Benign prostatic hyperplasia (BPH) is one of the most common benign diseases in men, as it leads to an enlarged prostate, the development of lower urinary tract symptoms, and worsens the quality of patient’s life. Surgical treatment is indicated to patients after non-effective drug treatment. Most often, transurethral resection of the prostate (TURP) is used. The objective: to improve the results of TURP in patients with BPH and acute urinary retention by optimizing antibacterial prophylaxis of postoperative complications in the early postoperative period. Materials and methods. An analysis of the surgical treatment of 179 patients with BPH with acute urinary retention after TURP was performed. The age of the patients varied from 51 to 84 years old, the average age was 64.9±5.1 years. All patients had a complex urological examination in the preoperative period. The patients were divided into two groups: I group – 85 patients after operation who were prescribed ceftriaxone in the early postoperative period; II group – 94 patients who received levofloxacin in the early postoperative period. Results. It was determined that complications occurred in 43 (24.1%) patients in the early postoperative period. Long-term macrohematuria was found in 23 (12.9%) patients, exacerbation of chronic pyelonephritis was in 13 (7.3%) patients after operation, acute urethritis developed in 7 (3.9%) patients, acute orchiepididymitis – in 9 (5, 0%) patients. It has been proven that the total frequency of complications in patients with BPH who received levofloxacin in the early postoperative period was statistically significantly lower than in the patients who were prescribed ceftriaxone. Conclusions. The use of levofloxacin for the prevention of early postoperative complications after TURP in patients with BPH complicated by acute urinary retention improves the results of surgical treatment by reducing the frequency of postoperative complications by 60%.
Despite the progress in the field of etiology, pathogenesis and development of new methods of diagnosis and treatment of urinary tract infections (UTI), they remain among of the most common bacterial diseases in women. Women are predisposed to UTI due to anatomical and physiological features (fluctuations in sex hormones levels during the menstrual cycle, pregnancy and childbirth), playing the role both in normal and pathological conditions (gynecological diseases and operations). The objective: to evaluate the clinical and bacteriological efficacy of levofloxacin in women with uncomplicated acute pyelonephritis (uAP) with the onset of the disease in different phases of the ovarian-menstrual cycle (OMC). Materials and methods. The study was conducted at urological departments of the Olexandrivska Clinical Hospital, Kyiv. 82 women of reproductive age were hospitalized for uAP. All of them underwent standard diagnostic procedures and were treated with levofloxacin. The Group-1 comprised 59 women with uAP, diagnosed in the period from the 20th to the 5th day of OMC. The Group-2 included 23 women with uAP, developed in the period from the 6th to the 19th day of OMC. Results. In women with uAP overall clinical efficacy of levofloxacin was 93% and bacteriological efficacy – 91.5%. In Group-2 in women with mild course both clinical and bacteriological effectiveness of treatment were 100%. Conclusion. The use of antibiotics with a broad spectrum of action, targeting most microorganisms and protozoa, reduces the reduces the costs associated with treatment and rehabilitation of women of childbearing potential. Levofloxacin demonstrates good efficacy, tolerability and safety in the complex treatment of acute uncomplicated pyelonephritis, which allows the use of this drug in clinical practice.
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