Platelet-rich plasma: application for interstitial cystitis and erectile dysfunction

Up-to-date, the platelet-rich plasma (PRP) treatment method is actively used in many fields of medicine. In traumatology, PRP is used to treat bone and cartilage defects, ligamentous apparatus. In combustiology for the healing of burns, in surgery ¾ trophic ulcers. There is evidence of the feasibility of using PRP in some dermatological diseases, as well as in dental practice. For urology, the method is new and is just beginning to be studied. The article discusses the methods of treatment of interstitial cystitis (IC) and erectile dysfunction (ED) using PRP. During the review, we relied on existing data on the effectiveness of intravesical injections of PRP in the treatment of IC, as well as on the successful treatment of ED with activated, nonactivated PRP and PRP augmented phosphodiesterasetype 5 (PDE-5) inhibitors

Comparative analysis of unilateral and bilateral flexible ureterorenoscopy: a cohort multicentre study

Introduction. Flexible ureteroscopy (fURS) with laser lithotripsy is the «gold standard» for minimally invasive treatment in patients with kidney stones less than 20 mm. Currently, there are no objective data on the efficacy and safety of bilateral interventions.Objective. To study the results of bilateral flexible URS (B-fURS) versus unilateral flexible URS (U-fURS).Materials & methods. Eighty patients prospectively enrolled in the study from July 2022 to December 2022 and was divided into 2 groups. Group 1 (n = 40) underwent U-fURS and Group 2 (n = 40) underwent B-fURS. A single stone up to 20 mm or multiple small calyx stones was an indication for the operation. The baseline values were comparable between the groups, but in the B-fURS group a 39.0% higher incidence (p > 0.002) of multiple stones and a 28.0% higher incidence (p > 0.001) of stones in the lower pole. Previous interventions were also more frequent in Group 1 (B-fURS) patients.Results. Stone-free rate did not differ (p > 0.9) between the groups and was 95.0% and 97.5%, respectively. No serious complications (p > 0.9) of Clavien III–V were observed in both groups.Conclusion. Bilateral flexible ureteroscopy is a safe and effective option for patients with bilateral kidney stones, allowing removal of stones in one anesthesia on both sides

Urinary pH: its regulation and relevance in urolithiasis metaphylaxis

Urolithiasis is a common multifactorial disease characterized by a high recurrence rate. This review is devoted to the urine pH as one of the main factors determining its lithogenic properties. It affects the excretion of lithogenic substances and stone formation inhibitors, the solubility, and the crystallization of substances involved in stone formation. The urine pH significantly affects the solubility of uric acid in urine, which decreases at a pH < 5.5. This explains the high incidence of uric acid concretions in patients with metabolic syndrome. Their insulin resistance leads to a decrease in the excretion of ammonium ions in the proximal tubules, leading to persistent urine acidification. The activity of many transport processes involved in the processing of calcium, citrates and phosphates is sensitive to changes in systemic or local pH. The data on the effect of urine pH on the solubility of calcium oxalate remain contradictory. At the same time, there is no doubt about the determining role of urine pH in the excretion of citrate, the most important stone formation inhibitor. The alkaline urine pH promotes the formation of concretions containing calcium phosphates. In conditions of constantly elevated urine pH in patients with persistent urease-producing urinary tract infection, a rapid growth of "infectious" concretions occurs. The review summarizes information on the causes of the decrease and increase in the urine pH, as well as the possibilities of medicinal and non-medicinal methods of modifying the urine pH during the prevention of stone formation recurrence