[TREATMENT OF ERECTILE DYSFUNCTION FOLLOWING TRANSVESICAL PROSTATECTOMY].

This study examines the efficacy and safety of phosphodiesterase type 5 (PDE-5) inhibitors in treating erectile dysfunction after transvesical prostatectomy. The study involved 63 men aged 55 to 68 years, divided into two groups--29 and 34 patients, respectively. Patients in group 1 received 50 mg of sildenafil citrate (Ereksezil®) on a daily basis, in group 2--100 mg of sildenafil citrate (Ereksezil®) on demand. Postoperative visits were scheduled at the stage of screening, then after a month of treatment and on day 14 after treatment completion (3 visits altogether). Changes of patients' complaints according to IIEF-15 questionnaire showed a significant improvement in erectile function and its components of sexual life satisfaction in both groups of patients, but more significantly with regular medication intake, which has a positive impact on patients' quality of life. At the same time, treatment by PDE-5 inhibitors did not affect the maximum urinary flow rate and residual urine volume. Given the high incidence of the postoperative erectile dysfunction, postoperative administration of PDE-5 inhibitors is relevant and promising.

[BILATERAL NEPHROURETERECTOMY WITH CYSTOPROSTATECTOMY AD BLOC AND LYMPHADENECTOMY IN A PATIENT WITH END-STAGE RENAL FAILURE AND CANCER OF THE URINARY BLADDER T2BN0M0].

The article introduces a clinical example of a patient who was first diagnosed with bladder cancer, which contributed to the development of end-stage renal failure. Initially, given the significant upper urinary tract retention and post renal acute renal failure, the patient underwent bilateral percutaneous nephrostomy. Taking into account periodic gross hematuria, cystoscopy and transurethral electrocoagulation and biopsy of bladder tumor were performed and bladder cancer was identified. Despite adequate functioning of nephrostome drainage and daily urine output up to 3000 ml, kidney failure was not resolved. After creation of an arteriovenous fistula, a hemodialysis program was launched. The patient continued to experience persistent gross hematuria, he had a hectic fever, which was estimated as a symptom of acute pyelonephritis. The patient was scheduled for bilateral nephroureterectomy, cystoprostatectomy as the only option to remove the source of bleeding and infection. The operation was carried out without complications. The patient is currently maintained on chronic hemodialysis and followed by an oncologist at the place of residence; there are no data of bladder

[REHABILITATION OF PATIENTS WITH URIC ACID AND MIXED UROLITHIASIS].

This paper presents evaluation of rehabilitation effectiveness of 113 patients aged 19-78 years diagnosed as having mixed and uric acid stones. 88 patients with uric acid stones 0,5-2,5 cm were assigned to group 1 and treated with Trometamol N parenteral litholis and a complex metaprophilaxis by dietary supplements Prolit and Urisan. 25 patients with mixed stones 1-3,5 cm were allocated to group 2 and treated with external shock wave lithotripsy and complex metaprophilaxis by dietary supplements Prolit Super Septo and Urisan. Positive results were achieved in all the patients. In the patients of group 1 the stones were completely dissolved. In group 2 treatment resulted in stone disintegration and clearance of small fragments 0,4 cm after partial dissolution.

[Significance of matrix metalloproteinase-9, tissue inhibitor of metalloproteinase and protein Ki-67 in prostate tumors].

Immunohistochemical evaluation of localization of matrix metalloproteinase-9 (MMP-9) and an inhibitor of matrix metalloproteinase-1 (TIMP-1) and cell proliferative activity in the production Ki-67 protein in benign prostatic hyperplasia (BPH), and adenocarcinoma with different Gleason scores was performed. Moderate positive correlation between the Gleason scores and cell proliferation index usind Ki-67 antigen (rs = 0.674), moderate negative correlation between Gleason scores and levels of MMP-9 production (rs = -0.660), and weak significant negative correlation between the levels of cell proliferative activity and MMP-9 production by tumor cells (rs = -0.369) were established. Invasive properties of tumor cells, expressed in the destruction of type IV collagen in basement membrane and connective tissue of the stroma of the prostate, are associated with imbalance in MMP-9 protein, and blocking enzyme, TIMP-1; and TIMP-1 production is reduced significantly in adenocarcinomas with different Gleason scores compared with BPH.

[Tamsulosin in the treatment of patients with ureteroliths of the lower third of the ureter clinical and pharmacoeconomic grounds].

Alpha1-adrenoblocker tamsulosin reduces muscle spasm in the ureteric wall, decreases peristalsis below and raises pressure above the stone thus facilitating stone passage. Patients on tamsulosin had spontaneous stone passage in 73.8% cases while only 22.4% patients on routine therapy became stone free. Tamsulosin also shortens hospital stay. Use of tamsulosin 0.4 mg daily in patients with distal ureteric stones is pathogenetically validated, is highly clinically and cost effective.