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Vol 12, No 3 (2022)

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Original articles

Bioregulatory therapy for chronic abacterial prostatitis

Kuzmin I.V., Slesarevskaya M.N., Al-Shukri S.K.


BACKGROUND: Chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) is the most common form of chronic prostatitis.

AIM: The aim of the study was to evaluate the effectiveness and tolerability of complex therapy in patients with CAP/CPPS using the bioregulatory peptide drug Uroprost-D.

MATERIALS AND METHODS: The study included 47 men aged 23 to 54 years (mean 38.1 ± 7.2 years) with CAP/CPPS (category III according to the NYHA classification, 1995). Patients of the 1st group (n = 24) were prescribed alpha-blocker tamsulosin 0.4 mg for 30 days and rectal suppositories Uroprost-D one per day for 15 days. Patients of the 2nd group (n = 23) were also prescribed tamsulosin 0.4 mg per day for 30 days and rectal suppositories indomethacin 100 mg, one per day for 15 days. The dynamics of clinical parameters was assessed on the 15, 30 and 60th day from the start of the study.

RESULTS: By the 15th day of the study, there was a significant positive dynamics of symptoms in patients of both groups. By the 30th day of the study in patients of the 1st group the treatment effect persisted, while in patients of the 2nd group pain increased, which was expressed in an increase in the scores for the “Pain” domains and the total score of the NIH-CPSI questionnaire. This trend is even more pronounced by the 60th day of observation, when a significant difference was found both in the total score of the NIH-CPSI questionnaire and separately in the domains “Pain”, “Dysuria” and “Quality of life”. During the study, there were no statistically significant changes in the maximum urine flow rate, prostate volume and residual urine volume. Tolerability of treatment was satisfactory, the frequency of negative manifestations was slightly higher in patients of the 2nd group.

CONCLUSIONS: The use of the bioregulatory peptide drug Uroprost-D in the complex therapy of patients with CAP was accompanied by a decrease in the severity of pain syndrome and dysuria. The appointment of Uroprost-D seems to be a pathogenetically justified alternative to the use of NSAIDs in this category of patients.

Urology reports (St. - Petersburg). 2022;12(3):191-202
pages 191-202 views

Ambulatory uroflowmetric monitoring: recommendations for implementation in clinical practice

Shaderkin I.A., Shaderkina V.A.


BACKGROUND: Urodynamic examination is recommended for patients with urinary disorders. In some categories of patients, it can be replaced by performing uroflowmetry in the patient’s usual home environment.

AIM: development of recommendations for health care managers and urologists on the introduction of ambulatory uroflowmetric monitoring and its use in everyday clinical practice.

MATERIALS AND METHODS: On the basis of the e-health laboratory of the Institute of Digital Medicine of the First Moscow State Medical University named after I.M. Sechenov, the Ministry of Health of Russia (Sechenov University) developed a unique method of home monitoring of uroflowmetry in male patients with symptoms of impaired urination using the wireless portable uroflowmeter “Flowselfi” developed in the Russian Federation. Based on experience, recommendations have been developed for the implementation of this method in clinical practice.

RESULTS: Equipment for home uroflowmetry should be reliable, simple, intuitive, affordable, portable, and able to wirelessly communicate with a patient’s smartphone or tablet for data accumulation and subsequent transmission to a doctor for processing the results. The patient should have preserved cognitive functions and be motivated to perform uroflowmetry, understand its importance in further treatment. The article provides typical instructions for patients and urologists using ambulatory uroflowmetry at home.

CONCLUSIONS: Ambulatory uroflowmetric monitoring (home uroflowmetry, outpatient home uroflowmetry) is a promising method of remote monitoring of patients requiring urination monitoring, including neurogenic and non-neurogenic urination disorders.

Urology reports (St. - Petersburg). 2022;12(3):203-210
pages 203-210 views

Thulium laser enucleation of prostate (ThuLEP): efficacy and safety evaluation in patients with a prostate volume more than 80 cm3

Kostenkov N.Y., Al-Shukri S.K., Amdiy R.E., Nevirovich E.S., Tkachuk I.N., Novitsky A.V.


BACKGROUND: Benign prostatic hyperplasia is a common condition in men over 60 years of age. The gold standard for the treatment of benign prostatic hyperplasia up to 80 cm3 is transurethral resection of the prostate. At the same time, with a prostate volume of more than 80 cm3, the choice of the optimal method of surgical treatment of benign prostatic hyperplasia is a matter of debate.

AIM: Evaluation of the efficacy and safety of thulium laser enucleation of the prostate (ThuLEP) in patients with benign prostatic hyperplasia with a prostate volume of more than 80 cm3.

MATERIALS AND METHODS: The study involved 75 patients with benign prostatic hyperplasia aged 64 to 83 years (mean age 70.4 years) with a prostate volume of 80 to 215 cm3 (mean 123.9 cm3). All patients underwent ThuLEP using a thulium fiber laser FiberLase U1 with a power of 120 W. Control examinations were performed 3 and 6 months after the surgery.

RESULTS: The duration of surgery averaged 84.7 minutes and ranged from 57 to 135 minutes. The duration of the urethral catheter after surgery averaged 2.8 days. The frequency of intra- and postoperative complications was low, none of the patients required blood transfusion, as well as repeated surgery to coagulate the vessels of the prostate bed. In 3 (4%) patients, superficial damage to the bladder wall occurred during marcellation, which required coagulation of the injury site. All recorded complications belonged to groups I and II according to the Clavien – Dindo scale. Examinations carried out after 3 and 6 months showed a significant decrease in the severity of voiding disorders, an increase in the quality of life and an improvement in the outflow of urine from the bladder compared with the baseline.

CONCLUSIONS: The results of the study showed high clinical efficacy and safety of the use of thulium laser enucleation of benign prostatic hyperplasia in patients with prostates more than 80 cm3.

Urology reports (St. - Petersburg). 2022;12(3):211-220
pages 211-220 views

Complex treatment of patients with chronic bacterial prostatitis using biologically active peptides

Neymark A.I., Davydov A.V., Kablova I.V.


BACKGROUND: Increasing the effectiveness of the treatment of chronic bacterial prostatitis is an actual problem of modern urology.

AIM: The aim of the study was to study the effectiveness of complex treatment of patients with chronic bacterial prostatitis using Prostatex.

MATERIALS AND METHODS: This study included 94 patients with chronic bacterial prostatitis aged 21 to 45 years. Patients of group I (n = 47) received standard antibiotic therapy (levofloxacin at a dose of 500 mg 2 times a day for 28 days), and patients of group II (n = 47) received standard antibiotic therapy combined with the prescription of Prostatex in the form of rectal suppositories 10 mg once a day.

RESULTS: The overall clinical efficacy of treatment in patients of group II was 2 times higher than in patients of group I. After treatment in patients of group II compared with group I a statistically significant decrease in chronic bacterial prostatitis symptoms according to the NIH-CPSI and IPSS questionnaires was recorded. Eradication of microflora in 91.4% of patients of group II was achieved, there was a significant decrease in prostate volume, an increase in the average volumetric flow rate of urine by 89.8%, normalization of perfusion parameters and the index of microcirculation efficiency.

CONCLUSIONS: The results of the study showed that the use of Prostatex in the complex treatment of chronic bacterial prostatitis patients has a positive effect on the main symptoms of chronic prostatitis, significantly reducing pain, urination disorders and improving sexual function. This therapy helps to reduce the volume of the prostate and the volume of residual urine, restores microcirculation in the prostate gland and can be recommended in this category of patients.

Urology reports (St. - Petersburg). 2022;12(3):221-228
pages 221-228 views

The role of clinical metabolomics in the diagnosis of bladder cancer

Zamyatnin S.A., Malushko A.V., Gonchar I.S.


BACKGROUND: Bladder cancer is a widespread disease characterized by high cancer-specific mortality and high cost of treatment. The search for available and reliable biological markers for the early diagnosis of urothelial carcinomas is an urgent task of oncourology. One of the promising ways to improve the efficiency of bladder cancer diagnostics is the use of the possibility of the clinical metabolomics.

AIM: Was to study the possibility of assessing the content of various amino acids and their metabolites in blood serum for the diagnosis of bladder cancer.

MATERIALS AND METHODS: Serum concentrations of 28 amino acids and their metabolites were studied in 18 patients with urothelial cancer and 20 representatives of the control group without an oncological history. History taking, routine oncological screening, and blood sampling for laboratory tests were performed.

RESULTS: Four metabolomes (glycine, phenylalanine, asparagine, and threonine) were identified, the blood serum concentration of which significantly changes in patients with urothelial cancer. These metabolomes can be considered as potential biomarkers of urothelial cancer.

CONCLUSIONS: The study of the serum content of these four amino acids seems to be the most promising for the isolation of a potential biomarker of urothelial cancer.

Urology reports (St. - Petersburg). 2022;12(3):229-238
pages 229-238 views


Post-COVID syndrome in urological practice

Kuzmenko A.V., Petrova D.A., Gyaurgiev T.А.


This review article examines the impact of the SARS-CoV-2 coronavirus on the urinary system, as well as on men’s health. Data on aspects of pathogenesis and features of the course of a new coronavirus infection are presented. Possible risk factors for contracting a new coronavirus infection associated with an abundance of angiotensin-converting enzyme-2 (ACE2) receptors in the kidneys and urinary tract, to which SARS-CoV-2 has an affinity, are considered. The article provides an extensive range of studies that provide convincing evidence for the presence of changes in the spermogram of patients who have undergone COVID-19. Works demonstrating gender differences in the incidence of COVID-19 and concomitant diseases are presented. The literature review considers both direct and indirect factors (oxidative stress, cytokine storm, decreased libido), through which coronavirus infection negatively affects male sexual health.

Urology reports (St. - Petersburg). 2022;12(3):239-248
pages 239-248 views

Case reports

Simultaneous treatment of urolithiasis and cholelithiasis

Protoshchak V.V., Sivakov A.A., Lychev A.B., Gozalishvili S.M., Kushnirenko N.P., Kharitonov N.N., Grafschina E.N.


Urolithiasis and cholelithiasis are among the most common diseases among the adult population worldwide. The combination of these diseases requires the development of an individual approach in the treatment of each patient. This article presents a clinical case of a combination of urolithiasis complicated by terminal hydronephrosis with cholelithiasis. Successful simultaneous surgical treatment is described.

Urology reports (St. - Petersburg). 2022;12(3):249-254
pages 249-254 views

History of medicine

Professor G.M. Mukhadze and Professor A.P Tsulukidze: mentor and student. On the 100th anniversary of joint activities

Morgoshiia T.S., Kuzmin I.V.


The historical aspects of the development of medicine in Georgia are briefly described. The main milestones in the life and achievements of the outstanding Soviet medical scientists, Professor G.M. Mukhadze and his student Professor A.P. Tsulukidze. Their scientific and practical activities, contribution to the development of surgery and urology in the USSR are analyzed. G.M. Mukhadze and A.P. Tsulukidze were the founders of the surgical and urological schools in Georgia, tireless innovators, talented teachers and educators of young doctors, the founders of higher medical education in Georgia and prominent public figures.

Urology reports (St. - Petersburg). 2022;12(3):255-262
pages 255-262 views

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