[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.

[Potentials of phytotherapy in the complex treatment of acute pyelonephritis].

The purpose of this study was to increase the effectiveness of treatment of patients with acute pyelonephritis by incorporating of phytopreparation "Prolit Super Septo" in complex therapy. The study included 38 patients with acute primary pyelonephritis. All patients have received standard medical therapy, 21 of them (Group 2) have additionally received "Prolit Super Septo" 2 capsules 2 times a day for 1 month. Outcome measures included basic laboratory parameters, and results of bacteriological examination and immunological assessment of patients 12-14 and 28-30 days after initiation of therapy. Against the background of the therapy, positive dynamics of the level of leukocyturia and bacteriuria was detected in both groups; therapeutic effect, however, was more pronounced in the Group 2 treated with complex therapy: after the end of treatment, the proportion of sterile cultures was 85.7%, whereas in Group 1--70.6%. In addition, complex treatment had a positive effect on the immune status of patients, as evidenced by normalization of blood immunoglobulins, circulating immune complexes and C-reactive protein. The inclusion of "Prolit Super Septo" in the complex conservative treatment of patients with acute pyelonephritis promotes the development of an adequate immune response and the rapid elimination of the pathogens, thus preventing the development of purulent forms of the disease, or chronization of process.

[Combined treatment of nephrolithiasis with canephron H].

A total of 35 nephrolithiasis patients aged 26-64 years entered the trial. They were divided into three groups: patients of group 1 (n = 12) received canephron H (50 drops or 2 dragees 3 times a day for 1 month), patients of group 2 (n = 11) were exposed to extracorporeal shock wave lithotripsy (ESWL) followed by standard spasmolytic therapy, patients of group 3 (n = 12) were given canephron H for 1 month before ESWL and 1 month after it in combination with standard therapy. In addition to standard examinations, measurements were made of urinary alkaline phosphatase, lactate dehydrogenase, gamma-glutamyltransferase, N-acetyl-beta-D-glucosaminidase, leucinaminopeptidase. At admission, patients of the three groups had high enzymuria. A course of canephron therapy reduced urinary enzyme levels in groups I and 3 to control levels. Within 24 hours since ESWL patients of groups 2 and 3 demonstrated growth of urinary enzymes (p < 0.05) but in group 3 this rise was less pronounced. On postoperative day 7 enzymuria in groups 2 and 3 diminished (in group 3 enzymuria was close to normal) while in group 2 it was elevated. Thus, canephron H reduces enzymuria and can be used in combined treatment of nephrolithiasis.