[Use of the antioxidant complex Androdoz in men with fertility impairments].

INTRODUCTION: Infertility is a global problem, affecting more than 15% of sexually active couples worldwide. The frequency of the male factor reaches 40-50% and continues to increase. Fertility problems with unknown causes are referred as idiopathic. AIM: To evaluate the possibility of using the Androdoz antioxidant complex in men with infertility. MATERIALS AND METHODS: A retrospective analysis of the medical records of 32 infertile men aged 21 to 45 years (average of 27.8 +/- 6.7 years) with pathospermia was carried out. Antioxidant complex Androdoz was prescribed 2 capsules bid with meals according to the package insert for up to 3 months. The results were assessed after 3 and 12 months (follow-up period) from the start of therapy. In addition to ejaculate analysis, all patients underwent digital rectal examination, transrectal ultrasound of the prostate and ultrasound of the scrotum, microscopic examination of ejaculate and expressed prostate secretions, and PCR-based assay of urethral swab (Androflor). The zinc concentration in seminal plasma, as well as the total antioxidant capacity of sperm, was also evaluated. Damage to sperm chromosomes was characterized by DNA fragmentation using an assessment of sperm chromatin dispersion. RESULTS: Based on the results of a comparative analysis of ejaculate, it was revealed that taking Androdoz complex not only had a positive effect on sperm motility and viability, but also led to a decrease in the percentage of sperm with DNA fragmentation to a level of less than 15%, and significantly increased the total antioxidant capacity of the ejaculate. CONCLUSIONS: The use of Androdoz antioxidant complex in men with reproductive disorders improves the qualitative and quantitative markers of the sperm analysis and the morphological state of the male reproductive system, and allows to replenish the lack of vitamins. The most important effect of Androdoz complex appears after 3 months.

[The role of antioxidants in the therapy of metabolic syndrome in men].

INTRODUCTION: Metabolic syndrome (MetS) is a combination of hormonal, metabolic and clinical disorders. Currently, MetS in men is considered as one of the main risk factors for the development of cardiovascular diseases, insulin resistance, and pathology of the reproductive system. AIM: To study the effect of a complex of folic acid, L-carnitine, vitamin E, zinc and selenium, which are part of the biologically active food supplement "Speroton", on the parameters of carbohydrate and lipid metabolism in men with MetS, especially in the early stages of its development, as well as on erectile function and quality of life of patients. MATERIALS AND METHODS: A total of 64 patients aged 30 to 51 years with MetS of varying severity were included in the study. The main group consisted of 34 patients aged 32 to 51 years (mean age 46.2+/-2.1 years), while in the control group, there were 30 patients aged 30 to 49 years (mean age 45.4+/-3.4 years). The standard therapy in the main group was supplemented by taking the dietary supplement "Speroton" for 3 months. In the control group, patients received only standard therapy for MetS. The results were evaluated after 3 and 6 months from the start of treatment. All patients underwent laboratory evaluation of sex hormones, carbohydrate metabolism and lipid profile. In addition, the concentration of zinc in the spermatozoa was measured, as well as the level of total antioxidant capacity of the sperm. The uroflowmetry, ultrasound of the bladder with the measurement of the postvoid residual, and transrectal ultrasound of the prostate were also performed. RESULTS: An addition of the antioxidant complex "Speroton" to the combination treatment of MetS in the main group allowed to decrease the parameters of oxidative stress by almost two times. By the 6th month of follow-up, the level of insulin improved, which was accompanied by a decrease in the level of HbA1c by 16.3%, suggesting the stabilization of carbohydrate metabolism. A decrease in body mass index by almost 14% (p<0.05) in the main group was found, as well as normalization of the lipid profile. According to the analysis of the erectile function in patients of the main group after 6 months from the beginning of therapy, there was a decrease in the total score to a moderate erectile dysfunction (12.5+/-2.1 points). There was a decrease in storage symptoms and, in part, voiding symptoms in patients in the main group, who received antioxidant therapy. In addition, a positive correlation between the concentration of zinc and the level of total antioxidant capacity in the ejaculate was seen. CONCLUSIONS: Our results suggest the high therapeutic efficiency of dietary supplement "Speroton" as an antioxidant complex for the treatment of patients with MetS of varying severity. The addition of antioxidants "Speroton" to the standard therapy of MetS contributes to the improvement of the sensitivity of insulin receptors, the normalization of carbohydrate and lipid metabolism, endothelial function and blood pressure, which is accompanied by a significant decrease in LUTS severity, as well as an improvement in the erectile function of patients.

[Laparoscopic segmental ureteral resection with ileal-ureter substitution for ureteral urothelial carcinoma].

Ureteral resection for the mid-ureter urothelial carcinoma is the operation of choice in patients with low-grade tumors. However, extensive excision within normal tissues may lead to difficulty in appropriate apposition of the ends of the ureter, while incomplete resection increases the risk of oncological progression. This article describes the first experience with laparoscopic segmental ureteral resection with the ileal - ureter substitution for mid-ureter urothelial carcinoma. In this case, a short non-reconfigurated segment of the ileum was interposed between the distal and proximal ends of the resected ureter. Operative time was 230 min, and blood loss was less than 100 ml. No complications were observed. The patients postoperative hospital stay was seven days. Follow-up examination 12 months after surgery showed no evidence of the disease progression and preserved normal renal function. The proposed method may be considered as an alternative treatment for carefully selected patients.

[Tuberculosis of the prostate].

Genitourinary tract is the second most common site where extrapulmonary tuberculosis (TB) occurs. Genitourinary TB is notable for a latent clinical course and difficult diagnosis. The paper presents clinical observations of two patients treated in a urology department of a general public hospital. One of them was diagnosed with tuberculosis of the prostate, MTB+. In the other, TB of the prostate was suspected based on pathologic assessment of the surgical specimen after surgery for prostate cancer.

[ANTIOXIDANT THERAPY FOR INFERTILE COUPLES].

This study presents results of 113 infertile couples treated with supplements speroton and pregnoton containing folic acid, L-carnitine, vitamin E, zinc, and other vitamins and minerals. Infertility in couples was due to both the pathology of spermatogenesis, and female genital diseases. It has been demonstrated that intake of Speroton restores impaired motility in the ejaculate of patients with several forms of pathospermia, and Pregnoton ensure its preservation in vaginal secretions.

[Efficiency of spematon in male infertility].

The article presents the results of the application of spematon in 39 men from infertile couples with different forms of pathospermia (asthenozoospermia, oligozoospermia, teratozoospermia). It is shown that the effect in the first 3 months of use of spematon is mainly associated with normalization of acrosome reaction of sperm cells. It was established that spematon, due to content of L-carnitine content, zinc, vitamin E, contributes restoration of induction of acrosome reaction.

[The role of immunomodulating therapy in the treatment and prevention of exacerbations of chronic cystitis].

The article presents the results of the examination and treatment of 60 women with chronic cystitis aged 20 to 80 years. The mean disease duration was 4,9 years (ranged from 6 months to 40 years). Immunomodulator Tilorone was included in the complex therapy of 30 patients of the main group. Besides the standard examination, immunological studies, including the definition of netrophil phagocytic rates in the patients were performed. It was revealed that the inclusion of immunomodulator in the treatment regimen of exacerbations of chronic cystitis contributes to an increase of index of activation of neutrophil phagocytic reserve, significant reduction in the frequency of exacerbations of the disease after the basic and preventive courses of treatment.

[Transurethral electrosurgery of a new generation (TURis) in the treatment of the lower urinary tract and prostate diseases].

Surgical interventions were made in 175 patients aged 23-87 years (mean age 64.8 years) with different diseases of the lower urinary tract (adenoma, prostatic cancer, cancer of the urinary bladder, etc.) with application of a new generation of endoscopic technique--transurethral resection in saline (TURis system) with a generator UES-40 SurgMaster (Olympus). Three patients had a cardiac pacemaker. The size of the prostate in prostatic adenoma ranged from 4.8 to 121 cm3 (mean 62.5 cm3), residual urine--92.3 ml (42.6 to 310.2 ml). Duration of surgery averaged 63 min (14 to 127 min). Mean amount of the resected tissue in sclerosis of urinary bladder cervix was 7 g (5-11 g), in prostatic adenoma--41 g (10-85 g), prostatic cancer--27 g (17-49 g). In postoperative period tamponade of the urinary bladder developed in 2 (1.5%) patients. Red cell transfusions were not necessary. Incontinence was observed in 7 (5.3%) patients after removal of urethral catheter, in 5 (3.8%) patients it stopped spontaneously to the time of discharge from the hospital, 2 (1.5%) patients with prostatic cancer retained partial orthostatic incontinence. TURis raised Qmax from 8.1 to 19.8 ml/s, on the average. The scores by IPSS fell from 20.8 to 7.5, QoL--from 5.1 to 3.7, on the average. Residual urine after operation reached 35 ml maximum. Informative value of histological material rose significantly in view of a minimal zone of coagulatory changes in the samples. Standard time limitation for transurethral resection (60-90 min) becomes insignificant in using isotonic irrigation allowing urologists to resect safely larger adenomas than it was possible earlier.

[Resistance of causative agents of uncomplicated urinary tract infections in Russia].

A prospective epidemiological study of the spectrum of causative agents (CA) of uncomplicated urinary tract infections (UTI) in adult patients and CA resistance to antimicrobial drugs was conducted in nine cities of the Russian Federation in 2004-2005. Minimum inhibiting concentrations were ascertained by dilution in agar according to NCCLS (2000-2002) recommendations. The study has found that uncomplicated UTI are most frequently caused by E.coli (73.9%). Other CA occur much less frequently: K.pneumoniae--6.4%, E. faecalis--4.4%, S. epidermidis--4.1%, Staphylococcus spp--3.4%, others--2% patients. E. coli demonstrated high resistance to ampicilline (33.1%), co-trimoxasol (19.4%). Most active against E. coli were fluoroquinolones (norfloxacin, ciprofloxacin, levofloxacine), the resistance being 4.8%; cefalosporins of the second and third generation (cefuroxim, ceftibuten), nitrofurantoin, no resistant strains were found.

[Arterial factors in the mechanism of penile erection]. / Arterial'nye faktory v mekhanizme érektsii polovogo chlena.

Hemodynamic study of the penis in diagnosis of erectile impotence is thought essential because many investigators have obtained evidence for involvement of vascular affections in the mechanisms of somatogenic erectile disturbances in 70-80% of the cases. The authors have assessed arterial and venous phases of penile hemodynamics in healthy males at rest and erection (28 subjects aged 24-56) and in 37 patients with functional sex disturbances aged 21-43. It was found that erection is maintained not only in participation of deep penile arteries, but also dorsal ones. This is also confirmed by synchronous changes in a.a. dorsalis et profunda penis circulation in response to sexual stimulation. However, more expanded network of arteriovenous anastomoses in the system of dorsal arteries makes hemodynamic changes in the course of erection less pronounced than in deep penile arteries. No hemodynamic alterations in the system of common iliac arteries during erection confirmed autonomic pattern of the processes running in penile vascular system.

[The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps]. / Kliniko-statisticheskaia kharakteristika generativnoi funktsii semennikov pri muzhskoi subfertil'nosti posle épidemicheskogo parotita.

The paper emphasized the role of mumps complicated by orchitis in the etiology of male subfertility with allowances for a possible development of testicular degeneration in the course of epidemic parotiditis alone, i.e. without clinically evident orchitis. To distinguish the impact of mumps sustained in childhood on the infertility development clinical and laboratory investigations would be advisable in the majority of subfertile males. The results of clinical and statistical study of 865 infertile males aged between 20 and 36 yrs whose marital life varied from 8 mos to 12 yrs were reported. Anamnestic evidence of epidemic parotiditis sustained at the age of 5-13 yrs was found in 174 examinees (20.1 per cent). Spermographic data on subfertile males with a history of mumps were exposed to statistical computation and correlated with the data on 200 subfertile males who avoided the disease and the data on 22 healthy fertile males. The authors noted significantly low (p less than 0.05) contents of ejaculate spermatozoa in subfertile males with a history of mumps and a significantly low number of morphologically normal spermatozoa (p less than 0.001) in comparison to those values in subfertile males without a history of epidemic parotiditis.