[Results of a multicenter trial of serenoa repens extract (permixon) in patients with chronic abacterial prostatitis].

Chronic prostatitis (CP) morbidity now makes up 8 to 35% in males aged 20-40 years (N.A. Lopatkin et al., 1998; O.L. Tiktinsky, 1999). In general population CP incidence rate is 5 to 8% (J.C. Nickel, 1999). Phytotherapy is now widely practiced in CP. A multicenter trial conducted by the authors demonstrates high efficacy ofpermixon in the treatment of chronic prostatitis/chronic pelvic pain syndrome. The results of 6-month follow-up are presented.

[Combined extract of Sabal palm and nettle in the treatment of patients with lower urinary tract symptoms in double blind, placebo-controlled trial].

A multicenter, prospective clinical trial was performed to study efficacy and tolerance of a compound drug PRO 160/120 in the elderly men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). A total of 257 patients were randomized into two groups. Group 1 of 129 patients received PRO 160/120; group 2 of 128 patients received placebo. In 2-week induction blind phase of placebo the patients received for 24 weeks 1 capsule of the drug or placebo twice a day in conditions of double blind study. The double blind phase was followed by an open control period for 24 weeks when all the patients received PRO 160/120. Treatment efficacy evaluation was based on I-PSS, quality of life index, urodynamic and ultrasonography evidence. PRO 160/120 was superior to placebo by attenuating LUTS assessed by I-PSS, improved obstructive and irritative symptoms, was effective in patients with moderate and severe symptoms. Tolerance of the plant extract was good.

[The results of long-term permixon treatment in patients with symptoms of lower urinary tracts dysfunction due to benign prostatic hyperplasia]. / Rezul'taty dolgosrochnogo primeneniia permiksona u bol'nykh s simptomami narusheniia funktsii nizhnikh mochevykh putei, obuslovlennymi dobrokachestvennoi giperplaziei predstatel'noi zhelezy.

The trial enrolled 155 patients (mean age 65 years) with documented benign prostatic hyperplasia and lower urinary tracts symptoms (LUTS) (IPSS > 6). All the patients received permixon in a dose 160 mg twice a day for 2 years. The data on 130 patients eligible for assessment were processed statistically by dynamics of IPSS, quality of life (QOL), index of sexual function (MSF-4), size of the prostate, urodynamic and biological parameters which were estimated in 6 (V6), 12 (V12), 18 (V18) and 24 months (V24). Clinical examination with registration of all side effects was made each 3 months. Permixon was found to noticeably reduce IPSS and QOL and increase maximal urine flow speed. The size of the prostate diminished insignificantly. Sexual function remained unchanged for 1 year and improved markedly within the second year (p = 0.001). Permixon had no effect on the level of prostate-specific antigen. Plasma hormones (testosterone, DHT, estradiol, LH, androstendion) did not change. Nine patients developed 10 side effects but they were unrelated to the treatment.

[Efficacy of meropenem in the treatment of severe complicated urinary tract infections]. / Effektivnost' meropenema pri lechenii tiazhelykh oslozhnennykh infektsii mochevyvodiashchikh putei.

The clinical and bacteriological efficacies of meropenem in the treatment of 12 patients with urinary tract infection were studied. In 8 patients the drug was administered intravenously in a dose of 1 g every 8 hours and in 4 patients with the creatinine clearance below 50 ml/min it was administered in a dose of 1 g every 12 hours (the treatment course of 7 to 10 days). Meropenem was used in the monotherapy. Severe complicated urinary tract infections were mainly observed in the patients with long-term urolithiasis, subjected to repeated surgical interventions and isolating as a rule polyresistant strains of Pseudomonas aeruginosa and E.agglomerans as the pyelonephritis pathogens at a titre of 5 x 10(5)-5 x 10(8) microbial cells per 1 ml of the urine susceptible to meropenem in 80 to 96 per cent of the cases. The clinical efficacy of the drug was stated in all the patients while the bacteriological efficacy amounted to 88.9 per cent.

[Occlusive factor in development of urolithiasis complications]. / Okkliuziruiushchii faktor v razvitii oslozhnenii mochekamennoi bolezni.

Causes and mechanisms of complications in urolithiasis are analysed with a focus on the role of occlusion of the urinary tracts in the onset of pyoseptic complications. Most severe of them is bacteriotoxic shock which is hard to treat and dangerous for essential body functions. The priority of the treatment must be reestablishment of urine passage. Additional tools of the treatment include wide-spectrum antibiotics, efferent detoxication, electrochemical blood oxidation, hyperbaric oxygenation, UV blood radiation.

[The rapid microbiological control of the efficacy of the antibacterial therapy of bacteremia and septicemia]. / Mikrobiologicheskii ékspress-kontrol' éffektivnosti antibakterial'noi terapii bakteriemii i septitsemii.

No previous isolation of the agent on the media is needed in using a new microbiological express-method of automatic control over antibacterial therapy of bacteremia and septicemia. The method is efficient in determination of sensitivity to the drug of the whole heterogeneous population of bacteria. It does not predict efficacy of antibacterial therapy but states the presence or absence of the effect in vivo. The method is integral, evaluates antibacterial plasma titer suggesting adequate correction. The duration of the test is maximum 12 h that is 3-4 times less than other methods.

[The percutaneous x-ray endoscopic surgery of simple kidney cysts]. / Perkutannaia rentgenoéndoskopicheskaia khirurgiia prostykh kist pochki.

An endoscopical method of treating solitary renal cysts (RC) > 5 cm in diameter has been used in the Research Institute of Urology since 1989. The method implies percutaneous puncture of the cyst controlled by x-ray television or ultrasound, dilatation of the cystostomy fistula, cystoscopy followed by resection or dissection of the cyst wall with a cold knife or electrosurgically. A total of 38 patients with large solitary cysts have been treated. A 6-12-month follow-up revealed no recurrences. Complications of the surgery were not reported. The method is easy to accomplish, effective and well tolerated.

[Clinical effectiveness of pefloxacin (abaktal)in the treatment of inflammatory diseases of the kidneys, urinary tracts and genital organs]. / Klinicheskaia éffektivnost' pefloksatsina (abaktal*) v lechenii vospalitel'nykh zabolevanii pochek, mochevyvodiashchikh putei i polovykh organov.

Pefloxacin (Abaktal) was used in treatment of 83 patients: 14 patients with acute pyelonephritis, 5 patients with carbuncle of the kidney, 17 patients with postoperative acute pyelonephritis, 3 patients with urosepsis, 7 patients with acute prostatitis, 18 patients with chronic pyelonephritis in the phase of active inflammation, 9 patients with exacerbation of chronic prostatitis, 3 patients with acute cystitis, 2 patients with acute urethritis and 5 patients with epididymo-orchitis. Two dosage forms of pefloxacin were used i.e. tablets of 400 mg and ampoules of 5 ml containing 400 mg of the active substance. The treatment course amounted to 7-14 days. In the patients with inflammatory infectious diseases of the lower urinary tracts (cystitis and urethritis) the treatment course amounted up to 5 days. The results of the treatment with the ampoule solutions were good and satisfactory. With the use of the tablets the results were unsatisfactory in 3 patients (8.1 per cent). Satisfactory bacteriological efficacy of the treatment was stated in 89.5 per cent of the cases. The adverse reactions such as nausea, vomiting, diarrhea and skin eruption were recorded in 5 patients (6 per cent).