Nº 2 (2013)

The cross-sectional study of a random sample (population of patients and healthy subjects) was performed. Questionnaire survey of 970 women aged 18 years and older in Vladimir using an Urination Disorder Questionnaire was performed. The prevalence of violations of lower urinary tract function according to incidence of outpatient visits from 03/29/11 to 01/04/11 was evaluated. According to the data of examination, urination disorders were detected in 61% of women aged 45 years and older, in 23% of respondents aged 40—45 years and in 16% — up to 40 years old. Urine collection disorders were found in 94% of women, disorders of urinary bladder emptying — in 83%, disorders after urinary bladder emptying — in 36% of patients. The most common disorders of urination were urinary incontinence — in 27% of women, and nocturia — in 19% of women. The frequency of urinary incontinence (27%) was significantly higher than the overall prevalence of overactive bladder (9%). Among women, 21% said that they have sexual problems, but 70% does not solve this problem.

Results of surgical treatment of patients with ureteral obstruction are not always successful. Prevention of cicatricial and sclerotic complications in the postoperative period plays an important role. In this connection, search for pathogenetic methods that prevent the recurrence of strictures is one of the urgent problems of modern urology. 80 patients, divided into two groups (study and control), each of which was divided into three subgroups depending on the cause and degree of hydronephrosis, were followed-up. The first group consisted of patients with congenital hydronephrosis, the second group consisted of patients who underwent gynecological surgery with development of ureterohydronephrosis as complication. The third group consisted of patients with urolithiasis. All patients received surgical treatment. In postoperative period, active prevention of cicatricial and sclerotic complications in study group of 44 patients was performed. The control group consisted of 36 patients with history of surgery on the upper urinary tract without active antisclerotic prevention in the postoperative period. After interventions on urinary tract, comprehensive postoperative prevention of cicatricial and sclerotic complications using drug Longidaze® 3000 IU for 10 injections intramuscularly 1 time every 3 days in combination with magnetic-laser therapy is recommended.

The 118 operated patients with different forms of acute purulent pyelonephritis, including complicated with paranephritis were followed-up. Control group consisted of 65 similar patients who underwent traditional comprehensive treatment. Study group (n = 53) underwent additional wound dialysis with carbonic drainage-sorbent. Comparative analysis of the efficiency of the proposed method of drainage was carried out according to the clinical and laboratory parameters. The use of sorption therapy in patients with purulent and destructive forms of pyelonephritis and paranephritis allowed to reduce postoperative complications in patients of study group by 11%, as confirmed by the positive dynamics of the proinflammatory and anti-inflammatory cytokines. Moreover, the effectiveness of wound dialysis is justified by accelerated rehabilitation of patients and the possibility of discharge for 3 days before the control group of patients. The efficacy of wound dialysis (pyosorbtion) was equal to 18%.

The article presents a method of conservative treatment of men with I-II stage prostatic; adenoma using a combination of doxazosin and indigal, whiah Llels antioxidant, antiproliferative and anti-inflammatory properties, that allowed improving urodynamic parameters and reducing the progression prostate adenoma, minimizing the adverse effects of treatment.

The article presents the results of evaluation of features of the structural organization of microvascular complexes of muscular fascicles and glands in the prostate of men of different ages. Autopsy material of 103 human prostate was used for examination. The data on the structural transformation of glands, muscle cells and connective tissue components in human prostate suggests that at different age periods the growth and differentiation of various structures occur unevenly, constantly changing relationships between components of organ and parts of its circulatory bed. Circulatory bed of prostate is developed and transformed according to the needs of structures perfused. Age involution processes in the prostate and circulatory bed develop irrespective of man's age and are individual in nature. The general trend of involutional changes of prostate histology suggests that the involution begins within paravasal zones. It seems that the reason is increase the hydrodynamic pressure on the venous bed of prostate.

Currently, there are no reliable biomarkers of blood plasma for early detection of prostate cancer (PC), a one of the most common malignancies in men. This study developed, universalized and tested a new standardized methodology of detection of prostate cancer biomarkers - profiling of low-molecular weight proteome of blood plasma (1-17 kDa). This approach includes three main components: a preliminary sample preparation, time-of-flight mass spectrometry with an matrix-assisted laser desorption/ionization ALDI-TOF-MS), and the processing of data using bioinformatics software package. The potentials and prospects of the approach developed for identification of potential PC markers are demonstrated. 46 samples of blood plasma of PC patients and 26 controls were screened. This evaluation identified peptides/polypeptides that have the potential to be used for the detection of disease.

The article presents a comparative study of the nanosecond electropulse and holmium laser lithotriptors in vitro. Two types of samples simulating the «hard» and «soft» urinary stones were used; for their preparation stomatological ultrastrength plaster BegoStone was used. For the tests, four sizes of samples of stones in the cuboid shape were made. The sizes of the probes and stones, to some extent, simulated real clinical situation. In the experiments for Ho:YAG laser lithotriptor (LL), three sizes of probes were used: 230, 365 and 600 microns; for electropulse lithotriptor (EPL) - 2.7, 3.6, 4.5, and 6 Fr probes. A comparison of the effectiveness of lithotriptors in the experiments was performed for pairs of probes, which corresponded to a specific size of the stones. Comparative studies were performed in water at room temperature. «Stones» with specified size for each type of probe of lithotriptors were placed on stainless steel mesh with a mesh size 2x2 mm, immersed in water. Distal part of the probe (tip) was placed at an angle of 900 to the horizontal surface of the «stone» and brought into contact with the sample. The experiment was stopped when the surface of the mesh was free of particles of «stone» destroyed. Each experiment with the type and size of the «stone» and the probe was repeated at least 5 times. The results showed that nanosecond EPL requires much lower energy and time costs than the LL, ie, its physical parameters are more effective for the destruction of all types of samples stones. For the destruction of the «soft» stones, EPL always required much less energy than for the he destruction of «hard» stones. At the same time, working with LL often required same energy, and sometimes even more than for the destruction of «hard» stone. For the two methods of contact lithotripsy, different depending on the pulse energy and the properties of the «stones» in their destruction is confirmed experimentally.

An open prospective study' aimed to assessment the efficacy of a new formulation - rectal suppository vitaprost plus — compared with the standard antibacterial prevention of infectious and inflammatory complications and irritative disorders after transurethral resection of the prostate (TURP) was performed. From January to November 2011, TURP for prostatic adenoma was performed in 73 patients. Patients were randomized into two groups. The study group received rectal suppositories vitaprost plus once a day as a prophylactic antibacterial therapy before and after surgery, control group — pefloxacin 400 mg 2 times a day. Both groups began taking the drug in the morning before surgery. Duration of antibiotic therapy was 10 days in both groups. In the study group, hyperthermia over 37,5 oC in the 1st postoperative day was observed in 13 (43%) patients, in the control group — in 16 patients (53%). Cancellation of antibacterial treatment was required in four patients of the study group. There was no discontinuation of treatment due to adverse reactions in any case. In all patients, cancellation of drug treatment has been associated with the development of febrile hyperthermia in the presence of clinical need for catheter deployment, which required a change of antibacterial therapy. In the study group this parameter was 13% versus 37% in control group (P <0.05). No significant differences in objective parameters (maximum urinary flow rate, residual urine volume, prostate volume) were registered. However, a statistically significant reduction in subjective parametres (IPSS and QoL scores) in the study group (11.5 ±1.2 and 2.6 ±0.3 points, respectively) compared with controls (15.5 ±1.4 and 3.8±0.5 points, respectively) was observed.

From June 1991 to December 2011, endoscopic treatment of vesicoureteral reflux (VUR) was performed more than in 4,000 children aged 4 months to 17 years. As bulking agents, teflon paste, DAM +, urodex, and vantris were used. A comparative evaluation of the effectiveness of single endoplasty with various bulking agents in children with I-V degree primary VUR, who had no gross congenital abnormalities in ureterovesical anastomosis, such as paraureteral diverticula, complete duplicated ureter or extravesicalisation of ureter, and not suffered from chronic cystitis, was performed. It was found that the use of Teflon paste led to elimination of reflux in 102 (95.3%) of 107 patients, vantris - in 52 (92.9%) of 56 patients, DAM+ - in 145 (77.8%) of 186, urodex - in 47 (68.1%) of 69 patients. Among modern bulking agents meet all safety requirements, vantris is recommended for the optimal treatment of vesicoureteral reflux in children.

The arsenal of professionals providing assistance to men with erectile dysfunction includes a new, mouth dissolving dosage form of the vardenafil — levitra* ODT. This form is effective, safe, and has a higher bioavailability as compared to vardenafil in the form of coated tablets. POTENT I and POTENT II studies revealed that levitra* ODT equally successfully corrects erectile dysfunction in men younger and older than 65 years regardless of concomitant diseases and metabolic disorders: hypertension, diabetes, dyslipidemia. In addition, it was found that this drug helped to successfully carry out sexual intercourse in the first 15 minutes after dosing in 62.5% of patients. This allows to widely recommend levitra * ODT for the treatment of erectile dysfunction in young men and older men.

The article summarizes the results of the clinical trials on application of likoprofit ® in patients with a chronic prostatitis and prostate adenoma, which were conducted by the Russian urologists for the last 8 years. Application of likoprofit® in patients after TURP contributes to significantly earlier and effective restoration of microcirculation, which decreases the risk of development of postoperative complications and accelerates rehabilitation of patients. Studies in which likoprofit® was applied in patients with a chronic prostatitis and prostate adenoma, proved that likoprofit ® also has antiedematous effect, improves the urination act, improves ejaculate parameters, positively impacts on sexual function, and has a high safety profile.