No 3 (2014)

108 patients (89 women and 19 men) aged from 18 to 59 years with chronic pyelonephritis (CP) on the background of urolithiasis in a phase of active inflammation were evaluated. Along with the standard methods of examination, survey plan included the use of specific biochemical diagnostic methods. The latter included an evaluation of lipid peroxidation, the level of fat-soluble antioxidant α- tocopherol, fractions of phospholipids and cholesterol in the membranes of polymorphonuclear leukocytes (PMN). Asa a result of examination, The changes in the activity of lipid peroxidation and structure of the lipid phase of PMN membranes were identified. There was an increase in urinary excretion of catecholamines (epinephrine and norepinephrine), which indirectly indicates an increase in the activity of sympathetic nervous system contributing to the progression of CP.

We observed 66 patients with chronic pyelonephritis in the exacerbation phase who received standard treatment with antibacterial drugs based on susceptibility of causative agents. All patients were randomly divided into two groups. Patients of study group have received phytodrug prolit super septo 2 capsules 2 times a day for 4 weeks in addition to standard treatment. Patients of control group have received standard therapy only. As a result of treatment, high effectiveness of therapy and reduction of length of treatment was noted in the study group. There were no subjective symptoms of disease in all patients at the end of treatment. Reduction of leykocituria and bacteriuria, normalization of body temperature, normalization of blood analysis and restoration of intrarenal blood flow were observed earlier in the study group compared with the control group. Recurrence of disease 3 months after end of treatment was not revealed in none of the patient in the study group, whereas it was noted in 14% of patients in the control group.

According to the results of epidemiological studies of prevalence of erectile dysfunction in the Russian Federation, the search for the determinants of risk of its development was performed. It was found that the leading risk factors for the development of erectile dysfunction, in descending order of statistical significance, include the amount of accumulation of points according to the IPSS score, arterial hypertension, Lipss quality of life index, age, diabetes, and overweight and obesity.

Varicocele and prostatitis are the most common andrological diseases, which may be accompanied by a decrease in the production of sperm cells, the deterioration of their quality and increased risk of infertility. This work was aimed to the evaluation of sperm DNA fragmentation index (DFI) and main indices of sperm fertility (concentration, motility and morphology), and the relationship between these parameters in the men of active reproductive age suffering from prostatitis or varicocele. Assessment of sperm DNA fragmentation was performed by SCSA (sperm chromatin structure assay) using flow cytometry; sperm parameters were evaluated according to WHO recommendations. It was shown that men with prostatitis (n = 9) and varicocele (n = 22) had significantly higher DFI compared with men in the control group (n = 22). Negative influence of these diseases on the concentration and the percentage of motile sperm cells in the ejaculate was revealed. These data suggest that the deterioration in the quality of semen in varicocele and prostatitis may be caused not only by pathospermia, but also, at least partially, by violation of the integrity of the sperm DNA. Evaluation of sperm DNA fragmentation can be recommended for use in laboratory diagnostics for prediction of fertility in infertile men.

It is shown that the synchronization of energetic, spectral, frequency, and temporal parameters of technique with biorhythms of physiological processes in the organ, which is target of impact, and in the human body as a whole, allows to significantly improve efficiency, and achieve stable and reproducible results of treatment. The article presents the results of study including 62 patients with vasculogenic ED. The study design included the randomization of patients into 3 groups depending on the complex of the therapy with the use of combined techniques, including negative pressure and laser illumination (LLNP) as a part of combined therapy and as monotherapy. Significant increase in the peak flow velocity after a course of treatment was observed in all three groups of patients. Improvement in erectile function was observed in all groups; according to IIEF score, erectile function has increased by 22.3±0.05% in group 1, by 34±1.5% in the group 2, and by 19±1.7% in the group 3, indicating the best results of treatment in the group receiving combined therapy. Combination of LLNP with the administration of PDE5 inhibitors significantly increases the effectiveness of treatment of vasculogenic ED due to the influence of physical factors on the stabilization of hemodynamics in the main arteries of the penis. After a course of therapy, increase in systemic vascular elasticity by 39.8±1.5% was also noted. The efficiency of the LLNP methodology in the treatment of patients with vasculogenic ED is demonstrated. The best results were obtained in the group of patients treated with combined therapy, including the use of LLNP and PDE-5 inhibitor.

The article presents the results of endoscopic and nephrolithotripsy and ureterolithotripsy in 73 overweight patients (body mass index of over 30 kg/m2) with kidney stones and urinary tract infections of different locations compared with 30 patients without obesity. The features of choice of tactics of surgical treatment and access, possible complications and their prevention are described.

The article presents the description of the clinical observation of the 36 years old patient with testicular feminization syndrome: genetic (karyotype 46 XY) and gonadal male sex, female external genitalia and the absence of derivatives of Mullerian ducts (uterus, fallopian tubes, the upper third of the vagina). At the first stage, testes were removed; then, vaginoplasty using segment of the sigmoid colon for possible sexual intercourse was performed. There were no complications. Currently, the patient's condition is satisfactory; she lives a regular sex life.

The article presents the clinical observation of a rare anatomical variant of congenital malformation of the upper urinary tract in 11 years old girl (horseshoe kidney, doubling of each of the halves, hydronephrosis of the bottom half of the doubling left segment of the horseshoe kidney), which was correctly diagnosed only during surgery.

Incidental prostate cancer (IPC) - cancer, identified by morphological evaluation of prostate tissue removed during transurethral resection (TUR) or open prostatectomy, in cases where the results of preoperative prostate biopsy revealed no prostate cancer. Literature review presents the data on the incidence of IPC, features of its diagnosis, prediction of tumor progression, and choice of treatment approaches. Many questions remain unresolved and require additional research.

Treatment of patients with chronic prostatitis is one of the most urgent problems of modern urology. According to most of the existing recommendations, fluoroquinolones are the drugs of choice in treatment of prostatitis. Recently, however, many researchers have noted the increasing role of intracellular pathogens, and high activity of macrolides and tetracyclines against these pathogens. This article provides an overview of the literature on recommended and promising antibiotics used in the treatment of patients with chronic prostatitis.