Vol 12, No 3 (2022)

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 1^st 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 2^nd 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 60^th day from the start of the study.

RESULTS: By the 15^th day of the study, there was a significant positive dynamics of symptoms in patients of both groups. By the 30^th day of the study in patients of the 1st group the treatment effect persisted, while in patients of the 2^nd 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 60^th 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 2^nd 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.

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.

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.

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.

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.

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.