[Treatment of chronic cystitis in postmenopausal women].

A randomized double blind controlled trial of intravaginal cream ovestin (estriol) was conducted in 102 postmenopausal females with chronic cystitis. The patients were divided into two groups. Group 1 (n = 52) received standard therapy, group 2 (n = 50) received standard therapy plus ovestin (daily intravaginal administration for 2 weeks, then twice a week). Final results were evaluated 1 year after therapy. Before the treatment 94% patients had subnormal levels of blood estradiol. One year after the treatment positive results were achieved in 91.3% patients of group 2 and 65.8% of group 1 (p < 0.001). In group 2 patients ovestin significantly reduced pollakiuria, nocturia, episodes of urgent urinary incontinence, painful voiding. Percentage of patients with leukocyturia diminished from 100 to 8%, bacteriuria--from 74 to 4%, with vaginal lactobacilli increased from 0 to 56%, enterobacterial contamination of the vagina fell from 66 to 12%. Vaginal pH decreased from 6.0 to 3.6. Addition of ovestin to standard therapy reduced the number of cystitis recurrences 11-fold, days of antibacterial therapy--12.4-fold. Side effects of ovestin (vaginal pruritus) were seen in 4% patients.

[Iatrogenic foreign body]. / Iatrogennye inorodnye tela.

Three cases of iatrogenic foreign bodies are described. In case 1 a large stone was removed from the urinary bladder of a 80-year-old man 8 years after suprapubic prostatectomy. The concrement contained a fragment of the gauze tampon left during that operation. In case 2 a surgeon trying to stop a profuse hemorrhage lost a surgical needle in paraurethral tissues above the urinary bladder of an elderly man undergoing prostatectomy. Because of the foreign body the patient developed complications: scarry obliteration of the bladder neck, concrement, a vesical fistula, chronic cystitis and chronic pyelonephritis. In case 3, the Dormia's basket broke with ureteral perforation and the metal fragments penetrated into the paraureteral fat in a 46-year-old woman undergoing ureterolithoextraction. 11 months later, the fragment migrated into the bladder wall and perforated it. The fragment was removed endoscopically.

[Prostatic adenomectomy in patients with a history of myocardial infarct, acute cerebral circulatory disorder and pulmonary thromboembolism]. / Adenoméktomiia predstatel'noi zhelezy u bol'nykh, perenesshikh infarkt miokarda, ostroe narushenie mozgovogo krovoobrashcheniia i tromboémboliiu legochnoi arterii.

Immediate and long-term outcomes of adenomectomy have been analyzed for patients with prostatic adenoma with a history of 1-3 myocardial infarctions (185 subjects), 1-2 episodes of cerebral circulation disorder (74 cases) on pulmonary artery thromboembolism (3 cases). The surgery was urgent because of acute urine retention for 88 patients, while it was scheduled in 174 patients. The postoperative developments were uneventful in 84.9%, 87.8%, 100% of postinfarction, postapoplectic and post-thromboembolism patients, respectively. Postoperative lethal outcomes occurred in 6.5% of patients with postinfarction cardiosclerosis, 5.4% of those with postapoplectic complications. As shown by long-term follow-up available for 225 patients, 19 of them died (8.4%), 296 survived 1-11 years after the surgery. One more myocardial infarction developed in 17, apoplexy in 3 patients. Long-term functional results of adenomectomy can be considered good in most of the patients in absence of a significant progression of cardiovascular disease. The authors think adenomectomy not contraindicated and promising in terms of short- and long-term outcomes if made in above kind of patients 4, 6 and 9-12 months after myocardial infarction, pulmonary artery thromboembolism and disturbance of cerebral circulation, respectively.