Vol 18, No 7 (2016)

Study design. An open label, non-randomized, multicentre clinical trial. Purpose of the study. Efficacy and safety of Canephron® N in the management of women with uncomplicated urinary tract infections. Introduction. Despite of increasing prevalence of bacterial resistance to antibiotics and possible adverse drug reactions, uncomplicated lower urinary tract infections are usually treated with antibiotics. Canephron® N, a herbal medicinal product, was investigated for safety and efficacy in women suffering from uncomplicated urinary tract infections. Methods. The study included 125 patients suffering from uncomplicated urinary tract infections. Cases with the sum score of at least 6 for the symptoms of dysuria, frequency and urgency were enrolled. Patients were treated with 3.2 tablets Canephron® N for 7 days. Symptom assessment was performed by the patient on a daily basis and by the investigator at Day 0, Day 7 and Day 37. Incidence of adverse drug reactions during the treatment was considered as primary endpoint; clinical cure on Day 7, severity of uncomplicated urinary tract infections symptoms on Day 7 and Day 37, patients requiring antibiotic treatment until Day 7, duration of uncomplicated urinary tract infections symptoms and patients with early recurrence - as secondary endpoints. Changes in laboratory parameters were also analyzed. Results. None of the 19 adverse reactions reported in the study was not associated with the use of the drug and not characterized as "serious". The response rate was 90.4% and 93.6% on Day 7 and Day 37 with a significant improvement of all symptoms (p<0.001). Only 2.4% of patients required antibiotics during the treatment. None of the patients met the definition of recurrence until Day 37. The mean changes of the main symptoms on Day 7 and Day 37 compared to Day 0 were: -1.9/-2.3 (dysuria); -1.8/-2.4 (frequency); -1.6/-1.9 (urgency). Decreased nitrite, leukocytes as well as erythrocyte levels accompanied symptomatic improvement from Day 0 to Day 7 and Day 37. Conclusion. The study confirmed the safety and efficacy of the Canephron® N without antibiotics.

The article shows the results of treatment of 311 patients with benign prostatic hyperplasia with dutasteride. Duration of the drug intake has ranged from 6 to 48 months. It turned out that in order to achieve a stable clinical effect duration of treatment of benign prostatic hyperplasia with this drug should not be less than 48 months.

Rather rare occurrence of encrusted cystitis led to that by today prominent researches haven’t been done both at Russian and foreign clinics on this form of cystitis, while scientists' works contain only description of unit cases of this disease, seeing standards of diagnostics and treatment could not have been worked out. The aim of our research was to analyze experience in treating patients with encrusted cystitis at S.P.Botkin City Clinical Hospital, to suggest the most optimal algorithm of diagnostics and treatment and to reveal roots of disease and possible ways of prevention from it.

Introduction. Urinary tract infections (UTIs) have a leading role in the structure of outpatient reception of the urologist. This issue is dedicated to a great number of publications in domestic and foreign literature. However, unacceptably high relapse rate that underscores the urgency does not reduce the problem. Material and methods. Critically evaluate the results of studies on the epidemiology and characteristics of UTI treatment for 37 and sources. Results. Among all inflammatory diseases of the genitourinary system in the structure of municipal polyclinic receiving 60.9% are chronic pyelonephritis and acute cystitis - it was diagnosed in 7.5% of ambulatory patients of urologists. Revealed heterogeneity spectrum shows uropathogens and volatility of microflora resistance. It is likely that treatment failure and a tendency to chronic urinary tract infections caused by spread spectrum uropathogens and increasing their resistance to standard antibiotics. The issue of antibiotic selection can not fully rely on the data in the literature, it is necessary to know the range of flora and its resistance in the region, and have fresh, not older than 2 years, the results of bacteriological research, since these parameters are highly variable. 82.4% of young pregnant women with acute uncomplicated cystitis, were cured without the use of antibiotics, by combined use of nonsteroidal anti-inflammatory drug and herbal medicine Canephron. Conclusions. Within the structure of acute cystitis UTIs share is minimal. Sub-optimal treatment leads to chronic disease and diagnostic errors. The selection of treatment should take into account the data of bacteriological research.

The paper presents the current data on the diagnosis and treatment of gestational pyelonephritis. Currently, there are opportunities for a reliable diagnosis of pyelonephritis in pregnancy due to the introduction of modern techniques such as magnetic resonance imaging, Doppler ultrasound. Scientific progress and the emergence of innovative diagnostic methods also influenced the formation of a new approach to the treatment etiopathogenetic gestational pyelonephritis. Modern possibilities of evaluation of structural and functional state of the parenchyma of the kidneys and urinary tract in the early stages of the disease (magnetic resonance imaging, Doppler ultrasound), the emergence of minimally invasive technologies and highly efficient broad-spectrum antibiotics significantly reduced the number of open surgical benefits with gestational pyelonephritis. This article discusses the clinical samples to more fully acquainted with this disorder and its treatment.

Urinary tract infection is one of the most common complication of spinal cord injury. Its influence on the course of the underlying disease is possible in the acute period of spinal shock, and can be traced throughout the subsequent recovery period. The literature review assesses the factors, which cause development of urinary tract infection in spinal cord injury patients, shows the impact of catheter-related infection and issues of diagnosis, treatment and prevention of urinary tract infection.

To help the practitioner in the article the modern data on infectious / parasitic and non-infectious forms of balanoposthitis. Outlines etiology, clinical manifestations, diagnosis and treatment balanoposthitis with clinical observation of his rare form - syndrome larva migrans. Each form balanoposthitis is illustrated by a photograph.