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We observed 66 patients with chronic pyelonephritis in the exacerbation phase who received standard treatment with antibacterial drugs based on susceptibility of causative agents. All patients were randomly divided into two groups. Patients of study group have received phytodrug prolit super septo 2 capsules 2 times a day for 4 weeks in addition to standard treatment. Patients of control group have received standard therapy only. As a result of treatment, high effectiveness of therapy and reduction of length of treatment was noted in the study group. There were no subjective symptoms of disease in all patients at the end of treatment. Reduction of leykocituria and bacteriuria, normalization of body temperature, normalization of blood analysis and restoration of intrarenal blood flow were observed earlier in the study group compared with the control group. Recurrence of disease 3 months after end of treatment was not revealed in none of the patient in the study group, whereas it was noted in 14% of patients in the control group.

The study was aimed to the evaluation of the efficacy of prolit in patients with urolithiasis and localization of stone in the ureter. 225 patients with various localization of solitary ureteral calculi ranged from 0.4 to 0.7 cm were under observation. Depending on the treatment, the patients were divided into two groups. The study group (n = 175) has received prolit for 30-40 days, control group (n = 50) has received standard therapy. As a result of treatment, spontaneous discharge of ureteral stone was registered in 158 (90.3%) patients of study group and only in 21 (42%) patients of control group. Renal colics during treatment were recorded four times more often among patients of control group. The intensity of pain in patients receiving prolit was less pronounced.

A total of 76 patients with chronic abacterial prostatitis (CAP) in combination with erectile dysfunction were divided into two groups. Clinical symptoms of CAP and severity of erectile dysfunction were the same in both groups. Patients of the study group (n = 36) received pathogenetic treatment (vitaprost plus physiotherapy) and impase. The control group (n = 40) received vitaprost and physiotherapy. The results of the treatment showed that impase addition to combined treatment of CAP patients with erectile dysfunction significantly improves erectile function: 80.6% patients given impase raised their score by International Index of Erectile Function Scale to normal (26 points and higher). Impase efficacy increased with prolongation of the treatment from 4 to 12 weeks.

Our study of efficacy of Prolit-septo phytotherapy following extracorporeal shock-wave lithotripsy (ESWLT) in patients with nephrolithiasis has demonstrated that Prolit-septo noticeably reduces the time of evacuation from the urinary tract of the destructed stone fragments as well as renal colic incidence and renal inflammation exacerbation.

Pharmacotherapy of prostatic adenoma is based in present-day practice primarily on two basic groups of medicines--inhibitors of 5alpha-reductase and blockers of alphal-adrenoreceptors. Our trial included 98 patients with prostatic adenoma aged 59-79 years given combined treatment with finasteride (inhibitor of 5alpha-reductase) made in Hungary (prosteride, Gedeon Richter) and an uroselective blocker of alpha1-adrenoreceptors sonisin (Gedeon Richter, Hungary). Prosteride was given for 12 months, sonisine--for the first 6 months of combined treatment. Positive results were achieved in 97 (99%) of 98 patients. After 12-month combined treatment symptoms of the disease reduced by IPSS from 17.9 +/- 1.8 to 3.9 +/- 0.9 points, Qmax rose from 8.8 +/- 0.3 to 14.6 +/- 0.3, residual urine volume diminished from 91.7 +/- 8.5 to 31.7 +/- 4.4, the size of the prostate reduced from 72.4 +/- 2.9 to 50.6 +/- 3.7, quality of life improved 2-fold. Combined administration of finasteride (prosteride) and alpha1-adrenoblocker tamsulosine (sonisine) meet three principles of pharmacotherapy of prostatic adenoma: prevents progression of the disease and surgical treatment, relieves symptoms and improves quality of life.

The efficiency of afala in the therapy of chronic abacterial prostatitis was demonstrated. The preparation considerably improved urodynamics, reduced pain syndrome and inflammation, decreased prostate volume, improved patient's quality of life, and restored microcirculation in the prostate. No changes in blood, urine, and ECG parameters were noted. No side effects requiring afala withdrawal were recorded.

Phytotherapy with prolit was given to 95 patients with ureteroliths (size of the concrrements 0.4-0.6 cm). A 40-day treatment resulted in elimination of the concrements from the ureter in 89 (93.7%) patients. Prolit had a positive action on metabolism in urolithiasis patients: lowered hypercalciuria, uric acid in the blood, oxalates and uric acid in urine. This is important for prevention of recurrent lithogenesis which for 3 years after the treatment occurred only in 4 (4.2%) patients.

Optical coherence tomography (OCT) was tested in diagnosis of bladder cancer (BC) in 100 BC suspects. This method showed higher sensitivity (by 16%) in diagnosis of BC compared to standard cystoscopy as it more presicely identified squamous intraepithelial and noninvasive tumors. The analysis of OCT images was made with a noval computer program of filtration and color overlay. This improved quality of the image allowed verification or rejection of BC, its localization on urinary bladder wall.

Efficacy and safety of a new bioregulatory peptide vitaprost forte was studied in 30 patients with prostatic adenoma. It is shown that this drug relieves clinical symptoms of the disease, improves quality of life, uroflowmetric parameters, reduces the size of the prostatic gland. Vitaprost forte is more effective in patients with prostatic adenoma combined with chronic prostatitis.

Finasteride effect before transurethral resection (TUR) of the prostatic gland was studied in 88 patients with prostatic adenoma (PA). Forty seven patients received prosteride (Gedeon Richter), forty one patients - proscar (MSD) in a dose 5 mg/day for 3 months. Finasteride reduced blood flow in prostatic tissue, density of the vascular plexus, epithelium/stroma coefficient from 1.26 to 0.84. This decreased intraoperative blood loss, postoperative hematuria, TUR duration, postoperative rehabilitation, number of early and late TUR complications.

We studied efficacy of a new cytomedine drug--vitaprost--in 98 patients with chronic abacterial prostatitis. Vitaprost was found to relieve symptoms of the disease, improved blood flow in the prostate, normalized blood rheology and immunological indices, increased mobility of spermatozoa in ejaculate.

Prostatilen was used in 1115 patients with chronic pyelonephritis and prostatitis. It is shown that prostatilen has a corrective effect on hemocoagulation and immunity disorders, restores microcirculation, suppresses inflammation in the kidney and prostate. Thus, prostatilen is a pathogenetically sound drug for treatment in urogenital inflammation while in chronic prostatitis it can be used as a basic therapy.

A long-term proskar (finasterid, MSD) treatment was given to 428 patients with benign prostatic hyperplasia (BPH). The response was achieved in 93.8-95.8% patients. The duration of the course should be at least 12 months. Side effects were rare: libido, erection, ejaculate volume diminished in 5.1, 5.6 and 4.2% patients, respectively. 20 patients were operated on after proskar therapy. Such pretreatment reduced glandular prostatic tissue.

Combined treatment including alpha-1a-adrenoreceptor blocker tamsulosine was given to 92 patients with chronic prostatitis having marked urination disorders (IPSS score 12.1 +/- 2.4). The response was achieved in 98.9% of cases. There was attenuation of the urination symptoms, speeding up of the maximal urine flow, decreased amount of the residual urine. It is recommended to add alpha-1-adrenoreceptors to combined treatment of chronic prostatitis patients with urination disorders.

Augmentin (amoxycillin/clavulanate) was used in the treatment of 88 patients with mild and moderate infections of the urogenital organs. The drug was administered in a single dose of 375 mg thrice daily for 6 to 12 days. The renal function in 62 patients (70.5 per cent) was normal and in 26 patients (29.5 per cent) the chronic renal insufficiency latent stage was stated (the decrease of the glomerular filtration up to 55-70 ml/min). When augmentin was used before lithotripsy in 35 patients for 6 days, all the laboratory and clinical indices came to normal in 30 patients (85.7 per cent) and only in 4 patients (11 per cent) leukocyturia and in 1 patient bacteriuria persisted. When augmentin was used in 26 patients before adenomectomy or after transurethral resection for 7 to 9 days, all the indices came to normal in 13 patients (50 per cent) and in the other 13 patients leukocyturia persisted, while no bacteriuria was recorded. When augmentin was used in the treatment of 19 patients with pyelonephritis exacerbation during the postoperative period for 7 to 12 days, all the clinical and laboratory indices came to normal in 13 patients (68.4 per cent), leukocyturia persisted in 6 patients and bacteriuria persisted in 2 patients. When augmentin was used in the treatment of 8 patients with acute orchiepididymitis for 7 to 10 days, the clinical effect was stated in all the patients. As a rule, the drug was well tolerated by the patients.

The authors have performed urodynamic investigations pressure-flow in 39 males (mean age 57.9 +/- 1.8 years) to detect infravesical obstruction. Interpretation of the findings rested upon Abrams-Griffits index (AGI) derived by the formula AGI = PdetQmax - 2xQmax, where Qmax is the maximal speed of urine flow and PdetQmax is detrusor pressure when the maximal urine flow is reached. Definite conclusion on the presence or absence of infravesical obstruction was feasible for 21(53.8%) of 39 examinees, was not possible for 18(46.2%) patients. Statistical processing yielded non-linear relationship between PdetQmax and Qmax (cubic parabola) requiring correction for AGI (coefficient K calculated according to the formula K = 58.7 - 0.00554x(Qmax)3). This correction for nonlinearity K allowed classification of 11 out of 18 patients who were initially indefinite. By standard AGI technique, the uncertainty zone made up 46.2% while correction for nonlinearity reduced this zone to 18.0% (p < 0.008). Thus, the account for nonlinearity of the relationship between PdetQmax and Qmax may contribute to a rise in diagnostic value of urodynamic investigations.

Patients with benign prostatic hyperplasia (BPH) received proscar (finasteride) in daily dose 5 mg for: at least 6 months (n = 206, 20.4%), 12 months (n = 513, 50.9%), 24 months (n = 164, 16.3%), 3-4 years (n = 125, 12.4%). Because the size of the prostatic gland reduced significantly (by 22%) only after one year of proscar treatment, the duration of this treatment should be continued for at least 12 months, in some patients as long as the whole life. The duration of the treatment should be decided for each individual patient. The improvement after the proscar treatment was observed in 95% of the patients treated for benign prostatic hyperplasia.

88 patients with benign prostatic hyperplasia (BPH) were given the inhibitor of 5 alpha-reductase proscar (finasteride, Merck and Co. Inc., USA) for 12-14 months and uroselective blocker of alpha-adrenoreceptors alfuzosin (dalfas, Synthelabo Group, France) for 4-5 months. The patients were examined before the combined treatment and on the treatment month 1, 3, 6 and 12. The proscar plus alfuzosin combination produced a response after 2-3-week treatment due to alpha-blocker Further, the effect was enhanced by the action of inhibitor of 5 alpha-reductase. Combination of alfuzosin with proscar meets three principal requirements demanded of BPH chemotherapy: improves urination, inhibits the growth of adenomatous tissue, diminishes the size of the enlarged prostate.

A daily dose of alfusosine (an uroselective blocker alpha-l-adrenoreceptors produced as dalfas by Synthelabo Group, France) was given for 12 weeks to 124 patients with benign prostatic hyperplasia. The patients were examined before the treatment and on the treatment week 4, 8 and 12. The response (improved quality of life, higher rate of urine flow, smaller amount of residual urine in the bladder) was achieved in 120 (96%) patients. Alfusosine effect was more pronounced in patients with severe defects of urination. The drug was well tolerated, side effects observed in 7(5.6%) patients were mild and did not require treatment discontinuation. Alfusosine is indicated in benign prostatic hyperplasia with moderate infravesical obstruction, significantly disturbed urination caused by hypertonicity of bladder cervix smooth muscles, posterior urethra and prostate.

Bladder tumors morphological and treatment efficacy data obtained on 246 relevant patients over 60 years of age support the benefit of surgery in combined treatment of bladder cancer in elderly patients in spite of difficulties caused by concomitant diseases and defective adaptation. High-grade poorly differentiated cancer of the bladder causing more frequent recurrences and metastases occur in patients over 60 two times less often than in younger patients. Transurethral electroresection of the bladder with removal of the tumor followed by intravesical immunoprophylaxis of the recurrences is thought a radical treatment for elderly patients with bladder cancer stage T1 and T2. At stage T3 cystectomy is preferable. Positioning of the ureters into the straight ileocecal angle provides the best results in urine derivation after cystectomy. Transurethral electroresection is optimal in the treatment of elderly patients with bladder cancer stage T1-T2 and prostatic adenoma. Indications to transurethral adenomectomy in the presence of bladder cancer must be maximally extended as adenomatous nodes provoke infravesical obstruction and speed up the recurrence of bladder cancer.

The results of investigation of calving features in 371 cows of Ukrainian beef cattle were summarized. Variance and correlation analyses of factors affecting calving in cows were used. Breeds, pedigrees of parents and progeny, assessment of complicated and lethal calvings, duration of pregnancies and mass of newborns were registered. The influence of selection type on the normal calving was shown.

Responses to immunoprophylaxis of superficial bladder cancer in 94 post-transurethral resection patients were analyzed. Once-a-week intravesicular instillations of BCG vaccine in a dose 100 mg diluted in 50 ml of physiological solution were initiated 30 days after transurethral resection. The main course of therapy comprised 8 instillations made outpatiently. Subsequently the patients underwent a maintenance immunoprophylactic course once a month in the same dose (100 mg) for a year since transurethral resection. 3 years after therapy gave rise to the tumor recurrences in 12 (12.8%) out of 94 patients contrary to 37 (43.0%) patients out of 86 patients. BCG is able to prevent recurrences of superficial bladder cancer subjected to transurethral resection in the majority of patients.

Under analysis were results of operative treatment of 291 patients aged from 7 to 76 years with traumas and strictures of the urethra at the period from 1970 to 1990. Totally 325 operations have been performed. The primary suture of the urethra was successfully used in 8 of 36 patients with trauma of the urethra. Tunneling of the urethra for its strictures which was widely used in the clinic up to 1980 gave 46.2% of recurrences during the first 3 months after operation. It required the surgical methods to be changed. During the recent 11 years 161 operative interventions have been performed: 103 (64.0%) resections of the urethra, 45 (28.0%) internal optical urethrotomies and transurethral resections (TUR) of scarry tissues, 7 (4.3%) epidermoplasties of the urethra and 6 (3.7%) tunnelings of the urethra. The amount of recurrences dropped up to 13.7%. The primary suture of the urethra is necessary for penetrating ruptures of the urethra if the patient's state allowed. Resection of the urethra must be the operation of choice in patients with strictures and obliteration of the urethra. The endoscopic methods of treatment (urethrotomy and TUR) are indicated for short strictures and scarry deformity of the posterior urethra after operations on the prostate. The epidermoplasty is expedient for lengthy strictures.

Conventional methods of chronic prostatitis treatment aimed at destruction of pathogenic microflora have certain shortcomings. A promising approach is biologic control of prostatic function. A trial was performed of a new drug prostatilen which is a polypeptide isolated from the animal prostate. The study included 307 patients with chronic prostatitis of 4 mon to 36 years duration. Their age ranged from 18 to 74 years. The drug dose of 5-10 mg was administered once a day i.m. for 5-10 days. The immediate effect and long-term one were measured upon the treatment completion and 4-6 months later. A clinical effect manifested following 2-3 injections and grew to maximal values after 5-6 ones. In rare cases the treatment lasted up to 8-10 injections. The drug promoted disappearance or attenuation of the symptoms in 96.7% of the patients. Positive shifts were achieved in pain complaints, diuresis, sexual function, sleep, general condition. The subjective response agreed with objective laboratory and urodynamic evidence. Prostatilen proved effective for chronic prostatitis because it is tolerable, induces no side effects, beneficial in combinations with other modalities in management of this persistent and prone to recurrences disease.

The authors observed 812 patients with nephrolithiasis who underwent 876 sessions of shock-wave lithotripsy on Sonolith-3000 lithotriptor supplied with an ultrasonic system of the stone localization. The size of nephroliths ranged from 0.7 to 4.2 cm. Large-size nephroliths required repeated sessions and pretreatment establishment of the stent. The procedure proceeded without anesthesia. Subsequent renal colic was reported in 126 (15.5%), an exacerbation of pyelonephritis in 45 (5.5%), subcapsular hematoma in 4 (0.5%) of the patients. 790 patients showed clinical response (97.3%), with a complete destruction of the stone in 446 (54.9%) and partial one in 344 (42.4%) cases. 27 subjects were treated in outpatient setting. According to the authors, lithotripsy is contraindicated in urinary tract obstruction below the stone, renal failure, chronic pyelonephritis in the active phase of inflammation, marked impairment of cardiac rhythm.

The present work is dedicated to the study of the acupuncture analgesia efficiency in ambulatory practice in treatment of chronic post-traumatic pain syndrome as well as the comparative characteristics of the acupuncture analgesia and electric analgesia in treatment of this pathology. There have been analyzed the results of treatment of the pain syndrome after the traumata of the lower limbs by the IRT method (106 patients), compared the terms and the results of the treatment by the above mentioned methods as well as by the separate acupuncture analgesia and electro-analgesia methods. As a result, it should be noted that the IRT method is more effective in treatment of the chronic pain syndrome as compared with the common traditional methods. The electroanalgesia method, in turn, contributes to more rapid pain soothing and restoration of the vegetative and trophic functions than acupuncture.

The authors reviewed the results of surgical management of 233 patients aged 8-76 years who had suffered urethral strictures. A total of 266 operations were made in the period of 1970-1989. Urethral tunneling which had been widely used in clinical practice for strictures of the urethra until 1980 yielded 91.2% recurrences of the disease, which made surgeons modify the surgical policy. During the past decade 127 patients with urethral strictures and obliterations have undergone 138 surgical interventions: 91 (65.9%) urethral resections, 34 (24.6%) internal optical urethrotomies and transurethral resections of scarring tissue, 7 (5.1%) cutaneous urethral plastic surgeries and only 6 (4.4%) urethral tunnelings. The number of relapses was reduced to 13.4%. The authors consider that urethral resection should be the operation of choice in urethral strictures and obliterations. Endoscopic treatment techniques (urethrotomy and transurethral resection) are indicated in short strictures and scarring deformity of the posterior urethra after prostate operation. It is advisable to apply cutaneous urethral plastic surgery in case of extended strictures.

The data on the complicated character of endometriosis treatment, in females with the involved urinary system in particular, were discussed. The reported incidence of the affected urinary system in females with endometriosis ranged from 1-2 to 18.5 per cent. Out of 57 patients followed up by the authors, the ureter involvement was diagnosed in 52.6 per cent. For timely diagnosis, the authors recommended the performance of urological examinations prior to the nonoperative treatment. In case of urodynamic disorders, surgical intervention was advised to be the first, its extent depending on affection patterns and the performance of the upper urinary tract. A 1-3-year follow-up evidenced normal renal and urodynamic functioning in operated-on patients.

Based upon the present-day theories and their personal clinical experiences (236 patients with urgent adenomectomies) the authors show the expediency of the urgent radical operative treatment of patients with adenoma of the prostate complicated by ischuria.