[The experience of using drug Afalaza for treatment of lower urinary symptoms in treatment-nave patients with benign prostatic hyperplasia].

INTRODUCTION: Benign prostatic hyperplasia (BPH) is one of the most common diseases in men over 50 years. The prevalence of the BPH increases with age, and pathologic features of BPH are found in about 90% of men over 80 years. AIM: The aim of the study was to study the efficacy and safety of Afalaza for the treatment of lower urinary tract symptoms (LUTS) in treatment-nave patients with BPH. MATERIALS AND METHODS: A multicenter study of using Afalaza for the treatment of LUTS in treatment-nave patients with BPH was carried out in 9 urological centers in Moscow. A total of 80 treatment-nave patients with BPH were enrolled. The improvement in the total score of IPSS, IIEF-5 and QoL after 30 weeks of therapy was evaluated as well as changes in prostate volume and maximum urinary flow rate (Qmax). RESULTS: After 30 weeks of therapy, there was a significant decrease in the total IPSS score. A decrease in the total IPSS score by 5.5 points (+37.9%) from 14.5+/-4.0 at the baseline to 9.0+/-4.1 at the visit 9 was seen. The QoL decreased by 1.8 (-38.3%) points from 4.7+/-1.0 at the baseline. The Qmax also changed from 12.7+/-4.6 to 16.4+/-5.7 (+28.3%) after 30 weeks of therapy. At the visit 9, the total IIEF5 score increased by 3.4+/-4.4 (+19.9%) from 17.1+/-4.3 at the baseline. In addition, prostate volume decreased from 42.7+/-11.1 at baseline to 41.0+/-9.8 cc post-treatment (-5.15%). A reduction of post-void residual urine volume from 26.0+/-25.3 at baseline to 17.7+/-24.2 (-31.9%) post-treatment was also shown. CONCLUSION: The results of a multicenter study demonstrate the efficacy of Afalaza for treatment of treatment-nave patients with LUTS/BPH. Afalaza reduces prostate volume and improves an erectile function.

Efficiency assessment of shock wave therapy in patients with pelvic pain employing harmonic analysis of penile bioimpedance.

In searching for novel objective methods to diagnosticate pelvic pain and assess efficiency of analgesic therapy, 37 male patients were examined prior to and after the course of extracorporeal shock wave therapy (5-10 sessions) with the waves directed to projections of prostate and/or crura and shaft of the penis. The repetition rate of mechanical pulses was 3-5 Hz. The range of energy pulse density was 0.09-0.45 mJ/mm(2). The overall number of pulses in a session was 1500-3000 in any treated zone with total energy smaller than 60 J. The applicator was relocated every other series of 300-500 pulses. Effect of the shock wave therapy was assessed according to subjective symptomatic scales: International Prostate Symptom Score, International Index of Erectile Function, Quality of Life, and nociceptive Visual Analog Scale. The objective assessment of shock wave therapy was performed with harmonic analysis of penile bioimpedance variability, which quantitatively evaluated the low-frequency rhythmic and asynchronous activities at rest as well as the total pulsatile activity of the penis. The magnitude of spectrum components of bioimpedance variations was assessed with a novel parameter, the effective impedance. The spectral parameters were measured in 16 patients prior to and after the treatment course. The corresponding control values were measured in the group of healthy patients. Prior to the shock wave therapy course, all spectrum parameters of penile bioimpedance significantly differed from the control (p<0.05). After this course, low-frequency rhythmic and the total pulsatile activity decreased to normal, while asynchronous activity remained significantly different from the normal. The novel objective physiological criteria of pelvic pain diagnostics and efficiency of its treatment reflecting the regional features of circulation and neural activity corresponded to the clinical symptom scaling prior to and after the shock wave course, and on the whole, these criteria corroborated improvement of the patient state after this therapy.

[Effectiveness of Vitaprost Plus in the treatment of patients with chronic bacterial prostatitis].

The need for use of antimicrobial drugs in the treatment of patients with chronic bacterial prostatitis is indisputable. Given the variety of pathogenic mechanisms of chronic prostatitis, drug Vitaprost Plus in the form of rectal suppositories is of particular interest; it combines antibacterial activity with a positive effect on the various links in the pathogenesis of this disease. The evaluation of the efficacy and safety of drugs Vitaprost Plus and Lomflox was performed. Both groups showed a significant improvement in the NIH-CPSI score in summary and on individual domains; differences between groups were not statistically significant. The number of leukocytes in the prostatic exprimate decreased more markedly in the study group. Microbiological efficacy in the study group was 73.3%, in the control group--70%. Thus, the use of the drug Vitaprost Plus increased clinical and microbiological efficacy of treatment, which correlates with the data of previous studies.

[First experience with outpatient shock-wave lithotripsy].

Clinical experience with administration of extracorporeal shock wave lithotripsy (ESWL) in an outpatient clinic demonstrates feasibility of urolith fragmentation in some patients using certain lithotriptors. Concrements can be removed from about 97.0% patients without their hospitalization.