Prostate cancer is one of the most common cancers in men. Timely detection of clinically significant prostate cancer remains one of the key tasks of healthcare, while minimizing overdiagnosis of clinically insignificant prostate cancer, thereby avoiding overtreatment and resource waste. In recent decades, significant progress has been made in the diagnosis of prostate cancer, primarily due to the introduction of multiparametric magnetic resonance imaging and targeted biopsy. The sensitivity of targeted biopsy in detecting an index lesion exceeds 90%. However, systematic biopsy remains an important addition, as it helps detect 5% to 16% of clinically significant prostate cancer cases that may be missed when performing a targeted biopsy only. The utility of performing a systematic prostate biopsy when a lesion is detected on multiparametric magnetic resonance imaging remains a controversial issue. The results of most of the above procedures do not convincingly exclude the need for this biopsy. Of note, the conditions for performing multiparametric magnetic resonance imaging, the approaches and experience of urologists in performing biopsies, and the expertise of pathologists vary across different medical institutions. Centralized performance of multiparametric magnetic resonance imaging, prostate biopsy, and pathomorphological examination at expert centers is essential to improve the timely diagnosis and treatment of clinically significant prostate cancer.
In recent decades, neural networks have been widely applied in many fields of science and medicine. Accurate and early diagnosis of malignancies is a key challenge in oncology. Neural networks can analyse a wide range of medical data and identify relationships between qualitative and quantitative features. This allows for more precise and timely diagnoses. Moreover, they can be used to predict tumour progression, evaluate treatment effectiveness, and optimise treatment plans for each patientIn oncourology, the use of neural networks offers new perspectives for the diagnosis, prognosis, and treatment of various cancer conditions related to the urinary tract and male reproductive system. This review article explores how neural networks are being used in this field and present research into the use of neural networks for diagnosing, predicting the course and treating urological oncological diseases. The advantages and limitations of using neural networks in this field are demonstrated, and possible directions for future research are suggested. The application of neural networks in oncourology opens new horizons for the development of a personalised approach to diagnosing and treating oncological diseases. Artificial intelligence has the potential to become a powerful tool for improving the accuracy of patient outcome predictions and reducing undesirable side effects of therapy. Introducing neural networks into oncourological practice creates new opportunities for enhancing the work of healthcare organisations and improving the quality of care provided to patients. This can lead to better treatment outcomes and improved patient satisfaction.
Introduction. Prostate cancer (PC) is one of the most frequently diagnosed malignant diseases among men. It is necessary to search for new methods of additional visualization. The most promising modern diagnostic method is histoscanning (HS) with the software «True Targeting», which allows you to perform «targeted» prostate biopsy (PB) in real time. We conducted a comparative observational clinical study with anonymous Internet survey implemented based on the SurveyMonkey program. Material and methods. The survey of urology specialists was initiated from the beginning of the «Moscow program for «Histoffusion» biopsies». The survey was composed of 16 questions. Data were obtained and analyzed on the doctor's work experience, experience in performing pancreatic biopsy, hospital, features of the operation, method of choosing anesthesia, patient position and complications in the postoperative period. Results. The division by hospitals showed that transrectal prostate biopsy is performed under the conditions in one day hospital in 80% of cases. Biopsy takes no more than 19 minutes on average. Half of the respondents had experience about 5 years, and only about 15% about 15 years. About 68% of specialists recommend performing MRI with contrast. However, only 22% of patients perform results. About 16% note the impossibility of performing MRI due to contraindications or other difficulties of the healthcare system. The most common complications are hemospermia and hematuria. In 100% of cases, respondents noted the need to prescribe antibiotic therapy. In 64.9% of cases, doctors note the need for a histoscan-guided prostate biopsy, and 82.1% are sure that in the future it is necessary to standardize the method of performing histoscan-guided prostate biopsy. Conclusion. We note the lack of standardization of histoscan-guided prostate biopsy. We suggest that the results of histoscan-guided prostate biopsy can be improved by developing a standardized follow-up as well as an algorithm aimed at optimizing for each patient.
The need to process large amounts of data has led to the creation of software that can improve and facilitate the work of medical staff. Decision support systems (DSS) are now used in many branches of medicine both at the outpatient and inpatient stages of medical care, helping clinicians to choose the tactics of treatment and management of each individual patient. These systems to a certain extent can improve treatment results and diagnostic process. The introduction of DSS in clinical practice has shown many advantages in reducing the frequency of misdiagnosis and, consequently, the risk of medical errors. At the same time, DSS can have a number of disadvantages. For example, physicians may view them as a threat to their “clinical autonomy”, and the implementation and subsequent maintenance of DSS can be quite costly. Artificial intelligence, which is increasingly being used not only for diagnosis, but also for treatment and prediction of outcomes in various diseases, should be considered as a prerequisite for the creation of DSS. Active development of artificial intelligence has been noted in almost all branches of medicine. A non-systematic review of the available literature published in the period between 2012 and 2022 has shown that the application of AI in prostate cancer diagnosis has great potential in clinical practice, as it helps both in the choice of treatment method and in planning the course of further surgery.
Background. Prostate cancer is the 3rd most common diagnosis among malignant tumors. The first robot-assisted radical prostatectomy (RARP) was performed in 2001. Studies comparing RARP and radical retropubic prostatectomy (RRP) are limited. In Russia, the Da Vinci robot was first installed in 2007. At the Urology Clinic of the A.I. Evdokimov Moscow State University of Medicine and Dentistry the program of robot-assisted surgery started in November of 2008. Aim. To perform first in Russia evaluation of 10-year functional treatment outcomes for patients with localized prostate cancer after RARP. To perform comparative analysis with RRP outcomes. Materials and methods. Medical histories of 211 patients from the Urology Clinic of the A.I. Evdokimov Moscow State University of Medicine and Dentistry were analyzed. Among them, 62 patients did not satisfy the inclusion criteria. Therefore, the study included 149 patients who underwent surgical treatment for localized prostate cancer between January of 2009 and December of 2011. Depending on the technique of surgical intervention, patients were divided into 2 groups: 1st – RARP ( n = 82), 2nd – RRP ( n = 67). All RARP were performed by a single surgeon, RRP by 2 experienced surgeons (experience >1000 RRP). Results. Median follow-up was 120 months in both groups. Overall survival in the 1st and 2nd groups was 85.4 and 86.6 %, respectively ( p >0.05). For accuracy of functional outcomes analysis, patients who died during follow-up were excluded from the study. Frequency of neurovascular bundle preservation in the 1st and 2nd groups was 60.9 % (50/82) and 40.2 % (27/67), respectively ( p = 0.01). Erectile function was preserved in 60.0 and 44.4 % males of the 1st and 2nd groups, respectively ( p = 0.01). Age below 60 years ( р = 0.009) and disease stage рТ2 ( p = 0.026) were predictors of erectile function preservation after RARP. Continence frequency was 92.7 and 82.1 % in the 1st and 2nd groups, respectively ( p = 0.048). Conclusion. Ten-year comparative analysis shows that RARP allows to achieve significantly better parameters of urinary continence and erectile function preservation in men with localized prostate cancer than RRP.
In 2020, prostate cancer (PCa) ranked third in the structure of the most significant oncological diseases. In the Russian Federation, in terms of the frequency of detection among men, prostate cancer is second only to tumors of the upper respiratory tract and lungs, accounting for 14.9%. Radical prostatectomy (RP) in various modifications is still the most common treatment for localized prostate cancer, despite the existence of alternatives such as active surveillance, hormonal and radiation therapy, cryoablation, and others. And the technological pinnacle of the surgical treatment of prostate cancer at the moment is robot-assisted prostatectomy, the widespread use of which was marked by the publication of J. Binder back in 2002. This technology combined the advantages of minimally invasive laparoscopic RP with improved surgeon ergonomics and technical ease of vesicourethral anastomosis reconstruction and has now become the preferred minimally invasive approach. This article will consider the use of a robot-assisted technique in the stage of T3 prostate cancer.
As new methods of focal treatment become more and more popular in the treatment of prostate cancer, cases of ineffective treatment are gradually revealed, which require correction in the volume of surgical or other method of treatment.The article describes experience of radical treatment of prostate cancer in case of local recurrence of the disease after ultrasound ablation of the prostate.A 58-year-old man who 1 year ago had undergone high-intensity focused ultrasound (HIFU) hemiablation of the left prostatic lobe using Focal One robotic platrform due to prostate adenocarcinoma was examined 1 year after the operation. Total prostate-specific antigen blood level was 5.45 ng/mL. The patient underwent a control transrectal biopsy of the prostate from 12 cores, which revealed recurrence of the disease in the contralateral (previously untreated) prostate lobe. The patient underwent robot-assisted radical prostatectomy. Operative time was 80 minutes. The patient was discharged from the hospital on the 7th day with no postoperative complications. The urethral catheter was removed on the 6th day after control CT cystography. Erectile function and urine retention were preserved. Total prostate-specific antigen level after 6 months of follow-up did not exceed 0.02 ng/mL.Robot-assisted radical prostatectomy is an effective and safe method of treatment in patients with recurrent prostatic adenocarcinoma after HIFU if performed by a surgeon with sufficient experience in robot-assisted surgery.
INTRODUCTION:Prostate cancer (PCa) is the second most commonly diagnosed malignant tumor in men after lung cancer and is the fifth leading cause of death worldwide. In November 2019, the spectrum of alternative treatment for PCa was added by a novel minimally invasive method, namely high-intensity focused ultrasound (HIFU) using the latest Focal One machine (with the possibility of combining intraoperative ultrasound and preoperative MRI data).MATERIALS AND METHODS:During the period from November 2019 to November 2021, HIFU using Focal One device (manufactured by EDAP, France) was performed in 75 patients with PCa. Total ablation was done in 45 cases, while 30 patients undergone to focal prostate ablation. The average age of the patients was 62.7 (51-80) years, the total PSA level was 9.3 (3.2-15.5) ng/ml and the prostate volume was 32.0 (11-35) cc. The maximum urinary rate was 13.3 (6.3-36) ml/s, IPSS score was 7 (3-25) points, IIEF-5 score was 18 (4-25). Clinical stage c1N0M0 was diagnosed in 60 patients, 1bN0M0 in 4 patients, 2N0M0 in 11 patients. In 21 cases, transurethral resection of the prostate was performed within 4-6 weeks prior to total ablation. Before surgery, all patients underwent magnetic resonance imaging (MRI) of the pelvis with intravenous contrast and PIRADS V2 assessment. MRI data were used intraoperatively for precision planning of the procedure.RESULTS:In all patients, the procedure was performed under endotracheal anesthesia in accordance with the technical recommendations of the manufacturer. Prior to surgery, a silicone urethral catheter of 16 or 18 Ch was placed. The average duration of the intervention was 101 (56-147) minutes. The postoperative period was uneventful in all cases.Patients received antibiotic therapy via parenteral route for 4 days, followed by oral administration for another 10 days, as well as alpha-blockers (at least 1 month after procedure). After removal of urethral catheter on the 4th day, all patients started to void. In 9 cases there was acute urinary retention in the evening and in 4 patients in the next morning, requiring temporary bladder catheterization. A year after the procedure, 53 patients were fully examined: the average total PSA level in patients who underwent total ablation (n=53) was 0.96+/-0.11 ng/ml, the IPSS score was 6.9+/-0,6 points (no difference compared to baseline). Follow-up biopsy revealed PCa in 6 patients; in other cases, prostate fibrosis was determined.CONCLUSIONS:HIFU in patients with localized PCa using image-guided robotic HIFU (Focal One) is promising and feasible. This method has shown good oncological results with a short follow-up period. It is advisable to carry out further prospective analysis.
Urinary tract infections (UTIs) have long been among the most common diseases. In the structure of the general infectious morbidity, UTIs rank second after acute respiratory viral infection. Every year, researchers note an increasing number of mutations in the genomes of bacteria that cause infectious diseases, which leads to the formation of more and more aggressive forms of pathogens. Patients with infectious diseases of the urinary system have the highest risk of biofilm formation, the frequency of which is directly proportional to the length of time the urethral catheter is located and accounts for more than half of all nosocomial infections. The presence of resistant strains of pathogenic bacteria and the development of bacterial biofilms are major problems in the treatment of urinary tract infections. The increasing number of nosocomial bacterial strains in the hospital increases the postoperative bed-day, the frequency of readmission and the number of antibacterial drugs used. In light of increasing antibacterial resistance, the use of medical resources is dramatically increasing, which ultimately leads to an increase in the cost of treatment. Along with this, the selection of resistant strains brings to the fore both the rational use of antibacterial drugs and the search for alternative methods of therapy. This review of publications on the problem of bacterial biofilm formation in urological practice demonstrates updated information on the role of enzymes, probiotics, and bacteriophages in preventing biofilm formation on various medical biomaterials, such as urethral catheters.
Background. Urinary tract infections remain one of the urgent problems in the aspect of qualified medical care. The causative agents of nosocomial infections are becoming more and more resistant to the drugs used, while the rate of new drugs synthesis is lower than the rate of development of antibiotic resistance. Routine and empirical prevention of recurrent urinary tract infections is often ineffective. Aim. To study the efficacy and safety of intravesical application of the drug based on bacteriophages in therapy in patients with chronic recurrent cystitis. Materials and methods. A clinical study was carried out to study the efficacy and safety of the drug for intravesical administration based on bacteriophages in therapy in patients with chronic recurrent cystitis. The study included 75 patients who were divided into 3 groups in a 1: 1: 1 ratio. In the main group, the drug for intravesical administration based on bacteriophages, as well as rectal suppositories with bacteriophages were used; in the control group only a drug for intravesical administration based on bacteriophages or rectal suppositories with bacteriophages. On visits 1-4, all patients underwent a clinical blood test, general urine analysis, bacteriological urine analysis, as well as urine analysis by the polymerase chain reaction method. The analysis of the patients condition in groups was carried out according to the dynamics of main clinical symptoms changes, data from validated scales for assessing pelvic pain and urgency/frequency of urination and assessment of symptoms of acute cystitis (Acute Cystitis Symptom Score ACSS), as well as the dynamics of changes in objective parameters of laboratory studies and possible changes in sensitivity uropathogens to antibacterial drugs. Results. The average age of the patients included in the study was 50.6 years. In all 3 groups, bacteriological examination of urine showed a predominant growth of Escherichia coli (3104 CFU/ml). In the course of the study, there was a good tolerance to therapy, a decrease in clinical symptoms, as well as a significant decrease in the total score according to the pelvic pain scale and urgency/frequency of urination and the ACSS scale in all patients. Conclusion. The emergence of a large number of microorganisms resistant to various antibiotics and their rapid spread in the environment has led to an increase in scientific interest in bacteriophage therapy as an alternative method of treatment. The overall subjective effectiveness of the therapy in our study was more than 80%, safety - 100%. Further research will allow for a personalized approach to the treatment of infectious diseases of the urinary system.
Prostate cancer (РСа), being one of the leading causes of cancer mortality in men in Russia and in a number of other countries of the world, remains an urgent problem for modern oncourology, and the choice of surgical method is an important task for a surgeon. Such a pronounced interest in robot-assisted radical prostatectomy (RARP) in patients is driven by good tolerance and effectiveness of these surgical interventions, despite the fact that radical prostatectomy is considered to be the "gold standard" for treatment of patients with clinically localized РСа with regard to European Association of Urology data. The long-term oncological and functional results and the quality of life of patients after RARP deserve close attention and thorough study. According to the data presented in this article, it is obvious that RARP is the preferred method for surgical treatment of РСа, since oncological and functional results in the long-term follow-up are comparable to the results after radical prostatectomy, and according to some authors, these results are superior to the results of radical prostatectomy. The results of the study will allow to continue further introduction of RARP into clinical practice and its popularization as a method of surgical treatment of patients with localized PCa, which will reduce the length of hospital stay of patients, accelerate their medical and social rehabilitation, and improve the quality of medical care.The amount of data on the study of distant oncological and functional results of RARP as well as its superiority over other treatment methods is limited in medical literature, which prompted us to conduct our own research. Currently the urological clinic of the A.I. Evdokimov Moscow State University of Medicine and Dentistry continues work aimed at studying the longterm results of RARP in the first patients in Russia.
A prescribed amount of heat to be removed from biotissues during cryogenic treatment is currently calculated with the use of simple prediction models. Therefore, a significant distinction exists between the calculated and actual doses during the operation. For reliable simulation, it is necessary to have accurate thermal properties of human tissues in a wide low-temperature range, but in the literature the data regarding these thermal properties are inconclusive. In the present paper, the thermal properties of human prostate, kidney, liver, and pancreatic tissues are analyzed. Using differential scanning calorimetry (DSC), the specific heat capacity in the temperature range from –160 to 40oС, the latent heat of melting, and the initial ice melting temperature are measured. The moisture content and cryoscopic temperature of these tissues are also investigated. Due to the difficulties with getting access to a human cardiac muscle and large specimens of other human biotissues, in the present study equivalents (porcine tissues) are used on the basis of their high similarity to human biotissues. In this case, only the thermal conductivity of a porcine cardiac muscle is determined. Based on the measurement results, the thermal properties of the same tissue type and of different types (including healthy tissues and tumors) are compared. The adaptation of experimental data for simulation software is proposed. The impact of the accuracy in determining the thermal properties on the thermal diffusivity is analyzed. The prospects in predicting the thermal properties of different biological tissues are considered. Based on the data obtained, it is possible to more accurately simulate heat transfer during cryoexposure.
Since the first cases of coronavirus disease were detected in Wuhan (Hubei Province, China) in December 2019, the spread distribution of COVID-19 has expanded so much that the World Health Organization declared COVID-19 a pandemic. The most common symptoms of coronavirus infection are fever (85-90%), cough (65-70%), general weakness (35-40%), shortness of breath or feeling short of breath (15-20%); less common symptoms such as myalgia, headaches, sore throat and chills (10-15%). Currently, cases of infection are recorded in almost all countries of the world, there is a daily increase in the number of infected by an average of 100,000, and the death toll by average estimates is over 3,000,000. At present time, the "leading" position in the number of cases of COVID-19 detected belongs to the United States, in which over the entire observation period, more than 32,000,000 thousand cases were recorded. Another badly affected region is Europe, in which more than 43,000,000 thousand cases were recorded. The rapid growth in the number of newly diagnosed cases of COVID-19 dictates the need to search for optimal ways of providing medical care. It is obvious that inpatient practice carrying high risk of infection for patients as well as for medical stuff. Moreover, postoperative mortality rate in infected patients may be as high as 20%. Since the pandemic onset many authors and societies have provided recommendations on how the risk of infection during inpatient practice should be reduced. This article discusses the options for providing inpatient care to urological patients in a pandemic of the coronary viral infection COVID-19.
This paper provides the results of a study evaluating the efficacy and safety of etiotropic therapy in patients hospitalized with SARS-CoV-2 infection. Objective. Тo evaluate the efficacy and safety of favipiravir (Areplivir) in patients with coronavirus disease 2019 (COVID-19) and compare it with recommended standard therapy. Patients and methods. Two hundred men and women aged between 18 and 80 years with COVID-19 were randomized into this study. The experimental group included patients who received favipiravir, whereas the control group comprised patients who received causal therapy in accordance with the latest version of the temporary methodical recommendations of the Ministry of Health of Russia ‘Prevention, diagnosis, and treatment of coronavirus infection (COVID-19).’ The efficacy and safety of therapy were evaluated by assessing clinical improvement using the WHO Ordinal Scale for Clinical Improvement, clinical and laboratory parameters, findings of chest computed tomography (CT), and elimination of SARS-CoV-2. We also analyzed the frequency and type of adverse events, need for invasive and non-invasive ventilation, and death rates. Results. Our analysis has demonstrated significant benefits of favipiravir over standard therapy in terms of the time to clinical improvement (in the experimental group it was 4 days shorter on average), time to recovery, frequency of recovery after 10 days (44% of patients from the experimental group and 10% of patients from the control group had no clinical signs of the disease at this time-point), and frequency of virus elimination by day 10 of therapy. Treatment with favipiravir was associated with a significant improvement in the lung condition (according to CT), normalization of laboratory parameters, and saturation level. Favipiravir has demonstrated a good safety profile similar to that of standard therapy. There was no difference in the frequency of adverse events between the experimental and control groups. Conclusion. The use of favipiravir for the treatment of SARS-CoV-2 infection reduced the time to clinical improvement by 4 days on average compared to standard therapy, ensured improvement of the lung condition (according to CT scans), and facilitated virus elimination in more than 90% of patients, thereby promoting faster recovery. Favipiravir had a good safety profile and was well tolerated by patients. This treatment regimen was shown to be effective, sufficient, and clinically reasonable to achieve good outcomes. Timely initiation of therapy with favipiravir (Areplivir) improves disease prognosis and reduces the global socioeconomic burden of the current pandemic. Key words: COVID-19, Areplivir, coronavirus, causal therapy, favipiravir
The article presents for the first time the results of using organic substances belonging to the category of industrial waste as fertilizers for agricultural crops. The dairy industry has waste (hereinafter referred to as cake) generated during the cleaning of milk pipes and requiring additional costs for their disposal. Biogas plant products (hereinafter referred to as biofertilizer) obtained from fresh chicken manure by fermentation in an anaerobic environment are also promising as fertilizer for agricultural crops. Biofertilizer and cake were applied superficially at different plots at doses of 3 kg/m2 (30 t/ha), 6 kg/m2 (60 t/ha) and 9 kg/m2 (90 t/ha). The potato tubers of the ‘Gala’ variety of German selection were planted. It was found that the higher the dose of the used substances, the greater the yield of potatoes. The yield increase in the variant of 30 t/ha of cake was 5.9 t/ha of potato tubers, 60 t/ha of cake - 11.3 t/ha, and in the variant of 90 t/ha of cake - 15.5 t/ha. The use of biofertilizers also caused an increase in yield. The use of waste as fertilizers enhances the biological activity of soils, increases the content of mobile nutrients of plants of light gray forest soil.
During the spread of bacterial infections with extensive drug resistance, the potential of existing antibacterial drugs is significantly reduced. The medical community is seeking opportunities for the rational use of antibacterial drugs, the development of new drugs, as well as the use of alternative treatments for these infections. Aim. The objective of this study was to evaluate the effectiveness of the use of a complex antibacterial and analgesic drug based on bacteriophages in gel form during various instrumental studies and diagnostic procedures in order to minimize the risk of the urinary system infections complications. Materials and methods. The study included 235 women aged 18 to 75 years who underwent treatment at the Moscow State Clinical Hospital named after Spasokukotsky and in the clinic of urology of Moscow State University of Medicine and Dentistry from September 2019 to January 2020. During the manipulation, all patients of the main group (n=120) used a developed preparation based on bacteriophages, and in the control group (n=115), a topical gel based on chlorhexidine dihydrochloride and lidocaine hydrochloride was used. All patients before the manipulation, as well as 10 days after the manipulation, underwent bacteriological analysis of urine. Efficiency assessment was carried out on the basis of laboratory data obtained, as well as according to the visual analogue scale of the pain syndrome severity. Results. None of the patients in the main group showed intolerance, side effects and allergic reactions of the developed drug based on bacteriophages. Bacteriological analysis of urine received before manipulation in both groups showed the absence of clinically significant titers of pathogenic bacteria, while 1 week after manipulation the number of titers of pathogenic bacteria (104) was significantly higher in the control group (p0.04). In patients of the main group, the incidence of dysuria was lower compared with the control group (p0.05). Conclusion. The study showed good tolerance of the developed drug and its clinical effectiveness in reducing the number of symptomatic bacteriuria; severity of pain after undergoing manipulation was relatively lower in the main group of patients. Conducting multicenter studies with the inclusion of a larger number of patients in the future will reduce the economic costs associated with treating patients by reducing the number of cases of nosocomial infections and reducing postoperative time spent by patients in the hospital.
Электронные книги и статьи из каталога «ОСОБЕННОСТИ ЛЕЧЕНИЯ И ПРОФИЛАКТИКИ ПОСЛЕОПЕРАЦИОННОГО ПАРЕЗА КИШКИ И КИШЕЧНОЙ НЕПРОХОДИМОСТИ ПРИ ПРОВЕДЕНИИ РОБОТ—АССИСТИРОВАННОЙ ПРОСТАТЭКТОМИИ (100,00 руб.)». Скачайте в онлайн-библиотеке Rucont.
An increase in life expectancy and the number of older and elderly men, an improvement in the quality of medical care and socio-economic factors in most countries contributed to an increase in the number of patients with benign prostatic hyperplasia (BPH). Currently, improvement of the quality of life is the mainstay of strategy for managing patients with BPH, as well as prevention of complications and the need for surgery. In this regard, the pharmacotherapy with 1-adrenergic blockers (1-AB) is widely used as an effective method for improving lower urinary tract symptoms and reducing the risk of BPH progression. Given that the quality of life is becoming increasingly important in evaluating the efficiency of BPH treatment, including therapy in elderly patients, it is necessary to take into account its effect on sexual function, when choosing a particular drug. The use of 1-AB can be accompanied by side effects manifested by various sexual disorders. Alfuzosin does not adversely affect sexual function in men with BPH, may improve erectile and ejaculatory function and should be considered as the drug of choice, especially in sexually active men and patients who already suffer from worsening ejaculatory function while using another 1-AB.
The increase in the incidence of a new coronavirus infection has a significant impact on global health systems, shifting the vector of the COVID-19 pandemic in the direction of maximum conservation of resources Aim of the study is to summarize and analyze available data on the organization of treatment and surgical care for patients in the urology profile in the conditions of the COVID-19 pandemic Material and methods Materials published in the English-language literature were analyzed, which were searched in the Cochrane Library's, MEDLINE (PubMed, BioMedNet), Scopus and Biosis databases The following keywords were used: "COVID-19", "pandemic", "epidemic", "treatment of COVID-19 patients", "COVID-19 surgery" and "urology during a pandemic" Results and discussion Given the rapidly developing and difficult to predict scenario of the COVID-19 pandemic, existing global recommendations are sometimes temporary in nature, which must be adapted "individually" taking into account certain features of the modern health system, the rapidly changing epidemiological situation and the emergence of new clinical research data Рост заболеваемости новой коронавирусной инфекцией оказывает существенное влияние на мировые системы здравоохранения, смещая вектор борьбы с пандемией COVID-19 в сторону максимального сохранения ресурсов Цель исследования - суммирование и анализ имеющихся данных по организации лечения и оказанию хирургической помощи пациентам по профилю «Урология» в условиях пандемии COVID-19 Материал и методы Проанализированы материалы, опубликованные в англоязычной литературе, поиск которых проведен по базам данных Cochrane Library's, MEDLINE (PubMed, BioMedNet), Scopus и Biosis, использованы ключевые слова: «COVID-19», «пандемия», «эпидемия», «лечение пациентов с COVID-19», «хирургия COVID-19» и «урология во время пандемии» Результаты и обсуждение Учитывая быстро развивающийся и сложно прогнозируемый сценарий пандемии COVID-19, существующие мировые рекомендации подчас носят временный характер, их адаптация должна происходить индивидуально, с учетом тех или иных возможностей современной системы здравоохранения, стремительно изменяющейся эпидемиологической обстановки и появления новых данных клинических исследований