[Management of lower urinary tract symptoms in patients with benign prostatic hyperplasia during COVID-19. results of an all-russian observational study ATLANT].

BACKGROUND: COVID-19 aggravates lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). The optimal treatment regimen for patients with this disease during the COVID-19 pandemic is still under question. OBJECTIVES: The aim of the All-Russian observational study of Afalaza in the Treatment of LUTS in pAtieNTs with BPH during COVID-19 (ATLANT) was to obtain additional data on the efficacy and safety of Afalaza in this patient group. METHOD: s. The study enrolled 73 men aged 46-65 years with LUTS and diagnosed BPH who suffered from COVID-19. All patients received Afalaza for 16 weeks. The dynamics of BHP indicators, erectile function, and quality of life were assessed after 4, 12, and 16 weeks of treatment. RESULTS: Patients with LUTS/BHP who suffered from COVID-19 had a decrease in the total IPSS score from 21.6+/-8.6 to 6.4+/-2.4 (-70.4%) points after 16 weeks of treatment. There was a direct correlation between COVID-19 duration (and beginning of therapy) and the severity of symptoms after Afalaza treatment. According to the subjective assessment of patients, there was a significant increase in the quality of life and erectile function after 16 weeks of treatment. 9 mild AEs were registered in 12.3% of patients and were unrelated to the study drug. CONCLUSIONS: Results show that Afalaza may be a perspective drug for the treatment of LUTS/BPH in patients with COVID-19 and be used for this urological disease in the current COVID-19 pandemic.

[Possibilities of using sildenafil in patients with cardiovascular comorbidities who underwent transurethral resection of the prostate].

AIM: To study the efficacy and safety of using sildenafil in patients with erectile dysfunction (ED) and concomitant cardiovascular diseases (CVD) who underwent transurethral resection of the prostate (TURP). MATERIAL AND METHODS: A total of 59 patients (age from 50 to 75 years) with a diagnosis of benign prostatic hyperplasia (BPH), requiring surgical treatment due to inefficiency of drug therapy, I-PSS score more than 20 points), who were sexually active, but had erectile dysfunction (IIEF score < 21), coronary heart disease (NYHA class I) and stage 1-2 hypertension with stable blood pressure. All patients underwent bipolar TURP. From the first day after the TURP, therapy was prescribed as following: tamsulosin 0.4 mg once a day for 90 days, ciprofloxacin 500 mg twice a day for 10 days. In addition, the patients received treatment for comorbidities. In the main group (n=30), men additionally received sildenafil (EFFEX Sildenafil Evalar) 50 mg daily for 60 days, starting from the 30th day postoperatively. We have chosen this drug from an economic standpoint. RESULTS: At baseline, all patients in both groups had hemodynamic and microcirculatory disorders in the prostate, which got worse in the early postoperative period. During the long-term follow-up, hemodynamic and microcirculatory impairments decreased. This effect was more pronounced in patients who received sildenafil. In addition, patients had an improvement in sexual function. During follow-up, there was no adverse effects of sildenafil on hemodynamic parameters (blood pressure, heart rate). CONCLUSION: Our results allow to recommend sildenafil in order to restore sexual function postoperatively in patients with BPH, including those with concomitant cardiovascular disorders.