A New "Non-Traditional" Antibacterial Drug Fluorothiazinone-Clinical Research in Patients with Complicated Urinary Tract Infections.

In order to combat resistance, it is necessary to develop antimicrobial agents that act differently from conventional antibiotics. Fluorothiazinone, 300 mg tablet (The Gamaleya National Research Center), is an original antibacterial drug based on a new small molecule T3SS and flagellum inhibitor. A total of 357 patients with complicated urinary tract infections (UTIs) were divided into two groups and given Fluorothiazinone 1200 mg/day or a placebo for 7 days to evaluate the efficacy and safety of the drug. Additionally, all patients were given Cefepime 2000 mg/day. Fluorothiazinone with Cefepime showed superiority over placebo/Cefepime based on the assessment of the proportion of patients with an overall outcome in the form of a cure after 21 days post-therapy (primary outcome), overall outcome in cure rates, clinical cure rates, and microbiological efficacy at the end of therapy and after 21 days post-therapy (secondary outcomes). In patients who received Fluorothiazinone, the rate of infection recurrences 53 and 83 days after the end of the therapy was lower by 18.9%, compared with patients who received placebo. Fluorothiazinone demonstrated a favorable safety profile with no serious unexpected adverse events reported. The results showed superiority of the therapy with Fluorothiazinone in combination with Cefepime compared with placebo/Cefepime in patients with cUTIs.

A new method for the evaluation of pelvic organ prolapse in women using a three-dimensional optic scanner.

INTRODUCTION AND HYPOTHESIS: Modern classifications of pelvic floor movements are based on pelvic floor assessment in a static midsagittal plane. This study presents a new and potentially useful 3D noninvasive tool for studying pelvic floor mobility in women with pelvic organ prolapse (POP). MATERIALS AND METHODS: Thirty-four patients with POP [grade ≥3 using the Pelvic Organ Prolapse Quantification (POP-Q) system] and 30 healthy volunteers (controls) at rest and during Valsalva maneuver were scanned using an Artec™ 3D optic portable scanner and 3D pelvic floor models were generated. We calculated the volume of the prolapsed vaginal wall using dynamic prolapse increment (DPI), which is defined as an increase in prolapse volume from rest to its maximal Valsalva probe [DPI = (Vval - Vrest) / Vrest %)]. RESULTS: In the control group, the average DPI was 28 % (16-51 %). As the DPI in patients with POP varied widely, two subgroups were identified. In the first subgroup, the average DPI was 290 % (125-437 %), whereas it was only 48.8 % (41-55 %) in the second subgroup. Prolapse volume in subgroup 1 was not due to the most prominent component of POP but was induced by enlargement of the prolapsed vaginal wall from other components, such as a cystocele or enterocele, which was evident only during the 3D procedure and could not be validated by the POP-Q system. CONCLUSIONS: In addition to existing methods, 3D modelling is a useful tool for evaluating pelvic floor mobility. Further investigation of the pelvic floor dynamic features in women is necessary.

Management of urethrovaginal fistulae.

PURPOSE OF REVIEW: Urethrovaginal fistulae are a rare condition. It is a conceptual mistake to consider urethrovaginal fistulae to be synonymous with vesicovaginal fistulae. Urethrovaginal fistulae are a different entity requiring special attention and treatment. Due to the wide variety and individuality of the clinical manifestations of these injuries, it is practically impossible to find and create common guidelines for treatment. Taking into account the difficulty of urethrovaginal fistula treatment, we decided to conduct a review of the current literature on this subject. RECENT FINDINGS: Due to advances in obstetric care, urologists in the developed world encounter urethrovaginal fistulae rarely, and many of the fistulae seen are secondary to vaginal surgery. Surgical treatment procedures include direct primary anatomical repair and interpositional tissue restorations, mainly by Martius flap. Successful direct anatomical repair alone may result in the development of stress urinary incontinence or obstructed voiding in up to 50% of patients. Synthetic tape should be removed during fistula repair, which may lead to the resumption of stress incontinence. SUMMARY: Prevention of urethrovaginal fistulae can be achieved through both improvements in obstetric care and adequate training in vaginal surgery. The success of any surgical treatment depends on careful patient selection, and assumes knowledge of all possible treatment options. Potential work needs to be directed towards the application of the newest molecular technologies.