Search

The study purpose. Identification of structural and functional changes in pelvic lymph nodes in experimental metastatic prostate cancer.Materials and methods. The study included 30 male mice aged 3 months. All animals (n = 30) were divided into 2 groups. The first group (the main one, n = 20) included mice that had a model of metastatic prostate cancer created by transplanting an Ehrlich tumor into the prostate parenchyma. These animals were further divided into two equal subgroups: 1a (n = 10) – mice were withdrawn from the experiment on day 7; 1b (n = 10) – mice were withdrawn from the experiment on day 18. The second group (n = 10) included mice that were not manipulated, they made up the control group. After the end of the experiment, morphological analysis of the prostate gland and regional (pelvic) lymph nodes in mice of both groups was performed using light microscopy. Statistical processing of the results was carried out using the Statistica 8.0 software package. The differences were considered statistically significant at p < 0.05.Results. When compared to the control group the mice of groups 1a and 1b, the prostate parenchyma was almost completely replaced by atypical cells, which demonstrates the presence of neoplastic processes in the prostate gland. In group 1a mice, the number of pelvic lymph nodes was 1.9 times as large, and in group 1b animals, this indicator was 2.7 times higher compared to the second group (p < 0.01). In animals of the first group, the proportion of mast cells in the pelvic lymph nodes increased by 121 % compared to the control group (p < 0.01). At the same time, we revealed a direct relationship of mast cells with the number of tumor cells and immunoblasts in the medullar sinuses, which indicates the participation of tissue basophils in tumor metastasis. We also recorded a significant increase in the area of the medullar sinuses of regional lymph nodes in animals of groups 1a by 12.4 % (p < 0.05) and 1b by 20.2 % (p < 0.01) against the background of an increase in the number of mast cells in this zone compared to the control group, which indicates the possible participation of mast cells in lymphangiogenesis.Conclusion. Mast cells can potentially play a role in the development of malignant neoplasms of the prostate gland. The number of mast cells increases in pelvic lymph nodes in animals with a created model of metastatic prostate cancer. The obtained direct dependence of the increase in the number of mast cells and the increase in the number of tumor cells with immunoblasts suggests the participation of tissue basophils in the spread of metastases. It can be assumed that infiltration of lymph nodes by mast cells may correlate with a poor prognosis of prostate cancer, since these granulocytes contribute to tumor metastasis.

Background. Paraurethral cyst (PC) is often found in women aged 20–60 years. The prevalence of PC in the female population is 1–6 %. Since PC are often located in the distal urethra and lie close to the genitals of a woman, the symptoms associated with this disease cause women both physical and psychological suffering.Aim. To assess the quality of life of women with PC.Materials and methods. The study included female individuals (n = 106) aged 18–60 years, in whom PC were detected during examination of the perineal region. The quality of life of the patients was assessed on the basis of the health quality questionnaire – SF-36.Results. The average volume of the PC in the observed women was 3.2 ± 1.3 cm. In the observed women, the intensity of pain in the perineum was directly proportional to the duration of the disease: up to a year – 86.3 ± 4.1; from one to three years – 76.4 ± 8.3; more than three years – 64.4 ± 9.2 (p

Russian and foreign epidemiological data suggest that males may have an increased risk of morbidity and mortality associated with COVID‑19. It is known that due to the high expression of ACE2 in spermatogonia, Leydig and Sertoli cells, the testicle, as an organ producing male germ cells, is a potential target for the COVID‑19 virus, which directly affects the reproductive health of men. To date, several factors of the influence of the SARS-CoV‑2 virus on the male reproductive system are known. To begin with, when infected, the virus has a direct damaging effect on the testicle itself with the provocation of orchitis. In addition to the previous statement, high body temperature during inflammation contributes to an increase in testicular temperature, which can lead to a deterioration in the quality of sperm. Furthermore, a pronounced inflammatory reaction promotes the circulation of a large number of cytokines and damage to the hemato-testicular barrier. Also, the increased activity of immunocytes leads to an imbalance of the antioxidant system of men, an increase in the level of reactive oxygen species and the formation of oxidative stress. In a Nutshell, Leydig cell dystrophy provokes the development of secondary hypogonadism. Thus, COVID‑19, like a “multifaceted Janus”, has a polysymptomatic manifestation, but at the same time has a multifactorial effect on the reproductive function of a man. All these factors of the impact of the SARS-CoV‑2 virus on the testicle must be considered when rehabilitating the patient. It should be kept in mind that the deterioration of sperm quality is observed both during the acute period of coronavirus infection and during recovery period. Therefore, laboratory evaluation of the ejaculate in dynamics and its correction is necessary for males, especially those who plan to realize their reproductive potential.Conclusion. COVID‑19 generally has a negative impact on spermatogenesis and male fertility. To date, the timing and degree of restoration of a man’s reproductive function after a coronavirus infection remains completely unknown. Therefore, both in the early and late rehabilitation period, men of reproductive age need the supervision of an andrologist.

The proportion of men with impaired sperm fertility is increasing every year, which is one of the factors in the decline in fertility and is becoming both a medical and social problem. Modern diagnostic methods make it possible to recognize many factors of male infertility: genetic, endocrine, infectious, extra-genital, etc. However, despite all modern biomedical advances, 1/3 of patients remain with an unrecognized cause (idiopathic) of male infertility. At the same time, we must not forget that most patients from this category do not want to resort to assisted reproductive technologies to realize paternity, and they strive to achieve pregnancy in a natural way. Therefore, the search for the causes of male infertility remains an urgent issue in modern urology field. This article reviews the literature on the role of mast cells in the formation of fibrosis in tissues, including the testis. Mast cells affect the proliferation, functioning and phenotype of fibroblasts put under hypoxic conditions. Fibroblast activation enhances collagen fibrillogenesis. Studies by Russian and foreign scientists have shown that with sperm pathology, the number of mast cells in the connective tissue of the testicle increases sharply. Against the background of an increase in the number of mast cells in the interstitium of the testis, fibrosis of the wall of the convoluted seminiferous tubules increases. Moreover, in severe spermatogenesis disorders (Sertoli cell-only syndrome, Germ cell aplasia), mast cells were found both in the peritubular space and in the lumen of the convoluted seminiferous tubules. Most infertile men have significant amounts of significant amounts of mast cells in their ejaculate. There are sporadic data on the negative correlation between the presence of mast cells in seminal plasma and the concentration and motility of spermatozoa. Conclusion. The negative effect of mast cells on spermatogenesis remains unknown to the end. Mast cells have a high ability to migrate to connective tissue, which levels increase during inflammation, and the production of many mediators, proteases and histamine, cytokines, which can be both a trigger in the formation of sperm pathology and the cause of the formation of fibrosis in the testicle.

Purpose of the study. To evaluate morphological changes in the testes in experimental animals after tension-free inguinal hernia repair modeling.Materials and methods. The study included male rabbits, aged 120 days, weighing 3.8 ± 0.9 kg. All rabbits were divided into two groups depending on the type of operation: in the first group (n = 10) of animals, we made a model of tension-free inguinal hernia repair and used a polypropylene mesh; in the second group (n = 10) of animals, we left the structures of the inguinal canal intact. Morphological assessment of spermatogenesis was performed after 40 days. All morphometric measurements were carried out on strictly cross-sections of the convoluted seminal tubules.Results. In rabbits of group 1, the volume of the testicle was significantly three times less than in animals of group 2 (p < 0.05). In the animals of the first group, a significant deterioration in spermatogenesis was observed (p < 0.05). Histological examination of sections of the testes of these animals showed that hypoplasia of the spermatogenic epithelium was present in the convoluted seminal tubules, in 1/8 of the tubules there was subtotal aplasia of the spermatogenic epithelium, Sertoli-Cell-Only Syndrome was detected only in 2 %. Atrophy of the convoluted seminal tubules was not recorded at this period of observation. In the animals of the control group, almost 90 % of cases of spermatogenesis disorders were not detected.Conclusions. This experimental study on rabbits showed that after using a polypropylene mesh for inguinal canal plastic, inhibition of germ cell maturation occurs after 1.5 months. Therefore, in men of reproductive age, it is necessary to use polypropylene mesh implants with caution in terms of performing inguinal hernia repair.

Background. The etiology of benign prostatic hyperplasia (BPH) has not been fully studied. The main role in the induction of prostate tissue proliferation is assigned to the metabolism of testosterone. Recently, it has been reported that one of the risk factors for BPH is a chronic violation of the blood supply to the prostate.The study objective is to determine the level of reproductive hormones in blood serum and prostate tissue when creating a model of chronic ischemia.Materials and methods. The model of chronic pelvic ischemia was created in 10 white non-linear mature rats by partial ligation of the inferior vena cava. The control group of the study consisted of 10 male rats of the same age. After 1.5 months, we performed a hormonal study in all rats (n = 20) determining the concentration of testosterone, dihydrotestosterone and estradiol in the blood and prostate tissue. Also, in all animals (n = 20), a morphological study of the prostate was performed.Results. We’ve found a significant increase in prostate mass in the main group of rats by 16.4 % (p 0.05) in the prostate tissue.Conclusion. Long-term ischemic disorders in the prostate may be a trigger factor for the development of BPH due to an increase in the concentration of testosterone.

At the turn of 2019–2020, humanity was struck by a new viral infection SARS-CoV-2 (COVID-19), which quickly spread in many countries and reached the scale of a pandemic. A feature of the SARS-CoV-2 virus (COVID-19) is it’s high contagiousness, virulence and tropism to many cells of human organs. Human infection primarily occurs through the respiratory tract. Then, getting into the respiratory divisions, SARS-CoV-2 (COVID-19) can enter the blood and interact with cells of other organs. It is already known that COVID-19 uses the angiotensin converting enzyme type 2 (ACE2) receptor to enter the cell, and ACE2 is highly expressed in the kidneys. Therefore, kidney disease is a risk factor for COVID-19 infection, exacerbating the clinical course of the disease. This article discusses the main aspects of the etiology and pathogenesis of kidney diseases in the context of the COVID-19 pandemic. Since there is currently no specific vaccine against the SARS-CoV-2 virus, and there is no effective drug for the treatment of COVID-19, the identification of risk factors and early medical correction of kidney diseases can help reduce the overall incidence and mortality. Conclusion. Early detection and correction of violations of filtration and excretory function of the kidneys, including adequate hemodynamic support and restriction of nephrotoxic drugs, can improve the prognosis of recovery of a patient with COVID-19.

Purpose of the study. To assess the degree of influence of ischemic disorders in the prostate on the level of androgens.Materials and methods. This was an experimental study that included 20 white non-linear sexually Mature rats. All animals were divided into 2 equal groups: main and control (intact). In the main group of animals (n=10), we created a model of chronic ischemic disorders in the prostate by partial ligation of the inferior Vena cava. After 1.5 months, we conducted a hormonal study in all rats (n=20) — determining the concentration of androgens (testosterone, dihydrotestosterone) and estrogens (estradiol) in the blood of animals and prostate tissue.Results. In the blood of animals of both groups, the level of total testosterone and estradiol did not significantly differ (p>0.05). The level of dihydrotestosterone in the blood serum of rats of the main group on the background of ischemia was reduced by 18.1%, compared to the intact group (p>0.05). However, we detected elevated levels of testosterone (p0.05) in prostate tissue against the background of chronic ischemia.Conclusions. Chronic ischemic disorders in the prostate can be an independent pathogenetic factor in the development of BPH. Vascular damage leads to impaired blood flow and hypoxia, with increased tissue concentration of testosterone, which potentiates the development of BPH.

Renal cell carcinoma (RCC) accounts for 3.9 % of all cancers. In 2018, 24,291 and 63,990 new cases of RCC were recorded in Russia and the US, respectively. The most common approach to early stage RCC treatment consists in either radical or partial nephrectomy. This article presents a clinical case of the successful treatment of a localized renal cell carcinoma T3аN0M0 in a 65-year-old man. 8 weeks after the performed kidney resection, the biochemical blood parameters and glomerular filtration rate did not significantly differ from the initial values (p > 0.05). A control CT examination of the abdominal cavity and the retroperitoneal space (after 12 weeks) detected no enlarged regional, paraaortic and paracanal lymph nodes. Partial nephrectomy is considered to be an alternative surgical treatment of localized RCC forms due to its potential for maximal organ preservation. Partial nephrectomy should be a method of choice in cases where it is technically and strategically feasible, since this type of surgical intervention provides for a better preservation of renal function under a lower risk of postoperative complications.

In women aged from 20 up to 60 years paraurethral cysts occur in 1–6%. In most cases, the clinical course of paraurethral cysts is asymptomatic, so their diagnosis can cause difficulties. Women who have paraurethral cysts may complain of pain, dyspareunia, and urinary disorders. The size of a cyst more than 2 cm can affect the quality of patient’s life, and very often causes symptoms of the lower urinary tract, including obstructive ones. Paraurethral cysts need to be differentiated other perineal formations. This article presents a review of the literature on the etiology, clinical course and diagnosis of paraurethral cysts. The main points of differential diagnosis of paraurethral cyst with urethral diverticulum, adenocarcinoma are also consecrated. Taking into consideration the anatomical location and the specifics of the treatment of paraurethral cysts, this problem has an interdisciplinary nature and requires the attention of specialists such as: urologist, gynecologist, surgeon.

The article discusses the effectiveness of herbal medicine in inflammatory diseases of the prostate. This literature review presents clinical studies of the successful use of herbal ingredients in the treatment of chronic prostatitis and relief of lower urinary tract symptoms (LUTS). Biological active substances of Urtica dioica, Cucurbita moschata, Saw palmetto (Serenoa repens), and zinc are effective in the treatment of chronic prostatitis due to anti-inflammatory, antiproliferative, antiandrogenic and antioxidant action. Phytopreparations containing these substances can be recommended as the first line of correction of LUTS in chronic forgive categories III and IV; as a general tonic for men leading a sedentary lifestyle over the age of 35 years.

Inguinal hernia is a common disease affecting about 5-10% of the population. About 370 000 inguinal hernia repair per year is registered in Russia. Surgeons have reduced recurrence of hernias to a minimum after the widespread introduction of non-tension hernia repair. However, today other complications of inguinal hernias have become prevalent: infection, pain and paresthesia in the scrotum, pathospermia. Opinion about the negative impact on spermatogenesis of both herniation and surgery for hernia is still controversial. This article provides an overview of modern foreign and Russian literature on the аssociation of different types of inguinal hernia repair with pathospermia.

In the structure of infertile marriage male factor of infertility occurs in about 40-50%. About 30% of infertile men who have sought medical care have oligozoospermia or azoospermia of unknown etiology. The question of the chances of spermatogenesis recovery and increased probability of sperm extraction in repeated assisted reproductive technology (ART) programs is important for both the doctor and the patient.Purpose. To evaluate the morphological changes of spermatogenic epithelium in patients with male infertility in terms of prognosis of ART success.Patients and methods. 264 men with infertility were examined. The scope of clinical study of all patients included: history, examination, determination of blood hormones, study of ejaculate, karyotype, ultrasound. We performed a biopsy of the testis according to the patient's symptoms. Testicular tissue was subjected to morphological examination.Results. Primary infertility was observed in 172 men (65.2%), secondary — 92 (34.8%). 112 (42.4%) patients had severe infertility. The results of morphological studies in these men showed a different degree of violation of spermatogenesis. Based on the study, a diagnostic algorithm of patients with male infertility is proposed, which allows to predict the success of ART taking into account morphological changes in the testicle.Conclusion. On the basis of clinical and morphological study of the features of spermatogenesis of a particular patient a plan can be made for further personal diagnostic and therapeutic measures.

Erectile dysfunction (ED) requires a comprehensive, advanced diagnostics, as the judge the state of the microvasculature of the corpora cavernosa by ultrasound may indirectly.Purpose. To improve the diagnostic results of erectile dysfunction using falloscintigraphy.Materials and methods. We examined 56 men. All patients fulfilled the ultrasound study of penis itself and stimulated erections with pharmacological agents (prostaglandin E, 20 mg). We spent falloscintigraphy to identify the microcirculatory disturbances in the tissues of the penis.Results. Analysis of the questionnaire of erectile function demonstrated that in the group there were 4 (7.1%) patients with severe ED, 29 (51.7%) — with moderate ED, 23 (41.2%) — with mild erectile dysfunction. According to the ultrasound of the penis we registered signs of ED in 38 (67.9%): arterial — 24 (63.1%) patients, venous ED — 11 (28.9%) patients, mixed ED — 3 (8%). In 18 (32.1%) patients by ultrasound, we detected no structural pathology tissue of the penis, so we conducted additional tests — falloscintigraphy. Falloscintigraphy results showed that the two men (11.2%), we have not identified any pathology. Therefore we have regarded their erectile dysfunction as psychogenic. In 16 (88.8%) patients were detected during falloscintigraphy impaired microcirculation of the corpora cavernosa. The results of our study show that falloscintigraphy has a high sensitivity (91%) and specificity (94%) compared to the US (78% and 60%, respectively) in the diagnosis of disorders of the microcirculation of the corpora cavernosa of the penis.Conclusions. Falloscintigraphy may be used for the diagnosis of vasculogenic erectile dysfunction, if the ultrasound is not effective to detect microcirculatory disturbances of the corpora cavernosa.

One of andrology's most important and exciting tasks is to disclose the workings of these mechanisms und ultimately to eliminate their cause by rational therapy idiopathic male infertility. This study shows that the use of additional diagnostic method – dynamic orhoscintigraphy – allows to identify an additional violation of the venous drainage of the scrotum in patients with idiopathic infertility. Use of pathogenetic therapy can improve the quality of semen in these patients by 25–30 %.