No 9 (2010)

There are more than 17% of infertile couples in Russia, and this figure tends to increase. About half of cases of infertility are caused by male infertility. Infertility is idiopathic in 31 to 75% of men. These patients are mainly empirically treated using drugs of different groups (antiestrogen, aromatase inhibitors, luteinizing hormone, follicle-stimulating hormone, gonadotropin-releasing hormone, antioxidants and biologically active dietary supplements, etc.) that are frequently ineffective. As possible, obesity is one of the factors that adversely affect sperm parameters. According to the WHO data (2003), 1.7 billion people worldwide are overweight, a significant portion of them are men of reproductive age. This article discusses the main ways of pathogenesis, diagnosis and treatment of infertility in men with obesity.

Cryptorchidism is one of the most common abnormalities of sexual maturation. In adults, the disease often leads to serious complications such as infertility, testicular hypotrophy, and testicular cancer. By assumptions of some authors, the frequency of occurrence of these complications depends not only on the form of cryptorchidism, but also period to surgical treatment. The present review is concerned with the analysis of published data for the prevalence, causes, and pathogenesis of complications of cryptorchism. In addition, comparisons between different methods of treatment of cryptorchidism, particularly, in relation to the period of treatment, are presented.

Multicenter epidemiologic DIALOGUE II study was aimed to assess the tactics of management of pregnant women with arterial hypertension (AH) and pharmacoepidemiology of antihypertensive drugs used in pregnant women in Russia in comparison with the results of DIALOGUE I study in 2005-2006. The study was conducted in 27 cities of Russia, 2033 doctors managing pregnant women with arterial hypertension were interrogated. Used terminology, diagnostic criteria, the spectrum of laboratory tests used for diagnosis and monitoring of the status of pregnant women with arterial hypertension, antihypertensive therapy during pregnancy were analyzed. The results showed that in routine clinical practice there are still no well-established diagnostic criteria and common principles for the formulation of the diagnosis of AH in pregnant women; there are no well-established criteria for the start of antihypertensive therapy. A number of necessary laboratory tests are not used adequately, 7.4% of physicians continue administrating ACE inhibitors to pregnant women, as well as other non-approved drugs, and almost 80% of physicians use drugs that are not strictly antihypertensive for the treatment of pregnant women with arterial hypertension.

The adjustment of optimum treatment of premature ejaculation (PE) remains controversial due to the wide range of drugs used in treatment of this disease. It is important to remember that PE can exist both separately and in combination with erectile dysfunction (ED). In case of combination of these disorders, it is often difficult to determine which of them occur first, resulting in problems in diagnosis and treatment. This study was aimed to evaluation the efficacy of different treatment regimens in patients with PE in combination with and without ED, as well as evaluation of long-term results of treatment.

This study was aimed to development of prognostic criteria for efficacy of treatment of iron deficiency anemia based on erythrocyte indices and causes of anemia. For the purpose of assess the effectiveness of therapy of iron deficiency anemia (IDA), authors have analyzed results of a survey of 60 patients (9 men, 51 women, including nine pregnant women), treated by hematologist. Three prognostic factor of efficacy of treatment of IDA were defined. The treatment is ineffective in case of combined pathology of female reproductive system and gastrointestinal tract, no significant decrease in red count in peripheral blood, depression of red cell lineage of the bone marrow. The hemoglobin level is not a prognostic factor in the treatment of IDA. The transfusion therapy with erythrocyte concentrate or administration of recombinant erythropoietin in relation to the severity of patient's condition is required in patients with severe IDA or in the case of ineffective therapy with iron supplements. Correction of erythrocyte indices should be carried out even in case of with minimal decrease of hemoglobin level in all pregnant women.

The history of Reiter's syndrome description, the main clinical symptoms (urethritis, conjunctivitis, and arthritis), and the course and treatment principles are discussed. Men aged 20 to 40 years are more susceptible to Reiter's syndrome. The disease tends to recurrence, especially in the case of absence of inadequate sanitation of focus of infection stimulating the development of disease.