AIM:To study obstetric outcomes and urological complications using various diagnostic criteria for asymptomatic bacteriuria (AB) in pregnant women. MATERIALS AND METHODS:A multicenter, retrospective, non-interventional, descriptive, parallel-group study was carried out. A total of 225 pregnant women with AB aged 18 to 45 years were included. They underwent bacteriological examination of urine. After the examination, patients were divided into 5 groups. Group 1 (n=82) included patients with 1 urine culture and antimicrobial treatment. Group 2 (n=57) included patients with 2 urine cultures and antimicrobial treatment. Group 3 (n=16) included patients with positive criteria for bacteriuria, but who refused treatment. In group 4 (n=51), there were women with uncomplicated pregnancy. Group 5 (n=19) included patients with bacteriuria, which did not meet the criteria for AB (<105). RESULTS:Based on the results of 225 patients (average age 28+/-5.5 years), preterm birth occurred significantly more often in all groups when AB was detected, regardless of treatment, in comparison with a normal pregnancy. In patients of groups 2, 3, 5, preeclampsia was significantly more common. There were no significant differences in complications such as arterial hypertension and amnionitis. Urological complications. The degree of AB and administration of treatment did not affect the incidence of pyelonephritis or obstetric outcomes. However, in group 1 there was a weak tendency towards a more frequent development of pyelonephritis in the 3rd trimester.

AIM:To evaluate the efficiency of therapy with Prostatex plus rectal suppositories in the treatment of patients with chronic abacterial prostatitis and benign prostatic hyperplasia (BPH). MATERIALS AND METHODS:A total of 50 men with chronic abacterial prostatitis of category III A, occurring in combination with BPH, were included in the study. All patients received Prostatex plus (rectal suppositories) 1 suppository 1 time per day. The duration of treatment was 20 days. After taking the drug, patients were followed-up for 40 days. There were three follow-up visits during the study period (days 1, 20 and 60). RESULTS:The study proved that the use of Prostatex plus rectal suppositories has a positive effect on urinary parameters, subjective and objective symptoms of chronic abacterial prostatitis and BPH, which allowed to recommend it for this group of patients, according to the following scheme: 1 suppository 1 time per day for 20 days.

INTRODUCTION:Symptoms of dysuria due to bladder inflammation associated with sexual intercourse (postcoital cystitis) negatively affect the psycho-emotional state of patients, reduce the quality of life and lead to the development of sexual dysfunction. With the advent of the possibility of antibacterial prophylaxis and improved sanitary and hygienic conditions, interest in surgical treatment of postcoital cystitis has decreased. MATERIAL AND METHODS:An open, prospective, non-comparative study included 56 patients with postcoital cystitis in different periods of menopause (perimenopause, menopause and postmenopause). At the time of inclusion, all women had symptoms of cystitis associated with recent (no more than 24 hours ago) sexual intercourse. Patients filled out a specially developed questionnaire and the Acute Cystitis Symptom Score (ACSS). They underwent urinalysis and urine culture with antibiogram. All patients were prescribed Superlymph suppositories in a dose of 10 units as monotherapy according to the scheme: 1 suppository rectally in the evening, 1 suppository vaginally in the morning. Patients with leukocyturia and bacteriuria were initially given antibacterial therapy, after which they were prescribed Superlymph according to the scheme described above as monotherapy. The targeted cytokine therapy was prescribed for 1 month. During treatment, the patients continued to have sexual activity as usual. The efficiency of treatment was assessed immediately after completion of the course and 3 months after its completion. The efficiency was evaluated according to the incidence of postcoital cystitis. RESULTS:In patients included in the study, the first episode of cystitis occurred on average at the age of 33.1+/-2.4 years. In almost half of women (n=24 (42.9%)), the onset of cystitis was associated with sexual activity. During reproductive age, 42 (75%) women had postcoital cystitis, and 10 (23.8%) of them had only one episode. At the same time, every fourth woman (n=14 (25%)) suffered from first episode of postcoital cystitis during menopause. The average age of patients at which the first episode of postcoital cystitis occurred was 38.6 +/- 7.7 years. After a month of monotherapy with Superlymph, 31 patients (55.4%) did not report a single episode of postcoital cystitis, while after three months, 42 women (75.0%) achieved recurrence-free status. Of the 26 patients (46.4%) who were initially diagnosed with bacterial vaginosis, the vaginal normocenosis was found in 18 (69.2%) cases. CONCLUSION:Postcoital cystitis can occur in women of any age, including those with a normal anatomy of the genitourinary system. Combined rectal and vaginal use of Superlymph suppositories at a dose of 10 U for a month helps to avoid relapse of postcoital cystitis in 55.4% of patients. Targeted cytokine therapy has a prolonged effect within three months after completion therapy, and 75% of women did not report relapses of postcoital cystitis.

INTRODUCTION:Despite all the achievements of modern medicine, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains a difficult disorder to treat. Patients are often dissatisfied with the treatment outcomes, since the main symptoms, namely pain and urination disorders, usually decrease, but do not completely resolve. AIM:To study the efficiency of the combined drug Prostatex Plus in the treatment of patients with CPPS (IIIb). MATERIAL AND METHODS:A total of 60 patients with chronic abacterial prostatitis of category IIIb with a severe pain were included in the study. The main group included 37 patients, who received one suppository Prostatex Plus per rectum at night for 20 days. In the control group (n=23), patients received non-steroidal anti-inflammatory drugs and vitamins. The examination was performed at baseline, on the 20th day (upon completion of the Prostatex Plus therapy) to assess the immediate effect and 30 days after completion of cytokine therapy to assess the long-term results. RESULTS:The average age of patients was 48.3+/-3.7 years. The duration of the disease ranged from 2 to 16 years, averaging 9.7+/-3.2 years. The leading symptom was pain in 100% of patients, the pain intensity was higher than 8 points. For all the assessed parameters, more significant positive results were obtained in the Prostatex Plus group, the effect of the treatment lasted for a month. CONCLUSION:The combined use of tamsulosin and organ-specific regulatory in patients with CP/CPPS with severe pain syndrome led to a stable effect. A significant decrease in pain intensity and the total score on the CP symptom scale was seen, as well as an improvement in local microcirculation, sexual function, an increase in the maximum and average urine flow rate compared to the control group. Satisfactory treatment outcomes led to an improvement in the quality of life.

Introduction. Urinary tract infections are the second most common type of bacterial infections worldwide. Treatment of patients with chronic (recurrent) cystitis remains challenging and requires an individual approach.Aim. To assess the efficacy of combined therapy for exacerbation of chronic cystitis.Materials and methods. A total of 65 women aged 18–48 years were enrolled in an open comparative bidirectional study. All participants received antibacterial therapy for exacerbation of chronic cystitis in accordance with the clinical guidelines for the treatment of cystitis in women. After the therapy was completed, the comparison group (35 patients) did not receive any drugs, whereas 30 patients from the treatment group were prescribed Cystenium II biologically active dietary supplement at a dose of 1 orally disintegrating tablet twice daily for 2 weeks. The examination included a measurement of the severity of complaints using the Acute Cystitis Symptom Score (ACSS), a clinical urinalysis and urine culture + sensitivity test. The efficacy of treatment was assessed following completion of antibiotic therapy and two weeks after the therapy.Results. After finishing antibiotic treatment, no patient has achieved full recovery (improvement of urinalyses, no growth of pathogenic microbial flora, no complaints). Both groups showed statistically significant decreases in ACSS scores on Visit 2. Over the following two weeks, the symptoms in the comparison group did not change (p > 0.05), and in the treatment group the sum of scores continued to decrease, reaching an average of 3.62 ± 0.42, which is 5.5 times less than the baseline level and almost 3 times less than the sum of scores following completion of antibacterial therapy (p < 0.05). The positive changes in leukocyturia and bacteriuria were also more pronounced in the treatment group.Conclusion. After completion of antibiotic therapy for relapse of chronic (recurrent) cystitis, the patients usually have residual effects that cannot be regarded as presentations of an active disease, but they disturb patients. A two-week course of pathogenetic therapy with a combination drug containing A-type Vaccinium macrocarpon proanthocyanidins, vitamin C and D-mannose to be received as the second step can increase the efficacy of treatment.

INTRODUCTION:Chronic cystitis predominates in the structure of urinary tract infections (UTIs). International guidelines are mainly focused on the treatment of acute uncomplicated cystitis; the approaches for managing patients with chronic cystitis has not been sufficiently developed.MATERIAL AND METHODS:A total of 91 patients were included in prospective multicenter randomized comparative controlled study. They were divided into three groups. In the group 1, 32 women received only standard antibiotic therapy for 5 days. In the group 2, 28 patients (received standard therapy plus rectal suppositories Superlymph 25 IU 1 time per day for 10 days). In the main group, 31 women received standard therapy in combination with the use of rectal suppositories Superlymph at a dose of 10 IU 1 time per day for 20 days. Standard antibiotic therapy included fosfomycin trometamol 3.0 g once and furazidin 100 mg three times for 5 days. To assess the long-term results, patients were invited for a follow-up 6 months after the end of therapy.AIM:To determine the long-term results of combined etiologic and pathogenetic therapy, including Superlymph rectal suppositories at a dose of 10 U and 25 U, in patients with chronic cystitis.RESULTS:Six months later, 82/91 (90.1%) women were examined to assess the long-term results. At 6 months, in group 1 a relapse of the cystitis developed in 17 women (60.7%) after an average of 67.3+/-9.4 days. In group 2, recurrence was observed in 12 patients (44.4%), and the relapse-free period was longer, averaging of 84.3+/-9.2 days. The best results were demonstrated in the main group, in which the relapse-free period lasted an average of 123.5+/-8.7 days, and a relapse developed in only 8 cases (29.6%). In 19 patients (70.4%) there were no symptoms after six months. Differences between groups were highly significant (p<0.001). In all groups, none of the patients had more than one recurrence of the cystitis during the follow-up.CONCLUSION:Combined antibiotic therapy results in the absence of recurrence within six months in 39.3% of patients with chronic cystitis. Complex etiologic and pathogenetic therapy, including Superlymph rectal suppositories, allows to significantly reduce the number of recurrences and prolong the relapse-free period. Among the patients who received a course of local cytokine therapy at a dose of 25 units for 10 days, 55.6% did not have a recurrence of chronic cystitis within 6 months. In the group of patients who, along with etiologic therapy, received Superlymph rectal suppositories at a dose of 10 IU for 20 days, a relapse was absent in 70.4% of patients.

Tuberculosis (TB) is a communicable disease that is a major cause of ill health. Urogenital TB was a frequent urological disease in the pre-antibiotic era: about 20% of patients in urological hospitals had renal TB, mostly in the form of pyonephrosis. We composed a narrative review of the literature with keywords “urogenital tuberculosis’, “prostate tuberculosis” “kidney tuberculosis”, “treatment of tuberculosis”. Urogenital TB (UGTB) includes TB of the kidney and the urinary tract and male and female genital TB. Each clinical presentation requires tailored antibiotic therapy depending on stage and general management. Anti-TB therapy should be multicomponent, continuous, long-lasting and controlled with a follow-up for 2-3 years. Otherwise, the risks of development of drug-resistance and relapse increase. Index of suspicion on UGTB is generally low, causing a delay in diagnosis; consequently, complicated forms of UGTB respond poorly to anti-TB therapy, while timely diagnosed “minor” forms are curable medically without surgery. Even with timely diagnosed UGTB, non-optimal therapy may result in over-fibrosis, scarring and strictures of the urinary tract, making surgical repair inevitable. Nevertheless, we have a wide enough spectrum of anti-TB drugs to cure urogenital TB.

Introduction . With a depressingly high prevalence of chronic cystitis (it is believed that half of women suffer from acute cystitis at least once in their lives), there is still no clarity on this disease. We were unable to find any studies on the anthropometric characteristics of patients with chronic cystitis either in the domestic or in the English literature. Objective . To assess the anthropometric characteristics of patients with chronic recurrent cystitis. Material & methods . A prospective multicenter cohort study included 91 patients with symptoms of acute cystitis. All underwent anthropometric measurements, analyzed complaints, studied anamnesis morbi et vitae, performed a study on a gynecological chair; urine was sent for general analysis and bacteriological examination for nonspecific microflora with the determination of the sensitivity of the isolated pathogen to antimicrobial drugs. The patients answered questions about the Russian version of the Acute Cystitis Symptom Score (ACSS). A urethra and cervical canal smear was studied using the polymerase chain reaction method to identify the causative agents of sexually transmitted infections. The diagnosis was considered confirmed in the presence of leukocyturia, bacteriuria, and the sum of symptoms on the ACSS scale was 6 or more. Results. The duration of chronic recurrent cystitis was averaged at 7.1 ± 4.2 years. The age of the patients ranged from 18 to 49 years, averaging 28.9 ± 3.9 years. The height ranged from 150 cm to 178 cm, on average 165.9 ± 7.1 cm. The average weight was within the normal range: 64.2 ± 6.1 kg. However, the spread in the cohort by body weight was two-fold: from 42 to 86 kg. Overweight was found in five (5.5%) patients; two patients (2.2%), on the contrary, had a body weight deficit. When analyzing anthropometric indicators, along with the obvious ones (direct dependence of the duration of the disease on the age of the patient; direct dependence of the quality of life on the severity of symptoms), other statistically significant correlations were established: a positive relationship between age and weight, weight and duration of the disease. Conclusion. The analysis showed that overweight women respond to treatment worse, they have a longer history of cystitis. Neither typical symptoms nor ACSS score correlated with any of the anthropometric measures.

The analysis of domestic and foreign literature on the epidemiology, etiology, and possible sexual transmission of urinary tract infections (UTI) was carried out. It has been established that more than 30 pathogens are currently classified as sexually transmitted infections (STI). The molecular genetic method has shown the identity of uropathogenic Escherichia coli in familial cases of UTI, which confirms the sexual route of infection transmission, which was not previously classified as a classic STI. Several works are cited that undoubtedly testify to the possible sexual transmission of Mycobacterium tuberculosis. Up to date, few reports of sexual transmission of UTI have been published, although tuberculosis is one of the most common infectious diseases worldwide. Perhaps because the partner of a patient with genital tuberculosis or other UTI is not actively evaluated. Thus, the possibility of sexual transmission may be underestimated. Sexual transmission of M. tuberculosis as well as uropathogenic E. coli is unlikely, but possible.

INTRODUCTION:Urinary tract infections (UTIs) are among the most common bacterial infections. At the request "cystitis", there are 12,067 publications in the RSCI system (e.library) as of 10/08/2023 and 16,332 articles were screened in the Pubmed. This is evidence that the problem of cystitis is far from being resolved.MATERIAL AND METHODS:A total of 425 patients with bacterial vaginosis and 77 women with chronic recurrent cystitis were included in the study. In all patients, the vaginal biocenosis was assessed through molecular genetic testing. The examination included filling out the Russian version of the Acute Cystitis Symptom Score (ACSS), urinalysis, and urine culture. In addition, local microcirculation was measured using laser Doppler flowmetry (LDF). After examination, patients were prescribed basic therapy and randomly assigned to one of three groups. In a control group (n=17), only basic therapy, consisting of fosfomycin 3.0 once at night + furagin 100 mg after meals 3 times a day for 5 days was prescribed. In the main group 1, 29 women received basic therapy plus Superlymph suppositories 10 units 2 times a day vaginally for 10 days. In the main group 2, 31 patients received basic therapy plus suppositories Superlymph 10 units (rectally in the morning) and Acylact Duo (vaginally in the evening) for 10 days.RESULTS:Among 425 patients with bacterial vaginosis, 78 (18.3%) complained of various urinary disorders, but only 21 women (4.9% of those with vaginal dysbiosis and 26.9% with dysuria) had a diagnosis of cystitis. In all cases, it was an exacerbation of a chronic disease. Among 77 patients with chronic cystitis, normal vaginal flora was initially present in 32 patients (41.6%), and bacterial vaginosis was found in 45 (58.4%) cases. After therapy, positive results were noted in patients of all groups. Complete eradication of the pathogen occurred in 15 women (88.2%) who received only basic therapy; in the main groups 1 and 2, uropathogens were not detected in 27 (93.1%) and 28 (90.3%) cases, respectively. In the control group, the proportion of patients with normal vaginal flora remained virtually unchanged (41.2% [n=7] vs. 47.1% [n=8]). In the main group 1, the proportion of patients with normal vaginal flora almost doubled: from 41.4% (n=12) to 79.3% (n=23). In main group 2, restoration of vaginal flora was noted in 87.1% of cases.CONCLUSION:According to our data, only 4.9% of patients with bacterial vaginosis were diagnosed with chronic cystitis, however, 58.4% of patients with chronic cystitis had vaginal dysbiosis. The use of a complex of antimicrobial peptides and cytokines has significantly increased the bidirectional effect of therapy. Suppositories Superlymph in a combination with vaginal use of Acylact Duo allow to obtain the best results.

Urethral tuberculosis is a rare disease since the advent of highly effective anti-tuberculosis drugs. The article describes an extremely rare clinical observation of a 34-year-old patient with the transition of tuberculous inflammation from the subcutaneous tissue to the wall of the urethra with intact kidneys. Since the first blood discharge from the urethra, the diagnostic process took 3.5 years, all these years, multiple examinations for tuberculosis were carried out and the results were negative, while the disease progressed. The diagnosis was differentiated between acute purulent anterior subcutaneous paraproctitis and festering pararectal cyst. There were repeated openings of the perineal abscess, no bacterial growth was observed, histological tests revealed chronic purulent inflammation. In view of the persistent recurrent course of perineal abscess, tuberculosis was repeatedly suspected. Acid-resistant mycobacteria were found in the discharge from the fistula by fluorescent microscopy: 10-99 in the sample. Tuberculous mycobacteria were not found in the urine by polymerase chain reaction. The patient was diagnosed with A18.4. Tuberculosis of subcutaneous fat (perineum). Mycobacterium tuberculosis (+). The course of disease was complicated by perineal fistula. With the anti-tuberculosis treatment, the fistulous opening healed within a month.

INTRODUCTION:There are publications about the impact of a new coronavirus infection (COVID) on the lower urinary tract, including the development of overactive bladder (OAB) or COVID-associated cystitis. The cause of dysuria in patients with COVID is not fully understood.MATERIAL AND METHODS:A total of 14 consecutive patients after COVID with complaints of frequent urination with urgency were included in the study. The main inclusion criterion was the development or worsening of OAB symptoms after resolution of COVID, confirmed by the eradication of SARS-CoV-2 by a polymerase chain reaction. The severity of OAB was assessed using the International Scale of Symptoms (Overactive Bladder Symptom Score, OABSS).RESULTS:Three (21.4%) out of fourteen patients had OAB symptoms prior to COVID, while in 11 (78.6%) patients OAB symptoms developed in post-COVID period. In 4 patients (28.6% of the entire cohort and 36.4% of patients in de novo group) urge urinary incontinence and urgency developed. The average score on the OABSS scale in patients with baseline OAB was 6.7+/-0.8, which corresponded to the moderate severity. In this group, one patient developed urge urinary incontinence and urgency, which were not present prior to COVID. In a retrospective evaluation of symptoms before the COVID, their average score on the OABSS scale was 5.2 +/- 0.7, i.e., past COVID led to an increase in OAB symptoms by 1.5 points. In patients with OAB de novo, the symptoms were less pronounced, with a score of 5.1+/-0.6 points, that is between mild and moderate OAB. At the same time, urinalysis in 9 patients did not have signs of inflammation: in 5 cases, 5-7 white blood cells per field of view was seen only once. A follow-up urine test was normal, suggesting contamination. None of the cases revealed bacteriuria over 102 CFU/ml. All patients were prescribed trospium chloride at a dose of 30 mg per day. The choice of the drug was due to the absence of a negative effect on the central nervous system, which is very important both during COVID and in post-COVID period, since the neurotoxicity of SARS-CoV-2 has been proven.CONCLUSION:A past history of COVID led to an increase in OAB symptoms by 1.5 points in patients who had OAB prior to infection. In 11 patients, after the treatment of COVID, the moderate symptoms of OAB developed de novo. Our small study showed the importance of focusing the attention of internists and infectious disease doctors on urination disorders in patients with COVID and timely referral to a urologist. For the treatment of post-COVID OAB, trospium chloride is the drug of choice, as it does not aggravate the potential neurotoxicity of SARS-CoV-2.

Introduction. Genital herpes is a chronic sexually transmitted infection characterised by recurrent self-limiting genital ulcers caused by herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2) and can be associated with chronic prostatitis (CP).Objective. To determine the efficacy of cytokines-antimicrobial peptides complex in therapy of patients with herpes virus-associated chronic prostatitis.Materials & methods. The pilot, open, prospective, non-comparative study included 23 patients who were followed up for CP for a mean of 9.7 ± 4.2 years. All were diagnosed with abacterial CP / chronic pelvic pain syndrome (CPPS) with signs of inflammation and detection of HSV DNA in urethral swabs by polymerase chain reaction (PCR). Prescribed therapy: Tab. Valaciclovir 500 mg b.i.d. p.o. for 10 days, Tab. Ketoprofen 100 mg q.d. for 5 days, Supp. Superlymph 10 IU q.d. p.r. q.h.s. for 20 days. The results were evaluated at the end of therapy, 3 and 6 months after its completion.Results. At the end of therapy, the leukocytes count in prostate secretion decreased by almost five times and remained stable throughout the entire follow-up period. The total symptom scale score at the end of therapy decreased from 22.96 ± 6.01 to 6.61 ± 3.71 points (p < 0.05). There was also a change in the perception of pain on a visual analog scale. If, before the start of treatment, 14 patients (60.9%) assessed the pain intensity as “severe” and only two (8.7%) had “weak” pain intensity, then after the end of therapy, none of the patients had severe pain, 21 (91.3%) patients noted "mild" pain and in 2 patients (8.7%) the intensity of pain was regarded as "average". Quality of life improved from baseline 8.23 ± 1.91 points to 2.43 ± 1.41 points immediately after completion of therapy (p < 0.05). Three months after therapy, patients assessed the quality of life as 2.43 ± 1.41 points, and six months later, as 2.81 ± 1.21 points. During the first three months, one patient experienced a HPV-relapse; one more — within the next three months. These patients underwent a second course according to a similar scheme. None of the patients reported significant side effects on any component of the therapeutic complex.Conclusion. In abacterial CP/CPPS, a herpes infection should be identified. Being neurotropic, HSV can cause / exacerbate the pain characteristic of CP/CPPS. In case of persistent pain, HSV infection should be excluded. In the treatment of patients with herpes virus-associated abacterial CP, Supp. Superlymph showed good immediate and long-term results.

Introduction. Asymptomatic bacteriuria (ABU) occurs in 2–15% of pregnant women, but opinions about ABU in pregnant women are controversial. The aim of the study was to assess the outcomes of delivery in pregnant women with ABU, depending on the therapy and urological history. Material and methods. The histories of childbirth of 46 women with ABU detected during prenatal screening, were analyzed. The outcomes of pregnancies were analyzed, and the relationship between the presence of ABU, the type of therapy, the presence of pyelonephritis in history and the development (exacerbation) of pyelonephritis during pregnancy was determined. Results. The structure of uropathogens was typical: E. coli was found in 36 cases (78.3%), Enterococcus faecalis - in 10 cases (21.7%). Seven women (15.2%) had a history of chronic pyelonephritis, 4 (8.7%) had chronic cystitis. The remaining 35 pregnant women (76.1%) had no any urological diseases. More than half of pregnant women with ABU (32/69.6%) received Сanephron; all of them had normal delivery. The average weight of newborns was 3768±101.9 grams. The rest of the 14 (30.4%) pregnant women with ABU, including 7 patients with a history of pyelonephritis, received amoxicillin with clavulonic acid. In more than half of the them (4/57.1%) gestational pyelonephritis developed. Correlational analysis showed that the low weight of the newborn, the development of gestational pyelonephritis and the likelihood of preterm birth did not depend on the therapy for ABU (antibacterial or herbal medicine), but on the presence of chronic pyelonephritis in the pregnant woman. Conclusion. The detection of ABU in a healthy pregnant woman without urological history is not a convincing basis for prescribing antibiotics. Preventive phytotherapy with the drug «Canephron» in such women was sufficient; none of the cases developed gestational pyelonephritis or preterm labor

The objective : to identify structural features of genital tuberculosis in men depending on their HIV status. Subjects and Methods . The medical records of 95 patients with genitourinary tuberculosis were analyzed, and records of patients with isolated tuberculosis of the male genital organs were selected. Results . Among 95 male patients with genitourinary tuberculosis, 72 (75.8%) were HIV-negative, and 23 (24.2%) were HIV-positive. Among 72 HIV-negative male patients, 33 had isolated genital tuberculosis. Among 23 HIV-positive male patients, 9 had isolated genital tuberculosis. HIV infection had a significant impact on the structure of genital tuberculosis in male patients; among cases of isolated genital tuberculosis, tuberculosis of the testicle and its epididymis prevailed (88.9%). In HIV-negative male patients, the prostate gland was affected most often (prostate tuberculosis alone or in combination with tuberculous orchiepididymitis was diagnosed in 90.9% of patients).

INTRODUCTION:The term "chronic prostatitis" includes many different symptomatic patterns, many aspects of which still remain a mystery. The role of oxidative stress in the pathophysiology of many diseases, including prostatitis, is undisputable.AIM:To evaluate the capabilities of a mineral-vitamin antioxidant complex for the treatment of patients with chronic abacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS).MATERIAL AND METHODS:A total of 47 patients with inflammatory type of chronic abacterial prostatitis/chronic pelvic pain syndrome (CPPS) were included in the study. The examination, along with standard tests, included evaluation of the antioxidant status. Patients were randomized into the main group (n=26), and the control group (n=21). All men received standard therapy. However, in the main group, Selzinc-plus was additionally prescribed, 2 tablets per day for 2 months. The results were assessed after 2 months of therapy.RESULTS:Standard therapy had a significant effect in patients of both groups, which lasted for two months. However, additional antioxidant therapy practically doubled this effect on the symptom scale, although it had no influence on the number of leukocytes in the expressed prostate secretions. At baseline, all patients in both groups had a decrease in antioxidant protection. Two months of taking Selzinc-plus led to normalization of the overall antioxidant status. In the control group, there was also a positive trend in antioxidant status, but significant differences were obtained only in the activity of erythrocyte superoxide dismutase.CONCLUSION:CP/CPPS is accompanied by oxidative stress. Taking Selzinc-plus for two months allows to restore the activity of the antioxidant system.

Tuberculosis of the genitourinary system has not lost its relevance. During the years of the pandemic of a new coronavirus infection, the number of newly diagnosed cases of tuberculosis of all localizations has decreased, but their structure has become more severe and mortality has increased. There is a wide variation in the statistics of urogenital tuberculosis (UGT) in the literature. The true incidence of scrotal tuberculosis is not known; at the end of the last century, it was believed that it was 7% of all cases of tuberculosis. It is believed that the share of isolated tuberculosis of the genital organs of men accounts for no more than 30% of all localizations of UGT, and most often tuberculosis develops in the epididymis. The spread of M. tuberculosis to the organs of the scrotum, as a rule, occurs by the hematogenous route from the primary focus in the lungs or kidney. However, the infection can also spread retrogradely from the prostate and seminal vesicles to the epididymis and testicles. Tuberculosis of the testis and its epididymis is often complicated by infertility and the formation of fistulas. This disease has no pathognomonic symptoms. Differential diagnosis is carried out between tuberculous epididymo-orchitis, testicular tumor, testicular torsion, bacterial epididymo-orchitis. Ultrasound examination is of great diagnostic value in tuberculosis of the scrotal organs. The ultrasound picture in tuberculosis of the testis and its epididymis is divided into 4 types: diffuse enlargement, heterogeneous hypoechogenicity; diffuse increase, uniform hypoechogenicity; nodular enlargement, heterogeneous hypoechogenicity; miliary dissemination. The world literature does not describe an example of tuberculosis of the scrotal organs, when the disease would be diagnosed during the patient’s initial visit to the doctor. As a result of late diagnosis or low suspicion for TB, up to 70% of patients undergo unnecessary surgery, although TB orchiepididymitis can be treated medically. The lecture also analyzed a number of clinical observations.

Introduction. Everywhere there is a weighting of the structure of urogenital tuberculosis. Tuberculosis of the testis and its epididymis is difficult to diagnose because it does not have pathognomonic symptoms; the diagnosis cannot be verified microbiologically in the study of ejaculate or prostate secretion, however, it is possible to detect a pathogen in biopsy specimens or surgical material. Materials and methods. Search results were analyzed in the scientific databases eLibrary, PubMed, Web of Science, Embase, Cochrane Library and PEDro, Wang-fang and Cnki, Edline for the queries «urogenital tuberculosis», «tuberculosis of the male genital organs», «tuberculosis testicles», «tuberculosis of the epididymis», «tuberculous epididymitis», «tuberculous orchiepididymitis», «diagnosis». Results. An isolated lesion of the scrotum is observed with testicular neoplasms, bacterial epididymo-orchitis, genitourinary sarcoidosis, inguinal-scrotal hernia, and hydrocele. Since oncological diseases cause the greatest concern, misinterpretation of clinical and laboratory data and neglect of the epidemic history can lead to an erroneous diagnosis and unnecessary orchiectomy. At best, the patient is initially diagnosed with bacterial epididymo-orchitis and given antibiotic therapy. At the same time, the wrong choice of antibiotic can subsequently make it impossible to identify the pathogen and distort the pathomorphological picture. Description of the clinical case. The article presents a case of incorrect tactics in the treatment of a patient with tuberculous epididymitis, erroneously diagnosed as an «epididymal cyst». Neglect of microbiological data led to the formation of a fistulous form of orchiepididymitis. Conclusions. The diagnosis of tuberculous orchiepididymitis is difficult. With the help of radiation diagnostic methods, tuberculosis of the testicle and apidymis can be suspected; to confirm the diagnosis, identification of the pathogen or the presence of specific pathological signs is required. High vigilance is required for tuberculosis when examining a patient with complaints of enlargement and tenderness of the scrotum.

Background. Tuberculosis is a serious medical and social problem that does not lose its importance, despite all the advances in pharmacology and surgery. Diagnosis of urogenital tuberculosis (UGTB), as a rule, is delayed due to low index of suspicion to tuberculosis and the absence of pathognomonic symptoms. Aim. Determining the change in the ratio of clinical forms of renal tuberculosis from 1999 to 2020. Materials and methods. A retrospective cohort comparative non-interventional study on the spectrum of the incidence of extrapulmonary tuberculosis (EPTB) was carried out. Among all 13852 extrapulmonary tuberculosis patients which were diagnosed from 1999 to 2020, patients with renal tuberculosis were selected, and the spectrum of their clinical forms in three periods was analyzed: 1st period 19992004 (1155 patients), second period 20052014 (2657 patients), and the third period 20152020 (671 patients). The clinical features of nephrotuberculosis in 88 patients was also estimated. Results. Over the 20 years of the analyzed period, the number of patients with UGTB decreased by 80.6%; for the year of the COVID-19 pandemic, this figure fell by another third. In the first period, destructive complicated forms of nephrotuberculosis prevailed (922 patients 79.8%), while the so-called "minor forms" were diagnosed in 233 patients (20.2%). In the second period, the situation was statistically significantly more favorable: the proportion of destructive and complicated forms of renal tuberculosis decreased to 43.8% (1124 patients), "small forms" were diagnosed in 1443 patients (56.2%). In the third period, destructive and complicated forms of nephrotuberculosis were diagnosed in 531 patients (77.6%), and the proportion of "small forms" in comparison with the previous period decreased by half, to 22.4%. Analysis of the clinical features of renal tuberculosis, depending on the prevalence of the destruction, showed that an asymptomatic course is possible, and pain, dysuria, intoxication and renal colic are present with different frequencies, and the clinical picture of tuberculosis of the renal parenchyma differs significantly from the clinical picture of tuberculous papillitis, cavernous nephrotuberculosis and symptoms of renal tuberculosis as whole. Conclusion. Currently, there is no screening on urogenital tuberculosis at all. Patients are diagnosed by referral, with a long history, after receiving multiple courses of antibacterial treatment; mainly through the pathomorphological examination of the operating material. Thus, a sharp decrease in the proportion of UGTB patients does not mean the disappearance of tuberculosis of this localization, but only states the tragic defects in timely diagnosis and low index of suspicion of medical doctors in relation to UGTB.