Vol 8, No 4 (2018)

This study evaluated the efficacy and safety of two organic dietary supplements, AndroDoz and Testogenon, in the treatment of 58 men with spermatologic disorders and oxidative stress after experiencing reproductively significant diseases caused by sexually transmitted infection. Over a 12 week period, 38 patients (test group) received both AndroDoz and Testogenon as a combination therapy, whereas 20 patients (control group) received AndroDoz alone. The combination therapy with both AndroDoz and Testogenon showed a statistically significant increase in treatment effectiveness. A positive clinical effect was noted in 92.2% of patients in the test group who received combination therapy. This was reflected as an increased concentration and mobility level of spermatozoa, similar to values observed in men with normozoospermia. Moreover, these men exhibited a two-fold reduction in the risk of fertility disorders due to DNA fragmentation in spermatozoa; their testosterone also increased to normal levels. Additionally, patients in the test group showed improvement in the quality of erection and increased blood flow in the prostate gland and testicles. Men in the control group, who received monotherapy with AndroDoz, did not show improvement similar to that of men in the test group; normozoospermia was established in 70% of men in the control group. These results confirm that AndroDoz and Testogenon are more effective when used concomitantly. These supplements showed no side effects and could be used in complex treatment of spermatologic disorders and oxidative stress in men who experienced reproductively significant diseases caused by sexually transmitted infection. (For citation: Kalinina SN, Korenkov DG, Fesenko VN. Treatment of spermatologic disorders and oxidative stress after reproductively significant diseases caused by sexually transmitted infection. Urologicheskie vedomosti. 2018;8(4):5-15. doi: 10.17816/uroved845-15).

Aim of research. To assess the state of spermatogenesis in men after an experience of testicle torsion in childhood and adolescence. 

Materials and methods. A semen analysis was performed involving 76 men, ages 18 to 29 years, who had testicle torsion in childhood and adolescence. Inclusion criteria in this study were an age of 18 years and an active sexual life. Analysis of the ejaculate was performed in accordance with the World Health Organization Guidelines for the study of human ejaculate. Macroscopic and microscopic evaluation of ejaculate, as well as assessment of motility, viability, number, and morphology of sperm was performed. The control group included 49 men who lacked potential risk factors for male infertility. 

Results and discussion. Changes in the ejaculate depended on the patient's age, as well as the duration and degree of testicular ischemia. When the gonad was preserved after critical ischemia occurred, the spermogram indices were significantly worse than when performing primary orchiectomy, which indicates functional failure of the gonad following its atrophy and suggests that it is inadvisable to maintain the gonad with the expectation of improved long-term results. 

Conclusions: 1. Changes in the spermogram after ischemia were observed in terms of sperm morphology and mobility. 2. The most pronounced changes in the spermogram were noted in patients who had experienced third-degree inversion of the testicle with preservation of gonads; the least pronounced changes were noted in patients who had experience inversion with spontaneous generation and incomplete inversion, which involved minimal ischemic damage. 3. The worst ischemia in puberty occurred in the context of mature sex glands. 4. There was a direct dependence of spermogram changes on the duration of acute ischemia. 5. The most unfavorable combination occurred in puberty, with disease lasting for more than 1 day, comprising complete inversion with “critical” ischemia. 6. After critical ischemia with preservation of the gonad, the semen is less favorable than after completion of orchiectomy, due to the failure of atrophied gonads; this finding casts doubt on the practice of gonad preservation.

This case comprised treatment of a patient with penile injury involving damage to the urethra. Revision of the penis, suturing defects of the tunica cavernous membrane, and primary suture of the urethra were performed. The postoperative period was complicated by necrosis of the skin of the penis, requiring repeated surgical intervention. Replacement plasty of the skin of the penis, using skin from the outer surface of the thigh, was performed with a satisfactory result.

The main milestones of the life and creativity of Professor S.R. Mirotvortsev are described in the article. Little-known facts from the professor's biography are noted. He was rewarded with two gold medals for his students' works: “Vessels and nerves of sinews of the human foot” (with his student V.P. Vorobyov) and “Dislocations of bones of the wrist.” Notably, during the Russian-Japanese war, S.R. Mirotvortsev spent 11 months in the besieged Port Arthur and remained with the wounded who were taken prisoner by the Japanese there. From 1905 to 1914, S.R. Mirotvortsev worked in the Military Medical Academy (Saint Petersburg), initially under the leadership of Professor S.P. Fedorov and then as assistant for Professor V.A. Oppel. From 1914 until the end of his life, S.R. Mirotvortsev worked in Saratov, in the Department of General Surgery; beginning in 1920, he was a member of the fa­culty of the surgical clinic. From 1922 to 1928, S.R. Mirotvortsev was the rector of Saratov University. In the period of the Great Patriotic War, he was the chief surgeon of Saratov and the Saratov region. S.R. Mirotvortsev published approximately 150 scientific works regarding questions of clinical and field surgery. In 1908, he demonstrated the first transplantation of ureters in the rectum and defended a doctoral dissertation (1909) on this subject. Broad popularity was gained by his work regarding malignant new growths, particularly sarcomas of tubular bones. S.R. Mirotvortsev developed methods of unilateral closure of the large intestine, determined the plasticity of the sealing gland of the meninx, and processed burn wounds with potassium permanganate solution. S.R. Mirotvortsev suggested the use of the hemostatic properties of catgut for local cessation of bleeding from parenchymatous bodies and channels within the meninx. His numerous works on field surgery provided statistical analysis of 180 000 cases involving gunshot wounds; these were especially valuable during World War I (1914–1918). Notably, the Department of Faculty Surgery of the Saratov Medical Institute, as well as a street in Saratov, carries the name of S.R. Mirotvortsev. He was awarded the Labour Red Banner, the Red Star, and numerous medals.