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No 6 (2010)


Three-year results of a clinical study of prostamol Uno efficacy and safety in patients with initial symptoms of prostatic adenoma and risk of its progression

Vinarov A.Z., Alyaev Y.G., Apolikhin O.I., Mazo E.B., Darenkov S.P., Demidko Y.L., Lokshin K.L., Medvedev A.A., Permyakova O.V., Spivak L.G., Shkol'nikov M.E., Vinarov A.Z., Alyaev Y.G., Apolikhin O.I., Mazo E.B., Darenkov S.P., Demidko Y.L., Lokshin K.L., Medvedev A.A., Permyakova O.V., Spivak L.G., Shkolnikov M.E.


Prostamol® Uno (PU) efficacy and safety were studied in a multicenter, open-population, randomized and comparative trial. PU was given in a single daily dose 320 mg for 36 months to 50 patients with initial symptoms of prostatic adenoma (PA) in comparison with 50 matched controls. The trial evaluated PU action on the symptoms progression and quality of life with application of questionnaires IPSS and QoL (BS). It was found that PU treatment relieved PA symptoms by IPSS, while these symptoms progressed in the controls. QoL improved in the study group and deteriorated in the control one. Administration of PU significantly increased urinary flow rate though in the controls urinary flow rate decreased, size of the prostate diminished and increased, respectively. Changes in the PSA were not seen and were insignificant, respectively. The results of the study say that prostamol® Uno in a dose 320 mg/day can prevent PA progression without side effects.
Urologiia. 2010;(6):3-10
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Overactive bladder in patients with infravesical obstruction caused by prostatic adenoma

Alyaev Y.G., Gadzhieva Z.K., Petrovskiy N.V., Alyaev Y.G., Gadzhieva Z.K., Petrovsky N.V.


According to the literature, overactive bladder (OB) occurs in 52-80% men with infravesical obstruction (IVO) due to prostatic adenoma, 38% patients retain the disorder after surgical correction of the obstruction. Urodynamic investigation of the lower urinary tract (LUT) function was conducted in 206 patients with prostatic adenoma admitted to the urological clinic of I.M. Sechenov Moscow Medical Academy. All of them had LUT obstruction. Detrusor overactivity was detected in 58,25% cases. This bladder dysfunction played a leading role in development of IVO complications (vesicoureteral reflux, ureterohydronephrosis) entailing marked disorder of the upper urinary tract disorder - chronic renal failure. Thus, early detection of the cause of urodynamic disorders in IVO patients has a great practical value for functional results of surgery.
Urologiia. 2010;(6):10-15
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Pharmacourodynamic non-invasive studies in patients with prostatic adenoma

Danilov V.V., Vasil'chenko A.V., Danilova T.I., Besedin S.A., Borshchenko S.A., Danilov V.V., Danilov V.V., Vasilchenko A.V., Danilova T.I., Besedin S.A., Borschenko S.A., Danilov V.V.


After examination 47 patients with prostatic adenoma (mean age 63 years) received a course of alpha1-adenoblocker (omsulosin in a dose 0.4 mg/day). A three-day uroflowmetric monitoring was made at home before and after treatment. The findings were assessed with Liverpool nomo-gram by maximal flow. Omsulosin treatment was found to change voiding structure, to identify the obstructive component due to displacement of the flow characteristics to the low centiles of the nomogram. Thus, long-term treatment with alpha1-adrenoblockers can be used as a pharmacourodynamic test to detect infravesical obstruction in patients with prostatic adenoma.
Urologiia. 2010;(6):16-19
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Hemostasis methods comparison in open adenomectomy

Shakhmachev V.N., Shakhmachev V.N.


The article compares effectiveness of different methods of hemostasis after transvesical adenomectomy for prostatic adenoma practiced in the world and presents original experience in surgical treatment of 224 patients with prostatic adenoma. The latter experience allowed recommendation of the extraurethral method of adenomatous tissue removal as least traumatic, causing minimal blood loss and minimal number of early and late postoperative complications.
Urologiia. 2010;(6):20-23
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Calcium antagonist effects on contractile ureteral activity in experiment

Komyakov B.K., Bat'ko A.B., D'yachuk G.I., Komyakov B.K., Batko A.B., Diachuk G.I.


Dihydropiridine (nifedipine), phenilalkilamine (isoptin) and a novel domestic calcium channel blocker A-29 were studied for effects on motor activity of an isolated segment of a rabbit ureteral upper-third. Strength of muscular contractions (134 measurements) was evaluated in per cents to the baseline level. Tonic reaction and its duration were measured. Calcium antagonist action on ureteral contractile activity was studied by changes in contractile power in concentration rage from 10-9 to 10-5 M/l. Beginning from 10-9 M/l concentration of all the drugs studied there was a gradual decline of the initial contractile activity of the ureter. The following concentrations of calcium antagonists significantly reduced the amplitude of phasic contraction, whereas therapeutic concentrations - by more than 40%. In elevation of the concentration in some cases washing of the isolated ureteral segment with Krebs' solution failed to reestablish tonic reaction. Only A-29 spontaneous contractile activity recovered after washing. The maximal effect was achieved with nifedipin and A-29 in concentrations 10-5 M/l. Thus, calcium antagonists change contractile activity of smooth muscle cells of the ureter with a dose-dependent effect making it possible to use calcium antagonists for inhibition of contractile ureteral activity in clinical practice.
Urologiia. 2010;(6):23-27
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Bladder microcirculation in females with overactive bladder

Neymark A.I., Neymark B.A., Klyzhina E.A., Batanina I.A., Neimark A.I., Neimark B.A., Klyzhina E.A., Batanina I.A.


We studied microcirculation and a blood nitric oxide level in 30 females aged 23-63 years with overactive bladder (OAB) before and after administration of oxibutinin. We found that OAB patients have microcirculation disorders accompanied with elevation of nitric oxide in the blood. Oxibutin improved bladder microcirculation, normalized blood nitric oxide with resultant positive changes in clinical symptoms with less frequent voiding and alleviation of imperative disorders.
Urologiia. 2010;(6):28-30
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Sexual dysfunction in females with overactive bladder and their correction with M-cholinolytic spasmex

Danilova T.I., Danilov V.V., Luchinskiy S.A., Danilov V.V., Vasil'chenko A.V., Danilova T.I., Danilov V.V., Luchinsky S.A., Danilov V.V., Vasilchenko A.V.


A 4-month course of spasmex (15 mg three times a day) was conducted in 57 females (age 18-69 years, mean age 48 years) suffering from imperative urination manifesting as pollakiuria, imperative urges and urgent urinary incontinence in combination with sexual disorders. After the treatment the score of urination disorders went down from 21.4 to 12.7. Quality of life score decreased from 4.3 to 1.7. Sexual dysfunction diminished from 3.6 to 0.8 points. Clinical data showed that spasmex has a marked effect on m-cholinoreceptors, is well tolerated, has a moderate spasmolytic effect on the smooth muscles of the lower urinary tract. Moreover, spasmex can be used for correction of female sexual dysfunction caused by overactive bladder.
Urologiia. 2010;(6):30-34
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Treatment of urinary incontinence in postmenopausal women

Semenyuk A.A., Bityukov N.N., Krest'yaninov S.S., Semenyuk A.A., Bityukov N.N., Krestianinov S.S.


Examination of 65 postmenopausal women with urinary incontinence demonstrated that most of the patients had mixed urinary incontinence. Pathogenesis of urinary incontinence in postmenopausal women is strongly associated with estrogen deficiency. This dictates necessity of preoperative hormone replacement therapy. Surgical treatment of postmenopausal women aims at elevation of obturator pressure, prolongation of the urethra with narrowing of its orifice which can be managed with combination of urethrocystoplasty, levatoroplasty and sling operation.
Urologiia. 2010;(6):34-36
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Safocid antibiotic prophylaxis in low-invasive endoscopic operations and manipulations

Proskurin A.A., Asfandiyarov F.R., Kalashnikov E.S., Miroshnikov V.M., Proskurin A.A., Asfandiyarov F.R., Kalashnikov E.S., Miroshnikov V.M.


Efficacy of safocid (1g of seknidasol, 1g of azitromycin, 150 mg of fluconasol) was studied in antibiotic prophylaxis before conduction of urological endoscopic operations: diagnostic cystoscopy, renal stenting, ureteroscopy with contact lithotripsy. A total of 128 patients of the urological department received a single safocid dose 90 min before surgical intervention. Safocid efficacy in prevention of infectious complications reached 96.2%.
Urologiia. 2010;(6):37-40
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Peyronie's disease: comparative results of conservative treatment

Kovalev V.A., Karaguzhin S.K., Abdulkhamidov A.N., Danovich V.M., Kyzlasov P.S., Matskevich S.V., Kovalev V.A., Karaguzhin S.K., Abdulkhamidov A.N., Danovich V.M., Kyzlasov P.S., Matskevich S.V.


Long-term clinical experience with conservative treatment of Peyronie's disease has demonstrated that clinical efficacy of this therapy comprises maily anesthesia while erectile problems are not solved. Introduction of the drugs into the fibrous plaque is not adequate and hard to perform. Some drugs affect only some components of pathogenesis. For stabilization of the process it is recommended to use transdermal electrophoresis or phonophoresis. The search for new effective drugs and methods continues.
Urologiia. 2010;(6):40-44
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Vardenafil (levitra): new aspects of clinical efficacy

Gamidov S.I., Iremashvili V.V., Pavlovichev A.A., Tazhetdinov O.K., Gamidov S.I., Iremashvili V.V., Pavlovichev A.A., Tazhetdinov O.K.


Vardenafil (levitra, Bayer Schering Pharna, Germany) is a 5-phosphodiesterase inhibitor which proved highly effective and safe in the treatment of erectile dysfunction. Special techniques were used to study sexual satisfaction of female partners of men treated with vardenafil. It was found that vardenafil raises significantly sexual satisfaction of female partners of men treated with vardenafil and prolongs erection. This is a new aspect of vardenafil efficacy.
Urologiia. 2010;(6):44-47
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Microbiological diagnosis of chronic bacterial prostatitis

Chesnokova M.G., Novikov A.I., Novikov Y.A., Kabanov V.N., Solov'eva T.D., Chesnokova M.G., Novikov A.I., Novikov Y.A., Kabanov V.N., Solovyeva T.D.


We made a microbiological study of the urine and prostatic secretion (Meares-Stamey test) of 35 patients with chronic bacterial prostatitis (CBP) aged 35-75 years. We conducted a bacterial assay, determined species, sensitivity to synthetic antibacterial fluoroquinolone drugs. A total of 163 bacterial strains were isolated, of them 13 were staphylococcal. Gram-negative bacteria were identified in the test biomaterial only in 16.6% cases. The analysis of staphylococcal sensitivity showed the highest antistaphylococcal effectiveness of levofloxacin and lomefloxacin. Our study confirms an essential role of staphylococcal bacteria in CBP etiology.
Urologiia. 2010;(6):47-50
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Vitaprost efficacy in patients with infertility caused by chronic prostatitis

Ziganshin O.R., Bezpal'ko Y.V., Kovalev Y.N., Ziganshin O.R., Bezpalko Y.V., Kovalev Y.N.


The article provides the results of vitaprost® efficacy in 40 infertile men with chronic prostatitis. Vitaprost treatment was found effective, safe and well tolerated.
Urologiia. 2010;(6):50-54
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Approaches to raising efficacy of treatment of patients with chronic prostatitis associated with intracellular infections

Kul'chavenya E.V., Breusov A.A., Brizhatyuk E.V., Kholtobin D.P., Kulchavenya E.V., Breusov A.A., Brizhatyuk E.V., Kholtobin D.P.


The efficacy of indigal plus containing indol-3-carbinol, epigallocatexin-3-gallat and Serenoa repens extract in combination with sparfloxacin was studied in a trial with participation of 30 patients with chronic infectious prostatitis associated with intracellular agents. Group 1 (n = 15) received indigal plus (2 capsules twice a day for 3 months) and sparfloxacin (200 mg twice a day for 1 month). Group 2 including 15 matched controls received sparfloxacin alone according to the same schedule. The examination included questionnaire survey (IPSS, QoL, NIH-CPSI), blood count, urinalysis, PSA test, microscopy, bacteriological study of prostatic secretion, uroflowmetry, transrectal ultrasound investigation of the prostate with residual urine assay, laser doppleroflowmetry. The examinations were performed on the treatment day 30, 60 and 90. After the antibacterial treatment chlamidia, ureaplasma and E.coli were detected in 13.3, 6.7 and 26.7% patients of the control group, in 6.7, 6.7 and 6.7% patients of the study group, respectively. Thus, the addition of a pathogenetic drug indigal plus to sparfloxacin treatment promoted normalization of apoptosis of the infected cells, led to more effective bacterial eradication, enhanced regression of the symptoms. It is recommended to include indigal plus in a basic scheme of treatment of patients with chronic infectious prostatitis.
Urologiia. 2010;(6):55-58
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Focal immunophysiotherapy in combined treatment of males with manifest symptoms of papilloma virus infection

Kuntsevich L.D., Komov N.N., Shibaeva E.V., Komarova V.D., Kopytova T.V., Pyshkina E.I., Shchelchkova N.A., Kuntsevich L.D., Komov N.N., Shibaeva E.V., Komarova V.D., Kopytova T.V., Pyshkina E.I., Schelchkova N.A.


We compared efficacy of combined treatment of males with anogenital warts given intramuscular cycloferon or cycloferon electrophoresis. Patients with manifest HPV infection (n = 107) were divided into two groups. Group 1 (n = 72) received intramuscular cycloferon (2 ml 12.5% solution each other day for 10 days), group 2 (n = 35) received cycloferon electrophoresis on genital region (2 ml 12.5% solution daily in 1-2 days, 5 injections). Measurements were made of local cytokines in urethral secretion, IFN-alpha, IFN-gamma, lactoferrin, sexual hormones (estradiol and testosterone) in blood serum before and after treatment. Focal immunophysiotherapy with cycloferon in combined treatment of males with anogenital warts vs intramuscular cycloferon treatment reduces recurrence rate 2 times, has no negative effect on serum level of sexual hormones, a course dose and duration of immunotherapy decreased 2-fold, is well tolerated, is not painful. Cycloferon electrophoresis has a more potent effect on improvement of local immunity. Thus, local immunophysiotherapy with cycloferon can be a method of choice in the treatment of manifest HPV infection in males.
Urologiia. 2010;(6):58-62
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Salamov A.K., Bogov K.K., Pliev R.N., Kakabadze S.A., Borodina A.V., Alyautdinova V.T.
Urologiia. 2010;(6):63-65
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Makedonskaya T.P., Chernen'kaya T.V.
Urologiia. 2010;(6):66-68
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