[Efficiency and safety of phenazopyridine for treatment of uncomplicated urinary tract infection: results of multi-center, randomized, placebo-controlled, clinical study].

AIM: to evaluate the efficiency and safety of phenazopyridine for the treatment of patients with uncomplicated lower urinary tract infection, accompanied by pain. MATERIALS AND METHODS: A multicenter double-blind, randomized, placebo-controlled study with parallel groups to evaluate the efficacy and safety of phenazopyridine in patients with acute uncomplicated cystitis was performed. A total of 60 women were divided into two groups of 30 patients. In the main group (average age 32.6+/-7.4 years) phenazopyridine was prescribed (2 tablets of 100 mg p.o., with a total dose of 200 mg, once). In the control group, patients (mean age 35.53+/-8.79 years) received a placebo according to the same scheme. To evaluate the efficiency of treatment, the severity of the main symptoms 6 hours after taking the drug was analyzed. After that, patients started antibiotic therapy. They were followed-up for the next three days. The tolerance of therapy was evaluated by the presence of adverse events. RESULTS: All 30 patients taking phenazopyridine had an improvement after 6 hours, and the most frequent response was "significant improvement" (43.3%). The responses of patients in the main group significantly (p<0.05) differed from responses of patients in the control group. Six hours after taking phenazopyridine/placebo, the severity of all values according to VAS score, including the degree of general discomfort, pain during urination and increased frequency of urination improved significantly in the main group compared to the control group. The average assessment of general discomfort in the main group decreased by 53.4% in comparison with 28.8% in the control group, while the severity of pain during urination and urination frequency decreased by 57.4 vs. 35.9% and 39.6 vs. 27.6%, respectively. An analysis of the time before the complete absence of the general discomfort was performed. In the main group this period of time was significantly less than in the control group (p<0.05). There were no serious adverse events while taking phenazopyridine. Rate of adverse events was comparable between two groups. CONCLUSION: The results of the study showed that phenazopyridine is an effective and well-tolerated drug for symptomatic therapy in patients with acute uncomplicated cystitis and can be recommended in addition to etiological therapy.

[Imidafenacin for treatment of overactive bladder and urgent urinary incontinence: the results of open-label multicenter randomized controlled clinical trial].

INTRODUCTION: The analysis of the results of a multicenter, open, randomized comparative phase III clinical trial on the use of imidafenacin for treating patients with OAB was carried out. A clinical study was conducted according to GCP standards in 12 urological centers of the Russian Federation with the support of company AO "R-Pharm". MATERIALS AND METHODS: A total of 296 patients (men and women) aged from 18 to 65 years with OAB and urgent urinary incontinence were included in the study. All patients were randomized into two groups. In Group 1 (n=148) patients received -cholinoblocker imidafenacin 1 tablet (0,1 mg) twice a day. Group 2 patients (n=148) were prescribed a comparison drug tolterodine 1 tablet (2 mg) twice a day, as well. The duration of treatment was 12 weeks. RESULTS: The analysis of results showed a significant decrease in the OAB symptoms in both groups. In Group 1 a decrease of episodes of urge urinary incontinence was more pronounce compared to Group 2, as well as amount of day-time and night-time of episodes of urge urinary incontinence by the 2nd, 4th, 8th and 12th weeks of treatment in comparison with baseline scores. There were no differences between two groups in the severity of reducing average urinary frequency per day. Reducing the severity of urinary disturbances in patients of both groups was accompanied by an improvement in the quality of life. There was a significant and similar decrease in the average total score of both OAB Awareness Tool and EQ-5D questionnaires. Tolerability of treatment was satisfactory in both groups and there were no differences in the adverse events in Group 1 and 2. CONCLUSION: Imidafenacin showed high clinical efficacy for treating patients with OAB, which is not inferior, and in some values, is superior in comparison to tolterodine. Both drugs had a similar safety and tolerability profile.

[Age peculiarities in prostate cancer detection based on the prostate-specific antigen and its alterations control].

Data on epidemiology of a prostate cancer are presented in article, high prevalence and body height of a case rate cause relevance of researches on this oncopathology. It is shown that the number augmentation for the first time of the taped cases is bound including to the program of a screening of inspection of men by determination of level of prostates-specific antigen (PSA). Modern diagnostic methods of identification of modifications of PSA, possessing larger sensitivity and specificity concerning a prostate cancer are lit. The attention to change of level of PSA depending on age is focused that needs to be considered at diagnostics of malignant neoplasms of a prostate.

[ASSESSMENT OF EFFICIENCY OF TREATMENT OF OVERACTIVE BLADDER IN ELDERLY PATIENTS].

The effectiveness of overactive bladder treatment with M-cholinoblocker solifenacin (Vesicare) as monotherapy and in combination with α1-andrenoblocker terazosin (Setegis) or bladdrer training in elderly patients was evaluated. The results of 12 weeks treatment in all treatment modality groups were comparable. Use of solifenacin in combination with α1-andrenoblocker in comparison to solifenacin monotherapy resulted in longer symptoms remission.

[VARICOSE VEINS OF PELVIS IN ELDERLY WOMEN AS ACTUAL PROBLEM IN GERIATRICS].

The article presents an overview of the problem of varicose veins of pelvic (VVP) in elderly women. VVP is severe suffering to women, especially in the elderly, it promotes social exclusion, leads to psychoemotional disorders and occurrence of chronic pelvic pain due to pelvic varicose veins transformation. Despite the 150-year history of the disease, there is still no clear understanding of the clinical picture of the disease and, most importantly, how to treat this condition. In this regard, it is highly relevant research on timely diagnosis and appropriate treatment of VVP.

[Completion technology of pelvic surgery accompanying with cystectomy in elderly and senile patients].

Results of treatment of 204 elderly and senile patients who underwent cystprostatectomy or anterior pelvic exenteration are analyzed. A comparative analysis of two groups of patients whose operation ended with the traditional drainage through the anterior abdominal wall (n = 100), and bilateral perineal drainage (n = 104) is presented. Bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy in conjunction with the restoration of the peritoneum lateral pelvic walls, improves postoperative recovery of intestinal peristalsis, promotes an earlier reduction in the intensity of pain and morbidity in the early postoperative period. Perineal installation of drains is a simple in design and safe procedure. We recommend bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy.

[Peculiarities of clinical course, diagnostics and treatment of overactive bladder in men older than 60 years].

The article presents the issues of the characteristics of the course, diagnostics and treatment of hyperactive urinary bubble in older men. Conservative treatment of urinary incontinence includes changes in lifestyle, behavioural and medical therapy with m-anticholinergic drugs. The combination solifenacini in a dose of 5 mg/day and α1-adrenoceptor blocking agent terasolini in a dose of 2 mg/day significantly improves the results of treatment and well tolerated.

[Ways to improve the quality of life of elderly and senile patients after the operation by Brikker].

The present study is devoted to improving quality of life of patients in elderly and senile age after operation of Bricker by finding the optimal method of forming ureterointestinal anastomosis. From 2007 to 2009 103 patients of elderly and senile age with diseases requiring removal of the bladder were treated in the Lenigrad Regional Oncology Centre. All the patients were made cystectomy. Patients were divided into two groups: In 1st group, the ureterointestinal anastomosis was formed a classical way "end to side" described Bricker, in the 2nd group ureterointestinal anastomosis was performed by the method of Wallace - "common area". Pathological conditions developed in patients in late postoperative period were as follows: hydronephrosis in early and later stages, obstructive pyelonephritis, frequent attacks of chronic pyelonephritis, chronic renal failure, urinary fistula. Formation of ureterointestinal anastomosis by Wallace during surgery reduces the amount of later postoperative complications. Quality of life was better after the formation of ureterointestinal anastomosis by Wallace.

[Optimization of the operative treatment of patients of elderly and senile age with superficial bladder cancer].

A comparative study of radical transurethral resection (TUR) of bladder carcinomas (BC) was performed in standard conditions and the application of fluorescence cystoscopy (FCS) for diagnosis of early recurrence of BC and the extent of tumor aggressiveness and prognosis of the disease. We examined 174 elderly and senile age patients with BC through 4-6 weeks after surgery to re-endoscopic study, which includes the standard cystoscopy (CS), fluorescent cystoscopy (FCS) and the TUR--the area of post-biopsy scar and the fluorescent sites. The first group consisted of 95 patients who performed a traditional TUR, the second one of 79 patients whom TUR on the fluorescent control (TUR-FCS) was performed. Repeated endoscopic examination detected the fluorescence in 56 (58.9%) patients in 1st group and 28 (35.4%) patients in 2nd group. Endothelial swelling was revealed in 45 (47.4%) from 1st group and 19 (24.1%) among patients from 2nd one. Residual tumor was found significantly less frequently in patients from group 2, compared with the patients from 1st group. The significant difference was determined in frequency of residual tumor in pTa stage in patients from 1st and 2nd groups (16.8 and 8.9%, p < 0.005). The differences in frequency of residual papillary tumors in stage rT1, in the analyzed groups, were also significant (0.5 and 6.3% respectively, p < 0.05). The difference in frequency of relapses correlated significantly with the age of the patients. In 1st group, among the 27 patients with multiple lesion of the bladder, residual tumors were detected in 14 (51.9%). Among the 22 patients from the 2nd group who had the multiform BC, residual tumors were found only in 4 (18.2%) patients (p < 0.001). Early repeated cystoscopy and biopsy with the use of fluorescent monitoring should be recommended for patients with BC in stages Ta, Tis and T1. Early repeated cystoscopy and biopsy with the use of FCS enable the timely identification and removal of residual tumor and recurrence of superficial BC.

[Short-term outcomes of radical surgery for bladder cancer]. / Blizhaishie rezul'taty radikal'noi operatsii pri rake mochevogo puzyria.

A total of 102 radical cystectomies have been conducted for 1996-2001 (94 males, 8 females, age 37-78 years, mean age 57.5 years). Most of the patients (81.4%) were diagnosed to have transitional cell carcinoma. Supravesical urine derivation was made by means of ureterocutaneostomy and transureteroureteronephrostomy in 7(6.9) patients, ureterosigmoanastomosis--in 41(40.2%), Sigma-rectumpouch--in 1(0.9%) patients, ileocystoplasty, largely by Hautmann and Studer was carried out in 52(51%) patients. Postoperative complications developed in 25(24.5%) patients who often had adhesive ileus. Four patients died: 2 of pulmonary artery thromboembolism, 1 of acute cardiac failure and 1 of sepsis. Methods of continence urine derivation were preferred, such as ureterosigmoanastomosis by Mainz-Pouch II and creation of orthotopic bladder of the ileum.

[Correction of proteolysis disturbances and erythrocyte resistance in experimental burns by the antioxidant carbaton]. / Korrektsiia narushenii proteoliza i rezistentnosti éritrotsitov pri éksperimental'noi ozhogovoi bolezni antioksidantom karbatonom.

The total proteolytic activity in blood and tissues and peroxide resistance of erythrocytes were studied in animals at different stages of burn disease. Carbaton, an antioxidant of a pyridine series, is analyzed for its effect on these indices. Considerable activation of proteolysis in tissues and a decrease of the erythrocyte resistance at burn shock and septicotoxemia stages are established. Carbaton being applied as a drug, influences positively the studied processes; a degree of the shift correction depends on the preparation dose.