No 9 (2009)

A progress has been achieved in the studying of premature ejaculation (PE), but until now there is no universal diagnostic criteria and definition of this pathology. The lack of epidemiologic data is the reason of the absence of the common treatment strategy. But in recent years the selective serotonin reuptake inhibitors, and if it is combined with erectile dysfunction - the phosphodiesterase type 5 inhibitors.

Till now there is uncertainty concerning of benefits and risk of the hormone replacement therapy (HRT) in menopause regarding its effects on the cardiovascular system, breast, thromboembolic complications, cognitive disturbances and Alzheimer disease. If the women's quality of life is not decreased and menopause can be considered physiological, the risk of HRT is not approving its using. But in the same time, if the menopause symptoms exist, HRT is the only and effective way of its reduction, improving of quality of life and sexuality. There are no other therapies which can be compared with HRT. The article includes the recommendations of the Executive committee of the International associations of menopause of HRT using during menopause, developed on the basis of results of metaanalysis of many trials.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the effective pathogenic therapy of acute and chronic pain, including gynecology for the reduction of pain in the small pelvis. Choosing the particular drug, it is necessary to prefer selective cyclooxygenasa-2 inhibitors, which are less toxic compared with traditional NSAIDs and combines alalgetic and anti-inflammatory effects. One of the most popular and widely used NSAIDs on the Russian market is nimesulide (Nais), which is very effective and at the same time save and have low risk of gastric adverse effects.

The article includes the description of the specifics of clinic an treatment of necrotizing fasciitis of external genitalia and perineum. It also includes the historical facts (Fournier disease), data on prevalence, etiology, diagnostics and outcomes. The clinical features are described, The authors successful experience of its treatment is described, it included the combination of active surgery tactics and adequate antibiotic therapy. The mortality was just 9%, what is considerably less then in other Russian and foreign clinics.

It describes the pathogenesis of endomethriosis, and underlines that common mechanisms for all its forms are disbalance of hypothalamus-hypophysis-ovarium axis and defects of immune mechanisms with immunosuppresion. In 75% of patients the diseases progresses during the first year, after the full complex treatment the frequency of relapses is 47%. It discusses the hormonal (combined oral contraceptives, progestagens, gonadotropin-relising hormone antagonists and other), nonhormonal methods of endomethriosis treatment and preventing of relapses in different disease variants in different women.

It includes the results of the comparison study of efficiency and safety of Omnic Okas (tamsulosin) and doxazosin in the treatment of benign prostatic hyperplasia (BPH). The open 12-weeks trial included 62 patients with BPH. The positive results of Omnic Okas treatment were achieved in 96,7% of patients. The symptom index IPSS decreased on 53%, nocturia in 4,9 times, quality of life increased in 2,1 times, maximal urinary flow rate - on 55%, the residual urine decreased on 70%, adverse effects revealed in 3,3% patients. Positive effect was achieved in 71,9% and safety in 75,0%. Doxazosin have no advantages compared with Omnic Okas. The frequency of adverse effects was in 3,1-18,8%. Doxazosin decreased systolic and diastolic blood pressure on 19 and 9 hg mm, myocardial ischemia - in 15,6%, and arrhythmias - in 12,5% patients, positive orthostatic test was registered in 37,5% of patients. Omnic Okas was more effective and safe drug for treating symptoms of BPH.

The aim of the study was to evaluate the influence of the individual choosing of erotic video material for sexual stimulation on the results of pharmakodopplerographia with using of vardenafil (Levitra) - Levitra-test. The data suggest that anketa, developed for the evaluating of individual sexual preferences helps to choose erotic stories, which lead to more sexual excitation during the levitra test, what increase the diagnostic accuracy of the test. Using of this simple and suitable instrument can lead to maximal diagnostic accuracy of the Levitra-test.