Probiotics in the Prevention of the Calcium Oxalate Urolithiasis

Nephrolithiasis ranks third among urological diseases in terms of prevalence, making up about 15% of cases. The continued increase in the incidence of nephrolithiasis is most probably due to changes in eating habits (high protein, sodium, and sugar diets) and lifestyle (reduced physical activity) in all developed countries. Some 80% of all kidney stones cases are oxalate urolithiasis, which is also characterized by the highest risk of recurrence. Frequent relapses of nephrolithiasis contribute to severe complications and high treatment costs. Unfortunately, there is no known effective way to prevent urolithiasis at present. In cases of diet-related urolithiasis, dietary changes may prevent recurrence. However, in some patients, the condition is unrelated to diet; in such cases, there is evidence to support the use of stone-related medications. Interestingly, a growing body of evidence indicates the potential of the microbiome to reduce the risk of developing renal colic. Previous studies have primarily focused on the use of Oxalobacterformigenes in patients with urolithiasis. Unfortunately, this bacterium is not an ideal probiotic due to its antibiotic sensitivity and low pH. Therefore, subsequent studies sought to find bacteria which are capable of oxalate degradation, focusing on well-known probiotics including Lactobacillus and Bifidobacterium strains, Eubacterium lentum, Enterococcus faecalis, and Escherichia coli.

Initial Evaluation of Uroplakins UPIIIa and UPII in Selected Benign Urological Diseases

Background: Uroplakins (UPs) are glycoproteins that play a specific role in the structure and function of the urothelium. Disorders which affect the normal expression of UPs are associated with the pathogenesis of infections and neoplasms of the urinary tract, primary vesicoureteral reflux, hydronephrosis and renal dysfunction. The appearance of uroplakins in the urine and/or plasma may be of potential importance in the detection of urinary tract dysfunction. The aim of the present study was to investigate uroplakin IIIa (UPIIIa) and uroplakin II (UPII) expression in patients with selected urological diseases. Methods: Plasma and urine from patients with benign prostatic hyperplasia (BPH), urethral stricture (US), urinary tract infection (UTI) and urolithiasis were compared to healthy people without urological disorders. UPs concentrations were measured by the immunoenzymatic method. Results: In patients with BPH and UTI, concentrations of UPIIIa in urine and plasma, as well as UPII in urine, were statistically significantly higher than in the control groups. In the US group, only the plasma UPIIIa concentration differed significantly from the control. Conclusion: The conducted research shows that benign urological diseases may affect the state of the urothelium, as manifested by increased concentrations of both UPs in patients’ urine and plasma, especially in BPH and UTI.

The Therapeutic Potential of Saw Palmetto Extract in Urological Disorders

Saw palmetto extract (SPE) has been widely used as a therapeutic remedy for urinary dysfunction in western countries. Furthermore, as an herb drug, it can be used as an alternative therapy for benign prostatic hyperplasia (BPH) due to its safety and minimum adverse effects. Reportedly, SPE improves the urinary symptoms, which mainly depend on anti-androgenic effects and effects on autonomic receptors in the lower urinary tract. However, the mechanisms of action responsible for the therapeutic roles of SPE have not been fully elucidated. Relevant studies indicate that SPE has some positive effects on the treatment of urological diseases in animals, and clinical trials are ongoing. In this review, we summarize the pharmacological properties and discuss the possible therapeutic mechanisms of SPE in urological diseases, including anti-androgenic effects, effects on autonomic receptors in the lower urinary tract, anti-inflammatory activity, anti-proliferative and pro-apoptotic effects, and highlight a potential therapeutic approach in the clinical treatment of patients with BPH, prostate cancer, chronic prostatitis (CP) and erectile dysfunction (ED).

Persistent dysuria in women: etiological diagnostics and treatment

INTRODUCTION:Dysuria is a painful urination combined with its frequency and/or difficulty. Dysuria is observed in many urological diseases and is one of the most common reasons for treatment for urological cause. AIM:The aim of the study is to identify the etiological factors of dysuria in women and to evaluate a personalized approach to their treatment. MATERIALS AND METHODS:We analyzed the data of 368 women with chronical cystitis. The inclusion criteria for the study were the presence of dysuria (painful and frequent urination more than 8 times a day with or without difficulty), the prescription of urination disorders over one year old and age 18 and over. All patients underwent a comprehensive urological examination to identify the causes of urinary disorders. RESULTS:The Bacterial cystitis was confirmed only in 78 (21.2%) patients among all 368 women. In the remaining 290 (78.8%) patients, the causes of persistent dysuria were other diseases: bladder leukoplakia in 154 (41.8%), bladder pain syndrome/interstitial cystitis in 38 (10.3%), viral cystitis in 34 (9.3%), paraurethral formations in 29 (7.9%), neurogenic urinary dysfunction bladder in 25 (6.8%), urethral pain syndrome in 5 (1.4%) patients. Dysuria was also caused by postradiation cystitis (2 patients), secondary stones in the urinary bladder (2 patients), and one patient had extragenital endometriosis. CONCLUSIONS:The variety of reasons for the development of persistent dysuria in women requires careful examination of patients. Treatment should be carried out only after accurate verification of the diagnosis.

Evaluation of Galdakao-modified Valdivia Position in Combined Simultaneous Access to Upper and Lower Urinary Tract Pathologies

Background Simultaneous retrograde and antegrade endoscopic combined intrarenal surgery in modified supine lithotomy positions offer significant progress in the endoscopic management of urolithiasis. The operative time has been significantly reduced. Aim of the Work To evaluate the Galdakao-modified Valdivia position in simultaneous handling of upper and lower urological pathologies in the same units. Patients and Methods The evaluation for the Galdakao-modified Valdivia position regarding the benefits in different upper and lower urological diseases was the aim of our prospective randomized clinical trial that will started on April 2017 and ended by April 2019. Results The study has included 60 patients comprising males and females. Conclusion We believe that GMSV provided a great versatility in the treatment for urolithiasis along the whole urinary tract, ante-retrograde access, treatment of uretero-ileal strictures in patients with urinary diversions or neobladders, missed double j stent, bilharizoma of the ureter and bladder mass involving the ureteric orifice. Also, the advantage provided by this approach to the surgeon, patient and anesthetist may lead to widespread adaptability of this technique in the management of complex urolithiasis.

Features of the Course of Lower Urinary Tract Symptoms in Men with Benign Prostate Hyperplasia and COVID-19

Nowadays men’s health remains in priority. It is given no less attention than to the cardiovascular disorders and cancer. Low urinary tract symptoms (LUTS) accompany most urological diseases and thus are among the most significant syndromes in urology. The medico-social significance of the syndrome puts the development of protocols for its effective detection and drug treatment with long-term efficacy in a number of priority tasks, stimulating the pharmaceutical industry to search for promising candidates.. Restrictions of COVID-19 Pandemic prevent routine procedures by urologists, prompting them to provide online counseling. Under these circumstances, recommendations were made on the strategy and tactics of treatment of urological diseases during a pandemic, as well as strategic directions in the urology of the future were identified. There is a worldwide consensus among experts on minimizing invasive treatments for benign prostatic hyperplasia (BPH) to maximize the protection of medical personnel from the potential risk of COVID-19 infection, while direct contact with patients is not always possible to avoid. It is known from scientific sources that, in contrast to 2019, in 2020 there was a tendency of increase the share of hospitalizations for emergency urological conditions as well as the share of critical conditions, requiring the strengthening of anti-epidemic measures. Over the past year the ability of the SARS-CoV-2 virus to increase the severity of LUTS in men with urological pathology was reported. Furthermore the development of severe urogenital symptoms (COVID-19-associated cystitis) with a high content of proinflammatory cytokines not only in blood plasma but also in urine was registered. This allows to include LUTS «de novo» in the complex of symptoms of COVID-19. Physicians should be aware of urogenital manifestations COVID-19 and include verification of bladder dysfunction to diagnostic program. Strict adherence to WHO and EAU anti-epidemic recommendations and algorithms is extremely important, so we provide online counseling to patients with symptomatic BPH, ensuring the continuity of the specialized treatment process and minimizing direct contact. The proposed method of treatment of moderate to severe BPH associated LUTS involves tamsulosin monotherapy or in combination with finasteride. The results of the use of tamsulosin hydrochloride in cases of LUTS in BPH indicate that the percentage of acute urinary retention in patients receiving monotherapy is almost similar to that when using combination therapy (tamsulosin + finasteride) and is about 7.0% per year. The obtained data suggest that the observation of patients at a distance can be justified only temporarily, but requires strict adherence to an individually designed treatment plan, which should be based on the guidelines of the Ministry of Health of Ukraine and WHO standards. The problem of BPH is a very important issue in modern medicine and requires clear treatment algorithms, with different contexts of modern realities, such as the latest data on certain links in the pathogenesis of urinary tract obstruction caused by BPH on the background of COVID-19.

Initial Evaluation of Uroplakins UPIIIa and UPII in Selected Benign Urological Diseases

BackgroundUroplakins (UPs) are glycoproteins that play a specific role in the structure and function of the urothelium. Disorders of normal expression of uroplakins are associated with the pathogenesis of infections and neoplasms of the urinary tract, primary vesicoureteral reflux, hydronephrosis and renal dysfunction. The appearance of uroplakins in the urine and/or plasma may be of potential importance in the detection of urinary tract dysfunction. The aim of the study was to investigate uroplakin IIIa (UPIIIa) and uroplakin II (UPII) expression in patients with selected urological diseases. Plasma and urine from patients with benign prostatic hyperplasia (BPH), urethral stricture (US), urinary tract infection (UTI) and urolithiasis, were compared to healthy people without urological disorders. MethodsA total 152 of human urine and plasma samples from normal and patients with selected benign urological diseases were analyzed. UPs concentration was measured by immunoenzymatic method. All calculations were done using the STATISTICA 13.3 (TIBCO software Inc.).ResultsIn patients with BPH and UTI, UPIIIa in urine and plasma also UPII in urine concentrations were statistically significantly higher than in the control groups. In the US group, only the plasma UPIIIa concentration differed significantly from the control. There were no significant differences between the concentrations of UPs compared to the controls in both the urine and plasma of patients with urolithiasis. ConclusionThe conducted research shows that benign urological diseases may affect the state of the urothelium, as manifested by an increased concentration of both UPs in patients’ urine and plasma, especially in BPH and UTI.

The factors affecting male infertility: A systematic review

Background: In recent years, the incidence of male infertility has increased worldwide. It is necessary to study the factors that influence male infertility in each area/region for better management. Objective: To determine the factors affecting male infertility in the Iranian male population. Materials and Methods: An online search was conducted in electronic databases including PubMed, Google Scholar, SID, and Scopus to identify articles on the factors associated with male infertility, published in English and Persian. The keywords used to perform the search included “factor”, “epidemiology”, “causes of infertility”, and “male infertility”. The search was conducted without a time restriction, up to April 2020. Results: The search resulted in a total number of 691 studies. After an assessment of the articles, finally 14 studies were included in this study with a total number of 26,324 infertile males. The factors associated with male infertility included semen abnormalities, varicocele and testis disorder, smoking, exposure to heat, obesity, anabolic steroids, vascular abnormalities, anti-spermatogenesis factors, antidepressants, taking ranitidine and cimetidine, penile discharge and genital ulcers, painful micturition, occupational factors, alcohol, chronic disease, sexual disorder, Surgical and urological diseases, genetic factors and herpes infection. Among these, the semen and varicocele disorders were common in most studies. Conclusion: The present review suggests that the factors affecting male infertility in Iran are similar to those reported from other countries. The results of this study can be used in adopting appropriate strategies for infertility management in Iran. Key words: Male, Infertility, Sterility, Urogenital diseases.