No 2 (2009)

The study of immunomodulating, antioxidant and hepatoprotective activity of some fluoroquinolones (norfloxacin, ofloxacin, levofloxacin) immobilized into erythrocyte and leukocyte carriers was made on Wistar rats with body mass about 150-180 g. It is shown that toxic action on the kidneys of mercury dichloride, especially a combined action of mercury dichloride and staphylococcal infection, raised the levels of urea and creatinine, caused immunosuppression, activated hepatotoxic, cytolytic and oxidative processes, decreased antioxidant and energetic potentials of erythrocytes. Unbound fluoroquinolones intensified the above processes. Introduction of fluoroquinolones immobilized into erythrocyte and leukocyte carriers, respectively, decreased and normalized intensity of lipid peroxidation, cholestasis, cytolysis, improved and normalized immune system functions, antioxidant and energetic potentials of erythrocytes.

Canephron® N, a medicine of plant origin, was tested in outpatient aftertreatment for prophylaxis of recurrent infection of the upper urinary tract, in intravesical therapy for prophylaxis of lower urinary tract infections in sexually transmitted diseases. Canephron® N provides an additional anti-inflammatory and symptomatic effect which lasts after active antibacterial therapy, and effective antibacterial protection in invasive manipulations, intravesical instillations, in particular. The drug showed good tolerance.

Efficacy and safety of endoscopic contact electroimpulse lithotripsy (EILT) were studied in 146 patients with urolithiasis (mean age 48±16 years). Of them, 10 (7%) had ureteropelvic (UP) concrements, 124 (85%) had ureteroliths and 12 (8%) had bladder stones. The impulses were generated by the electroimpulse lithotripter Urolit-105M (Lithotech Medical, Israel; MedLine, Russia). EILT produced a complete destruction of UP concrements, ureteroliths and bladder stones in 96% cases. Complications occurred in 8.2% cases. The risk of intraoperative EILT complications was higher in destruction of stones more than 8 mm in the largest parameter of size, long-standing ureteral concrements complicated by ureteritis. EILT of UP concrements must be conducted by means of single impulses (impulse energy 0.45 J), of ureteroliths - by single or paired impulses (impulse energy 0.45-0.6 J), of bladder stones - by paired or serial impulses (impulse energy 0.6-0.7 J).

Optical coherence tomography (OCT) was tested in diagnosis of bladder cancer (BC) in 100 BC suspects. This method showed higher sensitivity (by 16%) in diagnosis of BC compared to standard cystoscopy as it more presicely identified squamous intraepithelial and noninvasive tumors. The analysis of OCT images was made with a noval computer program of filtration and color overlay. This improved quality of the image allowed verification or rejection of BC, its localization on urinary bladder wall.

Partial denervation of cavernous tissue (CT) during nerve sparing radical prostatectomy (RPE) can cause development of neuropraxy and cavernous fibrosis (CF) resulting in erectile dysfunction (ED) after operation. We investigated the impact of intracavernous nitric oxide donor therapy on cavernous tissue after denervation in rats. Twenty six adult male Wistar rats were divided into three groups. Bilateral cavernous nerves (CN) crashing was made in ten rats (group 1). Ten underwent bilateral CN crashing with intra- and postoperative (2 times a week) intracavernous injection with new nitric oxide donor dinitrosyl iron complex (DNIC) in a dose 0.5 mmol/l (group 2). The latter six underwent sham operation (a control group). We evaluated CT changes by electrone microscopy (cells in the field of vision - CFV) and immunohistochemistry 3 and 6 months after the operation. CT denervation in group 1 led to a significant decline in mitotic activity of smooth muscle cells (1.79 ± 0.04 and 1.14 ± 0.03 CFV), in stimulation of endothelium and fibroblasts proliferation activity (3.14 ± 0.07 and 5.17 ± 0.11 CFV, 6.19 ± 0.97 and 8.21 ± 1.13 CFV, respectively) 3 and 6 month after operation. In the control group mitotic, endothelium and fibroblasts proliferation was 2.01 ± 0.06; 1.07 ± 0.01 and 4.18 ± 0.22 CFV, respectively. The greatest changes were in smooth muscle cells (SMC). We found synthetic activity of collagenase in SMC 3 (5.18 ± 0.64 CFV) and especially six (6.18 ± 1.19 CFV) months after CN crashing. Some of SMC had round or star-shaped forms which are common for fibroblasts. There were abnormalities of contact braking of the cellular layer and appearance of chaps between the endothelium. As a result, some cells were climbing and creeping onto neighbor cells causing changes in configuration of endothelial monolayer. Nitric oxide replacement therapy using DNIC prevented morphological changes of all types of cells in CT. We registered stabilization of endothelial (1.97 ± 0.07 and 1.74 ± 0.05 CFV) and fibroblast (3.97 ± 0.11 and 4.01 ± 0.17 CFV) proliferation and improvement of SMC mitotic activity (2.56 ± 0.09 and 2.34 ± 0.12 CFV) three and six months after operation. Synthetic activity of collagenase in SMC was 0.47 ± 0.01 DFV and was absent 3 and 6 months after CN crashing, respectively. These results show that restoration of a nitric oxide level in the penis can prevent development of cavernous fibrosis after CN injury and that DNIC has a significant potential for penile rehabilitation and treatment of ED after RPE.

Incidence of androgenic deficiency in Dagestan males was studied using AMS questionnaire. Assessment of the results was made by standard criteria. The obtained statistics on 780 responders over 30 years of age demonstrate that symptoms of androgenic deficiency exist in 51.15% males in Dagestan. They are primarily caused by sexual problems.

The analysis of the results of a complex investigation of a reproductive function including examination of semen and blood hormones in 100 metallurgists and 80 workers not engaged in metallurgy of ferrous metals (a control group) has shown that 44% metallurgists and 18.5% controls have pathology (p < 0.001). Metallurgists had more often agglutination, asthenozoospermia, increased semen viscosity, oligospermia, teratospermia, asthenoteratospermia, male sterility than the control group (p < 0.001). Metallurgists have a moderate and high relative risk of reproduction function pathology (RR = 1.6-2.9). Urological pathology in metallurgists can be reduced after prophylactic programs. This proves the necessity of including urological examination and ultrasonic scanning in programs of regular check-up of metallurgists.

We analysed surgical outcomes in 41 boys aged 2.5 months to 17 years with congenital hydrohephrosis who were treated with external drainage (nephrostoma, intubation drainage, Gibbons drainage) and by means of stenting. We discovered that stent drainage produces urethral traumas, orchitis, orchoepididymitis. Our study made us to recommend external drainage methods for boys with congenital hydronephrosis undergoing reconstructive plastic surgery to prevent injuries and inflammation in the urogenital system.