We describe a twenty-six year old patient who presented us with a dorsally retracted`hidden' penis, which was entrapped in scar tissue and prevesical fat, 20 y after a pelvic fracture with symphysiolysis. Penile`lengthening' was performed by V±Y plasty, removal of fatty tissue, dissection of the entrapped corpora cavernosa followed by ventral ®xation.

The article contains a review of domestic and foreign literature on the assessment of the clinical significance of inhibin B in the male factor infertility. Modern scientific evidence is given that inhibin B plays an important role in the regulation of spermatogenesis and can be an independent predictor of early violations of spermatogenesis, damage to the spermatogenic epithelium, as well as an important indicator in the identification of disorders of spermatogenesis.

The article presents clinical studies of low-intensity laser irradiation (LILI). The effect of laser therapy in male infertility is shown. Russian and foreign sources of literature on this topic have been analyzed. (For citation: Moskvin SV, Borovets SYu, Toropov VA. Сlinical justification of laser therapy efficiency of men’s infertility. Urologicheskie vedomosti. 2018;8(1):47-55. doi: 10.17816/uroved8147-55).

Male infertility is a multifactorial syndrome, which includes a wide range of disorders. It is a symptom of many different pathological conditions affecting both the reproductive and other body systems: endocrine, nervous, blood-vascular, and immune systems. Low level laser therapy is a method of modern physiotherapy, in which the impact is carried out by low-intensity laser irradiation (LILI). It is widely used in all areas of modern medicine, due to its high efficiency, simplicity of use, the absence of contraindications and side effects. The results of russian and foreign experimental studies on the article subject were analyzed. A definite conclusion is drawn that low level laser therapy should be used as much as possible in the complex treatment of men with infertility, since the effectiveness of the method is not just high, but often has no alternatives. At the same time, the available low level laser therapy techniques should be widely used: locally, rectally, laser acupuncture, ILBI (intravenous laser blood irradiation), on the projection of various organs, paravertebrally, etc. All parameters of laser action should be set (wavelength; mode of operation; frequency for pulsed lasers; power; power density, determined by the method of exposure; exposure, localization), which are specified by the relevant regulatory documents and clinical recommendations. (For citation: Moskvin SV, Borovets SJu, Toropov VA. Experimental justification of laser therapy efficiency of men's infertility. Urologicheskie vedomosti. 2017;7(4):44-53. doi: 10.17816/uroved7444-53).

The review summarizes the results of 30-year clinical application of the prostatic bioregulatory peptide Prostatilen. The data from experimental studies, testifying for the high biological activity of the drug is shown, the mechanisms of its therapeutic action are described. The review presents the results of clinical studies demonstrating the effectiveness and pathogenetic justification of the prescription of Prostatilen in the treatment of chronic prostatitis, benign prostatic hyperplasia, infectious and inflammatory diseases of the kidneys and urinary bladder, as well as of several other diseases. The experience of Prostatilen application in the urological clinic of First Pavlov Saint Petersburg State Medical University is shown.

Introduction. Due to insufficient efficacy of medical therapy of idiopathic secretory male infertility there is a need to develop and apply more resultative methods of treatment. The aim of our study was to assess the efficacy of low-level laser therapy (LLLT) in red spectrum on sperm parameters, sperm DNA fragmentation (SDNAF) and MAR-test rate in men with idiopathic infertility. Patients and methods. 85 men with idiopathic infertility were examined, 50 of them (first group) were treated with LLLT and 35 (second group) didnt have course of LLLT. Average age of patients of the first and second groups was 31.4 1.3 and 32.3 1.4 years. LLLT was performed in red spectrum on a Rubin-C device (Russia). 10 laser therapy procedures were carried out every two days with active luminescence for 10 minutes of both testicles. Male hormone panel, semen analysis, MAR-test, SDNAF were assessed before and after the treatment. Results. LLLT in patients of the first group resulted in significant increase in ejaculate volume, sperm viability, number of morphologically normal sperm forms (by an average of 11, 9 and 23% respectively), and active mobile sperm forms by an average of 14 and 19% one and two months after the therapy respectively. In 12 patients of the first group with initially increased SDNAF its level became normal after the treatment. Significant decrease of MAR-test we searched out in patients of the first group with its initial level less than 30%. As a result of the treatment, pregnancies developed in 10 (20%) out of 50 couples in the first group. Conclusions. LLLT in red spectrum leads to significant improvement of sperm quality in patients with idiopathic infertility, normalizes sperm DNA-fragmentation level and decreases MAR-test level.

INTRODUCTION: Autoimmune infertility is diagnosed in 515% of men. Currently applied methods of medical therapy of autoimmune male infertility are not very effective, which requires the development of new ones and creation of predictive algorithms for their efficacy. The aim of our study was to evaluate the influence of low-level laser therapy (LLLT) in infrared spectrum on MAR-test rate and sperm fertile properties in men with autoimmune infertility, develop ways to predict the efficacy of this therapy. PATIENTS AND METHODS: 47 men with autoimmune infertility were examined. 31 of them (1st group) underwent course of LLLT in infrared spectrum (10 procedures), and 16 patients (2nd group, comparison) had placebo-laser therapy sessions (10 procedures). MAR-test value, main semen parameters and sperm DNA fragmentation were assessed before and after the treatment. For creation of LLLT efficacy algorithm we used discriminate analysis. RESULTS: In patients of the 1st group we indicated statistically significant decrease of MAR-test by an average of 19% immediately after the course of procedures, and by 33% within two months after the end of the treatment, at its initial level 60% or lower. LLLT contributed to improvement of the semen fertile properties, pregnancy developed in the natural reproductive cycle in 19% of couples. We developed math model for prediction the efficacy of LLLT in infrared spectrum of autoimmune male infertility. CONCLUSION: LLLT in infrared spectrum of male autoimmune infertility leads to MAR-test value decrease at its initial level less than 60%; improves sperm fertile properties. It is appropriate to use before LLLT predictive algorithm of its efficacy developed by us.

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