[Evaluation of the effectiveness of various regimens of the immunomodulatory drug Superlimf in the prevention of relapses of chronic abacterial prostatitis].

INTRODUCTION: Immune defense mechanisms, including a decrease in the functional activity of monocytes/macrophages, neutrophils, as well as a violation of the balance of pro- and anti-inflammatory cytokines, are important in the development of chronic abacterial prostatitis (CAP). The discovery of the cytokine system and the determination of their biological role in the development and functioning of the immune system and in the pathogenesis of a wide range of human diseases led to the development of a new direction in immunotherapy - cytokine therapy. The aim of the study was to evaluate the effectiveness of various regimens of the use of the immunomodulatory drug Superlimf in the prevention of recurrence of CAP. MATERIALS AND METHODS: The study included 90 patients with category IIIa CAP (NIH, 1995). All patients underwent basic complex therapy was performed, which included behavioral therapy, taking an 1-adrenoblocker, an antibacterial drug from the fluoroquinolone group for 28 days, as well as the drug Superlimph 10 ME 1 suppository rectally 2 times a day for 20 days. Dynamic follow-up was recommended for patients of group (CG) in the next 12 months. In the main group 1 (MG1), patients underwent basic complex therapy, after which a preventive courses of Superlimph 10 ME 1 suppository 1 time per day for 10 days every three months for 12 months was prescribed. In the main group 2 (MG2), patients also underwent basic complex therapy, after which a preventive courses of Superlimph 10 ME of 1 suppository was prescribed 2 times a day for 10 days every three months for 12 months. The effectiveness of the treatment was evaluated after 4 weeks (visit 2). Long-term treatment results were assessed after 3 months (visit 3), 6 months (visit 4), and 12 months (visit 5). RESULTS: The study groups were homogeneous, and the results of examinations obtained before treatment did not differ statistically significantly (p>0.05). At visit 2, 4 weeks after the start of therapy, a statistically significant positive dynamics of the studied indicators in the main groups and CG was recorded. Thus, the average score on the IPSS scale decreased by 56.4% from the initial value, on the Qol scale - by 57.7%, on the NIH-CPSI scale - 70.2%. The number of leukocytes in the prostate secretion decreased to the normal level to 7.9 in the field of vision, which is 86.2% less than the initial value. The average Qmax value also increased to a normal value of 15.2ml/s, which is 51.3% higher than the initial value (p<0.001). In this study, for the first time, a comparative analysis of two different regimens of preventive administration of the drug Superlimf was carried out. In MG1, the drug was prescribed to patients at a dose of 10 ME 1 time a day, in MG2 - 10 ME 2 times a day. The data obtained indicate a comparable effectiveness of both dosage regimens after 3 months of therapy. However, after 6 months and 12 months, the results in MG2 were statistically significantly better than in MG1. In addition, during 12 months of therapy, the number of relapses in MG2 was 2.3 times less. According to ultrasound examination, the volume of the prostate gland in CG, after a significant (p<0.001) decrease against the background of basic complex therapy, increased by 24.6% from visit 2 to visit 5, whereas in MG2 the average value of this indicator did not significantly change. And according to the Doppler study, by the end of the observation period at visit 5, hemodynamic parameters in CG were statistically significantly worse than in MG1 and MG2. CONCLUSION: Thus, the use of Superlymph in patients with CAP as a preventive therapy every 3 months results to a longer preservation of the therapeutic effect and improved hemodynamics in the prostate. In addition, preventive courses of Superlymph 10 units 2 times a day for 10 days led to an increase in the duration of the relapse-free period and a decrease in the number of recurrences within 12 months by 7 times, while preventive courses of Superlymph 10 units 1 time per day for 10 days decreased risk of recurrence by 3 times. According to our results, the most effective preventive scheme in patients with CAP is the use of Superlymph 10 units, 1 suppository 2 times a day for 10 days every 3 months.

[The use of antioxidants in combination therapy of chronic prostatitis].

Currently, the significance of the chronic prostatitis (CP) is undoubted. Oxidative stress is considered as one of the standard mechanisms of cellular damage that is associated with inflammatory diseases such as CP. When choosing the combination therapy for this group of patients, a correction of oxidative stress is pathogenetically justified. Literature data about the pathogenetic feasibility and prospects of using a biologically active complex containing flavonoids and carotenoids quercetin, lycopene and naringin as part of the combination treatment of patients with CP are presented in the article. Considering the various effects of the biologically active complex Querceprost, containing quercetin, lycopene and naringin, among which antioxidant, anti-inflammatory, antimicrobial and immunomodulatory are of greatest importance, as well as taking into account the synergistic effect of flavonoids and carotenoids, we suggest that Querceprost is promising component of combination treatment of patients with CP.

[Evaluation of the effect of Alfuprost MR on detrusor thickness and bladder mass in patients with detrusor hypertrophy caused by benign prostatic hyperplasia].

INTRODUCTION: Benign prostatic hyperplasia (BPH) can lead to the detrusor hypertrophy and deterioration of the bladder function with a decrease in its contractile activity. A number of publications are presented in the literature, the results of which indicate the possibility of reducing bladder hypertrophy with alpha-blockers. AIM: To carry out the retrospective analysis to study the effect of Alfuprost MR on urodynamic parameters, as well as the influence of the therapy on detrusor thickness and bladder mass in patients with detrusor hypertrophy and bladder outlet obstruction caused by BPH. MATERIALS AND METHODS: Outpatient records of 30 patients with lower urinary tract symptoms (LUTS) caused by BPH who received Alfuprost MR as monotherapy for 24 weeks were reviewed. Based on the diaries, the following parameters were assessed: total IPSS score, IPSS voiding (questions No. 1, 3, 5 and 6) and storage subscale scores (questions No. 2, 4 and 7), maximum flow rate (Qmax) according to uroflowmetry, the volume of the prostate and the postvoid residual (assessed by ultrasound), satisfaction with treatment on the quality-of-life score (QoL), as well as the changes in detrusor thickness and bladder mass index. RESULTS: An improvement in LUTS severity, starting from the 4th week of treatment, followed by a positive trend that persists until the 24th week of therapy with Alfuprost MR, was found. The overall average IPSS score improved by 39.0% by the 24th week of therapy. At the same time, voiding symptoms improved by 46.8%, and storage symptoms improved by 30.9% by 24 weeks of therapy. The average Qmax increased significantly (p<0.05) by 22.1% after 24 weeks of therapy. The average detrusor thickness decreased by 40,2%. Bladder mass index decreased significantly by an average of 34,3% (p<0.05). QoL score improved significantly (p<0.05) by 2.2 points after 24 weeks of therapy. CONCLUSION: During the 24-week treatment of patients with BPH, Alfuprost MR demonstrated clinical efficacy not only in reducing voiding symptoms and in improving the QoL, but also a positive effect on detrusor hypertrophy, as evidenced by changes in detrusor thickness and bladder mass index. The absence of any adverse events, including decrease in blood pressure and heart rate, allows us to recommend Alfuprost MR as an effective treatment for LUTS associated with BPH, which reduces detrusor hypertrophy and has a high safety profile and minimal vasodilating effects.

[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.

[The efficiency of various cytokine therapy regimens in the complex treatment of men with chronic abacterial prostatitis].

INTRODUCTION: Chronic prostatitis (CP) is one of the most important and discussed urological diseases. Treatment of bacterial CP with an established pathogen usually is not associated with any difficulties. Chronic abacterial prostatitis (CAP) remains the most problematic issue. Immune defense mechanisms are important in the development of CP, including a decrease in the functional activity of monocytes/ macrophages, neutrophils, as well as imbalance of pro- and anti-inflammatory cytokines. AIM: To evaluate the efficiency of various schemes of using the immunomodulatory drug Superlymph as part of the combination therapy of men with CAP. MATERIALS AND METHODS: A total of 90 patients with category IIIa CAP (NIH, 1995) were included in the study. In the control group, patients received basic therapy of CAP, namely behavioral therapy, 1-adrenoblocker and fluoroquinolone for 28 days. In the main group I basic therapy in combination with Superlymph 25 ME in one suppository q.d. for 20 days was administered. In the main group II basic therapy in combination with Superlymph 10 ME in one suppository b.i.d. for 20 days was given. Evaluation of treatment efficiency was carried out after 14 +/- 2 days (visit 2) and 28+/- 2 days (visit 3) from the start of treatment. RESULTS: The study groups were homogeneous, and baseline characteristics did not differ significantly (p>0.05). However, significant differences were found between the results in the main groups and the control group at visit 2 for all the indicators (p<0.05). The number of daytime urinations was lower in the main group I and II compared to CG by 16.7% and 28.4%, the number of night urination by 28% and 40%, the average IPSS score by 29.1% and 38.3%, the average QoL score by 32.4% and 45.9%, the average NIH-CPSI score by 26.8% and 37.4%, the number of leukocytes in expressed prostatic secretion by 41.2% and 52.1%, prostate volume by 16.8% and 21.8%, bladder volume by 15.8% and 21.7%, and Qmax by 14.3% and 21.2%, respectively. Similar significant differences between the main groups and control group were also seen at visit 3, while the indicators in main groups I and II reached normal values after 28 days of therapy. In this study, for the first time, a comparative analysis of two different treatment regimens with Superlymph was carried out. In the main group I, patients received suppositories at a dose of 25ME q.d., while in the main group II, the drug was administered 10 ME b.i.d. The results indicate a comparable efficiency of both schemes after 4 weeks. However, in the main group II, after 2 weeks, there was a significantly more pronounced positive dynamics of all indicators in comparison with the main group I (p<0.05). Consequently, the use of Superlymph at a dose of 10ME b.i.d. a day allows to reduce the severity of the inflammatory process in a shorter time. CONCLUSION: The use of Superlymph in patients with CAP allows to reduce the severity of clinical manifestations in a shorter time, and has a positive effect on the dynamics of the inflammatory process, which leads to an improvement in the quality of life. According to our results, the most effective scheme in patients with CAP is basic therapy in combination with Superlymph 10 ME for 1 suppository 2 times a day for 10 days. In our opinion, Superlymph can be effectively used as part of the combination therapy of men with CAP.

[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.

[Evaluation of long-term results of the use of entomological drug in the combination therapy of patients with benign prostatic hyperplasia and chronic prostatitis].

INTRODUCTION: Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are among the most important urological diseases. The right choice of treatment for patients with BPH and CP continues to be contradictory. Recently, a new group of entomological drugs has been increasingly used, one of which is Adenoprosin. AIM: To study the efficiency of Adenoprosin as part of combination therapy, as well as to evaluate the long-term outcomes in patients with BPH and CP. MATERIALS AND METHODS: A total of 60 patients with BPH and CP were included in the study. They were randomized into two groups of 30 each. In the comparison group, traditional therapy with 1-blockers and fluoroquinolones was administered. In the main group, similar therapy was prescribed in combination with Adenoprosin for 6 months. The follow-up period was 12 months. RESULTS: At baseline, the groups were homogeneous. After three and six months, the results in the control group did not significantly improve, but negative dynamics was revealed at visit 4. The results obtained in the main group at visits 3 and 4 were also significantly better (p<0.05) compared to the control group. During 12 months of follow-up, 7 (23.3%) cases of recurrent CP in the comparison group and 1 (3.3%) case in the main group were seen. CONCLUSION: According to our results, the use of Adenoprosin for 6 months allowed more effectively to reduce the lower urinary tract symptoms. The obtained effect persisted for the next 6 months, as evidenced by the dynamics of the studied indicators and the relapse rate of CP.

[An observational randomized study of the efficacy and safety of the drug Longidase, vaginal and rectal suppositories 3000 iu in the treatment of patients with symptoms of the lower urinary tract on the background of benign prostatic hyperplasia].

INTRODUCTION: Benign prostatic hyperplasia (BPH) is among the most significant urological diseases, and improving the effectiveness of treatment of patients with this disease is one of the main tasks in modern urology. The aim of the study is to evaluate the effectiveness of Longidase in the treatment of men with benign prostatic hyperplasia. MATERIALS AND METHODS: The study included 120 patients with lower urinary tract symptoms caused by BPH, who were randomly assigned to 2 groups of 60 people. In the main group (MG), Longidaza 3000 ME therapy was performed in combination with tamsulosin. In the comparison group (CG), tamsulosin monotherapy was performed. The patients were examined during 5 visits for 162+/-3 days. RESULTS: During the treatment period, compliance was 100%, all patients followed the doctors prescriptions, there were no cases of refusal of therapy. In addition, there were no cases of adverse events associated with taking the drug Longidaza. The examination initially revealed symptoms of the lower urinary tract in both groups against the background of prostatic hyperplasia, erectile dysfunction and a decrease in the quality of life. The therapy performed in both groups was effective, as evidenced by a decrease in the average score on the I-PSS scale, an increase in maximum urine flow rate, a decrease in volume of residual urine, which led to an improvement in the quality of life according to the QoL scale. Nevertheless, in the group of patients receiving Longidaza, after 50 days of therapy, there was a more pronounced positive dynamics of both the average score on the I-PSS and QoL scales, and the average maximum urine flow rate value according to the results of uroflowmetry. The differences between the groups according to these indicators were statistically significant (p<0.05). After 50 days of follow-up in GS, the average prostate volume did not change significantly, whereas in MG it decreased, and the differences between the groups were statistically significant (p=0.001). During subsequent visits, there was a tendency to decrease the size of the prostate in the MG, while in the CG there was a moderate increase in the volume of prostate according to ultrasound. CONCLUSION: Thus, according to the results obtained in the course of this observational study, the drug Longidaza 3000 ME can be effectively used in patients with BPH, prevent the progression of the disease, contribute to the persistent relief of LUTS and improve the quality of life of patients in this category.

[Modern possibilities of therapy of a urological patient with concomitant diseases of the cardiovascular system].

INTRODUCTION: Currently, there is a large selection of -blockers on the pharmaceutical market, while they have comparable effectiveness, slightly differing only in safety profile. However, even small differences are of fundamental importance for comorbid patients, especially for those patients who are prone to developing cardiovascular diseases in adulthood. The choice of -blockers, which is able to minimize the risks of cardiovascular complications, is important. MATERIALS AND METHODS: Outpatient cards of 120 patients with BPH and concomitant high blood pressure or stage 1-2 hypertension, who had been taking Alfuprost MR for at least 12 weeks, were analyzed. All patients were divided into two groups of the same number. In group 1, 60 patients with LUTS/BPH and concomitant high blood pressure did not take any antihypertensive drugs, while 60 patients with LUTS/BPH and stage 1-2 hypertension in group 2 received antihypertensive drugs (according to the recommendation of an internist or cardiologist). Based on the analyzed data, the efficacy of the drug Alfuprost MR, its safety profile, including the effect on blood pressure and pulse, and the recorded adverse events after 4 and 12 weeks were assessed. RESULTS: An analysis of the results of a retrospective study showed an improvement in LUTS in both groups, starting from 4 weeks of treatment, followed by positive dynamics by 12 weeks of therapy with Alfuprost MR. The data obtained correspond to those presented in the literature. During 3 months of therapy, it was recorded: a decrease in the average score on the IPSS scale by 30%; an increase in the average urine flow rate by 20.6%; a decrease in the average amount of residual urine to normal values; an improvement in the quality of life of patients, according to the results of filling out the QoL questionnaire, by an average of 1.8 points. Patients in both groups had clinically insignificant fluctuations in systolic and diastolic blood pressure, less than 1 mmHg (in both groups) during 12 weeks of therapy; changes in heart rate during 3 months of therapy with Alfuprost MR were also clinically insignificant and averaged no more than 1 beat per minute In the medical records of patients, no adverse reactions were registered during therapy with Alfuprost MR, which confirms the high safety profile of the drug in clinical practice. CONCLUSION: Thus, Alfuprost MR is an effective means for the treatment of LUTI in BPH, with minimal vasodilating effects, which allows the drug to be prescribed to comorbid patients with concomitant high blood pressure or hypertension, including those taking antihypertensive drugs.

[The efficiency of probiotics in the prevention of recurrent lower urinary tract infections and bacterial vaginosis].

INTRODUCTION: The literature data indicate that bacterial vaginosis (BV) increases the risk of development of lower urinary tract infections (LUTI). Thus, it is reasonable to assume that the use of probiotics, in particular Lactoginal, can be effective in preventing relapses of LUTI. AIM: To study the efficiency of probiotics, particularly Lactoginal, for the prevention of recurrent LUTI and BV. MATERIALS AND METHODS: A total of 120 women with chronic recurrent bacterial cystitis in the acute stage and concomitant bacterial vaginosis were randomized into two groups of 60 patients. In group 1, standard antibacterial therapy was used according to guidelines of professional societies. In group 2, vaginal probiotic Lactoginal was prescribed after standard treatment. RESULTS: The results obtained in this study correspond to the literature data. The additional use of probiotics in the complex therapy of chronic lower urinary tract inflammation contributed to the normalization of the lactobacilli concentration in 93% of cases, in contrast to standard antibacterial therapy, after which the normal flora was preserved only in 40% of cases. In addition, a reduction in the number of relapses of BV was seen. Moreover, it was found that in the group of patients treated with Lactoginal, there was 18.3% less recurrence of cystitis within 6 months than in the control group (p<0.05). CONCLUSION: The use of probiotics, in particular, Lactoginal vaginal capsules, in women with BV after antibacterial therapy contributes to a faster recovery and longer preservation of the normal vaginal flora, which allows to the prolongate the relapse-free period of both chronic bacterial cystitis and BV.

[Treatment of the chronic prostatitis: current state of the problem].

A review of the literature on the urgent problem of urology, which is therapy of chronic prostatitis (CP) is presented. Despite numerous studies dedicated to the prevention and treatment of CP, it has not yet been possible to reduce the CP incidence. Therapeutic approaches aimed at improving the quality of life are not always effective due to the lack of a clear understanding of the etiology and pathogenesis of the disease. Leading Russian urologists recommend introducing into the complex therapy of CP a domestic drug from the cytomedin, namely Vitaprost, which causes a significant decrease in the severity of trophic disorders, inflammatory and congestive processes, improves microcirculation in the prostate, stimulates cellular and humoral immunity, all of which increase the effectiveness of CP therapy.

[The use of bioregulatory peptides in the treatment of men with benign prostatic hyperplasia and chronic prostatitis].

INTRODUCTION: Benign prostatic hyperplasia (BPH), and chronic prostatitis (CP) are considered to be among the most common causes of lower urinary tract symptoms (LUTS) in men. The combination of BPH with CP raises many questions when choosing the right treatment strategy. For a long time, bioregulators isolated from the prostate gland of cattle have been successfully used in the treatment of CP. OBJECTIVE: to evaluate the effectiveness of bioregulatory peptides, in particular vitaprost, in the treatment of men with benign prostatic hyperplasia and chronic prostatitis. MATERIALS AND METHODS: The study included 60 patients with BPH and CP, who were divided into two groups of 30 people. In the comparison group (CG), complex therapy with drugs from the group of alpha-blockers and fluoroquinolones was performed. In the main group (MG), a similar complex therapy was performed in combination with vitaprost tablets. The effectiveness of the treatment was evaluated after two weeks (visit 2) and after 4 weeks (visit 3). RESULTS: In the MG, a more effective reduction in the severity of LUTs and manifestations of the inflammatory process was noted than in the HS. After 2 weeks of therapy in OG, the average score on the IPSS, QOL and NICH-CPSI questionnaires was lower by 2.4 points, 1.2 points and 2.5 points, respectively, the number of white blood cells in the prostate secret was on average 1.5 times less, and Qmax was higher by 1.4 ml/sec. The revealed differences were statistically significant (p<0.05). This trend continued after 4 weeks of therapy. CONCLUSION: Thus, the use of bioregulatory peptides, in particular the drug vitaprost, in patients with BPH and CP helps to reduce the severity of LUTs and pain in a shorter time, has a positive effect on the dynamics of the inflammatory process, which leads to an improvement in the quality of life of patients in this category.

[Comparative analysis of the effectiveness of early and delayed initiation of combined DRUG therapy for bph].

INTRODUCTION: Currently, -blockers (-AB) and 5-alpha-reductase inhibitors (I-5-AR) are recommended as the drugs of choice for the treatment of patients with benign prostatic hyperplasia (BPH). However, despite the clear advantages of combination therapy, at the initial stages of treatment, I-5-AR is either not prescribed at all, or added to therapy after a few months. The aim of our study is to study the effectiveness of early and various options for delayed combined drug therapy of patients with BPH using -AB and I-5-AR. MATERIALS AND METHODS: The study included 90 patients with BPH, who were divided into three groups of 30 people. In group 1, monotherapy with drugs from the -AB group was performed for 6 months, after which they were transferred to treatment with a combined drug. In group 2, monotherapy was performed for three months, after which they were also transferred to treatment with a combined drug. And in group 3, patients were prescribed combination therapy from day 1. RESULTS: Early combination therapy with dutasteride was more effective than delayed Therapy for 6 months. There were no significant differences in the main parameters studied between patients who simultaneously started combination therapy and switched to it after 3 months, by the end of the 12th month of treatment. However, early therapy is a combined drug made it possible to achieve a more rapid effect in relation to LUTS. CONCLUSION: Thus, the data obtained confirm the clinical recommendations regarding the expediency of early initiation of combined therapy with an -adrenoblocker and a 5-reductase inhibitor in patients with moderate and severe LUTS caused by BPH and the risk of disease progression. Postponing the transition to combination therapy for 6 months or more may lead to a decrease in the effectiveness of treatment of patients in this category.

[Entomological drug adenosine for the treatment of patients with benign prostatic hyperplasia and chronic prostatitis].

INTRODUCTION: Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are common disorders that are typical for age-related health changes in men. The combination of BPH with CP raises many questions when treatment tactics is chosen. Currently, new drugs have been developed and widely used, namely entomological drugs, which are biologically active substances with anti-inflammatory and antioxidant properties. The aim of our study was to study the efficiency of the entomological drug Adenoprosin in the complex therapy of patients with BPH and CP. MATERIALS AND METHODS: A total of 60 patients with BPH and P were included in the study. Patients were randomized into two groups of 30 people. In the control group, alpha-blockers and fluoroquinolones were prescribed. In the main group, patients received the same therapy with alpha-blockers and fluoroquinolones, but additionally took Adenoprosin once a day for three months. The results were evaluated at baseline (Visit 1), after four weeks (Visit 2) and three months (Visit 3) of therapy. The frequency of urination, the number of night urinations, the average score on the IPSS, QOL, NIH-CPSI scales, the maximum urine flow rate (Qmax), prostate volume and residual urine volume, as well as microscopic study and culture of expressed prostatic secretion were evaluated. RESULTS: At baseline, there were no differences between group in all studied values (p>0.05). By the second visit, despite the absence of significant differences (p>0.05), a more pronounced positive changes in the most parameters were showed in the main group. According to evaluation at visit 3, in the control group all values didnt change significantly compared to those at visit 2. In the main group, there was a significant decrease in the number of day and night urinations, an increase in the Qmax and the average score on the NICH-CPSI, IPSS and QOL scales, and a decrease in the prostate volume and residual urine volume. There was significant difference between results in the main and control group (p<0.05). CONCLUSIONS: Considering anti-inflammatory, antioxidant activity and antiproliferative effect, entomological drug Adenoprosin may become a novel drug for the complex therapy of patients with BPH and CP. However, to validate the results and to study the mode of action of this group of drugs in details, there is a need to carry out large-scale placebo-controlled clinical trials.

[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.

[Modern view on the use of antioxidants in the treatment of male infertility].

Based on the literature data, this review discusses the prevalence and etiology of male infertility, as well as the current view of the reasons for the lack of effectiveness of treatment of idiopathic infertility in men. The effectiveness of antioxidant therapy in various variants of redox balance disorders is evaluated. Possible prerequisites and mechanisms of complications in the administration of antioxidants are described. In addition, the need to introduce laboratory confirmation of oxidative stress and review approaches to antioxidant therapy is justified. The article also discusses the possibility of treating idiopathic pathospermia with the help of a complex drug Androdoz, which, according to the literature, can improve such indicators of sperm as the volume of ejaculate, the number and viability of spermatozoa and the proportion of their actively mobile forms due to the synergy of its components.

[Use of D-mannose in the prevention of recurrent lower urinary tract infection in women].

Lower urinary tract infections (LUTI) currently retain the status of one of the most urgent problems of urology. According to extensive microbiological studies of UTIAP I and II, "DARMIS" the most common pathogens that are detected in the urine of women with LUTI are gram-negative bacteria of the Enterobacteriales family, in particular E. Coli. Antibacterial therapy demonstrates high effectiveness in the treatment of uncomplicated LUTI. However, the problem of recurrent infection remains unresolved. Taking into account known side effects of continuous antimicrobial prevention, as well as data on the high frequency of relapses after its cancellation, it is necessary to identify alternative LUTI prevention strategies. The use of D-mannose can be one of these strategies. D-mannose use for the prevention of relapses of INMP is indicated in the clinical recommendations of the American (AUA) and European (EUA) urological associations. D-mannose is a monosaccharide that is extracted from a larch rod. It is relatively quickly absorbed and reaches the peripheral organs in about 30 minutes, after which it is excreted in the urine. The structure of d-mannose allows it to bind to mannose-sensitive E. Coli fimbriae and prevent their adhesion to the urinary tract mucosa. Several studies demonstrated high safety profile and effectiveness of long-term D-mannose treatment in preventing LUTI. The data presented in the literature allow us to recommend patients with recurrent LUTI long term D-mannose intake helps to reduce the severity of symptoms in acute episodes and prolong relapse-free period. As a source of D-mannose, we can recommend Ecocystin 1 sachet 1 time a day.

[Systemic enzyme therapy for treatment of women with chronic recurrent bacterial cystitis].

INTRODUCTION: In most cases, treatment of infectious and inflammatory diseases, including lower urinary tract infections, includes antibacterial drugs. However, their efficiency decreases every year. The absence of new groups of antibiotics makes it necessary to develop alternative treatment schemes and methods for improving efficiency of existing drugs. Systemic enzyme therapy is one of the promising directions in the treatment of lower urinary tract infections, which was shown to be effective for treating a number of diseases. AIM: to evaluate the results of complex treatment of women with chronic recurrent bacterial cystitis using a drug for systemic enzyme therapy. MATERIALS AND METHODS: The examination and treatment of 60 women aged 19 to 45 years with an exacerbation of chronic recurrent bacterial cystitis, who were randomly divided into two groups of 30 patients, was performed. In the group 1, patients received standard antibiotic therapy. In the group 2, women additionally received Phlogenzym. An evaluation of the efficiency was carried out on the 1st, 7th and 14th day and included analysis of lower urinary tract symptoms, according to bladder diaries, assessment of pain intensity and laboratory tests (C-reactive protein [CRP], IL-6, IL-1, TNF. During long-term follow-up (6 months after completion of treatment), the relapse rate was evaluated in both groups. RESULTS: At admission, all women had clinical and laboratory signs of cystitis. By the 14th day, there was normalization of evaluated parameters in both groups. However, in patients receiving systemic enzyme therapy a more rapid relief of the inflammatory process (a decrease in the frequency of urination, urgency, nocturia, severity of inflammatory changes in the blood and urine) by the 7th day of treatment was observed. During a further 6-month follow-up, relapses were detected in 9 (30%) and 4 (13.3%) patients in group 1 and 2, respectively. CONCLUSION: The results of the study demonstrated the high efficiency of systemic enzyme therapy. Its use for complex treatment provides more rapid relief of lower urinary tract symptoms and pain, as well as reduces the number of relapses in women with chronic recurrent bacterial cystitis.

[Experience of application of hormonal and probiotic therapy in the complex treatment of women in peri- and postmenopausal with chronic recurrent bacterial cystitis in the background of vulvovaginal atrophy].

INTRODUCTION: Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used. MATERIALS AND METHODS: The study included 60 women aged with the diagnosis: "Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage". The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment. RESULTS: At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05). CONCLUSION: Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.

[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.