AIM: was to conduct a comparative assessment of copulative function and the severity of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) who underwent laser and bipolar transurethral enucleation of the prostate and who treated conservatively. MATERIALS AND METHODS: 143 BPH patients aged 50 to 80 years (mean age 65 years) with complaints of copulatory and urinary disorders were under observation. All patients were divided into two groups. The 1st (main) group included 102 patients who underwent surgical treatment: transurethral laser enucleation of the prostate (n = 55) and transurethral bipolar enucleation of the prostate (n = 47). Patients of the 2nd group (n = 41) received conservative treatment. Control examinations were performed before treatment, 4, 12 and 24 weeks after it. RESULTS: All 102 patients of group 1, regardless of the type of surgery, noted retrograde ejaculation four weeks after surgery. In the majority of patients of the 1st group during these periods weakening of orgasm was noted, in a significant number deterioration of erection and decreased libido were noted. Upon further observation, by the 12th week after the operation, restoration of all components of the copulatory function was noted, with the exception of ejaculation. By the 24th week of observation, only in 2 patients of the 1st group the normal mechanism of ejaculation was restored. Surgical treatment of patients in group 1, regardless of the method of surgery, led to a significant decrease in the severity of LUTS, an increase in the maximum urine flow rate, a decrease in the volume of the prostate gland and the amount of residual urine. There were no significant differences in the dynamics of these indicators depending on the method of transurethral enucleation. The patients of the 2nd group also had an improvement in clinical parameters, but it was much less pronounced than in the 1st group. CONCLUSION: Laser and bipolar transurethral enucleation of the prostate are effective surgical techniques that significantly improve the outflow of urine from the bladder, reduce the severity of LUTS and improve the sexual function of patients. Surgery is well tolerated by patients. At the same time, almost all patients operated on by these methods develop retrograde ejaculation.
BACKGROUND: Transrectal Doppler ultrasound is the leading method for studying blood flow in the prostate. Despite a significant number of studies on the use of ultrasound of the prostate in patients with BPH, many aspects of its clinical use remain unclear. One of these issues is the features of changes in blood flow in the prostate after transurethral surgical interventions. AIM: to assess the state of blood flow in the prostate gland in patients with BPH before and after transurethral enucleation by laser and bipolar methods. MATERIALS AND METHODS: The study included 88 patients with BPH aged 50 to 79 years who complained of urinary disorders. All patients underwent transurethral enucleation of BPH: 41 patients with the laser method (HoLEP) (1st group) and 47 patients with the bipolar method (TUEB) (2nd group). Before surgical treatment, 4, 12 and 24 weeks after surgery, patients underwent transrectal Doppler ultrasound of the prostate. RESULTS: The results of the study indicate a significant impact of surgery on the state of blood flow in the prostate gland. Examination 12 weeks after the operation showed a significant decrease in the peak blood flow velocity and values of the resistance index in patients of the 1st and 2nd groups compared with the corresponding values before the surgery and 4 weeks after the surgery. By 24 weeks after surgery, all patients showed normalization of blood flow parameters, while in patients of the 1st group (HoLEP) this process occurred faster than in patients of the 2nd group (TUEB). CONCLUSIONS: The high diagnostic efficiency and informativeness of transrectal Doppler ultrasound in the assessment of blood circulation in the prostate in patients with BPH has been confirmed. The blood flow velocity in the subcapsular and especially paraurethral arteries, as well as the values of the resistance index, were higher in patients with large prostates, which must be taken into account when planning surgical interventions.
This study evaluated the efficacy and safety of two organic dietary supplements, AndroDoz and Testogenon, in the treatment of 58 men with spermatologic disorders and oxidative stress after experiencing reproductively significant diseases caused by sexually transmitted infection. Over a 12 week period, 38 patients (test group) received both AndroDoz and Testogenon as a combination therapy, whereas 20 patients (control group) received AndroDoz alone. The combination therapy with both AndroDoz and Testogenon showed a statistically significant increase in treatment effectiveness. A positive clinical effect was noted in 92.2% of patients in the test group who received combination therapy. This was reflected as an increased concentration and mobility level of spermatozoa, similar to values observed in men with normozoospermia. Moreover, these men exhibited a two-fold reduction in the risk of fertility disorders due to DNA fragmentation in spermatozoa; their testosterone also increased to normal levels. Additionally, patients in the test group showed improvement in the quality of erection and increased blood flow in the prostate gland and testicles. Men in the control group, who received monotherapy with AndroDoz, did not show improvement similar to that of men in the test group; normozoospermia was established in 70% of men in the control group. These results confirm that AndroDoz and Testogenon are more effective when used concomitantly. These supplements showed no side effects and could be used in complex treatment of spermatologic disorders and oxidative stress in men who experienced reproductively significant diseases caused by sexually transmitted infection. (For citation: Kalinina SN, Korenkov DG, Fesenko VN. Treatment of spermatologic disorders and oxidative stress after reproductively significant diseases caused by sexually transmitted infection. Urologicheskie vedomosti. 2018;8(4):5-15. doi: 10.17816/uroved845-15).
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