[Penile prosthesis implantation through subcoronal approach in patients with total cavernous fibrosis]

Penile prosthesis implantation is a treatment choice in patients with erectile dysfunction (ED) accompanied by cavernous fibrosis. Methods for creation of space for penile cylinders during prosthesis implantation in patents with total cavernous fibrosis are still under discussion, considering high risk of complications and decrease in penile size. In the presented clinical case, a new surgical technique for performing a three-piece penile prosthesis implantation through subcoronal approach in patient with ED, complicated by total cavernous fibrosis, is described. This clinical case represents our first experience of excavation excision of scar tissue in cavernous bodies through an innovative subcoronoral approach. As a result of performing of excavation excision of scar tissue in cavernous bodies, capacious spaces were created which allowed to use a three-piece prosthesis with a standard cylinder diameter. It ensured good long-term functional and cosmetic results. The first experience of excavation excision of fibrotic cavernous bodies during inflatable penile prosthesis implantation through subcoronal approach suggests its potential efficacy and safety in patients with ED and total cavernous fibrosis.

[Fusion biopsy of the prostate]

AIM

to compare the prostate cancer (PCa) detection rate, accuracy and safety of prostate image-guided fusion biopsy methods (cognitive fusion, software-fusion and HistoScanning-guided biopsy) on the basis of published studies in patients from 48 to 75 years with suspected prostate cancer during primary or repeat biopsy. To identify the limitations of these methods and improve the efficiency of fusion biopsy of the prostate in a further clinical trial.

MATERIALS AND METHODS

search was carried out in the PubMed, Medline, Web of Science and eLibrary databases using following requests: (prostate cancer OR prostate adenocarcinoma) AND (MRI or magnetic resonance) AND (targeted biopsy); (prostate cancer OR prostate adenocarcinoma) AND (PHS OR Histoscanning) AND (targeted biopsy) and (prostate cancer OR prostate adenocarcinoma) AND (MRI or magnetic resonance) AND (targeted biopsy) AND (cognitive registration), targeted prostate biopsy, prostate histoscanning, histoscanning, cognitive prostate biopsy.

RESULTS

a total of 672 publications were found, of which 25 original scientific papers were included in the analysis (n=4634). According to the results, PCa detection rate in patients with an average age of 62.5 years. (48-75) and an average PSA of 6.3 ng/ml (4.1-10.8), who underwent cognitive fusion biopsy under MRI control (MR-fusion) was 32.5%, compared to 30% and 35% for histoscanning in combination with a systematic biopsy and combination of methods (MR-fusion biopsy and histoscanning-guided biopsy), respectively. The accuracy of cognitive MR-fusion biopsy was 49.8% (20.8%-82%), the accuracy of the software MR-fusion biopsy was 52.5% (26.5%-69.7%), the accuracy of histoscanning-guided targeted biopsy was 46.8% (26%-75.8%). The highest values were observed in the patients undergoing primary biopsy (75.8%).

DISCUSSION

Currently, imaging methods allow us to change the approach to the diagnosis of PCa by improving the efficiency of prostate biopsy, the only formal method for verifying PCa. A common method for PCa diagnosis in 2018 is a systematic prostate biopsy. However, due to the its drawbacks, fusion biopsy under control of MRI or ultrasound has being introduced into clinical practice with superior results. So far, there is a lack of sufficient scientific data to select a specific technique of the fusion biopsy of the prostate. According to the analysis, it was concluded that the incidence of complications didnt increase when performing targeted biopsy in addition to the systematic protocol.

CONCLUSION

The efficiency of cognitive MR-fusion biopsy is comparable to software MR-fusion biopsy. Histoscanning-guided biopsy has lower diagnostic value than MR-guided target biopsy using software. The lack of solid conclusions in favor of a particular prostate fusion biopsy technique stresses on the relevance of further research on this topic.

[The experience of using drug Afalaza for treatment of lower urinary symptoms in treatment-nave patients with benign prostatic hyperplasia]

INTRODUCTION

Benign prostatic hyperplasia (BPH) is one of the most common diseases in men over 50 years. The prevalence of the BPH increases with age, and pathologic features of BPH are found in about 90% of men over 80 years.

AIM

The aim of the study was to study the efficacy and safety of Afalaza for the treatment of lower urinary tract symptoms (LUTS) in treatment-nave patients with BPH.

MATERIALS AND METHODS

A multicenter study of using Afalaza for the treatment of LUTS in treatment-nave patients with BPH was carried out in 9 urological centers in Moscow. A total of 80 treatment-nave patients with BPH were enrolled. The improvement in the total score of IPSS, IIEF-5 and QoL after 30 weeks of therapy was evaluated as well as changes in prostate volume and maximum urinary flow rate (Qmax).

RESULTS

After 30 weeks of therapy, there was a significant decrease in the total IPSS score. A decrease in the total IPSS score by 5.5 points (+37.9%) from 14.5+/-4.0 at the baseline to 9.0+/-4.1 at the visit 9 was seen. The QoL decreased by 1.8 (-38.3%) points from 4.7+/-1.0 at the baseline. The Qmax also changed from 12.7+/-4.6 to 16.4+/-5.7 (+28.3%) after 30 weeks of therapy. At the visit 9, the total IIEF5 score increased by 3.4+/-4.4 (+19.9%) from 17.1+/-4.3 at the baseline. In addition, prostate volume decreased from 42.7+/-11.1 at baseline to 41.0+/-9.8 cc post-treatment (-5.15%). A reduction of post-void residual urine volume from 26.0+/-25.3 at baseline to 17.7+/-24.2 (-31.9%) post-treatment was also shown.

CONCLUSION

The results of a multicenter study demonstrate the efficacy of Afalaza for treatment of treatment-nave patients with LUTS/BPH. Afalaza reduces prostate volume and improves an erectile function.

[Penile prosthesis implantation through subcoronal approach with graft-free corporoplasty in patients with Peyronie disease with concomitant erectile dysfunction]

Penile prosthesis implantation is a treatment choice in patients with erectile dysfunction (ED) and concomitant penile curvature due to Peyronie disease. Methods for correction of penile deformity during prosthesis implantation are still under discussion, considering variable efficiency and higher risk of complications. Our aim was to describe clinical case which represent our first experience of performing multiple corporal incisions through innovative subcoronoral approach without subsequent substitution of tunica albuginea. As a result of graft-free technique an effective penile straightening was achieved after three-piece prosthesis implantation with good long-term functional and cosmetic results. The first experience of graft-free technique of corporotomy during penile prosthesis implantation through subcoronal approach suggests its potential efficacy and safety in patients with a combination of ED and Peyronie disease.

[Suprapubic cartilaginous cyst]

Suprapubic cartilaginous cyst represents a rare disease. Considering its low prevalence, only 9 clinical case have been described in literature. This lesion is often overlooked due to absence of clinical manifestations, incomplete diagnosis or the lack of necessary information about the disease. We observed a 74-year-old woman whose diagnosis of suprapubic cartilaginous cyst was confirmed by biopsy, as well as ultrasound, computer tomography and MRI results.

[Treatment of patients with lower urinary tract symptoms in Moscow]

INTRODUCTION

In recent years, there has been a persistent tendency to a decrease in surgical treatment of patients with lower urinary symptoms (LUTS). This fact can be explained by variety drugs which have acceptable safety and high efficiency for treatment of urinary disorders. As part of our survey of men in Moscow region, the trends in prescribing the different drugs for the LUTS was studied. In addition, the duration of therapy and patient adherence were analyzed.

MATERIALS AND METHODS

A prospective multicenter epidemiological study "Characteristics of lower urinary tract symptoms in men in the Moscow region" was carried out using data obtained from April 1 to May 31, 2017 with anonymous survey of 525 men with mean age of 64.2+/-9.93 years, living in Moscow and went to the urologist with urinary disorders. All respondents answered questions from specially designed questionnaire consisted from 140 items. All medical data were analyzed, including received drugs, the duration of the therapy and subjective assessment of efficiency.

RESULTS

A total of 419 patients from 525 (79.8%) received any kind of therapy. The most commonly used drugs were -blockers, which consisted 65% of all prescriptions. Other drugs were administered significantly rarely. It is surprisingly, that 85.6% of respondents in Moscow region received the original -blockers, not generic drugs. Satisfaction rate was 74.3%. Most of patients (58.3%) had received -blockers for 1-3 years and 33.3% administered these drugs for more than 3 years. Combined drug therapy was the second most popular (25.5%). The most commonly used combination included -blockers and inhibitors of 5-reductase. In 90.6% cases the appointment was made by urologist.

CONCLUSION

Drug therapy is the most popular treatment in patients with LUTS. Our data suggest that -blockers as monotherapy or in combination with inhibitors of 5-reductase is the most often prescribed therapy. These results are in concordance with the main conclusions of international studies dedicated to this issue.

Data on somatic mutations obtained by whole exome sequencing of FFPE tissue samples from Russian patients with prostate cancer

Prostate cancer (PCa) is the most frequently diagnosed among men malignant disease that remains poorly characterized at the molecular level. Advanced PCa is not curable, and the current treatment methods can only increase the life expectancy by several months. Identification of the genetic aberrations in tumor cells provides clues to understanding the mechanisms of PCa pathogenesis and the basis for developing new therapeutic approaches. Here we present data on somatic mutations, namely single nucleotide variations (SNVs), small insertions and deletions, detected in prostate tumor tissue obtained from Russian patients with PCa. Moreover, we provide a raw dataset on the whole exome and targeted DNA sequencing of tumor and non-tumor prostate tissue obtained from Russian patients with PCa and benign prostatic hyperplasia (BPH). This data is available at NCBI Sequence Read Archive under Accession No. PRJNA506922.

[Robot-assisted radical prostatectomy - functional result. Part II]

Robot-assisted surgery is one of the most important achievements of modern medicine. Robot-assisted operations widely used in urology, gynecology, general and cardiovascular surgery are considered by many experts as a new 'gold standard' of surgical treatment of various diseases in developed countries. Well-known advantages of robot-assisted surgery are low invasiveness, 3D-visualization of surgical field, high accuracy of instrument movements resulting minimal intraoperative blood loss, short hospital-stay, rapid recovery and short social maladjustment of operated patients. Robot-assisted radical prostatectomy in patients with prostate cancer is the most common robotic procedure worldwide. Better functional outcomes are due to another (new) understanding of pelvic surgical anatomy, changed approach to dissection and preservation of external urethral sphincter and neurovascular bundles. Prostate neuroanatomy, various variants of preservation of neurovascular bundles are reviewed in the article. Moreover, own experience of robot-assisted radical prostatectomy followed by favorable functional results is presented.

[Robot-assisted radical prostatectomy. Functional result. Part I. (in Russian only)]

Robot-assisted operations as widely used in urology, gynecology, general and cardiovascular surgery are considered by many experts as a new 'gold standard' of surgical treatment of various diseases in developed countries. Robot-assisted radical prostatectomy for prostate cancer is the most common robotic procedure. Better functional outcomes of robot-assisted radical prostatectomy are due to another (new) understanding of pelvic surgical anatomy, new approach implying dissection and preservation of external urethral sphincter and neurovascular structures. Prostate neuroanatomy, various approaches to preserve neurovascular structures and own experience of nerve-sparing robot-assisted radical prostatectomy with functional results are reviewed in the article.

[LUTS/BPH who treats? The results of the epidemiologic study]

INTRODUCTION

In this study an attempt was made to determine some reasons that prompted the urologist to make a choice in favor of particular drug or combination from a wide variety of available drugs. The prescribing habits and subjective evaluation of efficiency and safety of the drugs for the treatment of lower urinary tract symptoms/benign prostatic hyperplasia by the urologists in Russia was analyzed.

MATERIALS AND METHODS

a prospective multicenter epidemiological study "LUTS/BPH - who treats?" was carried out in 12 centers using data obtained from May 1 to July 31, 2018 with anonymous survey of 500 urologists living in 9 cities of the Russian Federation. The survey consisted of 46 questions reflecting a level of education, involvement in scientific life of urologic community, membership in various professional organizations, and subjective assessment of safety and efficiency of drugs used in Russian Federation for the treatment of urinary disorders. The obtained data was analyzed for a whole group and further in the subgroups.

RESULTS

Alpha-blockers are the most commonly prescribed drugs. These drugs constitute 63.4% of all appointments, followed by the 5-a-reductase inhibitors (23.98%) and combined therapy by the both drugs (24.68%). The most frequently used alpha-blocker is tamsulosin, but professors, MD and urologists, who read special literature at a regular basis, prescribed tamsulosin and silodosin equally. In primary cases and in patients with concomitant cardiac pathology, silodosin was prescribed more commonly in comparison with other alpha-blockers.

CONCLUSION

the results of the study indicate a concordance with global trends in the treatment of these patients. Our data reflect a significant influence of the level of education, work experience and involvement in scientific professional life of urologic community on the choice of a particular drug for the treatment of LUTS/BPH and prove the feasibility of further work which should be aimed at popularization of the modern medical knowledges among the urologists and organization of a process of continuous medical education.

[Good urodynamic practice: consensus on the terminology]

In this publication a summary of the published manuscript "Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study" developed by a working group under the guidance of the Standardization Steering Committee of International Continence Society (ICS)1 is presented. The members of the working group were: Werner Schaefer, Gunnar Lose, Howard B. Goldman, Michael Guralnick, Sharon Eustice, Tamara Dickinson, Hashim Hashim and Peter F.W.M Rosier.

[One-stage cryoablation of two renal tumors]

The progressive development of medical technologies allowed the introduction of alternative methods of treatment of localized renal cell carcinoma with a tendency to organ-sparing approach. Cryoablation, radiofrequency ablation, and some experimental methods of treatment (microwave and laser ablation, therapy with high-intensity focused ultrasound) are referred to minimally invasive treatment of renal cell carcinoma. Cryoablation is highly effective alternative method of treatment of renal cell carcinoma. The main advantages of this technique are tumor visualization and formation of 'ice ball' in real time, fewer complications compared with other methods, as well as the possibility of cryotherapy in critically ill patients. Compared to other ablative technologies, cryoablation is followed by low percentage of redo treatment and good intermediate oncological results. We described the experience of one-stage cryoablation of two kidney tumors in this report.

[Imidafenacin for treatment of overactive bladder and urgent urinary incontinence: the results of open-label multicenter randomized controlled clinical trial]

INTRODUCTION

The analysis of the results of a multicenter, open, randomized comparative phase III clinical trial on the use of imidafenacin for treating patients with OAB was carried out. A clinical study was conducted according to GCP standards in 12 urological centers of the Russian Federation with the support of company AO "R-Pharm".

MATERIALS AND METHODS

A total of 296 patients (men and women) aged from 18 to 65 years with OAB and urgent urinary incontinence were included in the study. All patients were randomized into two groups. In Group 1 (n=148) patients received -cholinoblocker imidafenacin 1 tablet (0,1 mg) twice a day. Group 2 patients (n=148) were prescribed a comparison drug tolterodine 1 tablet (2 mg) twice a day, as well. The duration of treatment was 12 weeks.

RESULTS

The analysis of results showed a significant decrease in the OAB symptoms in both groups. In Group 1 a decrease of episodes of urge urinary incontinence was more pronounce compared to Group 2, as well as amount of day-time and night-time of episodes of urge urinary incontinence by the 2nd, 4th, 8th and 12th weeks of treatment in comparison with baseline scores. There were no differences between two groups in the severity of reducing average urinary frequency per day. Reducing the severity of urinary disturbances in patients of both groups was accompanied by an improvement in the quality of life. There was a significant and similar decrease in the average total score of both OAB Awareness Tool and EQ-5D questionnaires. Tolerability of treatment was satisfactory in both groups and there were no differences in the adverse events in Group 1 and 2.

CONCLUSION

Imidafenacin showed high clinical efficacy for treating patients with OAB, which is not inferior, and in some values, is superior in comparison to tolterodine. Both drugs had a similar safety and tolerability profile.

[Robot-assisted pelvic floor reconstruction: review and own experience]

Pelvic organ prolapse (POP) is the most common urogynecological disease in women of middle and older age groups. This disease causes numerous urogenital symptoms and significantly reduces the quality of life of patients. Surgical correction of POP is the optimal method f treatment for this category of patients, however, the choice of surgery and access remains controversial. In recent decades, thanks to the development of robotic technologies, the use of robot-assisted sacrocolpopexy (RAS) has become increasingly popular. Numerous studies have shown the equivalence of results compared with the "gold standard" repair of prolapse - open sacrocolpopexy. This article presents a review of the current literature and our own experience of RAS.

[Evaluation bacteriological analysis of urine in patients with long-term bladder drainage]

INTRODUCTION

The experience of comparative evaluation of the effectiveness of various types of urethral catheters in prevention of catheter-associated infection is described in this article.

MATERIALS AND METHODS

The study included 69 patients treated at the CCH n.a. S.I. Spasokukotsky in the period from December 2017 to March 2018. The average age of patients was 67.5 years. In all patients, the bladder was drained by a two-way Foley catheter No. 16-18 Ch (100% silicone). In the 1st group (n=18), the bladder was drained with a standard urethral uncoated catheter, in the 2nd (n=16) - with a silver impregnated urethral catheter, in the 3rd (n=15) - with an urethral catheter coated with nitrofuran, in the 4th (n=20) urethral catheter with the possibility of controlled irrigation of the bladder and urethra with antiseptic solutions and (a new model of the urethral catheter developed during cooperative work of the Moscow State University of Medicine and Dentistry n.a. A.I. Evdokimov Urology Department and National Medical Research Center of Obstetrics, Gynecology and Perinatology n.a. V.I. Kulakov).

RESULTS

The bladder was drained by Foley urethral catheter for more or equal 15 days. A microbiological study of urine (on the example of clinical isolates of conditionally pathogenic microorganisms) with preparation of an inoculum, inoculation of nutrient media, counting cultures of pathogenic bacteria and determining the sensitivity of pathogenic bacteria to antibiotics was carried out. The study showed the effectiveness of the new urethral catheter model in patients with long-term bladder drainage.

CONCLUSIONS

Conducting multicenter studies evaluating the effectiveness of the proposed urethral catheter model with the inclusion of a larger number of patients will reduce the economic costs, associated with treating patients with prolonged bladder drainage in the long term by reducing the number of nosocomial infection cases and reducing postoperative day.

[A role of fesoterodine in treatment of overactive bladder]

The muscarinic receptors have been used as target in treatment of overactive bladder (OAB) for a long time. These patients have complaints of urgency, increased urinary frequency and nocturia, sometimes with urinary incontinence (involuntary urine leakage which is associated with abrupt and strong desire to void). Fesoterodine is a prodrug that is structurally and functionally associated with tolterodine and it is the novel drug for OAB treatment. As a result of fesoterodine cleavage by non-specific esterase, the active metabolite 5-hydroxymethyl tolterodine (5-HMT) is formed. Like other antimuscarinic drugs, fesoterodine allows to improve bladder storage function (reducing the frequency of urination) and urgency. For assessing an improvement of the quality of life after treatment by fesoterodine the KHQ questionnaire was used.

[Lower urinary tract symptoms among women in the Russian Federation: data from an online survey]

AIM

To estimate the prevalence and severity of lower urinary tract symptoms in the female population using a LUTS-specific questionnaire.

MATERIALS AND METHODS

The study analyzed the prevalence of LUTS in the population of women residing in the Russian Federation. Information about voiding disorders in women, which was announced on federal television health-related programs, was posted on the website of the medical portal zdorovieinfo.ru. All questionnaires were filled in by the patients anonymously. The questionnaire was prepared by the editors of the website. We analyzed the survey results.

RESULTS

After the TV announcement, the survey website was visited by more than 15,000 people. Of them, 2,600 people filled the questionnaire (17% of the number of visitors). The findings of the survey suitable for the analysis were obtained from 2419 women (93.07%) and 181 men (6.93%). The mean age of female participants was 55 years old.

CONCLUSION

The study had some limitations and was not truly epidemiological, as it involved only those women who had information and technical access to the Internet portal and questionnaires. Despite this, the findings suggest the high prevalence of LUTS among women in our country.

[Specific features of lower urinary tract symptoms in men living in the moscow region. Results of the epidemiological study]

INTRODUCTION

Voiding disorders in men are manifested by various symptoms associated with impairment of the urinary flow along the urinary tract and worsening of the urinary bladder storage function. There is a considerable lack of data on the prevalence of LUTS, their severity, and correlation with data from objective studies in men in the Russian Federation in general and in the Moscow region in particular.

MATERIALS AND METHODS

A prospective multicenter epidemiological study "Specific Features of Lower Urinary Tract Symptoms in Men Living in the Moscow Region" was conducted based on data acquired from April 1 to May 31, 2017 by an anonymous survey of 525 men (mean age 64.2+/-9.93 years old), residing in Moscow and presenting with complaints of urination disorders. The respondents answered questions of a specially developed 140-item questionnaire. All demographic and medical information was taken into account, including concomitant diseases and ongoing therapy. The patients filled out the IIEF, I-PSS, QoL, and AMS (Aging Male Screening) questionnaires.

RESULTS

Analysis the I-PSS scores showed that symptoms of the emptying phase predominated over the symptoms of the filling phase in all age groups. The most frequent complaints were "frequent urination" and "weak urine stream". Forty and 30% of respondents had moderate and severe LUTS, respectively. The remaining 30% of men had mild LUTS. Prostate volume was significantly greater than that reported in similar studies conducted in Asia, Europe and North America (mean 55.27 cm3). The level of total prostate-specific antigen (PSA) was known in 98.8% of patients over the age of 50 and averaged 3.87+/-4.41 ng/ml. The mean age at the first testing for total PSA in Moscow is 56.7+/-9.0 years.

CONCLUSION

This study is the first epidemiological study of this scale and focus. Its findings can be used to compose a "portrait" of a standard patient and identify patterns that limit the extrapolation of international epidemiological studies to the population of Russian patients. It seems necessary to develop an updated LUTS management strategy, taking into account the identified national characteristics.

[Quality of life in patients with lower urinary tract symptoms after TURP for benign prostatic hyperplasia]

INTRODUCTION

To date, the gold standard for the surgical management of BPH is transurethral resection of the prostate (TURP). Most patients who undergo TURP for BPH experience immediate effects and complete relief of lower urinary tract symptoms and do not need further urological care. However, some patients after this operation have some level of persistent residual lower urinary tract symptoms, which may require additional therapy.

AIM

To investigate voiding function and the need for medical therapy in patients who underwent TURP for LUTS due to BPH.

MATERIALS AND METHODS

This study was performed as an anonymous survey among male patients presenting to a urology clinic. During the visit, the patients were offered to fill out I-PSS and SF-36 questionnaires. Also, they were asked about their socio-economic status, history of BPH, their perception of surgery and the postoperative period up to the day of the interview, presence or absence of symptoms of voiding dysfunction and any drug therapy at the time of the interview or after surgery. The patients also rated the severity of the symptoms using the IPSS questionnaire. The study comprised patients after 12 months to 3 years following successful TURP for LUTS due to BPH. A total of 1100 questionnaires were forwarded to researchers for interviewing patients who underwent TURP for prostatic hyperplasia.

RESULTS

After collecting and reviewing all the questionnaires, 921 questionnaires were found eligible. The findings of the survey showed that a significant proportion of patients who underwent TURP require a long-term postoperative medical therapy. At the same time, in the Russian Federation, there are no standard approaches to medical management of this category of patients.

[The place of mirabegron in clinical practice]

Currently, a wide range of different drugs is available for te management of overactive bladder. This creates problems when it comes to drug selection and personalized care for each patient. Mirabegron is the only 3-adrenomimetic agent for the treatment of urinary disorders, which, after careful long-term multi-center randomized trials, has been approved for use in Europe and North America. Mirabegron has proven to be very effective in patients who had previously received anticholinergic drugs and discontinued them because of the insufficient therapeutic effect or pronounced adverse reactions. However, the question of using Mirabegron as a first-line treatment for overactive bladder and the existing limitations in its administration in clinical urology practice remains open.

[The role of the uretral catheter in the development of catheter- related urinary tract infection]

The most common source of nosocomial infection is the urinary tract, especially if they it is drained with a urethral catheter. Catheter-associated urinary tract infections account for at least 80% of all complicated urinary tract infections and are the most common type of hospital-acquired infection. Intestinal microflora plays the leading role in the pathogenesis of catheter-associated urinary tract infections, whereas the most important risk factor for their development is the long duration of urinary catheter drainage. In the case of short-term and intermittent catheterization, routine antibiotic prophylaxis is not required, but if a patient develops clinically significant infection, antibiotic therapy is required followed by definitive therapy based on culture. Urethral catheters coated with antimicrobial substances and anti-inflammatory agents can significantly reduce the adhesion and migration of bacteria, thereby reducing the incidence of urinary tract infections. Despite this, the incidence of catheter-associated infection remains high. We have reviewed recent literature related to catheter-associated urinary tract infections and the best means of preventing this condition.

[Current methods of early diagnosis of prostate cancer]

Prostate cancer is the most common cancer among men, except for lung cancer. Therefore, it is imperative to identify diagnostic methods for early detection of prostate cancer to determine patients from healthy populations, which helps guide a timely treatment at an initial stage of the disease. The article provides an in-depth review of the most current diagnostic biomarkers of prostate cancer, their role in clinical practice as a means of the early detection and screening for prostate cancer.

[Efficacy of tamsulosin for treating lower urinary tract symptoms in patients with advanced prostate cancer]

RELEVANCE

From the moment of their first use to the present day, -adrenoblockers remain the most popular medication in urology. Indications for their clinical use for various pathological conditions are constantly expanding.

AIM

To compare the efficacy of androgen deprivation therapy (ADT) alone and ADT with concomitant use of tamsulosin in treating lower urinary tract symptoms (LUTS), and to estimate the efficacy and safety of tamsulosin in relieving voiding dysfunction symptoms in patients with advanced PCa treated for 6 months.

MATERIALS AND METHODS

This paper presents data from a randomized, open, single-center trial that evaluated the efficacy and safety of tamsulosin co-administered with ADT for LUTS in patients with advanced prostate cancer. The study comprised 50 people aged below 75 years. In the first group of patients (n=25), ADT was used as a monotherapy, in the second group (n=25) ADT with concurrent administration of the -adrenoblocker. The duration of treatment was 6 months.

RESULTS

Both groups showed an improvement in the severity of LUTS, decrease in the total I-PSS score and residual urine volume and increase in the urinary flow rate. At the same time, co-administration of ADT and -adrenoblocker resulted in greater and faster relief of LUTS than using ADT alone. There were no significant side effects in any of the groups.

CONCLUSIONS

Co-administration of ADT and the -blocker is an effective and safe treatment for advanced prostate cancer in patients with LUTS.