[The efficiency of complex phytotherapy for the treatment of lower urinary tract infection in women].

Lower urinary tract infections (LUTI) are one of the most common urological diseases. Prevention of recurrences and development of chronic cystitis are among the key tasks in the treatment of women with LUTI. It consists of choosing adequate antibacterial therapy and preventive measures. Phytotherapy using various herbal preparations is considered to be one of the most common and effective preventive measure. Three clinical cases of effective treatment of patients with recurrent LUTI with Phytolysin paste and Phytolysin capsules as part of complex therapy are presented in the article, demonstrating the high efficiency of long-term courses of phytotherapy.

[Our experience of using hexane extract of Serenoa Repens fruit (Permixone) in the treatment of LUTS in clinical practice].

Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are among the most common causes of LUTS in men. LUTS occur on average in 62.5% of males, with irritative symptoms occurring in 51%, obstructive symptoms in 26%, and postmicturic symptoms in 17% of cases. According to the literature, moderate and severe LUTS were observed in 13% of men under the age of 50 and in 28% after 70 years. It should be noted that LUTS are not BPH-specific, since may be caused by prostate inflammation. According to publications, 57% of patients examined for CP have BPH, and 39% of patients with BPH have CP. The first line of drug therapy in patients with BPH is currently considered to be alpha-blockers and inhibitors of 5-a-reductase. In addition, it is possible to use herbal preparations made from fruits, roots, seeds, pollen and plant bark. Preparations based on Serenoa repens extract are among the most studied and are widely used both in our country and worldwide for the treatment of patients with BPH and LUTS. Only lipidosterol hexane extract of Serenoa repens is recognized as a drug, the use of which has a good evidence base. The clinical examples illustrating the pharmacological properties and results of the use of the preparation of lipidosterol hexane extract Serenoa repens are presented in the article. CONCLUSION: The presented clinical cases demonstrate the efficiency of the hexane extract of Serenoa repens fruit for the treatment of LUTS associated with BPH and CP. At the same time, the drug can be effectively used both as monotherapy and in combination with alphablockers. Therefore, it is reasonable to use the hexane extract of Serenoa repens fruit in clinical practice for the treatment of LUTS associated with BPH.

[Current trends in the treatment of chronic recurrent bacterial cystitis].

INTRODUCTION: Every year, more than 7 million women go to the doctor for chronic cystitis. An important factor is the psychoemotional component of this disease. OBJECTIVE: comparative analysis of various options for complex treatment of women with chronic recurrent bacterial cystitis using phototherapy, chronotherapy and correction of psychoemotional disorders with the anxiolytic drug Adaptol. MATERIALS AND METHODS: 90 women with chronic recurrent bacterial cystitis in the acute stage were examined and divided into 3 groups of 30 people. In group 1, patients received basic therapy with Furamag (furazidin kalium). In group 2, patients received standard therapy in combination with phototherapy in the acrophase of the chronorhythm. In group 3, basic therapy was performed in combination with phototherapy in the acrophase of the chronorhythm and Adaptol. The severity of dysuria and pain, leukocyturia, bacteriuria, chronobiological and psychoemotional status were evaluated. RESULTS: Initially, all patients showed signs of desynchronosis and psychoemotional disorders. All groups showed signs of exacerbation of chronic cystitis. The results obtained on the 5th day of therapy in groups 2 and 3 were statistically significantly different (p<0.05) from those in group 1. In group 3, the number of nocturnal urination (0.9+/-0.7), the number of imperative urges per day (0.7+/-0.5), and the intensity of pain (0.7+/-0.6) were the closest to normal. By day 10, clinical and laboratory parameters in all three groups reached normal values, which indicates the effectiveness of the therapy in each of the groups. CONCLUSION: Thus, the use of Furamag and Adaptol in combination with phototherapy at the maximum peaks of psychoemotional and physiological activity of the body effectively stops the clinical and laboratory manifestations of the disease, corrects the mental status and improves the quality of life of women in a shorter period of treatment.

[The efficacy of fesoterodine in patients after transurethral resection of the prostate].

AIM: For a long time, benign prostatic hyperplasia (BPH) was considered as only cause of lower urinary tract symptoms (LUTS) in elderly men. More than 30% of patients underwent surgery by the age of 80. Unsatisfactory outcome of surgical treatment of BPH are observed in 9-27% of cases. Various irritative symptoms, which are typical for detrusor overactivity, persist especially often. Currently, anticholinergic drug therapy (m-cholinoblockers) is the main treatment for detrusor overactivity. The aim of our study was to assess the effectiveness of m-cholinoblockers for the treatment of persisted LUTS in men with BPH who had undergone transurethral resection of prostate (TURP). MATERIALS AND METHODS: The study included 60 patients with BPH who underwent TURP. All patients were divided into two groups. In Group 1, anti-inflammatory therapy for 10 days with 1-month follow-up was prescribed. In Group 2, anti-inflammatory therapy was combined with the drug Toviaz for 1 month. Evaluation of the treatment effectiveness was carried out 3-5 days, 14-15 days and 1 month after TURP, respectively and included voiding diary, IPSS score, QOL, uroflowmetry, adverse events and acute urinary retention. RESULTS: At baseline, in the Group 1 and 2, average urination frequency was 12.6 and 12.7 times per day, the number of urgency episodes was 9.2 and 9.0 times and number of nocturnal voiding episodes was 5,2 and 5.3 times, respectively. The average IPSS score was 19.8 and 19.7 points and Qmax was 6.5 and 6.7 ml/sec, respectively. By the 14th-15th day of therapy, in both groups positive changes were found. There was a significant decrease (p<0.05) in the urination frequency and nocturnal voiding episodes according to voiding diaries, an increase in Qmax and average IPSS and QOL score. The adverse events rate in group 2 was 16.7%. By the 30th day of therapy in the group 1 there were no significant changes. However, in group 2, urination frequency, number of urgency episodes, average IPSS and QOL score decreased to an average of 5.7 times a day, 0.4 times, 1.2 times, 9.3 points and 1.6 points, respectively. Average Qmax increased to 15.5 ml/sec. No adverse events were detected. CONCLUSION: According to the results of our study, the use of m-cholinoblockers, in particular Fesoterodine (Toviaz), in combination with standard therapy in patients with detrusor overactivity after TURP is reasonable and allows to effectively and safely alleviate irritative symptoms.

[The effectiveness of complex phytotherapeutic medications in the management of uncomplicated lower urinary tract infections in women].

INTRODUCTION: Lower urinary tract infections (LUTI) are the most common urological diseases. Fosfomycin is one of the antibiotic agents with proven efficacy that are most frequently used to treat UTIs. Despite the high effectiveness of antibiotic therapy with this drug, in some patients, the LUTIs persist or recur. It is advisable to prevent the development of recurrent infections using herbal preparations. The study aimed to evaluate the effectiveness of integrated treatment of women with acute uncomplicated cystitis using the plant-based medication Phytolysin. MATERIALS AND METHODS: The study comprised 63 women with acute uncomplicated cystitis, who were randomly assigned to two groups. The women in the control group (n = 31) received a single 3-g dose of fosfomycin. In the study group (n = 32), women received a single 3-g dose of fosfomycin and Phytolysin according to the manufacturers instructions three times daily for a month. The examination was performed on admission and on days 3, and 7, and included daily filling out voiding diaries, a 5-point verbal assessment of pain, urinalysis and urine culture. During the next three months, cases of recurrence were registered, and bacteriological analysis of urine was conducted. RESULTS: On admission, all patients complained of pain in the projection of the urinary bladder, frequent urination in small portions, and a sensation of urethral discomfort. All women had leukocyturia and bacteriuria. By the 3-rd day after taking fosfomycin, both groups showed similar improvement in the clinical manifestations of the disease. All urine cultures were negative. By the 7th day after the initiation of therapy, the patients in the study group had normal laboratory parameters and no clinical manifestation of LUTI, while in the control group leukocyturia (p <0.05) persisted. During a 3-month follow-up, recurrence of LUTI was observed in 6 (19.4%) and 3 (9.4%) patients in the control and study group, respectively. Also, bacteriological studies of urine showed the same pathogen as on admission in 5 (16.1%) and 1 (3.2%) patients of the control and study group, respectively. CONCLUSION: Phytolysin can be recommended for use in the integrated management of acute uncomplicated cystitis, as well as a means of preventing recurrences of this disease.

[Chronobiological approach to managing an exacerbation of chronic recurrent bacterial cystite].

AIM: To investigate the effects of complex therapy with and without phototherapy for an exacerbation of chronic recurrent bacterial cystitis in women at the peaks of chronobiological activity. MATERIALS AND METHODS: The study comprised 60 patients (mean age 30.1+/-5.5 years) with exacerbations of chronic recurrent bacterial cystitis. Patients in the comparison group (n=30) were managed with standard therapy, in the study group (n=30) standard therapy was used concurrently with phototherapy by low-intensity light radiation carried out at the maximum peaks of chronobiological activity. An assessment of the results included estimation of clinical and laboratory outcomes and the chronobiological status of patients in both groups. RESULTS: The study findings showed that phototherapy at the peaks of patients chronobiological activity icombined with standard treatment resulted in a faster reduction of clinical signs of the disease and desynchronosis.