The aim of this study was to evaluate the state of blood flow in prostate in 59 men with chronic pelvic pain due to myofascial syndrome in the absence of clinical manifestations of chronic prostatitis and its dynamics against the background of the treatment. The results of the study revealed a reliable relationship between the severity of blood flow disorders in the prostate and the intensity of pain symptoms caused by myofascial syndrome. It was concluded that the hemodynamic disorders of the prostate caused by myofascial syndrome are important in the possible formation of clinical symptoms of chronic pelvic pain in men. (For citation: Krupin VN, Krupin AV, Belova AN, Nashivochnikova NA. The state of prostate hemodynamics in patients with myophascial pain syndrome. Urologicheskie vedomosti. 2017;7(4):39-43. doi: 10.17816/uroved7439-43).
In this study were analyzed the results of examination and treatment of patients with chronic prostatitis and vertebral neurogenic prostatopathy. Inclusion in the complex treatment of methods of correction of neurogenic disorders (segmental therapy, therapeutic gymnastics, psychotherapy, pharmacotherapy) showed high efficiency. Correction of the revealed neurological pathology and vertebral pathology as well, in most patients led to the elimination of not only neurological manifestations, but also symptoms of chronic prostatitis. (For citation: Krupin VN, Makhmudov IYa, Makhmudova LA, et al. Neurological aspects of diagnosis and treatment of chronic prostatitis. Urologicheskie vedomosti. 2017;7(3):22-27. doi: 10.17816/uroved7322-27).
Purpose of the research. To assess the incidence of arterial hypertension in men with varicocele and to identify the relationship between increased blood pressure and surgical treatment of varicocele. Material and methods. A survey of 412 men receiving treatment for arterial hypertension, 482 men previously operated on for varicocele and 68 patients with varicocele who had no surgical treatment was conducted. Results. Varicose veins of the spermatic cord in patients with arterial hypertension were detected in 44.6% of cases, which exceeds the incidence of varicocele occurrence in men of a comparable age category by 1.52 times. Surgical treatment of the left spermatic cord varicocele is combined with the development of arterial hypertension in 51.2% of patients, which is three times higher than the incidence of hypertension in men who didnt undergo surgical treatment for varicocele and twice the frequency of hypertension in the general population of men of comparable age. The more frequent occurrence of renal arterial hypertension in patients who underwent surgical treatment for varicocele may indicate an adverse effect of occlusion of the internal spermatic vein on the state of renal venous hemodynamics. Conclusion. Varicocele should be considered as a compensatory process for renal venous hypertension due to obstruction of blood flow through the renal vein, and elimination of compensatory blood flow can lead to renal venous hypertension, hypoxia and the development of arterial hypertension.
A total of 127 patients (mean age 38.1 ± 7.8 years) with chronic bacterial prostatitis who had concomitant neurologic diseases were treated. The patients were divided into 3 groups: group 1 (n = 47) included those with pain of the upper lumbar spine and myofascial syndrome; group 2 (n= 41), those with disorders of general and peripheral autonomic tone with vascular disorders in the pelvis; and group 3 (n = 39), those with disorders of the joints of the pelvic girdle, ligaments, and muscles of the pelvic floor. Treatment was given for the specific neurologic and hemodynamic disorders identified. No antibiotic therapy was prescribed. Patients in group 1 were prescribed pathogenetic therapy, including manual and regional therapy (for effects on the sclerotome and myotome), as well as medical correction of hemodynamics, physiothe rapy, psychotherapy, and hyperbaric oxygenation. Group 2 received treatment aimed at correcting autonomic innervation, including medications and magnetic therapy. Patients in group 3 were prescribed specific therapy aimed at eliminating pain-provoking factors, medications, massage, physiotherapy, manual therapy, therapeutic exercises, and reflex therapy. Treatment was associated with a decrease in the severity of pain and improvement of pelvic hemodynamics in patients in all 3 groups. Thus, the results indicate the potential efficacy of pathogenetic therapy for patients with chronic bacterial prostatitis with concomitant neurologic pathology.
The purpose of the study was to evaluate the blood flow in the left renal vein after ligation of the internal spermatic vein with varicocele and to study the changing of the level of biological markers of acute kidney damage in these patients. Materials and methods. Under observation were 64 men in age 1823 years with the first hemodynamic type of varicocele. In 3 patients clinically significant compression of the left renal vein was revealed and the remaining 61 patients underwent surgery by Ivanissevich approach. Before the operation, on the 2nd, 10th, 30th and 90th days after the operation patients underwent Doppler blood flow rate by ultrasound with color mapping of the left renal vein with measurement of venous blood flow velocity. During these periods all patients underwent laboratory tests, including the study of the content of cystatin C and interleukin 18 in the blood and urine. Results. On the first day after ligation of the internal spermatic vein an increase in the concentration of biological markers of acute kidney damage in the blood and urine was noted. After surgery all patients showed an increase in the diameter of the left renal vein by 1.52 mm and a decrease in the linear blood flow velocity in the region of the renal vien by 56 cm/s. On the 10th day after the operation the diameter of the left renal vein was increasesd by 34 mm more and the linear blood flow velocity slows down by 22.5 cm/s. The restoration of blood flow velocity and the diameter of the left renal vein occurred within three months and in most cases returned to baseline and in 22.9% of patients recovery did not occur by the 90th day of observation. Conclusion. Ligation of the internal spermatic vein with varicocele is accompanied by impaired blood flow in the left renal vein and an increase in the concentration of biological markers of acute kidney damage, which is a manifestation of venous hypertension and renal hypoxia. In most patients these indicators normalize to the 90th day of observation after surgery.
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