Search

Introduction. Ectropion of the cervix (EC) is a condition when there is a cicatricial deformity of the uterine cervix (as a result of traumatic injuries) with visualization of the ectopic columnar epithelium on the vaginal part of it. The ectopia is currently classified as a variant of the normal histophysiological state of the cervix. This article discusses the features of the course and methods of treatment of complicated EC.Objective of the study is: to develop and evaluate the effectiveness of a new method of complex treatment of CE.Material and methods. In an open prospective study, 133 patients with CE (groups 1 and 2) and 56 healthy women (group 3) has taken part. In group 1 (n = 83), we have used a method for treating CE developed by us, which included two stages: stage I – elimination of microbial and viral pathogen in combination with immunomodulatory therapy, II – electrosurgical treatment (Leep biopsy) and treatment of the cervix with Galavit (100 mg of dry matter) dissolved in 5 ml of Miramistin (Patent for invention RU 2568768 C1). In group 2 (n = 50), surgical treatment of CE has been preceded by vaginal sanitation, empirical antibacterial and antiviral therapy. Diagnostic measures, in addition to standards, have included: determination of interleukins IL-1β, IL-6, IL-8, IL-10 in the discharge of the cervical canal, ultrasound diagnostics with Doppler measurements in the vessels of the central zone of the cervix. Statistica 7.0, SPSS 17 packages have been used for statistical processing.Results and discussion. Before the start of treatment, patients in groups 1 and 2 have been found to have a combination of CE with cervicitis (100%), ASCUS cytological picture (more than 60%), abnormal colposcopic signs (100%), imbalance of the local immune system with a predominance of Th1 cytokines (the content of IL-8 increased 2.6 times; IL-1b – 13 times; IL-6 – 20 times, and IL-10 – in 1.7 times) against the background of increased vascularization and cervical perfusion. The reparative process after Leep biopsy in group 1 has ended by the end of 3 weeks in 65.6% of patients, in group 2 – in 25.5%, after 5 weeks – in 100% and 57.4%, respectively, after 8 – in group 2, 91.5%. The average period of epithelialization of a wound on the cervix in group 1 was 27.4 ± 4.3 days, in group 2 – 39.5 ± 5.6 days (p = 0.01). After 2 years, the recurrence of cervical pathology has been recorded only in group 2 (34.0%).Conclusion. The use of the developed method of two-stage complex therapy for CE increases the effectiveness of treatment, prevents complications after Leep biopsy, accelerates epithelialization by 30.6% and avoids recurrence of the disease.

The COVID (coronavirus disease 2019) pandemic has shown impressively that infectious diseases can have an enormous impact on the healthcare system and beyond. In the specialty of urology, patients present in daily practice with viral infections that are associated with numerous diseases.The aim of this review is to describe viral infections relevant for urology, and in particular to emphasize vaccination prevention. A selective literature search was carried out on the subjects of "COVID and urology", "urogenital viral infections", "viral urological infections in transplant medicine", and "vaccination prevention of viral diseases".Coronaviruses have already caused two local epidemics: SARS (severe acute respiratory syndrome) epidemic and MERS (Middle East respiratory syndrome) epidemic. The fact that the SARS-CoV‑2 (SARS coronavirus 2) disease is contagious even without symptoms has essentially led to the rapid spread and global pandemic. A large number of viruses, which can also induce viremia, have been detected in the ejaculate and are thus associated with a possible urogenital infection. These include the mumps virus, Coxsackie viruses or enteroviruses, among others. It has also been shown that a Zika virus infection can also be sexually transmitted via the sperm as a carrier. Viruses therefore also play an important role in reproduction. When performing kidney transplants, urologists are often confronted with viral infections. The most effective weapon against viruses is prevention by vaccination.In terms of ethiopathogenesis, the genitourinary tract is most often affected by viruses, in the context of viremia or through reactivation due to immunosuppression. Immunomodulation and vaccination prophylaxis play a leading role in therapy.EINLEITUNG: Die COVID-19-Pandemie („coronavirus disease 2019“) hat eindrucksvoll gezeigt, dass Infektionskrankheiten enorme Auswirkungen auf das Gesundheitswesen und darüber hinaus haben können. In der Urologie spielen Viren bei spezifischen Entitäten eine Rolle, wo sich der Urologe mit Viruserkrankungen beschäftigen muss.Diese Übersichtsarbeit hat zum Ziel in der Urologie relevante Virusinfektionen zu beschreiben und insbesondere die Impfprävention hervorzuheben. Es erfolgte eine selektive Literaturrecherche zu den Themen „COVID und Urologie“, „Urogenitale Virusinfektionen“, „Virale urologische Infektionen in der Transplantationsmedizin“ sowie „Impfprävention von Viruserkrankungen“.Coronaviren sind Viren, die bereits 2‑mal lokale Epidemien verursacht haben (SARS- [„severe acute respiratory syndrome“] und MERS-Epidemie [„middle east respiratory syndrome“]). Die Tatsache, dass die SARS-CoV-2-Erkrankung („severe acute respiratory syndrome coronavirus 2“) auch ohne Symptome ansteckend ist, hat im Wesentlichen zu der raschen Ausbreitung und weltweiten Pandemie geführt. Eine Vielzahl von Viren, die auch eine Virämie induzieren können, wurde im Ejakulat nachgewiesen und wird damit mit einer etwaigen urogenitalen Infektion in Verbindung gebracht. Hierzu zählen u. a. das Mumps‑, Coxsackie-Viren oder Enteroviren. Es wurde auch gezeigt, dass auch eine Zika-Virusinfektion sexuell über die Spermien als Carrier übertragen werden kann. Somit spielen Viren auch eine wichtige Rolle in der Reproduktion. Bei der Nierentransplantation sind Urologen häufig mit viralen Infektionen konfrontiert. Die effektivste Waffe gegenüber Viren stellt die Impfprävention dar.Äthiopathogenetisch ist der Urogenitaltrakt im Rahmen einer Virämie oder über eine Reaktivierung durch eine Immunsuppression am häufigsten mitbetroffen. Therapeutisch kommt der Immunmodulation sowie der Impfprophylaxe eine führende Rolle zu.

Assisted reproductive technologies (ART) are one of the most effective ways in fighting infertility, but their effectiveness is influenced by various factors. Our study focuses on examining importance of risk factors underlying ART failure related to altered microbiome pattern in the female reproductive system. The case-control study was based on conducting a laboratory examination of 129 infertile couples applied to the Department of Assisted Reproductive Technologies due to failure of in vitro fertilization (IVF), whereas control group consisted of females with successful progressive pregnancy after ART. Chlamydia, herpes virus and cytomegalovirus were assessed by using PCR and ELISA, whereas culture method was used to detect Trichomonas vaginalis in vaginal swabs and ejaculate applying Trichomonas Modified CPLM Medium (HiMedia, India) followed by microscopy. In addition, the qualitative and quantitative composition of the vaginal biocenosis was studied with multiplex RT-PCR by using Femoflor-16 kit (DNA-technologies, Russia). Serological tests were based on measuring IgG and IgA antibodies against Chlamydia trachomatis in ELISA (diagnostic kits purchased from Vektor Best, Russia; NovaTec, Germany; ImmunoComb, Israel) as well as antibodies against immediate early HSV-1/2 proteins (BioService, Russia) and immediate early HHV-5 proteins (Vector Best, Russia). C. trachomatis and herpesvirus DNA was measured by using PCR diagnostic kits Amplisens (Interlabservice, Russia). It was found that sexually transmitted infection agents were highly prevalent in infertile couples applying to the hospital for IVF. Significant factors for non-pregnancy were vaginal dysmicrobiocenosis (OR = 7.5 (95% CI 1.04—54.1), p = 0.02) and detected T. vaginalis (OR = 2.6 (95% CI 1.12—6.4), p = 0.01). Dysbiosis of the reproductive system, including those occurring due to trichomonas infection is associated with lowered ART effectiveness. It is evident to timely detect urogenital infections and dysbiosis while preparing infertile couples for IVF cycles.

The objective:the determination of the risk factors, causes and clinical features of very early preterm birth. Materials and methods.The data of anamnesis, the course of pregnancy, childbirth and perinatal outcomes in 166 women of reproductive age with very early preterm birth at 22–27 weeks of gestation were analyzed. The fact of childbirth at these terms of pregnancy is the main criterion of inclusion. The patients were divided into two groups depending on the criteria of live birth: 1 group — 79 women, whose labor was regarded as late miscarriage (retrospective study); 2 group — 87 women with very early preterm (prospective study). Exclusion criteria: congenital malformations of the fetus. Results.The main risk factors for the development of very early preterm labor are urogenital infections (83.7% and 78.9% in 1 and 2 groups, respectively). A combination of pathogens was found in almost half of the subjects (43% in 1 group, 44% in 2 group). The patients in both groups had a complicated general and obstetric anamnesis, in particular, a significant frequency of inflammatory processes of the genital organs (50.0 % – in 1 group and 59.2 % – in 2 group), surgical interventions (50.0 % and 59.2 %, respectively), as well as hormonal disorders and related diseases (ovarian dysfunction – 27.8 % and 27.6 %, uterine fibroids – 16.4 % and 17. 2%, ovarian cysts – 11.4 % in both groups). 35.4 % of patients in 1 group and 28.7 % of patients in 2 group had a history of chronic foci of infections, pathology of the urinary system – 30.3 % and 28.7 %, respectively, of the digestive tract – 24 % and 22.98 %, hypertension – 32.9 % and 31 %. The main complications of gestation in pregnant women in both groups in the II trimester were the threat of abortion (43 % and 30 %, respectively) and dysfunction of the fetoplacental complex (22.7 % and 21.8 %). This caused fetal growth retardation in both groups – 66 % and 63 % of newborns, respectively. Conclusions.Analysis of the general and obstetric history, the presence of infectious factor in combination with extragenital pathology confirm the polyetiology of the causes that leads to very early preterm birth. Considering the main risk factors of preterm birth, a complete examination for urogenital infections in women before and during pregnancy, followed by treatment and restoration of normal vaginal biocenosis, as well as the study of fetoplacental system function from early pregnancy is neseccary. Preventive measures and timely treatment of fetoplacental disorders should prolong pregnancy for the terms in which there is the best way to improve perinatal outcomes.

The issue of perinatal injury of the central nervous system and birth trauma draws close attention of various specialists. The objective: to identify the effect of extragenital pathology of the pregnant woman and obstetric factors on the formation of perinatal CNS injuries and traumatic injuries of the newborn. Materials and methods. The authors studied ante- and intranatal risk factors for perinatal CNS damage and birth trauma in 183 babies in severe or moderately severe condition (main group) born in the City Clinical Perinatal Center in 2011–2017. There were assessed the clinical manifestations and results of instrumental studies. The control group was formed by the case – control type of 183 women in labor and their children without birth injuries. The results. There were revealed the most significant risk factors for the formation of perinatal CNS injury and birth trauma of the newborn: a high frequency of pregnancy complications (100%), extragenital diseases (90.2%), urogenital infections (33.3%), umbilical cord pathology (33.3%) and other complications of labor (42.1%). The conclusion. The complications of pregnancy and childbirth, extragenital diseases, urogenital infections contribute to the frequency of perinatal CNS damage and development of birth trauma.

Goydyk V. S., Novikov M. V., Gozhenko A. І. Abacterial prostatitis of viral etiology and its chronobiological features. Journal of Education, Health and Sport. 2020;10(10): 314-324. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.10.030 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.10.030 https://zenodo.org/record/4501930 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 18.09.2020. Revised: 12.10.2020. Accepted: 30.10.2020. ABACTERIAL PROSTATITIS OF VIRAL ETIOLOGY AND ITS CHRONOBIOLOGICAL FEATURES V. S. Goydyk, M. V. Novikov, A. І. Gozhenko State Enterprise "Ukrainian Research Institute of Transport Medicine, Ministry of Health of Ukraine", Odessa Abstract Urogenital infections are a global health burden all over the world. The combination of general “aging” of the population and improvement of diagnostic capabilities led to a surge in the detection of diseases of the urogenital sphere, much of which have viral etiology. An increase in the load on doctors of the urological profile, especially working at outpatient units, dictates the need to improve the efficiency of their work. The use of mathematical modeling methods in the study of medical records of 600 men with urogenital diseases made it possible to ascertain the seasonality of requests for medical help, as well as to create a prognostic model, the use of which suggests the possible number of referrals for patients with abacterial prostatitis of viral etiology during any month of the next year. Key words: urogenital infections; mathematical modeling; Gaussian distribution; second degree polynomial.

Objective: To study the impact of asymptomatic semen infections on seminal parameters in men presenting for primary couple's infertility. Design: Cross-sectional study. Setting: Academic center. Patients: Socio-demographic, clinical, and laboratory data from 1689 infertile men were analyzed. Intervention(s): Semen analysis was based on 2010 World Health Organization reference criteria. Each patient underwent semen culture test to identify common urogenital pathogens. Infections by Mycoplasma, Ureaplasma, and Chlamydia spp. were evaluated through a real time polymerase chain reaction platform. Descriptive statistics and linear and logistic regression models were used to test the association between semen infections and clinical, seminal, and hormonal parameters. Main Outcome Measure(s): Prevalence of asymptomatic semen infection and impact of semen infection on sperm parameters. Results: Of 1689 men, 354 (21.0%) had an asymptomatic positive semen culture. Ureaplasma urealyticum (37.6%) was the most frequent single pathogen, followed by Enterobacteriaceae (any type; 24.8%), other pathogens (20.3%), Chlamydia trachomatis (3.4%) and Mycoplasma spp (3.4%). Positive semen cultures were associated with lower sperm concentrations (P

Urogenital infections (UGI) remain one of the urgent problems of obstetrics and gynecology. In the period of gestation, the UGI may cause such complications as chorioamnionitis, intrauterine growth retardation and intrauterine and intrapartum infection of the fetus, spontaneous abortions, premature birth, purulent-septic complications in the postpartum period. According to the literature, UGI in pregnant women have a high prevalence and often occur in a latent form, complicating timely diagnosis and subsequent treatment.

Uterine fibroids take a second place in the structure of gynecological diseases, after inflammation of genital organs, with a share of 40%. The aim of the study was to investigate cytokine profile and factors of immune dysfunction in patients with uterine fibroids complicated by hemorrhagic syndrome during a course of hormone replacement therapy.А detailed comparative analysis of a survey was performed in 95 women with uterine fibroids. Tumor size did not exceed 12 weeks of pregnancy, mainly with intramural and subserous localization of nodes, having indications for conservative treatment. The main group consisted of 43 patients with uterine fibroids and clinical signs of hemorrhagic syndrome observed in the course of hormone replacement therapy (Buserelindepot 3.75 mg). In a comparison group (n = 52), treatment of fibroids with hormonal therapy was not carried out.A control group comprised healthy women (n = 27). The survey consisted of a comprehensive ultrasound scan with Doppler ultrasound apparatus HITACHI 5500. The immune parameters were evaluated as contents of cytokines (interleukins IL-1β, IL-4, IL-6, IL-2, IFNγ, TNFα) and levels of the Fas-ligand apoptosis marker in blood serum using solid-phase immunoassay technique. For identification of urogenital infection pathogens, methods of diagnostic PCR and ELISA were used.The results of the study were as follows: it is established that emergence of hemorrhagic syndrome on the during hormone therapy for uterine fibroids is associated with activation of latent forms of urogenital infections, being a probable result of potentiating immunosuppressive action of hormonal drugs that promote alterations of immune status, reduction of Th1 and Th2 lymphocyte functions, as well as significant inhibition of apoptosis. In the main group, IL-1β, IL-2, IL-4, IL-6 and IFNγ concentrations were decreased by 1.3 to 1.5 – fold, whereas TNFα and FasL contents were 2 times lower than the levels in control group. In addition, qualitative analysis of uterine hemodynamics has shown that the complications associated with hormone therapy of uterine fibroids are accompanied by a significant increase of the systolic blood flow velocity in the uterine arteries (1.8%), against decrease in diastolic blood flow (2.5 times) and increased resistance index of the vascular wall (1.6 times), as compared with appropriate parameters in healthy women. In conclusion, the received data suggest a need for more detailed examination of women, in order to detect chronic forms of urogenital infections, by means of improving conservative treatment strategies of uterine fibroids, reducing frequency of complications and effectiveness of hormone therapy

Objectives: To assess the effect of microablative fractional CO 2 laser (MFCO 2 -Laser) therapy on the vaginal microenvironment of postmenopausal women. Methods: Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear

Diabetes mellitus (DM) is a widespread disease in our country. Urogenital infections, including urinary tract infections, vaginitis, balanitis, balanoposthitis, and male accessory gland infections, show a higher risk of occurrence in patients with DM that non-diabetic subjects. Both non-drug-related and drug-related mechanisms are involved in their pathogenesis. These conditions may impact on glucose control and islets function in DM and more likely develop into adverse complications. A throughout microbial characterization, including the drug-sensitivity test, is required for a proper management. To reduce the risk of recurrence, combined treatment, including antibiotic, anti-inflammatory, and fibrinolytic molecules, should be prescribed also to the sexual partner. The choice of the antidiabetic drug to prescribe should take into consideration the presence of urogenital infections. In conclusion, urogenital infections may more likely lead to complication in diabetic than non-diabetic patients, affect fertility and glucose control. Therefore, they need proper management.

The article presents a report on the international conference «Urogenital infections and tuberculosis», held in Novosibirsk from 24 to 26 October 2013.

The purpose of this study was to investigate the clinical symptoms, features of morphological structure of prostate in patients with chronic recurrent prostatitis associated with chlamydial and mycoplasmal infections. 60 male patients were examined. Anamnesis and interview data, results of laboratory and instrumental tests were analyzed. In 73.3% of cases cultural test and PCR allowed to identify M. hominis, U. urealiticum, M. genitalium, C. trachomatis in patients with chronic uretheroprostatitis. Out of 16 patients (26,6% of all examined) with chronic recurrent uretheroprostatitis for whom neither chlamidial nor mycoplasmal infection was diagnosed by laboratory tests, for 14 patients (87,5%) it was confirmed that patogenic urogenital infectious agents were localized intracellularly. Pathomorphological investigation of prostate bioptates allowed to estimate the type and degree of specific changes in the prostate tissue in cases of recurrent uretheroprostatitis resistant to the therapy and with frequent relapses.

In the 1970s, clinicians and researchers specializing in urinary tract infections (UTIs) established and published the first-ever Criteria for Clinical Evaluation of Drug Efficacy on UTI. There had so far been no uniform criteria for the evaluation of drug efficacy, and different criteria for determining drug efficacy had been used in the development of drugs, which had caused problems in determining drug efficacy and had made it impossible to compare efficacy between drugs. To resolve these challenges, the Criteria for Clinical Evaluation of Drug Efficacy on UTI were established on the basis of the results of a large number of studies. The late Dr. Masaaki Ohkoshi, the late Dr. Joji Ishigami, the late Dr. Tsuneo Nishiura, Dr. Toyohei Machida, Dr. Yoshiaki Kumamoto, Dr. Joichi Kumazawa, Dr. Yukimichi Kawada, Dr. Sadao Kamidono, and other senior physicians made efforts to create the world’s first Criteria for Clinical Evaluation of Drug Efficacy on UTI, which had contributed enormously to the development of antimicrobial agents for UTIs. In 1989, an International Symposium entitled ‘‘Clinical Evaluation of Drug Efficacy on UTI’’ was held in Tokyo and offered opportunities to get international recognition of the Criteria for Clinical Evaluation of Drug Efficacy on UTI. Thereafter, the International UTI Symposium was established and came to be held biennially in conjunction with the International Congress on Chemotherapy. The joint symposium has been held ten times to date. In Japan, the Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on UTI were created by the UTI study group. The Criteria, which were those of the revised 3rd edition, involved various urological infections, including prostatitis, epididymitis, and urethritis, in addition to UTIs. Meanwhile, Infectious Diseases Society of America (IDSA)/ Food and Drug Administration (FDA) guidelines and the Criteria for Clinical Evaluation of Drug Efficacy were established in theUnitedStates andEurope, respectively,which led to an increased need for international harmonization aswell as globalization of the development of antimicrobial agents. To move with the times and to allow compatibility between data accumulated in Japan and data fromother countries, the Study Group on Urology, the Committee of Clinical Evaluation Methods, and the Japanese Society of Chemotherapy discussed and created the 4th edition of Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on UTI (tentative) and its supplement in 1996. However, further international harmonization was needed, as international drug development, extrapolation of clinical data from other countries, and bridging studies had been increasing. In bringing about international M. Yasuda S. Takahashi H. Kiyota K. Ishikawa A. Takahashi S. Yamamoto S. Arakawa K. Monden T. Muratani R. Hamasuna H. Hayami T. Matsumoto UTI Subcommittee of the Clinical Evaluation Guidelines Committee, Japan Society of Chemotherapy, Tokyo, Japan

Urogenital infections are one of the most common causes for a woman to visit a gynecologist or a urologist. The well-known association between abnormal vaginal microbial flora and its formidable risk in the increased incidence of urinary tract infection underscores the importance of understanding the microbial flora and the efforts needed to maintain it, for ensuring urogenital health. Surprisingly in spite of the increased incidence urogenital infections receive very less attention from the medical fraternity. Growing awareness among people and newer advances in the medical field has brought them into the limelight. The importance of replenishing these depleting commensals with 'probiotics' has resurfaced in a big way. As the days go by science and medicines will touch new milestones, which will include probiotics. The value of a probiotics cannot be taken at face value. Probiotics must not be considered a panacea for treating urogenital infections. However, the available data promises that it will be a strong option in improving and maintaining urogenital health.

The report author shares his impressions of the Congress of the International Society of Chemotherapy infections and cancer, which took place from 5th to 8th June 2013 in Yokohama, Japan.

Cахарный диабет (СД), являясь одним из наиболее рас- пространенных заболеваний в мире, представляет собой острейшую медико-социальную проблему, приоритет- ную для систем здравоохранения всех стран. Неоспоримый прогресс в лечении СД привел, с одной стороны, к увеличению продолжительности жизни этих больных, а с другой ? к возра- станию частоты различных осложнений данного заболевания. Нарушение углеводного обмена оказывает негативное влияние практически на все органы и системы организма, в том числе на мочеполовую систему. Среди основных урологических ос- ложнений при СД наиболее часто встречаются инфекции мо- чевых путей (ИМП) и тесно связанные с ними воспалительные заболевания почек.

Objective Well-known natural unspecific antimicrobial factors acting in the vagina are additionally reinforced during menstrual bleeding by hemocidins—a recently discovered novel class of microbicidal peptides generated proteolytically from hemoglobin. The aim of the presented research was to investigate the relation between the average length of menstrual bleeding and the frequency of urogenital infections. We expected that the shorter menstrual bleeding might increase the risk of urogenital infections because is synonymous with the shorter period of exposition on bactericidal action of hemocidins. Study design The study contains statistical analysis of an average declared length of menstrual bleeding in the group of 267 young, sexually active women with the symptoms of urogenital infections. The control group consisted of 300 young healthy women. Results The length of menstrual bleeding in the group of patients with urogenital infections (average 4.35 days) was statistically significantly shorter than in the control group (average 4.95 days). The average length of the menstrual cycle was equal and counted ca. 28 days in both groups. Conclusion The length of menstrual bleeding seems to be a significant factor in the vaginal ecology maintenance.