[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.

[Use of "Serebrianyi Kliuch" mineral water in the postoperative treatment of patients with nephrolithiasis after extracorporeal shock-wave lithotripsy]. / Ispol'zovanie mineral'noi vody "Serebrianyi Kliuch" v posleoperatsionnom lechenii bol'nykh nefrolitiazom, perenesshikh distantsionnuiu udarno-volnovuiu litotripsiiu.

27 patients with nephrolithiasis were exposed to extracorporeal shock-wave lithotripsy (ESWL). They were divided into two groups: group 1 of 10 patients who were exposed to ESWL and drank tap water and group 2 of 17 patients who were exposed to ESWL and drank silver-containing mineral water Serebryany klyuch. In group 2 there was a marked diuretic effect manifesting with intensive excretion of electrolytes (K, Na), phosphorus and uric acid. This led to improvement and normalization of renal function, promoted faster elimination of concrement fragments and more frequent (by 52.3%) complete elimination of the concrements.

[Silver-containing hydrocarbonate-calcium-magnesium mineral water in complex treatment of patients with chronic pyelonephritis]. / Ispol'zovanie serebrosoderzhashchei gidrokarbonatnoi magnievo-kal'tsievoi mineral'noi vody v kompleksnom lechenii bol'nykh khronicheskim pielonefritom.

95 patients suffering from chronic pyelonephritis in active inflammation phase received antibacterial therapy with adjuvant drinking of silver-containing mineral water Serebryany klyuch (21 patients) or without such drinking (17 patients). Spa treatment with mineral water Serebryany klyuch in combined therapy of chronic pyelonephritis is shown to relieve clinical symptoms, decontaminate urine completely in 88.6% cases, to eliminate signs of immunodeficiency and endotoxicosis and to produce a 25.6% decrease in the recurrences for the nearest 2 years.

[The use of efferent methods in the combined treatment of pyelonephritis in pregnant women]. / Primenenie éfferentnykh metodov v kompleksnom lechenii pielonefrita beremennykh.

After-treatment immune effects of therapy were assessed in 57 pregnant females with pyelonephritis. Eleven patients received standard antibacterial treatment (ABT), 25 patients ABT plus plasmapheresis, 21 patients underwent UV irradiation of blood and ABT. ABT alone resulted in improved general condition of the patients, in reduced renal inflammation, but it failed to remove completely signs of immunodeficiency, B-lymphocyte and Ig levels remained low. The combined treatment with UV blood irradiation and plasmapheresis promoted rapid disappearance of clinical and laboratory evidence indicating pyelonephritis. UV irradiation could not correct deficiency of cellular immunity, while adjuvant plasmapheresis led to a complete cure of immune deficiency symptoms.