Vol 11, No 2 (2021)

BACKGROUND: Chronic pelvic pain syndrome / chronic abacterial prostatitis is one of the most common diseases in urological practice. Despite its frequency the pathogenesis of the disease remains poorly understood. It is known that the morphological manifestation of chronic inflammation is sclerosis, in the development of which the venous congestion of the prostate is also important.

AIM: To evaluate the effect of chronic venous congestion of the pelvis on the prostate in a chronic experiment.

MATERIALS AND METHODS: An original model of persistent chronic varicose of the pelvis has been created. The experiment was carried out on 35 mature rabbits weighing 2.6–3.2 kg. Animals were divided into 3 groups. Control (n = 5) study of the normal anatomy of animals. In group 2 (n = 15), the creation of a model: ligation of the v. sacralis mediana, in combination with administration of progesterone solution. In group 3 (n = 15), false surgery and progesterone administration. Duplex scanning of the pelvic veins was performed at 1, 3 and 6 months, the diameter of the veins and the reflux after manual compression was assessed. After removing the animals from the experiment histological examination and morphometry of the prostate tissue were carried out. In prostate samples the concentration of hydroxyproline was investigated as a marker of connective tissue development.

RESULTS: Venous congestion of the pelvic organs in animals in the second group negatively affected the structure of the prostate gland. Histological examination of the samples showed infiltration of the prostate tissue, edema of the stroma, a sharp expansion of the veins at the beginning of the experiment, later noted the proliferation of connective tissue, compression of the acini and a decrease in the secretory activity of the prostate gland. The results of morphometry showed an increase in the area of the stromal component to a greater extent due to an increase in the volume of connective tissue. There was a tendency to an increase in the concentration of hydroxyproline in the prostate tissue in animals of the 2nd group with the achievement of maximum values by the 6th month of the experiment. In animals of the 3rd group no significant changes in the structure of the prostate gland were revealed.

CONCLUSIONS: The morphological manifestation of chronic venous hyperemia is infiltration of the prostate stroma and sclerogenesis.

MATERIALS AND METHODS: 60 patients with benign prostatic hyperplasia (BPH) and category II chronic prostatitis (NIH, 1995) were examined. The average age of the patients was 60.5 ± 5.5 years. The patients were divided into two groups of 30 people each. The comparison group (GC) included patients who received standard therapy with drugs from the group of alpha-blockers and fluoroquinolones. The main group (MG) consisted of patients who received standard therapy in combination with physiotherapy sessions with the device “SMART-PROST”, which were carried out in the acrophase of the chronorhythm. After the end of the course of therapy all patients underwent transurethral resection of the prostate, after which a morphological and morphometric (immunohistochemical) study of the obtained material was carried out.

RESULTS: According to the results of the morphological and morphometric examination of the histological material in patients of the CG and MG, statistically significant differences were revealed in all the studied parameters, which testify to the persistence of signs of the inflammatory process in the CG, while in the MG, the severity of inflammation was significantly lower.

CONCLUSION: According to the results of the study, personalized complex therapy of patients with benign prostatic hyperplasia in combination with chronic prostatitis using a combined physiotherapeutic effect of the SMART-PROST device, taking into account the individual chronobiological characteristics of patients, allows to more effectively arrest the inflammatory process in the prostate tissue, which can lead to a decrease in the number of postoperative complications. However, the last statement requires further more detailed study.

BACKGROUND: Fundamental investigation of the issue how various factors influence on origin and behavior of the nephrolithiasis is very actual because of necessity of the information about of early diagnostic methods as well as a prognostication. So, the information about of formation dynamics of phase and elemental composition of oxalate-calcic nephrolithes pending of lifetime of one patient is useful.

AIM: The aim of the investigation is to obtain the information about of elemental composition as well as phase composition of the one patient nephrolithes formed pending of lifetime.

MATERIALS AND METHODS: In the paper the data of the careful investigation of the elemental and phase composition of the two nephrolithes ablated from one patient at different times are presented. First nephrolith had been ablated from the right kidney in the March of 2002 (patient was 41 years old), subsequently second that had been did from the left kidney in the December of 2019 (patient was 58 years old; the nephrolith was found in 2012). The study was carried out using mass spectrometry and atomic adsorption spectrometry with inductively coupled plasma, infrared spectroscopy, X-ray phase analysis, CHN/S analysis.

RESULTS: Both calculi were calcium oxalate, predominantly Vevellite structures. The chemical composition of the both nephrolithes is alike. They contain microimpurities of all essential as well as conditionally essential elements. Quantities of the toxic elements in the nephrolithes are identical too. Microquantities of the nitrogen and sulphur indicate a presence of amino acids and proteins in the nephrolithes structure.

CONCLUSIONS: The results indicate that the nephrolithes with invariable phase and elemental composition would be forming in the different kidneys of one patient pending of lifetime.

Based on the analysis of literature sources, modern data are presented on the nosological structure of urachus diseases in adults and children, diagnostic methods, as well as treatment tactics for various anatomical variants of anomalies in the development of the urinary duct. A modern classification of urachal malformations caused by disorders of its obliteration is presented. Various modifications of the laparoscopic approach are considered for the most common types of this pathology. The reasons for the development of malignant neoplasms from the urachus tissue, including in the gender aspect, are described, and a comparative assessment of the methods of surgical treatment of urachus tumors is given.

The review is devoted to the application of photodynamic diagnosis of non-muscle invasive bladder cancer. The recent data on the mechanism of action of photosensitizers, the method of performing fluorescence cystoscopy are presented, and the results of clinical studies of the application of photodynamic diagnostics in practical medicine are presented. It has been shown that photodynamic diagnostics significantly increases the efficiency of detecting bladder cancer in comparison with standard cystoscopy. The application of this method is especially valuable in cases of carcinoma in situ and multifocal growth of urothelial tumors. Improvement in diagnostics makes it possible to increase the radicality of surgical treatment and to increase the duration of the relapse-free period.

Bulbourethral cyst or Cowper’s syringocele (from the Greek “syringe” – tube, “cele” – expansion) is a cystic expansion of the excretory ducts of the bulbourethral glands (Cowper’s glands). This disease is extremely rare and is more often diagnosed in the child population. The clinical manifestations of syringocele are non-specific and depend on many factors: size, localization, communication with the urethra, and the presence of an infectious component. Detection of syringocele is impossible without the use of special radiation and endoscopic diagnostic methods. Most often, this pathology is “masked” under inflammatory diseases of the genitals due to the fact that the symptoms are limited to secretions from the external opening of the urethra, changes in the general analysis of urine and dysuric manifestations. Currently in the domestic and foreign literature there are not even 20 publications devoted to this pathology.