Introduction. The hypothalamic-pituitary-gonadal axis (HPG) is the most important part of the hormonal system that controls testicular function in men. It is known that testicular neoplasms (TN) can disrupt the regulation of HPG due to the occurrence of hormonal imbalance. However, changes in HPG in patients with TN have been little studied, especially before the start of treatment. Aim: to assess the degree of hormonal disorders affecting HPG in men with TN before treatment. Material and methods. The study included 49 patients with newly diagnosed TN. The concentration of total testosterone (T), free testosterone (cT), estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin (SHBG) and prolactin (PRL), as well as tumor markers (β-HCG, AFP) were measured in all men; the body mass index (BMI), tumor size, bad habits and surgical history (treatment of cryp- torchidism, varicocele) were evaluated. Clinically significant T deficiency (DT) was defined as the level of total T <8 nmol/l or the level of T in the range of 8-12.1 nmol/l, taking into account free T <243 pmol/L. Results. There were statistically significant differences in hormone levels between patients with normal 30 (61,2%) and high 19 (38,8%) values of cancer markers (p<0,05). A high concentration of β-hCG was associated with a decrease in the level of FSH and LH below normal values (p<0,001) and an increase in the level of total T (p=0.019), cT (p=0,01) and E2 (p=0,003) compared with patients without hypertension. an increase in this cancer marker. Laboratory signs of DT were found in 15 (30,6%) patients, mostly with normal β-hCG values (p=0,025). However, a causal relationship was not established due to a small sample in this subgroup. The probability of developing DT in men with a history of cryptorchidism (22,4%) was 6,56 times higher (95% CI: 1,532 – 28,120; p=0,021). Correlation analysis revealed the relationship between LH (p=-0,351; p=0,014), FSH (p=-0,3; p=0,041), E2 (p=0,323; p=0,03) and tumor size. When analyzing hormone levels depending on age, smoking and BMI, no statistically significant differences were obtained (p>0,05). Conclusion. Abnormalities in HPG were detected in 30% of patients with TN before treatment. One third of the men had laboratory signs of DT. Further studies involving more patients are required to develop practical recommendations.

Background. Existing methods for treating erectile dysfunction (ED) do not always provide the necessary therapeutic effect and/or may not be recommended for certain patients. Aim. Evaluate the effectiveness of correcting erectile dysfunction using platelet-rich plasma (PRP) and extracorporeal shock wave therapy (ESWT). Material and methods . 100 men were randomly assigned to 3 groups. Group 1 (n=20) received ESWT treatment on the penis twice a week for 6 weeks. Group 2 (n=40) and Group 3 (n=40) had two visits per week for 6 weeks, involving both ESWT and PRP injections into the penis. In Group 2, PRP activation was performed using ESWT, while in Group 3, it was done using a 10% solution of CaCl2. Patients were evaluated at 0 and 60 days of the study, assessing IIEF-5, SEP, EHS, GAQ, blood testosterone levels, and penile Doppler ultrasound with PGE1. Results. In group 1 IIEF-5 improved from 14.5 (10.5-17) to 19.5 (15.5-21) (р<0.05). SEP changed from 2 (1-2) to 3 (2-4) (р<0.05). EHS improved from 1.5 (1-2) to 3 (2.5-3) (р<0.05). Baseline PSV was 16.3 cm/s (12.2-22.7), at 60 days post ESWT was 24 cm/s (19.4-26.8) (р<0.05) and RI changed from 0.7 (0.7-0.9) to 0.9 (0.8-1) according D-PDU (р<0.05). 14 patients (70 %) noted positive dynamics by GAQ at the last exam. In group 2 IIEF-5 was 13 (11-15) at 0 days, 18 (16-20) at 60 day (р<0.05). SEP improved from 2 (1.5-2) to 3 (3-4) (р<0.05). EHS changed from 2 (1-2) to 3 (2-3) (р<0.05). D-PDU results demonstrated increase median PSV 15.6 cm/s (12.1-22.8) to 27 cm/s (20.6-33.5) (р<0.05) and median RI from 0.8 (0.7-1) to 1 (0.8-1) (р=0.02). 34 men declared positive effects according to GAQ (85 %) In group 3 IIEF-5 results improved from 13 (9-15) to 18.5 (15-20.5) (р<0.05). SEP improved from 2 (1-2) to 3 (3-4) (р<0.05). EHS changed from 1 (1-2) to 3 (3-3) (р<0.05). PSV increased from 17 cm/s (10.3-25) to 27.8 cm/s (20-36.6) (р<0.05). RI improved from 0.8 (0.7-0.9) to 0.9 (0.8-1) (р=0.005). 33 patients respond to an improvement of erectile functions (82.5 %) by GAQ. Conclusion. All treatment methods were well-tolerated by all patients. The study results indicate a positive trend in improving erectile function and increasing total testosterone levels in the blood. When comparing groups, combination therapy significantly improves erectile function according to SEP, EHS, and penile Doppler ultrasound assessments. ESWT can be suggested as an activator for PRP.

Introduction. Testicular neoplasms (TN) are one of the most common oncological diseases among young men. Currently the sexual function of such patients remains understudied. The aim of the study was to assess the state of sexual function in men with testicular neoplasms before treatment. Material and methods. The cross-sectional continuous single-center study included 35 men with TN. The average age of patients was 34.2–8.2 years (95% CI: 31.4-37.1). The comparison group included 28 healthy volunteers, average age 30.5–4.9 years (95% CI: 28.6-32.4). Some social characteristics of the patient (marriage and children), the state of sexual function (using the IIEF-15 and ICF questionnaires), the level of anxiety and depression (according to the HADS scale), the levels of total and free testosterone, globulin-binding sex hormone (SHBG), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin were evaluated. Results. Patients in the main group showed a decrease in erection in 10 (28.6%), satisfaction with sexual intercourse in 12 (34.3%), impaired orgasmic function in 2 (5.7%), decreased libido and overall satisfaction in 9 (25.7%). Nonparametric analysis revealed a statistically significant decrease in libido (p < 0.05), satisfaction with sexual intercourse (p < 0.05) and overall satisfaction (p = 0.007) in patients of the main group compared with the control group. Patients with testicular neoplasms had disorders of the mental component – in 12 (34.3%), erection – in 20 (57.1%), neurohumoral – in 25 (71.4%), ejaculatory – in 10 (28.6%) patients. Subclinical depression was observed in 13 (37.1%) and clinically pronounced depression in 11 (31.4%) patients of the main group. Anxiety and depression were statistically significantly more common in the main group (p = 0.0013). The level of anxiety and depression was more pronounced in unmarried (p = 0.013) children-free patients (p = 0.025). Low levels of total testosterone were detected in 13 (39.4%), free testosterone in 12 (38.7%), LH in 11 (33.3%), FSH in 6 (18.7%) patients from the main group. Elevated levels of LH were recorded in 4 (12.1%), FSH in 4 (12.5%), prolactin in 2 (6.9%) and SHBG in 1 (5%). Conclusion. Patients with TN have a deterioration in sexual function compared to a healthy population of the same age group. The further studies are needed to access the influence of tumor histology and treatment of sexual function.

The outbreak of the rapidly spreading COVID-19 infection in December 2019 became a catalyst for significant transforma­tions within the global healthcare system. This necessitated the reorganisation of specialised services to utilise available resources more effectively and to safeguard the safety of patients and medical staff. The diagnosis and treatment of cancer are processes that cannot be delayed, as doing so may result in irreversible detrimental outcomes. In light of this, oncology organisations, amidst complete uncertain­ty, advocated for the persistent treatment of cancer throughout this crisis with utmost diligence. The COVID-19 pandemic compelled on­cologists to overhaul aspects of medical care at every stage, impacting all involved in the process. The aim of this article is to analyse and assess the methods of organising oncological care under pandemic conditions, including an examination of the safety measures and treatment method adaptations already implemented amidst total uncertainty. As the pandemic rapidly evolves, it will require constant updating and reforming of strategies and guidelines to ensure safe and high-quality medical care.

The problem of infertility has recently become quite widespread all over the world, having a negative impact on couples themselves and society as a whole. The male factor of infertility accounts for about 50% of cases, in this regard, a large number of studies conducted are aimed at finding new methods of treating this disease. However, the accepted modern methods of treatment, including assisted reproductive technologies, are currently not effective enough. Recently, much attention has been devoted to the use of regenerative medicine technologies in the treatment of diseases of the reproductive system of men and women due to its significant potential. This review presents existing experimental and clinical studies that studied the effect, safety and efficacy of stem cells of various kinds of origin, induced pluripotent stem cells, exosomes, spermatogonial stem cells, platelet rich plasma in the treatment of various types of male infertility.

Introduction. Testicular cancer (TC) mostly affect young men of reproductive age. Several studies have shown correlation between the level of sex hormones in testicular cancer and serum tumor markers. However, currently, the relationship between hormone levels before orchidectomy and the clinical and pathomorphological characteristics of the tumor has not been sufficiently studied. Aim of the study: to analyze the relationship between hormone levels and the clinical stage and histological characteristics of the tumor in patients with testicular cancer and to develop prognostic models. Material and Methods. This prospective single-center study included 66 patients with testicular cancer. Localized, locally advanced and metastatic testicular cancer was diagnosed in 55 (83.3 %), 9 (13.6 %) and 2 (3.0 %) patients, respectively. A preoperative assessment of hormones such as total and free testosterone (T), estradiol (E2)), gonadotropic hormones (LH, FLH, Prolactin) and b-HCG was carried out. Patients were divided into 2 groups depending on the histological structure of the tumor: seminoma (n=31) and non-seminoma (n=35). The following parameters were assessed: tumor size, lymphovascular invasion and rete testis invasion. Results. In non-seminoma tumors, the values of sex hormones and beta-hCG were higher, but the values of gonadotropic hormones were lower compared with typical seminomas (p<0.05). High concentrations of b-HCG were observed predominantly in pT3 compared to pT1 stages (p=0.018). Correlation analysis revealed a connection between total (ρ=0.351; p=0.004) and free T (ρ=0.342; p=0.008), E2 (ρ=0.292; p=0.022), b-HCG (ρ=0.244; p= 0.048), LH (ρ=-0.287; p=0.039), FSH (ρ=-0.264; p=0.04) and the size of the primary tumor. The presence of rete testis invasion was accompanied by a low LH value and a high b-HCG value compared to patients without this prognostic parameter (p=0.015, p<0.001, respectively). Prognostic models were developed to determine the probability of histological structure and the presence of rete testis invasion (p<0.001) with high sensitivity (82.1 % and 76.5 %) and specificity (76.9 % and 100 %). Conclusion. The findings suggest that non-seminoma tumors are associated with changes in the pituitary-gonadal (HPG) axis. The high values of sex hormones and low values of gonadotropic hormones before orchidectomy are associated with a large size of the primary tumor. Additionally, a low LH value and a high b-HCG value are predictors of rete testis invasion. High b-HCG levels are associated with more aggressive tumor biology and poor prognosis.

The development of new local treatment methods of peritoneal carcinomatosis in ovarian cancer is an urgent task due to the fact that in most cases complete surgical cytoreduction is technically impossible, and systemic cytostatic therapy does not provide a stable therapeutic effect. The pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is a local method of treating peritoneal carcinomatosis in ovarian cancer, which allows for uniform distribution of medicinal aerosol over the peritoneum and is used together with standard combined treatment in order to improve its outcomes.Purpose of the study. To analyze the effect of PIPAC, used in addition to the standard combined treatment of ovarian cancer with peritoneal carcinomatosis, on the clinical outcome of surgical treatment and long-term results.Patients and methods. Our prospective randomized open-label controlled trial included 169 patients with newly diagnosed ovarian cancer with peritoneal carcinomatosis. The main group included 84 patients and 85 in the control group. Randomization was performed intraoperatively using a digital randomizer. The distribution was homogeneous according to the stages of ovarian cancer (Barnard's criterion = 0.292) and the peritoneal carcinomatosis index (PCI) (Mann-Whitney U test = 0.625). We used a combination of surgical cytoreduction with a one-time PIPAC session and subsequent systemic chemotherapy within the framework of one hospitalization, further PIPAC sessions were performed 2 more times with an interval of 42 days in combination with systemic chemotherapy within the framework of one hospitalization. All patients were operated on at the first stage in the volume of extirpation of the uterus with appendages and removal of the large omentum, all underwent systemic cytotoxic therapy scheme: paclitaxeln 175 mg/m2 , carboplatin AUC 5–7) (6 courses with an interval of 21 days). In the main group, 3 sessions of PIPAC were added to the standard treatment. To study the surgical safety profile of PIPAC, all adverse events of a surgical profile were recorded at each hospitalization. The duration of life without relapse was estimated as the main outcome, the median relapse-free survival was the main indicator. The total duration of the study was 36 months.Results. During statistical processing, it was found that the median disease-free survival in the group with the use of PIPAC was 8 months higher. Thus, in the control group, the median disease-free survival was 13 months in the 95 % confidence interval (in the range of values from 12 to 14 months), in the main group – 21 months (95 % confidence interval, range from 18 to 22 months). Surgical adverse events were reported in 1.2 % after 252 sessions of PIPAC over the entire study period. These phenomena didn’t require additional medical interventions, didn’t increase the duration of hospitalization and didn’t lead to the exclusion of patients from the clinical trial protocol.Conclusion. The use of the PIPAC technique as an additional method of standard regional treatment has demonstrated an improvement in the results of treatment of newly diagnosed ovarian cancer with peritoneal carcinomatosis. PIPAC has a favorable surgical safety profile and is a promising method of local exposure to peritoneal carcinomatosis in both clinical and research work.

Purpose of the study. To study the clinical efficacy of pressurized intraperitoneal aerosolized chemotherapy (PIPAC), which complements the combined treatment of ovarian cancer with peritoneal carcinomatosis.Patients and methods. The study included 175 patients with newly diagnosed ovarian cancer with peritoneal carcinomatosis (87 in the main group, 88 in the control group). All patients underwent extirpation of the uterus with appendages, removal of the large omentum and chemotherapy according to the TC scheme (Taxol, Carboplatin). In the main group, 3 additional sessions of PIPAC were performed. The duration of relapse‑free survival, PCI index, ascites volume and peritoneal morphology were evaluated.Results. Complete regression of carcinomatosis was noted in the second session of PIPAC, in 44 (52.4 %) patients (PCI = 0); complete resorption of ascites – in 74 (88.1 %); complete therapeutic pathomorphosis – in 48 (57.2 %) cases. Complete regression of carcinomatosis was noted in the third session of PIPAC in 73 cases (87.0 %), complete resorption of ascites in 80 cases (95.2 %), complete morphological pathomorphosis in 69 cases (82.2 %). 6 months after treatment, complete regression of carcinomatosis (PCI = 0) was detected in 81 patients (96.4 %), complete resorption of ascites in 83 (98.8 %), complete morphological regression in 72 (85.7 %). The advantage of the main group in terms of median relapse‑free survival was 7 months.Conclusion. Ascites resorption, a decrease in the PCI index and drug pathomorphosis of peritoneal metastases, detected during the 2nd session of PIPAC, had an increasing dynamics during treatment and persisted for a long time. From our point of view, the advantage in median relapse‑free survival in the main group is due to the local effect of PIPAC, which complemented the standard treatment of ovarian cancer with peritoneal carcinomatosis.

Background: ovarian cancer (OC) is considered an aggressive disease diagnosed at late stages, which leads to a decrease in the survival rate of female patients. According to the therapy standards at stage III–IV of this disease, it is recommended to use combined treatment in the form of cytoreductive surgery and adjuvant chemotherapy. At present, the administration method of chemotherapy drugs is being actively discussed, in particular, intravenously or intraperitoneally. Aim: to evaluate the 2-year survival rate of female patients with malignant ovarian neoplasm in peritoneal carcinomatosis after combined treatment with pressurized intraperitoneal aerosolized chemotherapy (PIPAC). Patients and Methods: a prospective randomized controlled trial included 164 female patients with stage IIIB and IIIC OC aged 32 to 75 years, who were randomly divided into two groups. The main group included 79 (48.1%) female patients who, immediately after cytoreductive surgery and anterior abdominal wall wound suturing, underwent a PIPAC course, as well as polychemotherapy (PCT) according to the TС (taxotere + cyclophosphamide) regimen. The control group included 85 (51.9%) female patients who underwent only cytoreductive surgery and PCT according to the above regimen. All patients were monitored for 24 months. Results: the number of fatal complications in the main group after performing three PIPAC courses decreased by almost 2.5 times versus the control group. At the same time, the median overall survival rate after 2 years of follow-up in the main group was 82.4% (95% confidence interval (CI) 0.551–0.939), and in the control group — 75.5% (95% CI 0.531–0.882). To identify statistically significant differences between groups in overall survival rate, the log-rank test, the likelihood-ratio test and the Wald test for the Cox proportional hazards regression model were used. The actual significance levels (p-value) of these tests were 0.07, 0.06, 0.08, respectively. Given the small number of fatal outcomes (only 15 cases), it can be concluded that the control and main groups differ statistically significantly in overall survival rate at the level of 0.06. Conclusion: PIPAC is a modern and effective method for adjuvant chemotherapy in advanced ovarian cancer. Due to the low mortality rate after three PIPAC courses (7.9% less in the main group), it is a safe palliative treatment option for stage IIIB and IIIC OC. KEYWORDS: ovarian cancer, peritoneal carcinomatosis, pressurized intraperitoneal aerosolized chemotherapy, PIPAC, locally advanced cancer, polychemotherapy, overall survival rate. FOR CITATION: Dzasokhov A.S., Kostin A.A., Astashov V.L., Turiev A.V., Luneva I.Yu. Overall survival rate of female patients with advanced ovarian cancer after combined treatment with pressurized intraperitoneal aerosolized chemotherapy. Russian Medical Inquiry. 2024;8(6):332– 337 (in Russ.). DOI: 10.32364/2587-6821-2024-8-6-3.

Introduction. Experimental induction of spermatogenesis disorders is possible mainly by physical, pharmacological methods. However, not all methods can cause non-obstructive azoospermia. Objective. To evaluate and compare the effectiveness of induction of spermatogenesis disorders in rat models by applying ligatures to the spermatic cords and administration of cisplatin. Materials & methods . Seventy-three mature male rats (Wistar) were divided into 2 experimental groups and 1 control (n = 9) group: group 1 (n = 27) with ligature on the spermatic cord for 12 h (n = 9), 24 h (n = 9), 36 h (n = 9); group 2 (n = 37) with five-fold intraperitoneal administration of cisplatin at concentrations of 5 mg/kg, 3 mg/kg, 1 mg/kg. On days 0, 7, 14, 28 after the last day of induction of spermatogenesis disorders, epididymal semen analysis, blood test, total serum testosterone, pathomorphological examination of testes tissue, body weight, reproductive system organ weight were performed to assess model performance. Results. Ligation to the spermatic cords did not have a negative effect on the general condition of the animals (p < 0.05), blood test (p < 0.05); there was a decrease in the testicular weight (p < 0.05), the appendage of the testis (p < 0.05), prostate (p < 0.05), the weight of the seminal vesicles did not change (p > 0.05). In group 1, the number of epidermal spermatozoa decreased in all subgroups, statistically significant changes were recorded at 7 (exposure 24 h) and 28 (exposure 12, 36 h) days of research. Histologically, there was no significant inhibition of spermatogenesis, except for a decrease in the area, diameter of the seminal tubules on 7, 28 days after surgery (exposure 24, 36 h). In group 2, the survival of animals was noted only when using cisplatin at a dose of 1 mg/kg five times. Body weight decreased in all rats without recovery, thrombocytopenia recorded after 1 wk, leukocytopenia regressed by 2 wk of the study. A decrease in the weight of all reproductive organs was noted. Sperm concentration decreased at 1 wk and recovered at 28 wk. In the analysis of testicular biopsies: pronounced disorganization of the spermatogenic epithelium, a decrease in the absolute area and diameter of the seminal tubules. Conclusion. Ligation to the spermatic cord does not cause permanent inhibition of spermatogenesis. Cisplatin at a dose of 1 mg/kg causes persistent severe damage to the spermatogenic epithelium.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common urogenital pathologies in working men. This disease could significantly negatively affect to the quality of life. The standard drug 3-Astherapy has not a corrective effect in some cases, depending on the phenotype of the disease, other groups of drugs and physiothera-peutic methods of treatment can be used additionally. Currently, the search is underway for the most effective non-drug and drug-based methods of treatment of CP/CPPS. One of these is extracorporeal shock wave therapy (ESWT) and the drug "Longidaza®". This review analyzes and summarizes the results of large clinical studies evaluating the effectiveness of the use of ESWT in/without combination with drugs, as well as "Longidaza®" in patients with CP/CPPS. The mechanism of action is analyzed in detail and the key effects of the action of ESWT are demonstrated, namely: decrease of pain and dysuria, anti-inflammatory and antibacterial effects, lysis of prostate calcinates and fibrosis.

Gunshot wounds of the external genitalia are present in two-thirds of all penetrating genitourinary trauma in the military setting with prevailing shrapnel wounds. The reported clinical case is aimed at providing rational and demonstrating benefits of endoscopic removal of a splinter from the urethral lumen. The clinical case presents the successful removal of a splinter from the urethral lumen. A 22-year-old man suffered gunshot shrapnel wound to the scrotum and urethra 7 months ago, а splinter was located in the urethral lumen and was successfully removed using endoscopic approach. In some cases X-ray diagnosis does not allow detecting the exact location of the splinter. Therefore, it is rational to use endourological diagnostic procedures.

The relevance of the problem of increasing the effectiveness of standard treatment of ovarian cancer is determined by the following characteristics of the disease: high one‑year mortality, high recurrence rate and unsatisfactory results of their treatment. Peritoneal carcinomatosis in ovarian cancer occurs in 65–70 % of cases. The standard modern approach to the treatment of ovarian cancer is a combination of surgical treatment and systemic intravenous chemotherapy. At the same time, more than 70 % of ovarian cancer cases are first diagnosed at stages III–IV. However, despite the successes in the field of surgery and drug treatment, the five‑year survival rate is no more than 24 % at the III and 4.6 % at the IV stage of the disease. One of the frontiers of ovarian cancer resistance to therapy is peritoneal carcinomatosis. Its resistance to therapy is due to the low bioavailability of cytostatics in metastases on the peritoneum to almost zero. In order to increase bioavailability, various forms of intra‑abdominal chemotherapy are used. The technique of pressurized intraperitoneal aerosol chemotherapy (PIPAC) has a number of advantages over other methods of intra‑abdominal antitumor treatment. These advantages include the uniform distribution of cytostatics over the peritoneum, the absence of penetration of cytostatics beyond the peritoneum, which allows PIPAC to be combined with systemic chemotherapy, low trauma and good tolerability of the procedure. PIPAC was implemented into clinical practice in 2011, and since then has been widely used in a number of foreign and domestic clinics. The conducted studies confirm the safety of the technique and its effectiveness against peritoneal carcinomatosis. The data of multicenter studies and the analysis of available literature data, as well as the successful own experience of PIPAC use create prerequisites for investigating the effectiveness of intra‑abdominal aerosol chemotherapy under pressure in relation to peritoneal carcinomatosis in ovarian cancer.

Background. Paraurethral cyst (PC) is often found in women aged 20–60 years. The prevalence of PC in the female population is 1–6 %. Since PC are often located in the distal urethra and lie close to the genitals of a woman, the symptoms associated with this disease cause women both physical and psychological suffering. Aim. To assess the quality of life of women with PC. Materials and methods. The study included female individuals (n = 106) aged 18–60 years, in whom PC were detected during examination of the perineal region. The quality of life of the patients was assessed on the basis of the health quality questionnaire – SF-36. Results. The average volume of the PC in the observed women was 3.2 ± 1.3 cm. In the observed women, the intensity of pain in the perineum was directly proportional to the duration of the disease: up to a year – 86.3 ± 4.1; from one to three years – 76.4 ± 8.3; more than three years – 64.4 ± 9.2 (p <0.05). In this regard, in this category of patients, indicators of physical activity, psychological health and role functioning due to emotional state were reduced. Repeatedor constant pain during urination and during sexual activity causes severe distress, which affects the quality of life of patients with cystic formations in the paraurethral region. Conclusion. In women with PC on the background of dyspareunia up to 3 years and more, physical and psychological aspects of health suffer.

Purpose of the study. To evaluate the effect of Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) on the quality of life of patients during standard combined treatment of newly diagnosed ovarian cancer.Patients and methods. A combination of surgical cytoreduction with a simultaneous session of intra‑abdominal aerosol chemotherapy under pressure and subsequent systemic chemotherapy within the framework of a single hospitalization was used. The study included 164 patients (79 in the main group, 85 in the control group). All patients were operated on at the first stage, all underwent systemic cytostatic therapy according to the TS scheme (6 courses with an interval of 21 days). In the main group, 3 PIPEC sessions were added to standard treatment: the first one simultaneously with cytoreductive surgery, followed by 2 more PIPAC sessions with an interval of 42 days. To assess the quality of life, the EORTC‑QLQ – C30 questionnaire was used, which the patients filled out 4 times: before the cytoreductive stage, and then after completing the first, third and fifth courses of systemic polychemotherapy (PCT).Results. Before the start of treatment in the control group, the average general condition was 1.6 ± 1.1 points, then 1.32 ± 1.0 points, then 0.96 ± 0.97 and 0.78 ± 0.87 points at the end of the 6th course of systemic PCT. A similar situation has developed in the main group. The average baseline value before treatment was 1.7 ± 1.1 points, with the second questionnaire – 1.3 ± 1.1 points, with the third questionnaire – 0.66 ± 0.83, and 0.43 ± 0.75 points with the fourth questionnaire. In the control group, the average assessment of the quality of life before treatment was 55.0 ± 11.0 points, and then sequentially with the following three surveys 50,8 ± 7,5, 47 ± 8, 45,6 ± 8,1 points, which indicates an improvement in the quality of life against the background of ongoing treatment. In the main group, the basic level of assessment of the quality of life was 53.8 ± 11.3 points. Subsequently, an improvement in the indicators was also revealed: 49.6 ± 7.5 points, 44.2 ± 5.3 points and 42.1 ± 5.4 points, respectively. The homogeneity of the distribution in the groups was established by means of an accurate two–way Wilcoxon–Mann‑Whitney rank sum criterion, the actual significance level was p = 0.498. A two‑factor model of nonparametric analysis of variance (ANOVA) was used to analyze the data obtained. To identify a significant difference between the indicators at different stages of the study, the Page rank criterion for an ordered alternative and an algorithm based on the Friedman rank sum test were used. As a result, it was shown that the revealed positive dynamics of indicators within the groups over the entire study period is statistically significant (p < 0.0001).Conclusion. The results of the study showed that PIPAC not only does not reduce the quality of life and does not worsen the well‑being of patients, but also improves these indicators by the time of completion of combined treatment (after the 6th course of systemic PCT): in the main group, the overall ECOG condition at this stage was estimated at 0.43 ± 0.75 points, in the control group – 0.78 ± 0.87 points. The survey of patients using EORTC‑QLQ – C30 at this stage showed that in the main group the indicator was 42.1 ± 5.4 points versus 45.6 ± 8.1 points in the control group of the study.

Purpose of the study. Dynamic assessment of the direct impact of pressurized intraperitoneal aerosol chemotherapy (PIPAC) on peritoneal carcinomatosis in ovarian cancer.Patients and methods. The study involved 164 people with visually detectable and morphologically verified ovarian cancer with peritoneal carcinomatosis of the peritoneum (IIIb-IIIc stages of ovarian cancer). All patients underwent combined treatment of ovarian cancer, which included primary cytoreduction and 6 courses of сhemotherapy according to the TC scheme. In the main group, the standard treatment was supplemented with 3 sessions of PIPAC. Statistical processing was carried out by analyzing the exact criterion of the Wilcoxon-Mann-Whitney sums, the distribution of patients in groups by age and peritoneal lesion was estimated. It was found that the distribution of the analyzed parameters was random. The distribution in the groups by stages of the disease was homogeneous, which is justified by the use of the Barnard criterion. The dynamics of the parameters of the study was evaluated by the methods of basic statistics. Used software packages: MedCals, Statistica.Results. The results obtained demonstrate a distinct positive dynamics in the group of patients receiving PIPAC in addition to standard treatment of newly diagnosed ovarian cancer: a significant decrease in the peritoneal cancer index, therapeutic pathomorphosis in peritoneal samples during treatment, reduction of ascites.Conclusion. The team of authors managed to establish that PIPAC simultaneously with standard combined treatment for newly diagnosed ovarian cancer with peritoneal carcinomatosis makes it possible to achieve a dynamic regression effect of peritoneal carcinomatosis of the peritoneum, morphological regression of carcinomatosis and complete resorption of ascites in the vast majority of treated patients. The revealed therapeutic effect was prolonged and persistent with an objective assessment 6 months after the end of treatment.

Peyronie’s disease (PD) is a benign fibrous lesion in the albuginea of the penis that can occur in men of various ages. Despite the fact that epidemiological and pathophysiological data on PD are contradictory, there are a number of comorbidities that suggest a genetic predisposition to this pathology. Genetic and molecular studies of PD are insufficient and their results are often contradictory. This literature review will consider the most studied and potential genetic predictors of PD, namely: transforming growth factor β1, myostatin, matrix metalloproteinases, Wnt signaling pathway, microRNAs (MiR-29b), major histocompatibility complex proteins (human leukocyte antigen). Expanding the possibilities of early diagnosis of the disease will increase the effectiveness of the treatment.

For the first time in 2021, prostate cancer took 1st place among other oncological diseases in Western countries. Radical prostatectomy is still the method of choice among the prostate cancer radical therapy. An important unresolved problem remains the rehabilitation, since the overwhelming number of patients in the postoperative period develop sexual dysfunction, urination disorders, which significantly reduces the quality of life. Thus, this condition actualizes the search and development of new approaches to the therapy of erectile function after radical prostatectomy. This literature review presents the results of a literary search of Russian and international databases on the erectile function recovery after radical prostatectomy using platelet rich plasma and extracorporeal shock wave therapy.