[Radio wave electrotherapy with a radiofrequency of 448 khz for the treatment of patients with organic erectile dysfunction: a prospective, randomized, blind, Sham-controlled, parallel-group study].

AIM: To evaluate the efficiency of radio wave electrotherapy (448 kHz) for the treatment of patients with organic erectile dysfunction (ED). MATERIALS AND METHODS: A prospective, randomized, blind, sham- controlled clinical trial was carried out. Inclusion criteria were as following: 1) patients with 5 to 20 points on the IIEF-5 score; 2) patients with proven organic erectile dysfunction lasting at least 6 months; 3) patients with penile arterial insufficiency and/or venous insufficiency, confirmed by doppler study of penile vessels with pharmacological stimulation (peak systolic velocity (PSV) <25 cm/s, end-diastolic blood flow velocity (DPV) >5 cm/s, resistance index (IR) < 0.8). The participants were randomized into two groups (experimental and control) in a 1:1 ratio. The full treatment course lasted 9 weeks. Patients underwent an assessment of erectile function based on questionnaires (IIEF-5, SEP, Schramek), as well as Doppler ultrasound of the cavernous arteries before inclusion in the study as well as a after treatment. RESULTS: The study included 61 men (experimental group [n=31], control group [n=30]. There was a significant difference in the IIEF-5 scores after treatment between the experimental group and the control group (19.5+/-3.2 vs. 15.1+/-5.4, p=0.017, respectively). Significant differences were also noted in mean total score of the SEP questionnaire: an increase to 3.6+/-1.0 in the treatment group compared to 2.4+/-1.1 in the control group (p=0.004). The results of the Schramek questionnaire also demonstrated a significant increase in the mean score in the experimental group compared to the control group: 4.2+/-0.6 vs. 3.2+/-1.0 (p=0.011). The response time to the drug and the detumescence time also significantly differed between the two groups: 11.9+/-4.0 min vs. 15.5+/-4.1 min, p=0.001 and 126.6+/-60.7 min vs. 66.2+/-40.9, p<0.001, respectively. Neither complications nor any adverse events were recorded during treatment or after its completion. CONCLUSIONS: Radio wave electrotherapy with a radiofrequency of 448 kHz can improve the IIEF-5, SEP and Schramek scores, as well as the indicators of ultrasound Doppler ultrasonography in patients with organic ED. To assess the feasibility of this method in patients with organic ED of different stages, further studies are needed.

[Clinical value of herbal terpenes after extracorporeal shock-wave therapy].

BACKGROUND: Rowatinex is a combined drug based on plant terpenes which provides diuretic, anti-inflammatory and antispasmodic effect. A use of herbal preparation Rowatinex in patients with urinary stone disease after extracorporeal shock-wave therapy (ESWL) is analyzed in the article. AIM: To clarify the efficiency of the drug Rowatinex in patients with urinary stone disease after ESWL. MATERIALS AND METHODS: All patients were divided into two groups depending on therapy administered after ESWL. In main group (n=150) patients received Rowatinex, while in control group (n=70), antispasmodics were administered. Spontaneous passage of fragments was observed in 104 patients in main group (69.3%) and 30 patients in control group (42.9%). RESULTS: When studying the effect of therapy on the changes of complete blood count, biochemical panel and daily excretion of some substances (magnesium, uric acid, calcium, etc) there were no significant differences between main group and control group. All values were normal. It was estimated that increase in diuresis during use of Rowatinex contributes to effective and rapid passage of stone fragments. In addition, there was a decrease in leukocyturia in both groups. CONCLUSION: Drug Rowatinex allows to reduce the time to spontaneous passage of fragments after ESWL, intensity of pain syndrome and leukocyturia as well as to increase in daily diuresis. This is not accompanied by the development of complications and side effects which allows to administer Rowatinex for a long time as part of complex medical expulsive therapy and use it for recurrence prevention of urinary stone disease. Effect of Rowatinex didnt depend on the stone composition.

[Issues of spectrum and local sensitivity of E. coli in female patients with acute uncomplicated lower urinary tract infection a review of M. Seitz study and own observations].

RELEVANCE: Acute uncomplicated lower urinary tract infections (AULUTI) are one of the most common diseases in urological practice. The management of cystitis is commonly based on antibacterial therapy. Despite the high efficiency, inadequate prescription of antibiotics leads to an increase in microorganisms resistance. In light of these matters, the selection of antibacterial agents to which the sensitivity of bacteria is the highest is becoming increasingly challenging. AIM: To estimate the spectrum and local sensitivity of E. coli in patients with AULUTI. MATERIALS AND METHODS: The present study analyzed the results of bacterial culture sampled from 45 patients with AULUTI. The mean age of the patients was 44+/-17 years. All bacterial cultures were obtained in out-patient settings in the framework of a multicenter initiative study on the prevention of recurrent AULUTI with d-mannose. RESULTS: Microbiological studies of the urine of patients with AULUTI revealed the growth of E. coli in concentrations ranging from 104 to 107 CFU/ml. Assessment of sensitivity demonstrated 100% sensitivity of Escherichia coli to fosfomycin trometamol. CONCLUSION: According to the findings of microbiological studies, the patients with the AULUTI retain the highest sensitivity level of E.coli to phosphomycin trometamol, which allows it to be used as a first-line drug.

[En bloc holmium laser enucleation of the prostate (HOLEP EN BLOC): our experience].

INTRODUCTION: Some authors consider HoLEP a new gold standard for the surgical management of prostatic hyperplasia. The increasing utilization of holmium enucleation has led to the development of various modifications of this treatment modality, including the so-called enucleation as a single piece (HoLEP en bloc), which reduces the operative time and, according to some authors, facilitates acquiring new surgical technique by surgical trainees. AIM: To compare the effectiveness and safety of the traditional HoLEP and HoLEP en bloc. MATERIALS AND METHODS: The study comprised 227 BPH patients aged from 53 to 86 years old (mean - 61.38+/-5.09 years). HoLEP en bloc was performed in 114 patients, of whom 39 patients had prostate volume (Vpr) less than 80 cm3, and in 75 patients it was more than 80 cm3. The standard HoLEP was performed in 113 patients, of whom 41 patients had Vpr less than 80 cm3, and in 72 patients it was more than 80 cm3. RESULTS: Enucleation time: HoLEP - 48+/-12 min, HoLEP en-bloc - 35+/-10; morcellation time: HoLEP - 20+/-3 min, HoLEP en-bloc - 16+/-12; duration of urinary bladder drainage by a urethral catheter: HoLEP - 58+/-3 h, HoLEP en-bloc - 41+/-2; length of hospital stay: HoLEP - 5.93+/-0.39 days, HoLEP en-bloc - 4.45+/-0.35; bladder tamponade, urethrocystoscopy and coagulation of bleeding vessels: HoLEP-3, HoLEP en-bloc-1; infectious-inflammatory complications (prostatitis): HoLEP-3, HoLEP en-bloc-2; acute urinary retention, stress urinary incontinence: HoLEP-6, HoLEP en-bloc-2; stress urinary incontinence: HoLEP - 5, HoLEP en-bloc - 2. CONCLUSION: En bloc holmium enucleation of the prostate results in the reduction of enucleation and total operative time compared with traditional HoLEP due to the fast identification of the surgical capsule and the right layer. Using this technique can improve the effectiveness of learning holmium laser enucleation of the prostate by surgical trainees.

[Results of a comparative multi-center randomized clinical study of efficacy and safety of EFFEX Tribulus and Tribestan in patients with erectile dysfunction].

RELEVANCE: Erectile dysfunction (ED) is a common condition. Pharmacological management of ED involves medications produced by chemical synthesis. Despite high efficiency, their use is often accompanied by some side effects. Considering this, herbal preparations with sufficient efficacy and greater safety have received much attention. AIM: To compare the efficacy and safety of two herbal preparations (EFFEX Tribulus and Tribestan) based on Tribulus Terrestris herb dry extract in patients with ED. MATERIALS AND METHODS: A total of 173 patients were enrolled in the study, of whom 87 (group I) and 86 (group II) received EFFEX Tribulus and Tribestan, respectively. The mean age of patients was 42.2+/-11.5 years in group I and 42.8+/-11.2 years in group II. One hundred fifty two patients completed the study. The follow-up was 13 weeks (the herbal preparation dose was titrated at week five after the treatment initiation). The effectiveness of treatment was assessed on five follow-up visits using the IIEF, AMS, MSF, GAQ questionnaires, and a complex of diagnostic and laboratory studies. RESULTS: At visit five compared to visit 1, the mean IIEF erectile function domain score increased by 5.7+/-4.6 and 5.2+/-4.3 points in group I and II, respectively. In both groups, all other IIEF domain scores demonstrated a statistically significant increase. The AMS scores decreased from 32.93+/-10.04 to 25.02+/-7.62 points in group I and 31.78+/-10.37 to 24.55+/-7.31 points in group II. The SMF scores increased from 22.36+/-4.85 to 27.16+/-4.80 points in group I and from 22.13+/-3.69 to 26.10+/-5.69 points in group II. Besides, the use of the herbal preparations was associated with a decrease in the serum cholesterol level, more pronounced with increasing patient age (correlation coefficient -0.06, p=0.41). CONCLUSION: The herbal preparations EFFEX Tribulus and Tribestan have a similar efficacy and safety profiles.

[Endoscopic enucleation of the prostate: a short term trend or a new treatment standard?]

Endoscopic enucleation of the prostate (EEP) techniques such as HoLEP (holmium laser enucleation of the prostate), ThuLEP (thulium laser enucleation of the prostate) and electroenucleation (mono- or bipolar) are highly effective and safe. They have been endorsed by the latest version of the European Association of Urology guidelines as an alternative to not only open adenomectomy but also transurethral resection of the prostate (EAU Guidelines on Treatment of Non-neurogenic Male LUTS 2018). Therefore, many urologists face the possibility of replacing the treatments of BPH. In this article, we analyze the history of EEP techniques, both their pros and cons and, what are they today - just a popular trend or a new standard procedure for the surgical treatment of BPH?

[Monopolar transurethral enucleation of benign prostatic hyperplasia. Our initial experience].

INTRODUCTION: The choice of surgical treatment in patients with BPH is one of the most discussed issues in urology. In recent years, the surgical treatment of prostates of medium and large sizes by means of enucleation has become increasingly popular. OBJECTIVE: The emergence of special loops to perform bipolar and monopolar enucleation using standard equipment for TURP has opened up new possibilities for the treatment of patients with BPH-transurethral monopolar enucleation BPH. PATIENTS AND METHODS: In the period from December 2014 to the current time 35 monopolar enucleations were performed in the clinic of urology Sechenov FMSMU. The mean age was 70,3+/-3,7 years; Prostate volume was 60,3+/-12,5 cm3; IPSS / Qol 24,6+/-3,3 / 5,1+/-1,1; Qsr 7.7+/-2.1 ml/s. We used resectoscope 26 Ch with constant irrigation, Hook-electrode, pusher-electrode, as well as a standard set of electrodes for mono- and bipolar surgery during the procedure. Enucleated adenomatous nodes were resected either by mono- or bipolar TURP and were laundered by Rene-Alexander syringe, or morcellated. RESULTS: Comparative analysis of different methods of surgical treatment of prostatic hyperplasia (laser and monopolar enucleation) shows the advantages of monopolar enucleation in patients with prostatic hyperplasia. CONCLUSION: Monopolar enucleation of prostate hyperplasia is a radical, as well as a safe and effective surgical method in the treatment of patients with BPH. Further observation of the operated patients will allow us to make a final conclusion about the place of this technique in the treatment of patients with BPH and adequacy of data.

[Prostadoz opportunity for prostate cancer prevention?]

Prevention of prostate cancer (PCa) is a vital problem dictated by the obvious benefit of prevention compared to the complexity of treatment. To date, a tremendous amount of research both in vitro, and in vivo assessment of different prophylactic measures has been published. They included consumption of protein, carbohydrate, fat, fiber, vegetable extracts and other solid products, and combinations thereof in the diet, vitamins, minerals, and biologically active substances, medicaments. The optimal preventive agent has not been found, and that prompted us to conduct our own research of dietary supplement ProstaDoz. The study was performed on a group of 58 patients with elevated prostate-specific antigen and the results of the histological study confirming the absence of prostate cancer and the presence of a high degree PIN. After 6 month course of ProstaDoz histological analysis of repeated biopsy samples revealed a significantly lower incidence of prostate cancer and atypical small acinar proliferation in the group receiving ProstaDoz (10.4%) compared to control group (20,7%; p <0,024), and in some cases even regression of PIN (32%) in the study group (p = 0.5). Also, there was a significant reduction in prostate-specific antigen after receiving ProstaDoz. These data show the potential effectiveness of ProstaDoz use as a means of PCa chemoprevention.

[Hormonal and metabolic disorders as systemic factor for the formation of urinary calculi].

In patients suffering from urolithiasis, metabolic diagnostics often reveals abnormalities contributing to the formation of stones: hypocitraturia, hyper- and hypocalcemia, hypercalciuria, hypomagnesemia/hypomagnesuria, hyperoxalaturia, etc. Before surgery, complex biochemical examination of blood and 24-hourcollection urine in 82 patients with urolithiasis was performed. The analysis of the main laboratory parameters of carbohydrate, lipid, calcium and phosphorus and purine metabolism found the prevalence of violations of calcium and phosphorus metabolism in these patients. Dyslipidemia was diagnosed in 31 (37.8%) patients. There was a significant positive correlation between serum total cholesterol and serum total calcium (rs = 0.3315, P = 0.0103). Low serum calcium levels were associated with hyperoxalaturia (rs = -0.4270, P = 0.0295). There was a significant effect of natriuria on urinary excretion of oxalate (rs = 0.6107, P = 0.0001), Mg (rs = 0.4156, P = 0.0096) and K (rs = 0.5234, P = 0.00005). The study shows the role of magnesium in the prevention of recurrence and manifestation of urolithiasis. The combination of two or more types of hormonal and metabolic disorders increases the incidence of recurrent stones. Timely correction of hormonal-metabolic status allows to reduce the risk of stone formation, and hospitalization attributable to the complications associated.

[Transurethral electrosurgery in the treatment of benign prostatic hyperplasia]. / Transuretral'naia élektrokhirurgiia v lechenii dobrokachestvennoi giperplazii predstatel'noi zhelezy.

The article is devoted to topical problem of modern urology, one of the lines of surgical treatment of benign prostatic hyperplasia (BPH)--transurethral electrosurgery. Physical principles which are the basis of transurethral electrosurgical interventions and influence of transurethral electrosurgery on prostatic tissue are described. Methods of necessary preoperative examination of patients with BPH are presented. The most often used transurethral electrosurgical technique for destruction of hyperplastic prostatic tissue is described. The results of 5-year use of combination of transurethral electroresection and electrovaporisation in the treatment of BPH and its complications are presented. Ways of prophylaxis of possible complications are proposed.

[Mineral water Volzhanka from Undorovski spring in combined therapy of patients with nephrolithiasis and chronic pyelonephritis]. / Undorovskaia mineral'naia voda "Volzhanka" v kompleksnoi terapii bol'nykh nefrolitiazom i khronicheskim pielonefritom.

Water loading is an essential component in therapy of nephrolithiasis, especially in the presence of small ureteral concrements or fragments after extracorporeal shock-wave lithotripsy. Saluretics, furosemide in particular, cause side effects. One of these is dyselectrolytemia due to potassium loss. Mineral waters have advantages in the treatment of nephrolithiasis and pyelonephritis as their drinking does not lead to electrolyte loss. Low mineral waters are highly diuretic, e.g. after drinking 1 liter of Volzhanka day-time diuresis increases by 300-400 ml. This relieves ureteral and calyceal-pelvic tonicity stimulating elimination of the concrements or their fragments after lithotripsy. Intake of Volzhanka proved effective in combined therapy of nephrolithiasis, calculous pyelonephritis, urate nephrolithiasis.