2 articles
Prostatitis is an inflammatory process of the prostate, which continues to be considered one of the most common urological diseases in men under 45. Predisposing factors such as trophic, microcirculatory, and congestive disorders contribute to the onset and development of the inflammatory process in the prostate, as do risk factors such as the urethral catheter, urethrocystoscopy, endoscopic surgery for infection, and deterioration of the integrity of the urethral epithelium. The purpose of this study was to determine the impact of chronic inflammation and fibrosis of the prostate on urodynamics and local prostatic microcirculation and to evaluate the efficacy of conservative treatment.
The study included 58 patients (with pronounced clinical symptoms such as dysuria, stranguria, nocturnal frequent micturition 2-4 times per night, and residual urine greater than 50 mL) who received Adenosprosine® 250 mg treatment.
A comparative study of the obtained data was performed on the pre- and post- treatment investigations with Adenoprosine® 250 mg suppositories, thus determining the correlation between urodynamic and microcirculation disorders depending on the degree of inflammation and prostate fibrosis.
According to the study results, we can outline that the level of microcirculation and urodynamic impairment indicates the level of prostate fibrosis. This process is reversible in chronic prostatitis with antifibrotic and anti-inflammatory therapy supplemented with Adenoprosine® 250 mg.
According to specialized literature, prostatic calculi are found in up to 80% of men over the age of 50. Prostatic calculi associated with chronic prostatitis may be closely related to lower urinary tract symptoms (LUTS) and may cause nonspecific symptoms of LUTS. The treatment drug therapy, minimally invasive as well as open surgeries, the number of which is actually decreasing worldwide. This phenomenon is mostly related to the emergence of both
new diagnostic technologies and endourological treatment.
The study included 40 patients with bladder outlet obstruction caused by prostatic calculi due to CNBP, who were diagnosed via a series of clinical and paraclinical investigations. The treatment methods to remove the bladder outlet obstruction included surgical approaches like transurethral resection (TUR) (n = 10 patients) and laser surgery (Ho: YAG) (n = 30 patients). Subsequently, the patients were monitored and monitored at 1 and 3 months.
All included patients in the study complained of difficulty urinating (bladder outlet obstruction and residual urine) underwent endoscopic surgical treatment. 30 patients underwent transurethral resection of the prostate with Ho:YAG laser operating at pulse energy of 2.3 J and a frequency of 18 Hz, with a peak power of 18.4 W. Laser incisions were made at 5 and 7 points of a standard quadrant by local tissue resection and removal of prostate stones. During 3 months of follow-up, the mean IPSS value improved from 23.2±2.57 points to 12.6±0.54 points; QoL also changed from 4.83±0.51 points to 2.23±0.1 points; Qmax shifted from 9.08 ± 1.8 ml/s before surgery to 14.07±1.7 ml/s after surgery; the mean value of residual urine decreased to 94.8±47.4 ml and 34.23±9.82 ml. The other 10 patients with prostate stones due to CNBP underwent another endoscopic method: incision (ITUP) or transurethral resection (TURP). The dynamics of the test findings during the follow-up period: IPSS improved from 22.9±2.42 to 10.7±0.5 points; QoL improved from 5.0±0.66 to 2.1±0.31 points; Qmax changed from 9.34±1.29 ml/s to 15.82±0.44 ml/s after the surgery. The average value of residual urine decreased from 92.9±17.95 ml to 38.9±5.97 ml. A decrease in prostate volume of 15.2 cm3 was also observed, possibly due to partial removal of sclerotic tissue and lithiasis.
Improvement in urodynamic parameters showed that endoscopic surgical treatment of prostate stones is an effective method for eliminating bladder obstruction and helps to restore urination, as well as improving the quality of life.