[X-ray-guided endovascular surgery in patients with benign prostatic hyperplasia and prostate cancer].

AIM: To evaluate the efficacy and safety of superselective embolization and chemoembolization of the prostatic artery as an independent method of treating prostate cancer and BPH. MATERIALS AND METHODS: From 2004 to 2015, 116 patients with BPH (mean age 73.2+/-5.2 years) underwent prostatic artery embolization. Mean prostate volume ranged from 55 to 296 cc3. From 2011 to 2015, 37 patients with prostate cancer (mean age 72.3+/-2.06 years) were treated with X-ray-guided endovascular chemoembolization. All patients had confirmed PCa, of whom 7 had stage T2a and 30 stage T2c disease. PSA ranged from 0.8 to17 ng/ml (mean 13.1+/-3.9). Prostate volume ranged from 61 to 93 cc3 (mean 69.4+/-9.3). The follow-up ranged from 8 to 42 months. RESULTS: Prostatic artery embolization in BPH patients resulted in a significant reduction in IPSS symptom score and increase in Qmax. The volume of prostate and nodular mass decreased on average by 53% and 47%, respectively, maximum by 82%. Chemoembolization was effective in 31 (83.7%) patients. An objective response was achieved in reducing the PSA level and prostate volume measured by TRUS, and improved urination. The median PSA at 6 months was - 3.4 +/- 0.02 ng/ml. In all patients, chemoembolization resulted in a marked reduction in the prostate volume. The greatest decrease in the prostate volume was observed at 6 months after treatment. Chemoembolization led to a marked improvement in the quality of urination confirmed by uroflowmetry and IPSS symptom scores. At 12 months, 16 patients with prostate cancer underwent the follow-up biopsy. In 12 cases pathology showed fibrosis and epithelial degeneration without signs of atypia and in 2 cases curative pathomorphosis was observed. Chemoembolization was well tolerated and did not cause any significant complications. CONCLUSION: Embolization techniques for BPH and chemoembolization for localized PCa showed good effectiveness and safety in patients who had medical contraindications to traditional treatments.

[EFFECTIVENESS OF COMBINED TREATMENT OF HPV INFECTION].

This study evaluates the effectiveness of immunomodulating drug isoprinosine in a comprehensive treatment of genital warts in men. Most of the patients were aged 20-30 years. The combination therapy was found to have long term effectiveness. In the group of patients undergoing only destructive methods of treatment relapse after 8 month follow-up was diagnosed in 32% and in patients of the combination therapy group (destruction plus isoprinosine) - in 7% of patients. The pharmacological action of the drug (immunostimulating, antiviral) and the effectiveness of its combination with destructive therapies justify the use of inosine pranobex (isoprinosine) both in the complex therapy of genital warts and for the prevention of the disease recurrence.

[SUPERSELECTIVE PROSTATIC ARTERY EMBOLIZATION AS A PREPARATORY STEP BEFORE TURP IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA IN PATIENTS WITH LARGE PROSTATES].

The study included 59 patients with benign prostatic hyperplasia (BPH) and high risk of anesthesia who underwent superselective embolization of prostatic arteries. The examination included a survey on the International Prostate Symptom Score (IPSS), assessment of quality of life (QoL), estimation of prostate and node size with transrectal ultrasound, determination of prostate-specific antigen level; in doubtful cases a needle prostate biopsy was performed. To analyze the quality of urination uroflowmetry was conducted. The effectiveness of the treatment was evaluated after 6, 12 and 24 months follow-up. By the 6th month of observation I-PSS score significantly decreased, while the maximum urine flow rate increased. This trend kept up during the subsequent six-month follow-up. The results of 24 months follow-up after embolization showed stable effect. Prostate and node volumes and reduced on average by 53% and 47%, respectively; the maximal reduction of prostate volume was 82%. 17 (28.8%) patients with prostate size reduction to less than 80 cm3 underwent transurethral resection of the prostate. In conclusion, prostatic artery embolization may be considered as a method of preoperative treatment of BPH patients with large prostates and multiple comorbidities, providing them with the possibility of endoscopic treatment. Further study will allow working out the methodology of embolization, to accurately determine the indications and contraindications for this treatment modality and to introduce it to clinical practice.