Оценка эффективности персонализированной комплексной терапии в профилактике послеоперационных осложнений у больных с аденомой простаты и хроническим простатитом

Abstract

Aim: to assess the efficacy of personalized combined treatment for preventing postoperative complications after transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) that involves complex physiotherapy using “SMART-PROST” device considering individual chronobiological characteristics. Patients and Methods: 60 patients with BPH and CP who were referred for TURP were examined. α-blockers and fluoroquinolones were prescribed for 28 days in the control group (n=30). Personalized complex therapy was additionally prescribed in the study group (n=30). Treatment efficacy was assessed at baseline (visit 1), after two weeks (visit 2), and after four weeks (visit 3). The severity of lower urinary tract symptoms, prostate volume and postvoid residual volume, and prostatic hemodynamics were evaluated. Additionally, expressed prostatic secretion bacterioscopy and culture and TURP specimen histology were performed. Results: significant differences (p<0.05) in all clinical laboratory tests and prostatic hemodynamics were demonstrated between the groups by the end of week 4. Histology of TURP specimens revealed more severe fibrosis and inflammatory infiltration in the control group. During a 6-month follow-up, acute urinary retention was detected in 2 patients (6.7%), leukocytes in the urine in 18 patients (60%), blood in the urine in 5 patients (16.7%), and bacteria in the urine in 14 patients (46.7%) of the control group. Meanwhile, acute urinary retention was detected in 1 patient (3.3%), leukocytes in the urine in 10 patients (33.3%), blood in the urine in 2 patients (6.7%), and bacteria in the urine in 7 patients (23.3%) of the study group. Conclusion: personalized combined therapy for BPH and CP reduced the severity of lower urinary tract symptoms and the signs of prostatic inflammation, improved prostatic hemodynamics, and increased the efficacy of antibacterial therapy as demonstrated by bacteriological tests. KEYWORDS: chronic prostatitis, benign prostatic hyperplasia, TURP, chronotherapy, personalized combined physiotherapy, TRUS, Doppler ultrasound, immunohistochemistry. FOR CITATION: Barannikov I.I., Kuzmenko A.V., Kuzmenko V.V., Gyayrgiev T.A. Efficacy of personalized combined treatment for preventing postoperative complications in patients with benign prostatic hyperplasia and chronic prostatitis. Russian Medical Inquiry. 2021;5(3):110– 117. DOI: 10.32364/2587-6821-2021-5-3-110-117.