Prostate – Male Genital

Urologiia.  2011 Jul-Aug;(4):29-32.

Correction of complement system failure in patients with chronic prostatitis.

[Article in Russian]
Teodorovich OV, Shatokhin MN, Mykolaenko TV, Konoplia AI, Krasnov AV, Mavrin MIu, Meshanin NV.

Abstract

The aim of the study was detection of local and systemic changes in the complement system in patients with chronic abacterial prostatitis (CAP) and chronic bacterial prostatitis (CBP) and to assess a relevant corrective efficacy of the hardware and software complex Andro-Gin (KAP-ELM-01 Andro-Gin). Before treatment, blood plasma of CAP patients contained elevated concentrations of all studied components of the compliment system and factor H but subnormal concentration of C1-inhibitor. Locally, all the compliment indices were high including C1-inhibitor and factor H except component C5. Initial blood plasma compliment fractions in CBP patients were elevated but regulatory proteins concentrations were low. Local compliment components C3, C4, C5 and C5a and factor H were significantly higher. Standard treatment of CAP partially corrected the level of C3, C3a, C4 components, locally normalized concentration of C3 component and corrected C4 component, while in CBP standard treatment normalized concentration of C3 component and reduced C3a, C4, C5 and C5a components, locally normalized the levels of C3, C4 components, corrected concentration of C3a, C5, C5a components, raised regulatory factors. Combination of the standard treatment with Andro-Gin unit compared to standard treatment alone, in CAP corrected plasma concentrations of C3, C3a, C4 compliment components and significantly raised levels of regulatory factors, locally–partially normalized the level of factor H. In CBP additional use of Andro-Gin more significantly improved concentrations of C3a and C5a components , locally–C5a component, raised significantly concentration of regulatory factors C1-inhibitor and factor H. Thus, KAP-ELM-01 Andro-Gin administration in CAP and CBP patients promotes more effective correction of systemic and local disorders in the compliment system, the improvement being more pronounced in CBP.

Urologii. 2010 Mar-Apr;(2):42-4.

Efficacy of magnetolaser therapy of patients with an inflammatory form of chronic abacterial prostatitis.

[Article in Russian]

Kogan MI, Shangichev AV, Belousov II.

Abstract

To assess efficacy of magnetolaser therapy (KAP-ELM-01 Andro-Gin unit) in the treatment of inflammatory chronic abacterial prostatitis (ICAP), 68 ICAP patients were divided into 2 groups. Group 1 patients (n = 33) received standard therapy. Group 2 patients received standard therapy plus magnetolaser (ML) therapy. The effect was assessed by the symptoms scale and indices of kallirrein-kinin system. After treatment pain relieved by 36,9%, on the average, in group 1 and by 63.1% in group 2. Lower urinary tract symptoms regressed insignificantly in both groups: by 4.8% and 7.1%, respectively. Quality of life improved by 27.6 and 65.5%, respectively. Kallikrein activity in prostatic secretion remained high in both groups. A 21.7% rise (p < 0.05) of prokallikrein level was seen after treatment only in group 2. Activity of KKS inhibitors (alpha2-MG and alphal-PI) in prostatic secretion normalized in group 2. Total activity of serin proteinases lowered in both groups (p < 0.05). High activity of alphal-PI (8.21 + 1.97 U/ml) persisted in group 1. Thus, standard treatment of ICAP does not result in biochemical normalization of prostatic secretion. ML therapy is more effective.

Vopr Kurortol Fizioter Lech Fiz Kult. 2009 May-Jun;(3):37-40.

Biologically controlled magnetolaser therapy of chronic abacterial prostatitis.

[Article in Russian]

Shangichev AV.

Abstract

Magnetolaser therapy of chronic abacterial prostatitis had more prominent beneficial effect on the outcome of the disease than its traditional treatment. Moreover, it improved clinical characteristics of the patients, better stabilized blood flow in the prostate gland, raised plasma levels of antioxidative enzymes, stimulated prostate secterion, and sperm production.

Urologiia. 2008 Nov-Dec;(6):55-61.

Magnetolaser and enzyme therapy in combined treatment of patients with chronic bacterial prostatitis.

[Article in Russian]

Avdoshin VP, Andriukhin MI, Mikha?lenkov TG.

Abstract

A comparative trial of efficacy of magnetolaser therapy, enzyme treatment with longidase and their combination in chronic prostatitis has shown that these methods significantly relieve symptoms, normalize laboratory, urodynamic and immunological indices, reduce structural changes in prostatic parenchyma. Combination of the methods provides a persistent remission for 12-month follow-up.

Urologiia. 2007 May-Jun;(3):50-4, 56.

Efficacy of low-intensity laser radiation and antibacterial therapy in the treatment of chronic prostatitis in the presence of sexually infections.

[Article in Russian]

Neimark AI, Khrianin AA, Safina ON, Neimark BA, Kondrat’eva IuS.

We studied 94 patients with chronic prostatitis (CP) in combination with urogenital chlamydiasis. The patients were divided into three groups. Group 1 consisted of 32 patients with bacterial prostatitis and sexually transmitted infection (STI). They were treated with fromilid in a dose 500 mg twice a day. Group 2 (n = 27) received also low-intensity laser radiation (LILR) on the prostatic gland. Group 3 patients (n = 35) with abacterial prostatitis were given fromilid (500 mg twice a day). We studied prostatic hemodynamics with color doppler mapping. A specific feature of prostatic vascularisation in CP and STI versus healthy subjects is heterogeneous decline of vessels density in ischemic zones with parallel decrease in these vessels diameter. A peripheral prostatic zone in CP patients with STI was characterized by lower vascularisation than central one. This deteriorates the course of the disease. The results of the study show that adjuvant LILR in CP patients with STI raises efficacy of therapy by 11%. Investigation of prostate vascularisation and hemodynamics of its vessels in CP patients with STI using transrectal ultrasonography and dopplerography provide detailed information about prostatic structure allowing for lesion zones. This facilitates choice of an optimal complex treatment with application of LELR in peripheral inflammation of the prostate.

Urologiia. 2006 Jul-Aug;(4):54-7.

Using AELTIS-synchro-02 device in the therapy of chronic bacterial prostatitis.

[Article in Russian]

Orlov VN, Kozboda AS, Kravchenko VV, Kalinina SA.

The treatment of chronic bacterial prostatitis combined antibacterial drugs and physiotherapy (low-energy laser radiation, electrostimulation of the prostate). Treatment of chronic bacterial prostatitis with medication and complex two-channel bio-synchronized electrolaser therapy with application of the unit AELTIS-synchro-02 raises efficacy of treatment with chronic bacterial prostatitis due to combined effect of antibacterial drugs and bacteriostatic and immunomodulating actions of the physical factors applied. These normalize microcirculation in the region of the prostatic gland, improve a draining function of the prostatic ducts, allows achievement of good results in 88.2% patients.

Urologiia. 2006 Jul-Aug;(4):49-54.

Use of Intramag devices with Intraterm and LAST-02 attachments in complex therapy of chronic prostatitis.

[Article in Russian]

Shaplygin LV, Begaev AI, V’iushina VV.

The examination of the patients exposed to physical factors (magnetotherapy, laser therapy and thermotherapy) has demonstrated that Intramag unit with attachments Intraterm and LAST-02 for local physiotherapy is effective in patients with chronic prostatitis and can be used in urological hospitals and outpatient clinics.

Urologiia. 2005 Nov-Dec;(6):16-8.

Changes in prostatic circulation in response to laser therapy and magnetic therapy in patients with benign prostatic hyperplasia.

[Article in Russian]

[No authors listed]

The results of preoperative preparation were analysed in 59 patients with prostatic benign hyperplasia (PBH) subjected to TUR. Treatment outcomes were assessed by transrectal ultrasound (color Doppler mapping) in two groups of patients. Group 1 received combined therapy including transrectal laser radiation of the prostate, group 2–transrectal magnetotherapy. The analysis showed that laser radiation reduced insignificantly the size of the prostate and adenomatous node, improved microcirculation and circulation in the prostate. This resulted in relief of inflammation and reduction of the number of postoperative inflammatory complications. Transrectal magnetotherapy has a positive effect on vascularization and hemodynamics of the prostate, local immunity, contamination of the tissues with pathogenic flora.

Curr Urol Rep. 2005 Jul;6(4):296-9.

Multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome.

Shoskes DA, Katz E.

Cleveland Clinic Florida, Department of Kidney Transplantation, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA. uro@dshoskes.com

Category III chronic prostatitis/chronic pelvic pain syndrome is a syndrome rather than a specific disease and the cause can be multifactorial. In clinical practice, monotherapy often has proven ineffective. Multimodal therapy, which sequentially or simultaneously can address infection, inflammation, and neuromuscular spasm appears to have the greatest potential for symptom improvement, especially in patients with longstanding symptoms.

Urologiia. 2004 Sep-Oct;(5):34-6.

Apparatus Aeltis-Synchro-02-“Yarilo” and vacuum laser therapeutic urologic massager AMVL 01-“Yarovit in the treatment of chronic prostatitis complicated with copulation disfunction.

[Article in Russian]

Shaplygin LV, Koval’ AM, Pavlenko AV, Kazachenko AIu.

Abstract

There are three directions in pathogenetic treatment of chronic prostatitis (CP) which is conducted in parallel to etiotropic one (antimicrobial): general immunological; improving arterial inflow and venous outflow; creation of prostatic secretion outflow and that of seminal vesicles by means of contractions of the pelvic and perineal muscles, muscular fibers of the prostatic gland. The latter two directions can be managed with physiotherapy. It is proposed to use combination of drugs with physiotherapy conducted by means of the devices [see text].

Urologiia. 2004 Jul-Aug;(4):34-7.

Male genital tuberculosis in West Siberia

[Article in Russian]

Kul’chavenia EV, Khomiakov VT, Zhukova II.

Clinical picture and structure of male genital tuberculosis were analyzed basing on case histories of Novosibirsk regional tuberculous hospital (outpatient department): 42 patients with tuberculous epidydymitis and 58 patients with prostatic tuberculosis. Efficiency of combined etiopathogenetic treatment was estimated in 91 patients admitted to the Urogenital clinic of Novosibirsk Research Institute of Tuberculosis. These patients received polychemotherapy alone (control group) or in combination with laser therapy (study group). Combination of polychemotherapy with laser radiation proved more effective than polychemotherapy alone.

Med Pregl. 2004 Jan-Feb;57(1-2):13-7.

The role of physical rehabilitation in the treatment of exudative pleurisy

[Article in Serbian]

Milojevi? M, Kuruc V.

INTRODUCTION: Exudates are due to a variety of diseases, the major and most common ones being tuberculosis, nonspecific inflammation and malignancy. They are usually treated conservatively, sometimes combined with surgery and physical treatment. Physical therapy includes positional exercises, breathing exercises and biostimulation. AIM OF THE STUDY: The study was aimed to find out the following: 1) Is lung function improved by physical therapy; 2) Can adhesions be diminished and mobility of the affected hemidiaphragm improved by physical treatment; 3) Is there a direct positive correlation between physical treatment and obtained improvement, or the same can be achieved in patients receiving medicamentous treatment only; 4) What are the effects of some factors we cannot influence (sex, age, effusion level, position of adhesions) on lung function and diaphragm mobility improvement, that is on the efficiency of physical treatment; 5) How do the factors we can influence (the time interval before initiating the treatment and its duration) affect improvement of the same lung function parameters, that is treatment efficacy? MATERIAL AND METHODS: Physical treatment of patients with exudative pleurisy was accomplished at the Department of Rehabilitation in our Institute and it consisted of directed breathing exercises and laser biostimulation. Its effects were examined in a group of 175 patients, who received both conservative and physical treatment, and results were compared with the control group patients, treated only conservatively (with antibiotics, antituberculotics, corticosteroids). RESULTS: Comparative analysis confirmed a significant improvement of lung function parameters (VC, FEV1, PEF) as well as of hemidiaphragm mobility on the affected side of the thorax in favour of the examined group. The severity of the lung function and diaphragm mobility impairments have been found to be in correlation with the localization of adhesions, whereas the degree of improvement correlated with the time interval before the treatment initiation, as well as with its duration. DISCUSSION AND CONCLUSION: The applied physical therapy resulted in: 1) significant improvement of all examined lung function parameters in the examined group, which was not registered in the control group; 2) significant improvement of the diaphragm mobility in general; 3) factors such as sex, age and effusion level have no effects on the physical treatment results; 4) treatment results are affected by the time interval passed before the treatment initiation and its duration, as well as the localization of adhesions; anterior adhesions affected lung function and diaphragm mobility least, posterior ones more, while the influence of lateral adhesions was most significant. It is finally concluded that physical treatment should necessarily be included in the treatment of exudative pleurisy.

Urologiia. 2002 Jan-Feb;(1):14-7.

Comparative analysis of long-term results of treating chronic prostatitis with the use of the Andro-Gin device.

[Article in Russian]

Alekseev MIa, Golubchikov VA.

Follow-up examinations covered 91 patients aged from 20 to 60 years with chronic prostatitis (CP) history 1-18 years. The primary examination has found that 79.1% examinees has CP complicated with sexual dysfunction, disturbed spermatogenesis and psychoneurological disorders. In one group of CP patients etiopathogenetic treatment of CP was combined with magneto-laser-electrostimulation of the prostate provided by the unit Andro-Gin. This combined treatment proved more effective as it induced long-term remission (two years and longer) in 60.5% patients. Unsatisfactory results were minimal. Without use of the unit unsatisfactory

Urologiia. 2002 Sep-Oct;(5):4-5.

Prospects for preoperative low-intensity laser therapy in preventing postoperative thrombohemorrhagic complications in adenomectomy.

[Article in Russian]

Ne?mark AI, Muzalevskaia NI, Ne?mark BA.

The authors analyse the results of preoperative preoperation of 143 patients with benign prostatic hyperplasia (BPH). Conventional preoperative preparation (antibiotics, uroantiseptics and phytotherapy) was used in combination with intravascular laser irradiation of blood (group 1, 30 patients), local laser therapy (transurethral and transrectal) (group 2, 27 patients), variation of laser methods (group 3, 28 patients) and alone (61 patients, group 4). Such preoperative preparation was aimed at prophylaxis of thrombohemorrhagic complications after adenomectomy. The efficiency of the treatment was assessed by hemostasis parameters. It was found that conventional antiinflammatory therapy had a weak effect on hemostasis, the greatest positive effects being achieved with combined laser preoperative preparation. Hyperfibrinogenemia, thrombinemia and activation of XII + a-dependent finrinolysis were stopped in patients of group 3. Because of less number of postoperative hemorrhages, hemotransfusions and transfusions of blood preparations were used less frequently, red cell parameters improved, exacerbations of chronic pyelonephritis occurred less often

Urologiia. 2000 Jan-Feb;(1):11-5.

Low-intensity laser radiation in preoperative preparation of patients with benign prostatic hyperplasia

[Article in Russian]

Ne?mark AI, Muzalevskaia NI.

Low-intensity laser therapy administered in the form of intravenous blood irradiation, transrectal and transurethral prostatic irradiation and their combination as preoperative preparation and correction of immunity disturbances in patients with benign prostatic hyperplasia (BPH) were studied. The response to the treatment was evaluated by positive changes in the immune status and bacterial contamination of the urine and prostatic tissue. Conventional preoperative preparation (uroantiseptics, antibiotics and phytotherapy) fails to correct signs of T-cell immunodeficiency, depression of phagocytic activity of neutrophils, significantly reduce bacteriurea. Laser therapy as intravenous laser blood radiation acts immunomodulatorily on cellular immunity and normalized the proportion of T-helpers of the first and second order (T-suppressors) and neutrophil phagocytosis. The antibacterial effect of this technique on urinary microflora and prostatic tissue is not very high. Local laser therapy is a potent immunostimulator of T- and B-lymphocytes, increased the index of immunoregulatory cells’ proportion, activated phagocytosis of neutrophils. It has pronounced antibacterial effect against gram-negative urinary microflora and tissue of the prostate. Combined laser therapy produced the highest immunomodulating action on T-lymphocytes and immunostimulating one on B-lymphocytes, potentiated phagocytic ability of neutrophils, elevated index of the immunoregulatory cells, but was unable to correct their imbalance completely. Antibacterial effects of combined laser therapy were the highest, including the bacterial group Proteus-Providencia. Preoperative low-intensity laser therapy of BPH reduced the number of postoperative pyoinflammatory complications, hospital stay, severity of postoperative period.

SEMICONDUCTOR LASER RAYS THERAPY FOR THE TREATMENT OF CHRONIC PROSTATITIS

Prof. Guido Strada, Dr med. Franco Gadda, Dr med. Paolo Dell’Orto, Dr med. Marilena Casu, Dr med. Andrea Baccalin

Department of Urology, San Gerardo Hospital, Monza (Milan-Italy)

Introduction: Chronic prostatitis (ACP) hasn’t a universally successful therapy yet. A lot of studies demonstrated that LASER therapy has an anti-inflammatory effect on tissues and can increase lymphatic and venous drainage reducing inflammatory swelling. For this reasons in the early 90s we proposed a new therapeutic system for ACP using semiconductor LASER rays consisting of a gallium-arsenide diode. At the beginning an endorectal probe was used; then we invented a particular endourethral probe for laser therapy. This is a brief abstract of what we achieved during these years.

Histological preliminary studies: Many authors studied biological effects of LASER on animal tissues (1). Before clinical practice LASER therapy was tested on a cancer cell line (SW 626) in order to evaluate if laser stimulation could increase mitosis cell rate (2) and therefore have a carcinogenic-like effect. We didn’t observe any change in mitosis cell rate. Another study (3) was made on rabbits to test in vivo any immediate histopathological damages and temperature rising in rectal ampulla using transrectal probe. Temperature rising was about 2/10th of a degree centigrade. No histopathological alterations of rectal wall and the prostate were observed with particular care of signs of swellig, flogosis or fibrosis.

Materials and methods: The gallium-arsenide diode in use has a wave lenght of 904 nm and a frequency of 3000 Hz. The Laser beam reaches the prostate with a special optic probe. This is divided in two sections: one contains the laser generator, the other has five optic fibers and it is screwed onto the first creating a single body of reduced dimensions. It can be sterilized and it is atoxic. We experimented 2 different approaches to the prostate: the first was an endorectal approach and the second was an endourethral approach. At the beginning we used a “Laser Super Sonic” machine with endorectal probe according to Strada. The treatment schedule was 1 treatment every two days (treatment’s time of 12 minutes,wave lenght 3000 Hz)) for a total of 12 applications. Transrectal laser therapy was not indicated in prostate larger than 4 cm because this is the maximum depth of the laser beam’s efficacy. Then we experimented an urethral probe (Med 130 Lasotronic â Wave lenght 820 nm, power 30 mW) in order to reduce energy leakage and increase patient’s tolerability. In this case patients underwent 1 treatment every 3 days for a total of 8 applications (treatment’s time of 4 minutes). From 1990 to 1999 more than 200 patients underwent this kind of treatment. We pubblished results in previous studies (4-5).

Clinical results: More than 65% of the patients obtained a symptoms’ relief even at 6 months after treatment. We observed a decrease in IPSS score and an improvement in maximum and mean urinary flow rate. We analyzed spermatic fluid before and after treatment (6) and we found that there was an increase in total germinal cells count, improvement in motility and in morphology. Concentration of zinc, fructose and citric acid was higher after treatment (Zinc:9.5 mg% vs 5.5 mg%; Fructose: 64.5 mg% vs 58 mg%; Citric acid: 360 mg% vs 305 mg%). Prostate ultrasounds allowed to appreciate a consistent reduction of prostate volume (21.9 cc vs 29.9 cc), probably due to resolution of oedema. Conclusion: In our experience laser therapy for chronic prostatitis can be an effective treatment in improving symptoms and modifying clinical and sonographyc parameters.

COMPLEX LASER MEDICINE THERAPY OF BENIGN PROSTATIC HYPERPLASIA

E.V. Koultachavenia, M.D.

Novosibirsk Research Institute of Tuberculosis, Russian Federation

Benign prostatic hyperplasia (BPH) is a common problem of aging men, affecting the majority of individuals aged 60 years and above. The expressed violations of urination accompanying BPH are largely explained by accompanying prostatitis too. So medicine treatment directed only on restoring of urination, infringed enlarged of prostate, is unsufficiently effective.

We have developed a technique of laser-medicine therapy of the patients with BPH, which successfully was tested in 23 patients. The essence of a technique consists in simultaneous assignment of selective alpha 1-blockers tamsulasin and of local low-level laser therapy. On a background of a daily reception of tocopherol influenced by infrared laser radiation with the density of 6 mW/cm2 on a perineum within 10 days, exposition – l0 min. A repeated rate – through 2-2,5 months.

Tamsulasin was taken in the usual dose – 0,4 mg per day. Simultaneous application of laser therapy and alpha-1-blocker tamsulasin achieved a relaxation of smooth muscles of prostate, removal of spasm, facilitation of outflow of a prostate secret and an inflammatory exudate, cupping of dysuria. The clinical observations, being available by us, have confirmed higher efficiency of an offered technique, than for want of use of monotherapy of tamsulasin.

Urologiia. 2005 Mar-Apr;(2):42-6.

Validity of using physical therapy in combined treatment of chronic prostatitis

[Article in Russian]

Razumov SV, Egorov AA.

To evaluate efficacy of combined physiotherapy in patients with chronic prostatitis (chronic bacterial, chronic abacterial prostatitis), an open comparative trial was made by specialists of the Research Institute of Urology in 2003-2004 of the unit Andro-Gin. Before the treatment, a standard examination was made including analysis of case history and complaints, rectal palpation, questionnaire filling-in, prostatic secretion tests, PCR diagnosis, transrectal ultrasonic scanning and uroflowmetry. In group 1 (chronic bacterial prostatitis) given monotherapy with an etiotropic drug (ED) or combination of ED with Andro-Gin treatment, a significant improvement was achieved by the scale NIH-CPSI, Sorensen scale (p < 0.05). In group 2 (chronic abacterial prostatitis with inflammation) subgroups C,D,E patients showed significant improvement by the scales NIH-CPSI and Sorensen (p < 0.05). The highest symptomatic effect was recorded in the subgroup D in combined treatment with ED and Andro-Gin physiotherapy. In group 3 low NIH-CPSI scale score occurred due to alleviation of pain in subgroup F (p < 0.05), In subgroup G symptoms by the above scales did not change.Uroflowmetry featured moderate dynamics of the increment in maximal voiding speed. Voiding improved significantly in subgroup F in patients with chronic abacterial prostatitis in the absence of inflammation.

NEAR RESULTS OF TREATMENT THE PATIENTS WITH COMPLICATED GENITOURINAL PATHOLOGY WITH APPLICATION OF LOW INTENSIVE LASER IRRADIATION

G.I. Mavrov, G.M. Bondarenko, T.V. Gybenko

Ukrainian Scientific Research Institute for Dermatology &Venereology, Kharkov, Ukraine

The problem of managing chronic inflammatory diseases of genitals is rather urgent. It is connected with increase of serious complica­tions, tendency to recurrence, resistance to treatment. We studied 28 patients (11 males and 17 females). The age of patients was 19-48 (medium age was 31). On etiologically diagnosis the patients were distributed as follows: Chlamidia trachomatis was found in 21 cases, C.trachomatis and Ureaplasma urealiticum – in 5, ?. trachomatis and Candida albicans – in 2. Chronic urethritis, prostatitis, cervicitis, cervical erosion, vulvovaginitis, endometritis, and pelvic inflamma­tory disease were prevailed. Antimicrobials, immunomodulators, vitamins, and symptomatic drugs were prescribed in combination with LILI. The laser therapy was conducted by He-Ne laser with the capacity of 25 mW. Males received intravenous or intraurethral LILI, 5-7 procedures. Females received LILI by the following techniques -intravenously, intraurethraly, intracervically and intrauterinely, 5-7 procedures, intravaginally – 10 procedures. Patients which received laser therapy were marked by pronounced clinical improvements – pain was soothed, acute urethral syndrome was arrested, discharge from the genitals was decreased. Blood and urine parameters normalized. On data from our institution the percentage of recur­rence after treatment of patients with chronic complicated genitourinal pathology without use of laser therapy was 10-15%. In the case of application of LILI the near results had shown 100 % clinical and microbiological curability.

Urologiia. 2002 Sep-Oct;(5):4-5.

 

Prospects for preoperative low-intensity laser therapy in preventing postoperative thrombohemorrhagic complications in adenectomy.

[Article in Russian]

Neimark AI, Muzalevskaia NI, Neimark BA.

The authors analyse the results of preoperative preoperation of 143 patients with benign prostatic hyperplasia (BPH). Conventional preoperative preparation (antibiotics, uroantiseptics and phytotherapy) was used in combination with intravascular laser irradiation of blood (group 1, 30 patients), local laser therapy (transurethral and transrectal) (group 2, 27 patients), variation of laser methods (group 3, 28 patients) and alone (61 patients, group 4). Such preoperative preparation was aimed at prophylaxis of thrombohemorrhagic complications after adenomectomy. The efficiency of the treatment was assessed by hemostasis parameters. It was found that conventional antiinflammatory therapy had a weak effect on hemostasis, the greatest positive effects being achieved with combined laser preoperative preparation. Hyperfibrinogenemia, thrombinemia and activation of XII + a-dependent finrinolysis were stopped in patients of group 3. Because of less number of postoperative hemorrhages, hemotransfusions and transfusions of blood preparations were used less frequently, red cell parameters improved, exacerbations of chronic pyelonephritis occurred less often.

Urologiia. 2000 Jan-Feb;(1):11-5.

Low-intensity laser radiation in preoperative preparation of patients with benign prostatic hyperplasia

[Article in Russian]

Ne?mark AI, Muzalevskaia NI.

Low-intensity laser therapy administered in the form of intravenous blood irradiation, transrectal and transurethral prostatic irradiation and their combination as preoperative preparation and correction of immunity disturbances in patients with benign prostatic hyperplasia (BPH) were studied. The response to the treatment was evaluated by positive changes in the immune status and bacterial contamination of the urine and prostatic tissue. Conventional preoperative preparation (uroantiseptics, antibiotics and phytotherapy) fails to correct signs of T-cell immunodeficiency, depression of phagocytic activity of neutrophils, significantly reduce bacteriurea. Laser therapy as intravenous laser blood radiation acts immunomodulatorily on cellular immunity and normalized the proportion of T-helpers of the first and second order (T-suppressors) and neutrophil phagocytosis. The antibacterial effect of this technique on urinary microflora and prostatic tissue is not very high. Local laser therapy is a potent immunostimulator of T- and B-lymphocytes, increased the index of immunoregulatory cells’ proportion, activated phagocytosis of neutrophils. It has pronounced antibacterial effect against gram-negative urinary microflora and tissue of the prostate. Combined laser therapy produced the highest immunomodulating action on T-lymphocytes and immunostimulating one on B-lymphocytes, potentiated phagocytic ability of neutrophils, elevated index of the immunoregulatory cells, but was unable to correct their imbalance completely. Antibacterial effects of combined laser therapy were the highest, including the bacterial group Proteus-Providencia. Preoperative low-intensity laser therapy of BPH reduced the number of postoperative pyoinflammatory complications, hospital stay, severity of postoperative period.

Proc. 2nd Congress World Association for Laser Therapy, Kansas City, USA, September 2-5 1998; p. 82-83.

 

Low level laser therapy of male genital tract chronic inflammations.

Gasparyan L et al.

Male genital tract chronic inflammations were treated by combinations of transdermal, transrectal (prostate gland) and intravenous HeNe laser irradiation. The energy of a 2 mW HeNe laser was applied via a light guide into a vein. The projections of the male genital organ and the inguinal areas were irradiated with a 890 nm 5W peak power cluster probe. For the transrectal prostate gland irradiation a 890 nm 15W peak power laser was used. 36 patients were given conventional medical therapy and another 36 were given LLLT in combination with medical therapy. Clinical and laboratory findings were statistically better in the LLLT group and relapse rate was lower. It is suggested that LLLT increases the local circulation and thus also improves the effect of antibiotics.

WALT 2-nd Congress (Kansas City, USA), 1998

LOW LEVEL LASER THERAPY OF MALE GENITAL TRACT CHRONIC INFLAMMATIONS.

Levon V. Gasparyan, Samvel R. Grigoryan

INTRODUCTION
The authors summarized their experience of treating patients with mail genital tract chro-nic inflammations caused by sexually transmitted diseases (STD) (Chlamidial infection, Trichomoniasis, etc.) using low level laser therapy (LLLT). Evolution of antibiotic resis-tant strains, spreading of chronic latent infections complicated the treatment and required several courses of medicament therapy.

LLLT helps to overcome the problems. LLLT of such patients includes laser irradiation of blood, prostate gland and skin projections of male genitals. Laser irradiation activates immune system, increases the permeability of prostate gland tissues for antibiotics, has antiinflammatory, analgetic properties, activates spermatogenesis, activates local micro-circulation, and sex function.

The obtained results proved that the combination of LLLT with medicament therapy provides better and faster treatment results.

REVIEW AND THEORY
The incidence of chronic and latent forms of STDs has risen recently despite advances in diagnosis and treatment. Changes in sexual behavior, imperfect and late diagnosis, lack of adequate laboratory facilities, poor cultural examinations, incomplete treatment as a result of usage of low quality and adulterated antibiotics, cases of non-professional and self-treatment, reinfection from infected, but not treated sex partners, evolution and spreading of antibiotic resistant strains complicated the treatment of STDs.

Several groups mentioned beneficial effects of LLLT in the treatment of male genital tract diseases. Sato et al. (1984) demonstrated that laser irradiation had potential to increase sperm motility in vitro. Therapeutic laser applied directly to testes at a dose of 1.3 J/cm2 has been successfully used in treatment of infertility (Hasan et al. 1989). Using HeNe laser applied directly to the scrotum, Miroshnikov and Reznikov (1989) found an immediate reduction in the pain, swelling, pyrexia and other symptoms of acute epididimitis. LLLT also reduced the necessity for surgical interventions. This group also reported about positive effects of HeNe laser irradiation in treatment of chronic intractable urethritis. LLLT produced reduction in pain, improvement in microscopic investigations, especially as regards the number of leukocytes. Such studies reported no side effects or complications so dangers associated with laser irradiation of or near the gonads are minimal. Koultchavenia (1997) found higher concentration of antibiotics in kidneys and prostate gland after local laser irradiation. Some studies showed the increase of sensitivity of microorganisms towards antibiotics after laser irradiation (Gorochov 1991, Avdoshin 1992). Kartachov (1994) mentioned that when some patients with bacterial latent urethritis started LLLT, Trichomonas vaginalis was found out in cultural studies. So laser irradiation could act like provocative test and help to diagnose latent STDs more precisely.

Duplik (1993) introduced a parameter “Specific Power Density” (mW/cm3) connected with both power characteristics of laser and optical properties of irradiated blood. Ovsjannikov (1997) suggested that calculation of energy absorbed in joules per cubic cm (J/cm3) of target organ tissues was physically more correct, than calculation of energy density in J/cm2 of irradiated skin.

The authors aimed to study the role and parametres of LLLT in the complex treatment of patients with male genital tract chronic intractable inflammations, caused by some STDs.

PROCEDURES
78 patients aged from 21 to 54 suffering from mail genital tract chronic inflammations (urethritis, prostatitis, vesiculitis, epididymo-orchitis) were divided to a medicament therapy group (group I, 36 patients) and medicament plus laser therapy group (group II, 42 patients). Subjective and objective methods of investigation were used to diagnose diseases and evaluate the treatment. Laboratory studies included microscopic and cultural examinations of specimens of urethral discharge, urine, prostatic fluid, sperm, blood, as well as ultrasound and other examinations. Provocative tests are used to make latent STDs diagnosis more reliable. Posttreatment cultures were studied to establish that the treatment was adequate.

Each patient of group II received 10-12 procedures of laser irradiation, including 3-4 LBI and 7-8 procedures of laser irradiation of skin projections of mail genitals and inguinal areas as well as transrectal irradiation of prostate gland. HeNe laser (632.8nm/ 2mW at the end of light-guide, inserted into a vein) was used for intravenous LBI. Pulsed IR laser cluster probe (12x890nm/5W pulse power) was used for irradiation of skin projections of male genitals. Pulsed IR diode laser probe (890nm/15W pulse power) with transrectally inserting fiberoptic probe was used for prostate gland irradiation. LLLT started simultaneously with antibiotic, antiinfalammatory and immune therapy.

RESULTS
Patients of group II reported (statistically reliable) faster resolution of symptoms of diseases (pain, dysuria, sex disorders), had better and more stable laboratory investigation reports (reduction and normalisation of leukocytes, elimination of microorganisms from specimens of urethral discharge, prostatic fluid, urine, sperm), grew of quantity and motility, as well as in percentage of normal forms of spermatozoa. Lower relapse rate for patients of group II (11%) than for patients of group I (18%) was recorded. No side effects or complications were detected. The authors estimated therapeutic 3D energy density for transrectal and cluster probe prostate gland irradiation.

The combination of intravenous LBI with local skin and prostate gland irradiation proved to be the most effective method of LLLT. The combination of medicament therapy and LLLT provides better and faster resolution of the symptoms and normalization in results of instrumental examinations.

DISCUSSION
Obtained results proved that laser therapy is an acceptable tool in the complex treatment of male genital tract chronic inflammations, caused by STDs. Our studies supported the opinion that acceleration of treatment was mainly the result of activation of immune system and increase of concentration of antibiotics in target organs.

More works are required to study laser light distribution in different tissues to determine the most effective 3D energy density for genital tract organs irradiation, combination of different wavelength lasers and methods of irradiation. Additional investigations are required to determine parametres of laser irradiation as the most promoting activity of immune system, increasing both microorganism sensitivity towards antibiotics and prostate gland permeability for antibiotics to create higher concentration of drugs in genital tract organs as well as to combine UV laser bactericidal action with the effect of antibiotics to achieve maximal medical effect.

COMPOSITE APPLICATION OF THE LOW-LEVEL LASER IRRADIATION (LLLI) AND OF BIOREGULATING PEPTU PROSTATILEN FOR THE TREATMENT OF SEXUAL DISTURBANCES CONDITIONED BY THE CHRONIC PROSTATITIS

V. Bondarcnko, A. Korobov

Ukrainian Research Institute of Pharmacotherapy of Endocrine Dis­eases, Research Institute of Laser Biology and Laser Medicine, Kharkov, Ukraine

The present research studies low-level laser irradiation the composite application of peptide bioregulator prostatilen and the LLLI for the treatment of the chronic prostatitis complicated by sexual disturbances. We have observed 32 patients at the age of 23-43 suffering from the chronic non-specific prostatitis. The patients have had numerous at­tempts to cure the disease and received various kinds of therapy. All the patients complained of the suppressed sexual function. Please note the fact that 12 patients received only this therapy, while the rest 20 underwent also a course of laser therapy which started after the 5-th injection of the medicine. Such semiconductor laser apparatus as “MOTYLEK-20” and “MURAVEY” (firm “Technica”) producing the laser irradiation with the wavelength of 0,89 nrn have been used. After the therapy which made use exclusively of prostatilen has been given, it turned out that in 50 % of the cases the erectile ability has been restored. The rapid ejaculation, however, remained in 75 % of the cases. The composite application of prostatilen and LLLI has improved the degree of the sexual activity more essentially. Here restora­tion of adequate erections has been found in 83,3 % of the cases. Only 25 % of the men still had the symptoms of the rapid ejaculation and of effaced orgasm. Thus, LLLI being applied to the prostate in the infrared range is successfully combined with the peptide bioregulator prostatilen for the treatment of the chronic non-specific prostatitis, as the medicine and the LLLI mutually reinforce the general medical effect. Such composite therapy substantially compensates the sexual function when the mentioned above pathology is observed.