Introduction. Postcoital cystitis, or urinary tract infection associated with sexual intercourse (UTI), is a pathological process characterized by inflammation and infection of the bladder occurring after sexual activity. Case Description: In this article, we present the results of surgical treatment for a complication after distal urethra transposition. Discussion. This article discusses the key surgical techniques for the treatment of postcoital cystitis. There is no single correct approach with regard to efficacy. Studies suggest that a transposition of the distal urethra is highly effective in reducing symptoms and recurrence rates. Conclusion. Surgical treatment for postcoital cystitis should be considered as a last resort, only in cases of ineffective conservative therapy and the presence of strict indications.
BACKGROUND : Worldwide, a high prevalence of benign diseases in women is registered, which in some cases can lead to the development of malignant neoplasms. The role of estrogens in the onset of neoplastic processes is well known. Long-term pathogenetically oriented prevention can contribute to disease regression and a reduced risk of malignant transformation. AIM : To compare the efficacy and safety of a complex product containing resveratrol and indole-3-carbinol (dietary supplement Imaston) administered in a once- and twice-daily regimen. METHODS : The article presents brief data on the molecular mechanisms and pathogenesis of estrogen-associated diseases, as well as the interim results of the open-label, multicenter clinical study PRIMA-024. RESULTS : The therapy demonstrates a pronounced initial clinical response in both groups of patients with benign mammary dysplasia. CONCLUSION : Plant-derived components (resveratrol and indole-3-carbinol) show high efficacy and safety in both the treatment and long-term prevention of benign neoplasms in women.
Introduction. Intermittent priapism is characterized by recurrent painful episodes of prolonged erection, predominantly at night (NPP), waking the patient and disturbing his sleep. NPP resolves spontaneously and alternates with periods of detumescence. It occurs from once a week to several episodes of erection per night. The pathophys-iology of NPP is not fully understood. In vivo and in vitro studies suggest that the underlying mechanisms of the disease include an imbalance between vasorelaxant and vasoconstrictive processes responsible for erection and detumescence. In foreign literature, NPP is designated as sleeprelated painful erection (SRPE). In Russian and foreign literature, there are no convincing randomized clinical trials on the treatment of this rare condition. The aim of the study. To evaluate the effectiveness and safety of complex X-ray endovascular technologies in the treatment of nocturnal intermittent priapism. Material and methods. Patient B., 73 years old, came in February 2024 with complaints of debilitating, prolonged, painful nocturnal erections not associated with sexual activity up to several times a week, sometimes relieved by positioning on the side with the knees brought to the stomach. Similar complaints for 12 years, the patient also com-plained of nocturia up to 2-3 times, pollakiuria, weight loss. During clinical and urological examination, including a study of monitoring nocturnal penile tumes-cence, the diagnosis of NPP was confirmed. Clinically significant benign prostatic hyperplasia was detected as a concomitant disease. Stage 2. Attempts at multiple outpatient treatment with antiandrogens, nootropics, hypnotics, antidepressants, vascular, neurotropic and anticonvulsant drugs were unsuccessful. At the end of March, X-ray endovascular embolization of the tributaries of the internal iliac vein system on the left was performed. Bilateral superselective embolization of prostatic arteries, bilateral embolization with autologous blood clots of the distal branch-es of the pudendal arteries. Results. In the postoperative period, after 7, 14, 30, 90 days of dynamic observation, the patient noted a subjective improvement in the quality of life, the absence of painful night tumescence, an improvement in the quality of urination, and normalization of vascular penile blood flow according to the data of triplex ultrasound examination of the penis. Conclusion. A successful case of complex X-ray endovascular treatment of NPP based on modern neurourological examination is presented. Abbreviations: Nocturnal intermittent priapism (NIP), Erectile dysfunction (ED), Penile Doppler ultrasound (PDИ).
Introduction. Prostate cancer ranks as the second most prevalent malignancy among men worldwide, with radical prostatectomy (RP) remaining the gold standard treatment for localized disease. However, postoperative complications including erectile dysfunction (ED) and urinary incontinence significantly impair patients’ quality of life. While penile prosthesis implantation is well-established for ED management, its potential role in addressing concomitant urinary incontinence requires further investigation. Aim. To evaluate the effect of implantation of a semi-rigid penile prosthesis on urinary incontinence after RP. Objective. The prospective study included 26 patients who underwent RP without nerve-sparing, with ED (> 1 year) and mild-moderate stress urinary incontinence (urine loss 33–98 g/day according to 24-hour pad test). Exclusion criteria: severe incontinence, cancer recurrence, inflammatory diseases. All patients underwent penoscrotal implantation of a semirigid penile prosthesis. The main efficacy assessment included the pad test, ICIQ-SF, I-QoL, IIEF-5 questionnaires Results: In the group of patients with mild incontinence (< 50 g/day, n = 17), full continence was achieved (0 g according to the pad test) with an improvement in I-QoL indices from 76.9% to 90.2%. In the group with moderate incontinence (50–200 g/day, n = 9), a decrease in urine loss to 74.8 g/day was noted with an increase in I-QoL from 57.5 to 67.8%. Despite the restoration of erectile function in all patients, a decrease in sexual desire associated with residual urine leakage persisted in the second group. No postoperative complications were observed. Conclusion: Penile prosthesis implantation effectively manages mild post-RP incontinence, enabling complete sexual rehabilitation and significant quality-of-life improvement (I-QoL >90%). For moderate incontinence, combined approaches with anti-incontinence procedures (artificial urinary sphincter/sling) are recommended.
Introduction: the relevance of the problem of infertility is indisputable fact in the medical community. The prevalence of male infertility, according to some data, reaches 50 %. Various treatment options for pathozoospermia have been studied for a long time, including conservative methods and surgical interventions, but assisted reproductive technologies still most effective. The high prevalence of infertility globally and in Russia in particular, along with the lack of regional data on providing medical assistance to the population with male factor infertility, has defined the relevance of this study. Research aim: to estimate the efficiency of treating male infertility using different options of conservative therapy, surgical interventions, and ART programs in the Krasnoyarsk region. Materials and methods: 540 clinical records of patients planning pregnancy were analyzed. Patients were divided into 5 groups: normozoospermia, moderate pathozoospermia, severe pathozoospermia, immunological factor of male infertility, and azoospermia. Changes in sperm parameters during conservative therapy, surgical treatments, and the outcomes of ART programs were evaluated in the study groups. Results: empirical antioxidant therapy is most effective for couples with moderate pathozoospermia. Prolonged courses of therapy with boggyaluronidase azoximer and inosine (over 3 months) show a significant reduction in the MAR test in the long term. Hormonal stimulation combined with antioxidants is an effective and relatively safe treatment method for patients with severe spermatogenesis disorders. Varicocelectomy had limited efficiency in the study groups. The success rate of ART is higher in the group with obstructive azoospermia, as is the probability of obtaining sperm compared to non-obstructive cases. Conclusion: the treatment methods’ data obtained in the study correlate with global statistics, and further data collection is necessary to uncover regional specificities.
