[Onto-phylogenetic prerequisites for development of chronic cystitis in women].

INTRODUCTION: Urinary tract infections (UTIs) are among the most common bacterial infections. At the request "cystitis", there are 12,067 publications in the RSCI system (e.library) as of 10/08/2023 and 16,332 articles were screened in the Pubmed. This is evidence that the problem of cystitis is far from being resolved. MATERIAL AND METHODS: A total of 425 patients with bacterial vaginosis and 77 women with chronic recurrent cystitis were included in the study. In all patients, the vaginal biocenosis was assessed through molecular genetic testing. The examination included filling out the Russian version of the Acute Cystitis Symptom Score (ACSS), urinalysis, and urine culture. In addition, local microcirculation was measured using laser Doppler flowmetry (LDF). After examination, patients were prescribed basic therapy and randomly assigned to one of three groups. In a control group (n=17), only basic therapy, consisting of fosfomycin 3.0 once at night + furagin 100 mg after meals 3 times a day for 5 days was prescribed. In the main group 1, 29 women received basic therapy plus Superlymph suppositories 10 units 2 times a day vaginally for 10 days. In the main group 2, 31 patients received basic therapy plus suppositories Superlymph 10 units (rectally in the morning) and Acylact Duo (vaginally in the evening) for 10 days. RESULTS: Among 425 patients with bacterial vaginosis, 78 (18.3%) complained of various urinary disorders, but only 21 women (4.9% of those with vaginal dysbiosis and 26.9% with dysuria) had a diagnosis of cystitis. In all cases, it was an exacerbation of a chronic disease. Among 77 patients with chronic cystitis, normal vaginal flora was initially present in 32 patients (41.6%), and bacterial vaginosis was found in 45 (58.4%) cases. After therapy, positive results were noted in patients of all groups. Complete eradication of the pathogen occurred in 15 women (88.2%) who received only basic therapy; in the main groups 1 and 2, uropathogens were not detected in 27 (93.1%) and 28 (90.3%) cases, respectively. In the control group, the proportion of patients with normal vaginal flora remained virtually unchanged (41.2% [n=7] vs. 47.1% [n=8]). In the main group 1, the proportion of patients with normal vaginal flora almost doubled: from 41.4% (n=12) to 79.3% (n=23). In main group 2, restoration of vaginal flora was noted in 87.1% of cases. CONCLUSION: According to our data, only 4.9% of patients with bacterial vaginosis were diagnosed with chronic cystitis, however, 58.4% of patients with chronic cystitis had vaginal dysbiosis. The use of a complex of antimicrobial peptides and cytokines has significantly increased the bidirectional effect of therapy. Suppositories Superlymph in a combination with vaginal use of Acylact Duo allow to obtain the best results.

[Practice of urological departments during the COVID-19 pandemic].

INTRODUCTION: The pandemic of novel coronavirus infection has had a strong impact on the whole medical system, including urological departments. MATERIAL AND METHODS: We assessed the impact of restrictions due to the pandemic on the work of urological departments of private (Medical Center "Avicenna", Novosibirsk) and community (KGBUZ "City Clinical Hospital No. 11, Barnaul") hospitals; GBUZ of the Novosibirsk region "City Clinical Emergency Hospital" (GBUZ CCEH) No. 2, Novosibirsk) clinics, as well as the urogenital department of the TB Research Institute of Ministry of Health of Russia during the period from 2019 to 2020. The changes in the spectrum of surgical procedures, as well as the structure of patients' visits to a urologist were evaluated. RESULTS: In March 2020, the urogenital department of the TB Research Institute of Ministry of Health of Russia was redesigned into an observational one. Community departments worked with small restrictions or without any limitations. In KGBUZ "City Clinical Hospital No. 11, Barnaul", an increase in the number patients with bladder cancer, ureteral stones, concomitant kidney and ureteral stones by 3-27% was noted (p<0.05), as well as those with acute epididymo-orchitis, including testicular abscess. At the same time, a significant decrease in the number of patients with varicocele, pyelonephritis, chronic cystitis, chronic prostatitis, and phimosis was found. A surgical department of GBUZ CCEH from October to December 2020 was restructured to an infectious hospital; this led to a decrease in the volume of urological care and the number of procedures. The Avicenna Medical Center also established anti-epidemic measures, which made it possible not only not to reduce, but in a number of procedures to increase the volume of surgical care. CONCLUSION: Owing to anti-epidemic measures, including the patient flow distribution, an introduction of mandatory testing, an early detection of patients and carriers among employees, mask regime, the opening of an observational department, single rooms, the lack of contact between patients, short length of stay, it was possible to prevent an outbreak of coronavirus infection among patients and personnel. Both in the municipal and private urological clinics, well-organized work precluded the negative impact of the pandemic.