[Diagnosis and treatment of urolithiasis in combination with infravesical obstruction in presenile and senile patients].

The analysis of the results of examination and treatment of 510 urolithiasis patients with organic infravesical obstruction (IVO) treated in the urological clinic of M. F. Vladimirsky Moscow Regional Research Clinical Institute and in the urological department of Zhukovsky city hospital from 1995 to 2009 made it possible to arrive at the following conclusions: the above patients have obstruction symptoms in 100% cases, irritative symptoms--in more than 2/3 of the patients; combined use of low invasive, endoscopic and open methods reestablishes urodynamics of the lower urinary tract in more than 90% patients; the decision on the treatment policy and techniques depends on severity of clinical symptoms caused by IVO and urolithiasis as well as disturbance of upper and lower urinary tract urodynamics. In adequate choice of the patients and correct indications combined use of low invasive, endoscopic and open methods provides good treatment effect in patients with IVO and urolithiasis.

[Current trends in pharmacotherapy of prostatic adenoma: role of a new alpha-adrenoblocker kamiren XL in the treatment of this disease].

The aim of our study was assessment of clinical efficacy and safety of a new alpha-adrenoblocker kamiren XL in patients with prostatic adenoma (PA) with or without acute retention of urine (ARU). Seventy PA patients were divided into two groups. Group 1 (n = 35) patients had no ARU. They received kamiren XL in a dose 4 mg/day for 1 month. Group 2 (n = 35) patients received the same doses of kamiren XL in addition to urethral catheterization for 3-7 days. In group 1 efficacy of the pharmacotherapy reached 91.4%. Overall symptoms score fell by 45.2% (from 18.5 +/- 6.9 to 10.2 +/- 5.9), quality of life--by 36.5% (from 3.7 +/- 1.5 to 2.4 +/- 1.4), volume of residual urine diminished by 54.9% (from 35.2 +/- 42.1 to 15.9 +/- 24.4 ml), Qmax rose by 37.7% (from 9.6 +/- 2.7 to 13.3 +/- 4.6 ml/s). Side effects (weakness--11.4%, vertigo--8.6%, sleepiness--5.7%) were registered in 5 (14.3%) patients. The drug produced significant changes neither in systolic, diastolic blood pressure nor heart rate. In group 2 urination resumed in 25 (71.4%) patients. Of them, 45.7% patients considered their voiding satisfactory, control ultrasound investigation detected that their residual urine was less than 50 ml while Qmax was over 5 ml/s. Difficulties in urination were experienced by 25.7% patients who demonstrated residual urine in the range 10-210 ml and Qmax under 5 ml/s. Side effects were seen in 14.3% patients. Thus, alpha-adrenoblocker kamiren XL (doxasozine retard) is a highly effective and safe drug for treatment of PA patients including those with ARU.