This prospective, controlled study was undertaken to evaluate the early urodynamic and symptomatic impact of the lipido-sterolic extract of Serenoa repens (Permixon 1 1 ) in the treatment of patients with benign prostatic hyperplasia (BPH).A total of 75 patients, aged 52 ± 78 y with lower urinary tract symptoms due to mild/moderate BPH (mean International Prostate Symptom Score (I-PSS) 8.2) were included in the study, of which 57 received Permixon 1 1 160 mg twice daily for 9 weeks. Urodynamic evaluation, including maximum urinary¯ow rate (Q max ) and detrusor pressure (DP), was performed at baseline and endpoint. Prostate volume and post-void residual urine volume were assessed by transrectal and transabdominal ultrasound respectively. In addition, the I-PSS and its associated quality of life (QoL) score were determined and adverse events were recorded.Baseline parameters were comparable between the active treatment and control groups. After 9 weeks of Permixon 1 1 treatment Q max increased (6.0%, P`0.001), and there were reductions in DP at maximum¯ow (12.8%, P`0.001), opening DP (12.6%, P`0.001), and residual urine volume (12.6%, P`0.05). In addition, the I-PSS and QoL score both decreased signi®cantly from baseline in the active treatment group (26.8% and 18.2% respectively, P`0.001). None of these parameters improved signi®cantly in control patients. There were also improvements in prostate volume (2.7%) and maximum DP (5.2%) in the Permixon 1 1 group which did not reach signi®cance. Three patients receiving Permixon 1 1 experienced gastrointestinal disturbances but these did not lead to withdrawal or require additional therapy.In patients with mild/moderate BPH, Permixon 1 1 treatment reduced infravesical obstruction and produced a rapid improvement in urodynamic parameters and symptoms. The drug was well tolerated. These data support the use of Permixon 1 1 as ®rst-line therapy in patients with uncomplicated symptomatic BPH. Prostate Cancer and Prostatic Diseases (2000) 3, 195±199.

Aim of the study.Estimation of the decrease of urinary bladder contractility in patients with benign prostate hyperplasia (BPH). Patients and methods.In 146 BPH patients (mean age 62,1 0,8) urodynamic investigation including uroflowmetry and pressure-flow study was performed. The results of miction cystometry were evaluated using Shafer nomogram, the emptying idex was calculated as relation of voiding volume to maximal cystometric capacity. Results.56,2% BPH patients showed the decreased detrusor contractility. The results of urinary bladder contractility estimation by Shafer nomogram are dependent on the degree of infravesical obstruction (IVO). The emptying index is not related to the presence and degree of IVO and characterizes the degree of urinary bladder emptying as well as contraction duration. Concomitant lumbar osteochondrosis and diabetes detoriates urinary bladder emptying. Reliable contractility estimation may only be performed based on urodynamic study since basic BPH patients examination is not sufficient. Conclusion.In has to be considered during treatment strategy planning that in many BPH patients low urinary truct disfunction is determined by the decrease of urinary bladder contractility and not by IVO.

К = 58,00554 × (Qmax) 3 , позволи-ло уменьшить число пациентов в «зоне неопределенности» до 7 (18 %).Ключевые слова: уродинамика; инфравезикальная обструкция; индекс Абрамса-Гриффитса; иссле-дование давление-поток. УДК 616.62-008.227 +616-072 Поиск надежных способов диагностики и ле-чения инфравезикальной обструкции (ИВО) про-должает оставаться весьма актуальной проблемой урологии. Известно, что наиболее частой причиной ИВО у мужчин является доброкачественная гипер-плазия предстательной железы (ДГП). Для многих урологов понятия ДГП и ИВО являются синонима-ми, хотя хорошо известно, что далеко не всегда при ДГП имеется ИВО [1, 2]. Установлено, что ИВО вы-являют только у 50-75 % больных с клиническими симптомами ДГП [3, 4]. Другими причинами по-явления симптоматики, характерной для ДГП, по-мимо ИВО, могут быть снижение или повышение сократительной активности детрузора, гиперчув-ствительность мочевого пузыря и ряд других дис-функций нижних мочевых путей [5, 6, 7].Общепризнано, что лечение больных с ИВО долж-но начинаться как можно раньше, еще до возник-новения осложнений болезни. В этой связи весьма важным является раннее выявление ИВО для диффе-ренциальной диагностики с дисфункциями мочевого пузыря и определения тактики лечения больных [8].Наиболее употребительным и широко распро-страненным методом, применяемым для диагности-ки ИВО, является урофлоуметрия. Преимуществами этого исследования являются простота и неинва-зивность. Однако отмечено, что при использовании для диагностики ИВО только урофлоуметрии вы-сока частота как ложно-отрицательных результатов (7-25 %) [8], так и ложно-положительных (25 %) [9]. Показатели урофлоуметрии без одновременного определения детрузорного давления не позволяют отличить ИВО от сниженной сократительной актив-ности мочевого пузыря, поэтому ее рекомендуют ис-пользовать как скрининг-метод для отбора больных для более расширенных уродинамических иссле-дований, в частности для исследования «давление-поток» (pressure

OBJECTIVE. The study aimed to develop diagnostics and treatment of urinary dysfunction in patients with unsatisfactory results of surgery of benign prostatic hyperplasia (BPH). MATERIAL AND METHODS. The urodynamic studies were made for 93 (72,7 %) patients after transurethral resection of the prostate and 35 (27,3 %) patients after open adenomectomy. All the patients had urinary dysfunctions after surgery of BPH. RESULTS. Detrusor hyperactivity was revealed in 51 (39,9 %) patients. Detrusor hypoactivity was noted in 21 (16,4 %) patients. Combination of detrusor hyperactivity during storage phase and detrusor hypoactivity during emptying phase had 25 (19,5 %) patients. Infravesical obstruction was detected in 22 (17,2 %). Urgent incontinence was diagnosed in 10 cases. There were 9 patients with signs of stress and condition combined with predomination of stress component. Treatment depended on the causes of urination dysfunction. CONCLUSIONS. Results of urodynamic studies allowed doctors to implement pathogenically verified therapy of urinary dysfunction after surgery of benign prostatic hyperplasia and improve its efficacy.

The review article is devoted to the usage of extracorporeal magnetic stimulation in the treatment of urological diseases. Based on the analysis of scientific publications in the PubMed, Medscape, Google Scholar databases, modern data on the mechanism of the therapeutic effect of this method, the method of performing the procedure, the results of clinical studies of its effectiveness in the treatment of urinary incontinence, bladder hypoactivity, chronic pelvic pain syndrome, erectile dysfunction and premature ejaculation are presented.

No abstract

Introduction. Transurethral resection (TUR) of the prostate remains the gold standard for surgical treatment of patients with benign prostatic hyperplasia (BPH). A proportion of patients who have undergone a prostatic TUR for BPH continue to have urinary dysfunction. Aim. The aim of the study was to determine the incidence of urinary disorders and quality of life in the long-term postoperative period in patients after prostatic TUR. Materials and methods. We interviewed and surveyed 176 patients who underwent prostate TUR between 2018 and 2021. To determine the prevalence of lower urinary tract symptoms (LUTs) after prostate TUR, we surveyed 176 patients between 12 and 36 months after surgical treatment. The age of the patients surveyed ranged from 47 to 89 years. Results. 53.4% of the patients were completely satisfied with the surgical treatment and 46.6% reported various urinary disorders. According to the questionnaire about the IPSS scale 47.7% patients moderate to severe symptoms persisted after prostate TUR. In 21.6% of the patients quality of life due to urinary disorders was unsatisfactory, poor and very poor. However, moderate and severe symptoms as well as worsening quality of life were more often observed in the older age groups. Conclusions. After prostate TUR, 10.2% of patients have severe and 37.5% have moderate urinary dysfunction in the long-term postoperative period. These urinary disorders worsen quality of life and are more frequent in older patients.

ВВЕДЕНИЕНарушение функции почек встречается, по раз-ным данным, у 15-72 % больных доброкачествен-ной гиперплазией предстательной железы (ДГПЖ), что связано с нарушением уродинамики верхних мочевых путей и развитием пиелонефрита [1, 2, 3, 4]. Большой разброс данных относительно часто-ты нарушения функции почек у больных ДГПЖ связан с несколькими факторами: разной степенью компенсации нижних мочевых путей, не всегда стандартизованными методами изучения функции почек, возрастными особенностями функциональ-ных показателей почек.В отечественной и зарубежной литературе нами обнаружено только одно исследование, посвящен-ное связи между функцией почек и состоянием де-трузора у больных ДГПЖ [7]. Чаще уделяли внима-ние изучению связи уродинамических показателей и функции почек у больных с нейрогенными рас-стройствами мочеиспускания и у детей с клапана-ми задней уретры [8, 9; 12].Целью настоящей работы явилось исследование наличия зависимости между уродинамическими показателями и показателями, отражающими функ-циональное состояние почек у больных ДГПЖ. ПАцИЕНТы И мЕТоДыДля уточнения особенностей изменения функции нижних мочевых путей (НМП) и почек 291 больно-му ДГПЖ, средний возраст 61,3 ± 0,7 лет, было про-ведено комплексное урологическое обследование, включавшее в себя ультразвуковое исследование почек, определение уровня креатинина и мочевины сыворотки крови и уродинамическое исследова-