stone disease is one of the most urgent and complex issue in modern urology. Citrate is one of the most important natural urinary inhibitors of stone formation. In this regard, the drugs containing citrate sodium and potassium are being actively used. AIM: to assess the efficiency and safety of Uryklar, dietary supplements. MATERIAL AND METHODS: A total of 57 patients with proximal ureteric stones were included in the study (intervention group (n=30) and control group (n=27)). After stenting all patients received antispasmoic, anti-inflammatory and antimicrobial therapy. In the intervention group Uryklar was additionally administered (405 mg), 1 capsule TID for 1 month. All patients were undergone to extracorporeal shock-wave lithotripsy with subsequent removing of the stent. In all cases multiplanar CT was done before and 28 days after initiation of drug therapy for determination of stone size, contour and density. 10 days after stent removal the symptoms and stone-free rate were assessed using US, plain X-ray and intravenous urography, blood count, urinalysis, biochemical blood analysis. RESULTS: In patients receiving Uryklar, there was a significant reduction of stone size during the observation, up to complete dissolution.

[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.

[The effectiveness of Uroprofit in women with chronic cystitis].

AIM: To evaluate the effectiveness of the biologically active dietary supplement Uroprofit in the comprehensive management of exacerbations of chronic recurrent cystitis in women. MATERIALS AND METHODS: We examined 40 women with chronic cystitis aged 20-68 years. All patients were allocated to receive either monotherapy with fosfomycin (Monural) (control group, n=20) or combination therapy with fosfomycin and biologically active dietary supplement Uroprofit (study group, n=20). The results were evaluated at 1 and 2 months after treatment initiation. All patients before and after treatment underwent diagnostic work-up including standard laboratory tests, uroflowmetry, cystometry, cystoscopy, and laser Doppler flowmetry to assess microcirculation. RESULTS: The patients of the study group showed faster improvement in clinical manifestations of the disease, laboratory indicators, the dynamics of the endoscopic pattern and had positive changes in the bladder mucosa microcirculation. DISCUSSION: Uroprofit produces an antimicrobial and anti-inflammatory effect, helps normalize urodynamics of the lower urinary tract, improves microcirculation in the bladder wall and reduces the risk of repeated relapses of chronic cystitis. CONCLUSION: Uroprofit could be recommended as a component of the comprehensive management of exacerbations of chronic recurrent cystitis in women and as the means of preventing relapses in disease-free periods.

[ROLE OF CYTOMEDINES IN THE TREATMENT OF PATIENTS WITH CHRONIC PROSTATITIS ASSOCIATED WITH IMPAIRED SPERMATOGENESIS].

The efficiency and safety of tablet drug Vitaprost in the treatment of 35 patients with chronic abacterial prostatitis associated with impaired spermatogenesis were evaluated. The treatment course comprises the use of drug 1 tablet 2 times a day for 60 days. It was shown that Vitaprost had a positive effect on the basic parameters of spermatogenesis, helping to increase the number of sperm cells (28.8%), their mobility (17%), and viability (14.2%). The number of abnormal sperm cells at the same time decreased by 26.2%.

[Potentials for the use of complex drugs in the treatment of patients with chronic abacterial prostatitis].

Efficiency and safety of complex preparation prostadoz was evaluated in 25 patients with chronic abacterial prostatitis. It is proved that the use of prostadoz has a positive effect on the main subjective and objective signs of the disease: improves urination, reduces the severity of pain, moderately reduces the prostate volume, improves sexual-ejaculatory performance and improves quality of life.

[Experience of the use of silodosin in acute urinary retention caused by benign prostatic hyperplasia].

For the treatment of acute urinary retention (AUR) as one of the most serious complications of adenoma of the prostate (BPH), alpha-adrenoblockers are widely used. The article presents an experience of the use of the new uroselective alpha-adrenoblocker silodosin approved for the treatment of patients with urination disorders caused by BPH. Its pharmacological profile has a number of advantages, including the highest uroselectiveness at the present day, immediate action, the potential for the use of standard dose of 8 mg 1 time a day, which does not require a correction depending on the age, and the possibility of the simultaneous application with antihypertensive drugs.

[The use of drug vitaprost forte in patients with benign prostate hyperplasia].

The efficacy and safety of vitaprost forte rectal suppositories 100 mg in 30 patients with benign prostate hyperplasia (BPH) were evaluated. It is proven, that the use of this drug positively affects both the subjective and the objective symptoms of BPH. Vitaprost forte significantly reduces the clinical signs of the disease and improves quality of life, that is, reduces the severity of bladder outlet obstruction (according to the data of uroflowmetry, it increases maximum urinary flow rate), decreases the amount of residual urine. In addition, moderate reduction in mean prostate volume was revealed in BPH patients receiving vitaprost forte.

[Administration of vitaprost plus for prevention of infectious-inflammatory complications of transurethral prostatic resection in patients with prostatic adenoma].

The study of efficacy and safety of the drug vitaprost plus (rectal suppositories) in its use for prevention of infectious-inflammatory complications after transurethral resection (TUR) of the prostate for adenoma included 55 male surgical patients with prostatic adenoma (PA). The patients were randomized into two groups matched by age, symptoms and clinical data. The control group consisted of 20 patients (group 1), the study group--of 35 patients (group 2). TUR of the prostate was made in both groups, but patients of group 2 were given additional prophylactic treatment--vitaprost plus, one suppository before going to bed 2 days before surgery and for 8 days after TUR, the course lasted for 10 days. Postoperative blood and urine samples showed inflammatory changes more often in group 1, free of infection bacterial tests were more often in group 2. Renal microcirculation in group 1 after TUR evidenced for functional depression on perfusion intensity and renal ischemia and congestion. These changes persisted on postoperative day 8, being a potential cause of renal inflammation and ascending pyelonephritis. Group 2 patients exhibited insignificant postoperative microcirculatory disorders in the kidneys and were not registered on postoperative day 8. Infectious-inflammatory complications in group 1 patients were registered much more frequently than in group 2 patients. Thus, vitaprost plus can be recommended for prophylaxis of infectious-inflammatory complications of TUR in PA patients.

[Combined treatment of patients with nephrolithiasis complicated with secondary pyelonephritis].

A total of 151 patients with nephrolithiasis participated in the study of efficacy and safety of the drug prolit cepto in conservative treatment of nephrolithiasis patients, preoperative preparation and in postoperative period after extracorporeal shock-wave lithotripsy (EC-SWL) or nephrolitholapaxy. It was found that combined treatment of nephrolithiasis complicated by secondary pyelonephritis with addition of prolit cepto raises efficacy in management of inflammation due to a positive action on microcirculation and urine bacteria. Administration of prolit cepto in nephrolithiasis patients exposed to EC-SWL or nephrolitholapaxy reduces the risk of infectious and inflammatory complications, has a nephroprotective effect and improves the course of postoperative period.

[Characteristics of a spermogram and metabolic parameters of active oxygen forms in the ejaculate of patients with chronic abacterial prostatitis].

Chronic inflammatory diseases of the prostate are accompanied by the accumulation of active oxygen forms and the activation of biopolymer peroxidation. The increased concentration of thiobarbituric acid reactive substances and the decreased activity of antioxidant enzymes in the ejaculate of patients with chronic abacterial prostatitis are attended by spermatozoon defects. It is suggested that correction of the metabolism of active oxygen forms in patients with chronic abacterial prostatitis has a positive effect.

[Defects in spermatogenesis and their correction in patients with chronic abacterial prostatitis].

A total of 28 males aged 20-46 years with chronic abacterial prostatitis (CAP) were divided into two groups. Group 1 patients received standard therapy (prostatotropic, vitamin, antioxidant); group 2 received the same standard treatment plus peloid therapy including silver-containing clay "Bekhtemirskaya". Eleven males with documented fertility (sperm donors) comprised a control group. The participants of the trial were examined for ejaculate indices, activity of the antioxidant system, ion composition of ejaculate, prostatic microcirculation before the treatment, on treatment day 14 and 90. The examination revealed the following disorders in CAP patients: low activity of anti-oxidant enzymes, abnormal static microcirculation, low content of normal spermatozoa in ejaculate. Complex rehabilitation of the patients of both groups improved prostatic microcirculation, raised activity of the antioxidant system resulting in better mobility and viability of spermatozoa. In group 2 the results were better showing the efficacy of local peloid therapy.