Genitourinary Organs Research Articles

Post-traumatic Embryonal Rhabdomyosarcoma: An Unfortunate Red Herring

Rhabdomyosarcoma (RMS) is a relatively rare malignancy but the most common cause of soft tissue sarcoma in children. It can present anywhere in the body, but most seen in the extremities, head, neck and genitourinary organs. The two most common types of RMS are embryonal RMS and the more aggressive kind, the alveolar RMS. Development of RMS occurring after trauma is uncommon but as children are readily prone for lumps and bumps due to their adventurous and playful nature, it is much important to always keep in mind the possibility of malicious causes of swelling as any delay in diagnosis directly affects the outcome of the disease. Here we present an infant who presented with symptoms suggestive of post trauma swelling but later was confirmed as embryonal RMS. The child underwent chemotherapy as the treatment of option.

P-053 Sperm chromatin integrity in men from infertile couples with teratozoospermia and normozoospermia

Abstract Study question What is the relationship between sperm morphology and sperm chromatin integrity (SCI) in patients with normal sperm concentration (SC) and motility (SM)? Summary answer SCI violations in form of sperm DNA fragmentation (SDF) and incomplete protamination (IP) are more common in teratozoospermia, even when SC and SM are normal What is known already Deterioration of sperm chromatin integrity in the form of SDF and IP are the significant factors affecting male reproductive potential (WHO, 2021). Study design, size, duration This multicenter retrospective cross-sectional study included 479 men aged 18-45 years who were observed for infertility for more than 1 year. Participants/materials, setting, methods Only men: 1) with sperm concentration and motility that were not lower than the 5% centile according to WHO-2021 (16 million/ml and 30%, respectively), 2) without any inflammatory processes in genitourinary organs, 3) with obtained tests for SCI were included in the study. The men were divided into 3 groups (gr.) depending on the percentage of morphologically abnormal forms: I - 86-95% (n = 229), II - 96-99% (n = 228), III - 100% (n = 22). Main results and the role of chance The mean SDF in groups I, II, III were 9.0% (6-15), 12.0% (8-16) and 16.5% (13-20) (pI-II = 0.009; pII-III = 0.002; pI-III = 0.001), respectively. SDF index (Halosperm® Assay) in groups I, II, and III were 1.3 (1.2-1.5), 1.4 (1.3-1.5), and 1.5 (1.4-1.7), respectively (pI-II = 0.004; pII-III = 0.001; pI-III = 0.009). In 23% (I), 27% (II), and 55% of cases (III) the SDF value exceeded the threshold value (>15%) (pI-II > 0.05; pII-III <0.02; pI-III <0.005). Histone-positive sperm were revealed in 17% (12-23), 19.5% (13-27), and 31% (19-42) of cases in groups I, II, and III, respectively (pI-II > 0.05; pII-III = 0.014; pI-III = 0.02); The 30% of SDF threshold value was exceeded in groups I, II, and III, in 12%, 20%, and 52% of cases (pI-II < 0.05; pII-III < 0.005; pI-III < 0.001). Limitations, reasons for caution The reference values of SDF and the proportion of histone-positive sperm have not yet been determined properly, even in WHO 2021, therefore, the prevalence of SCI abnormalities in various spermiological diseases needs to be clarified in the future. Wider implications of the findings SCI and IP can be applied more widely in the investigation of men from infertile couples, especially, men with teratozoospermia. It should also be considered in men from infertile couples with normal semen parameters. Trial registration number Not applicable

Un kyste müllérien de découverte fortuite dans une localisation rétropéritonéale exceptionnelle

Mullerian cysts are mostly described in women, near the genitourinary organs. Exceptional cases of retroperitoneal and posterior mediastinal located Mullerian cysts have been reported. When located in the retroperitoneum, those cysts are often confused with other retroperitoneal cysts such as cystic lymphangioma and cystic mesothelioma of peritoneum because of the poor clinical picture and a nonspecific radiologic presentation. The histopathological analysis is essential to make the diagnosis, and the positive staining of a Müllerian marker is a decisive argument in favor of a Müllerian cyst. Here, we report a case of an incidental finding of a retroperitoneal Müllerian cyst in a 68-years-old woman.

Pathological study of genitourinary invasion by Aspergillus flavus in male rats

Due to the widespread of A. flavus spores and the high risk of its mycotoxins in our environment, we investigated the pathological effects of A. flavus on genitourinary system in experimental rats using a whole sonicated antigen (WSA), and modified mycotoxin (mycotoxoid) in the immunization process. Fifty albino male rats were involved, subdivided into five group, each group of 10 male rats. Group one as a negative control received phosphate buffer saline, group two as a positive control received a challenge dose of 1×106 /0.5ml viable conidia/rat, while group three was immunized by a mixture of WSA and mycotoxoid, G4 was immunized by WSA alone, and G5 was immunized by mycotoxoid alone. The immunization was performed in two doses with 2 weeks interval. The results showed a high immune response (in group three G3) stimulated by the mixture (WSA and mycotoxoid), which revealed a significant increase in both IL-17 and IFN-γ. After experimental infection, the sero-analysis showed a significant increase in IL-17 and IFN-γ serum levels compared with the mixture-immunized group which showed no significant increases. In addition, the histopathologic sections illustrated severe chronic inflammation with a typical fungal granulomatous reaction in the prostate glands and kidneys compared with the WSA-immunized groups which showed mild histological reactions. Finally, we conclude that A. flavus is a serious opportunistic pathogen that can disseminate into genitourinary organs inducing severe pathologic lesions and even death. Moreover, we found that immunization by WSA and mycotoxoid can significantly reduce both immune and histopathological effects of A. flavus and its mycotoxins.

Management of genitourinary trauma - current evaluation from the Sub-Saharan region: A systematic review.

BACKGROUNDTrauma is a major cause of morbidity globally and the sixth leading cause of death, accounting for 10% of all mortalities. The genitourinary trauma is estimated for approximately 10% of all patients presenting with trauma, and the kidney is the most injured genitourinary organ globally. However, there is a paucity of data on genitourinary injury from the Sub-Saharan, and there may be variations from common genitourinary organs injured in developed nations. AIMTo provide insight on the epidemiology and management of genitourinary trauma in Sub-Saharan Africa with recommendations based on international guidelines.METHODSA thorough literature search of genitourinary trauma was conducted using PubMed, Google Scholar and African Journal Online. RESULTSA total of 30 studies from the Sub-Saharan region were eligible for the study and reviewed for epidemiology, biodata, types of injury, mechanisms of injury, treatment and follow-up. After evaluating 21904 patients presenting with urological emergencies, approximately 6.6% of cases were due to genitourinary trauma. The commonest injury was urethral 42.9% (22.2-62.2%) followed by injury to the external genitalia (penis, scrotum, testes) 25.1% (8.8-67.7%).CONCLUSIONGenitourinary injury in Sub-Saharan Africa is underreported, and the presence of more trauma registries, trained urologists and trauma facilities could improve the overall standard of care as well as providing data for research and development in the field.

Common Diagnostic Challenges and Pitfalls in Genitourinary Organs, With Emphasis on Immunohistochemical and Molecular Updates.

Lesions in the genitourinary (GU) organs, both benign and malignant, can demonstrate overlapping morphology, and practicing surgical pathologists should be aware of these potential pitfalls and consider a broad differential diagnosis for each specific type of lesion involving the GU organs. The following summary of the contents presented at the 6th Annual Chinese American Pathologists Association (CAPA) Diagnostic Course (October 10-11, 2020), supplemented with relevant literature review, exemplifies the common diagnostic challenges and pitfalls for mass lesions of the GU system of adults, including adrenal gland, with emphasis on immunohistochemical and molecular updates when relevant. To describe the common mass lesions in the GU system of adults, including adrenal gland, with emphasis on the diagnostic challenges and pitfalls that may arise in the pathologic assessment, and to highlight immunohistochemical workups and emerging molecular findings when relevant. The contents presented at the course and literature search comprise our data sources. The diagnostic challenges and pitfalls that arise in the pathologic assessment of the mass lesions in the GU system of adults, including adrenal gland, are common. We summarize the contents presented at the course, supplemented with relevant literature review, and hope to provide a diagnostic framework to evaluate these lesions in routine clinical practice.

18FDG-Positron Emission Tomography in patients with Tuberculous Meningitis: A Prospective Evaluation.

Lower yield of available diagnostic tests for tuberculous meningitis (TBM) frequently causes delay in diagnosis. Recently, 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has been used in infectious disorders such as pulmonary tuberculosis; however, it is rarely used in TBM. This study was aimed to ascertain the role of FDG PET in the diagnosis and determination of the extent of disease and prognosis in patients with TBM. After excluding unsuitable patients, 25 patients were subjected to whole-body PET-computed tomography (CT) image acquisition along with separate brain protocol with an integrated PET-CT device. FDG PET was found to be abnormal in 92% patients. Extracranial FDG uptake was observed in 80% patients. Most common extracranial site of involvement was lymph nodes (60%), followed by lung (56%), vertebral body (8%), genitourinary organs (8%), and spleen (4%). FDG PET observed extracranial involvement had 80% sensitivity and 20% specificity in detecting definite TBM cases. In conclusion, FDG PET may be a useful test in TBM evaluation.

S2423 Unusual Presentation of Crohn's Disease as Pelvic Mass Involving the Genitourinary Organs and Bowels

S2423 Unusual Presentation of Crohn's Disease as Pelvic Mass Involving the Genitourinary Organs and Bowels

Nosomorphosis of diseases caused by urogenital infections

One of the real threats to the health of the next generation are diseases caused predominantly by sexually transmitted infections (STIs). The frequency of these diseases is constantly increasing among the population of Ukraine and other countries. The aim of our work was to establish the features of the clinical manifestations of diseases caused by urogenital infections (UGI) at the present stage. Under our supervision, there were 577 patients with STIs, 83% of the patients were at the age of the highest socio-economic and sexual activity. A complex of methods for examining the patients included: physical and general clinical studies, laboratory research to identify STIs and conditionally pathogenic microorganisms. A comprehensive complex examination made it possible to identify urogenital chlamydia in 395 (68.5%), trichomoniasis – in 381 (66.03%), ureaplasmosis – in 240 (41.6%), microorganisms associated with bacterial vaginosis – in 80 (13.9%) and urogenital candidiasis – in 75 (13.0%). Monoinfection was diagnosed only in 61 (10.6%) of patients. Among the patients examined, the inflammatory process of the genitourinary organs was supported by two infectious agents in 487 (84.4%), three or more – in 52 (9.0%) of the observed patients. The affection of the urogenital system with STIs occurs with several infectious agents. Clinical manifestations of diseases caused by STIs are asymptomatic or low-symptomatic. The asymptomatic course of diseases caused by STIs leads to a chronic long-term course of the pathological process with the formation of multi-focal lesions and residual phenomena, including proliferative neoplasms.

Cancer Stem Cell Biomarkers Predictive of Radiotherapy Response in Rectal Cancer: A Systematic Review.

Background: Rectal cancer (RC) is one of the most commonly diagnosed and particularly challenging tumours to treat due to its location in the pelvis and close proximity to critical genitourinary organs. Radiotherapy (RT) is recognised as a key component of therapeutic strategy to treat RC, promoting the downsizing and downstaging of large RCs in neoadjuvant settings, although its therapeutic effect is limited due to radioresistance. Evidence from experimental and clinical studies indicates that the likelihood of achieving local tumour control by RT depends on the complete eradication of cancer stem cells (CSC), a minority subset of tumour cells with stemness properties. Methods: A systematic literature review was conducted by querying two scientific databases (Pubmed and Scopus). The search was restricted to papers published from 2009 to 2021. Results: After assessing the quality and the risk of bias, a total of 11 studies were selected as they mainly focused on biomarkers predictive of RT-response in CSCs isolated from patients affected by RC. Specifically these studies showed that elevated levels of CD133, CD44, ALDH1, Lgr5 and G9a are associated with RT-resistance and poor prognosis. Conclusions: This review aimed to provide an overview of the current scenario of in vitro and in vivo studies evaluating the biomarkers predictive of RT-response in CSCs derived from RC patients.

The significance of coronavirus infection in the development of reproductive and lower urinary tract lesions

The impact of COVID-19 on the organs of the genitourinary system is of particular interest to the urologist. There is insufficient information about this influence up to date. The studies are actively developing and require long-term data analysis to determine possible long-term complications, persistent changes in physiological parameters and anatomical and histological structures, as well as to establish the possibility of regression of these changes and complications. The results obtained will undoubtedly improve not only the diagnosis, treatment and prevention of coronavirus infection and its complications, but also make it possible to predict certain disease's outcomes and changes in the function of organs and systems. In turn, this will give an understanding of the measures that need to be taken to completely avoid or minimize these complications and changes.This review focuses on the impact of COVID-19 on genitourinary organs, particularly its place in the development of the lower urinary tract and reproductive organs lesions, as well as the role of androgens in the course of SARS-CoV-2.

GENITOURINARY INJURIES DURING WAR AGAINST TERROR: A SINGLE-CENTER EXPERIENCE

Objective: To compare our experience of genitourinary injuries during the war against terrorism with the record of those in previous wars of the World.
 Study Design: Cross sectional study.
 Place and Duration of Study: Urology department, Combined Military Hospital Peshawar, from Jun 2011 to Aug 2014.
 Methodology: We treated 89 (5.6%) cases of genitourinary injuries received in our tertiary care hospital in Khyber Pakhtunkhwa. The hospital was located at a distance of 2-3 hours of evacuation time by helicopter from the forward operational area.
 Results: The frequency of genitourinary injuries among 1589 war casualties was (5.6%). Out of these 49 (55%) were due to sniper shots and 40 (45%) due to improvised explosive device. Kidney was the most common organ injured 30 (33.7%), followed by bladder 20 (22.5%) and urethra 14 (15.7%). Majority of renal and bladder injuries were afflicted in those soldiers who were not wearing the protective jackets. Associated injuries to other organs were identified in 81% cases. Salvage of all genitourinary organs was the aim; however, nephrectomy and orchiectomy had to be performed in 30% and 50% respectively.
 Conclusion: Salvage of genitourinary war injuries poses a challenge to the trauma surgeon as lifesaving measures take precedence over organ preservation. Renal trauma in war was found to be the leading critical genitourinary injury.

Caudal duplication syndrome: a literature review and reappraisal of its pathoembryogenesis.

The term caudal duplication syndrome (CDS) was first introduced for complex anomalies of the distal caudal end of the trunk. The pathoembryogenesis of CDS is yet unknown, although a few theories have been proposed. We reviewed the previously proposed pathoembryogenetic theories and suggested a new perspective through the common clinical characteristics shown in CDS cases reported in the literature. We conducted a systematic literature search of the online database PubMed from October 1993 to October 2020, using the search term "caudal duplication syndrome", according to the first mention of this entity. A total of 17 articles with 23 patients were reviewed. The most common manifestations were the duplication of the distal colon, genitourinary organs, and lower spine. Specifically, the duplicated bladders or uteri contacted their counterpart through a septum, and the duplicated bowels ran parallel. More caudal structures, such as the urethra or anus, were formed separately. The duplication seems to be a result of division by an intervening septum or structure in each part. In addition, duplication was not limited to the structures formed from the caudal cell mass (CCM), such as the distal spine and spinal cord, but also included hindgut structures. Moreover, anomalies involving caudal mesenchymal defects were also present. Considering clinical manifestations that are related to all three germ layers and seemingly the overseptation of these germ layers in CDS patients, with supporting data from animal experiments, events such as late-stage errors involving Hensen's node/the primitive streak and the duplication of the CCM with the hyperplasia of the abnormally located central caudal mesenchyme are probable pathoembryogenetic mechanisms for CDS. The "leakage" of the normal growth power of the caudal mesenchyme into the intervening midline space between the two CCMs and consequent weak lateral and caudal pushes of the caudal mesenchyme may explain the association of caudal agenesis or its related anomalies with CDS. We propose a theory that by a molecular interaction, an insult causes late gastrulation phase problems, resulting in ectopic primitive streak formation, and therefore, a duplication of the CCM is induced. Subsequently, the overactivity of abnormally positioned midline mesenchyme between the two CCMs may divide the hindgut derivatives by a central septum. Underactive lateral and caudal pushes of the caudal mesenchyme may lead to an association of features shown in caudal agenesis.

Twenty-year Experience with Genitourinary Lymphoma at a Community Hospital.

Introduction: Non-Hodgkin lymphoma is the seventh most common cancer in the United States. It may involve any extranodal organ, although involvement of the genitourinary (GU) tract accounts for <5% of all primary extranodal lymphomas. Published GU lymphoma literature is currently limited to small case series and case reports. The last substantial American series was published in 2009. Our objective was to characterize cases of GU lymphoma from our institution based on organ involved and to review relevant literature.Patients and Methods: After institutional review board approval, we retrospectively reviewed medical records of patients diagnosed with lymphoma involving the GU organs from 1995 through 2015. Patients with obstructive uropathy from retroperitoneal adenopathy without parenchymal involvement of a GU organ were excluded. We classified extranodal GU lymphomas as primary or secondary, based on involvement of other organs and distant lymphadenopathy.Results: Thirty-six patients had lymphoid neoplasms involving the kidney, ureters, bladder, testis, penile skin, or prostate in our health system during the study period. Of these, 15 (41.6%) were primary. Most patients initially sought consultation for GU-related symptoms, such as bladder obstruction, hematuria, testicular mass, or abdominal pain. Histological subtypes and flow cytometry findings varied broadly.Conclusion: Our series reports site-specific outcomes data and adds detail to findings from other published series. Although GU lymphomas are rare, our series confirms prior studies demonstrating presentation in urologic organs. They should be considered in the differential diagnosis in all patients, especially those with unusual findings on examination, cystoscopy, or computed tomography scan.

Modern possibilities of radiological diagnosis of bladder cancer

Bladder cancer is one of the most severe and common diseases of genitourinary organs. According to WHO statistics, bladder cancer is the tenth in cancer morbidity structure and the 13th in cancer mortality structure in the world. In Russia, bladder cancer is 11th in cancer morbidity structure and 16th in cancer mortality structure. In most cases, bladder cancer is diagnosed at 6574 years of age. The 5-year survival rate for stage IV bladder cancer is about 15%. Early detection, correct staging, and management of the patient influence the prognosis and further quality of life. This review shows detection and staging methods of bladder cancer, staging categories based on multiparametric magnetic-resonance imaging with the use of Vesical Imaging-Reporting and Data System (VI-RADS). Illustrations and a brief overview of alternative visualization methods of bladder lesions, and new approaches in assessment of digital medical images, radiomics and radiogenomics, are presented. In the future, these methods should help to determine the biological characteristics of the tumor without taking a biopsy.

The effect of β3-adrenoceptor gene polymorphisms on lower urinary tract function in males

To clarify the role of Trp64Arg polymorphisms of the gene encoding the β3-adrenoceptor for lower urinary tract function in males, the present study investigated the association between the Trp64Arg polymorphisms and lower urinary tract symptoms (LUTS) and function. This prospective observational study included patients who underwent robot-assisted radical prostatectomy. Before surgery, blood samples were collected, and analyses of β3-adrenoceptor gene polymorphism were performed using the real-time polymerase chain reaction. The present cohort was divided into patients with wild type (Trp64Trp) and with variant type (Trp64Arg + Arg64Arg), and LUTS and lower urinary tract function before surgery were compared between them. Wild type was found in 247 patients, with variant type in 129. There were no significant differences in LUTS between the two groups. Residual urine volume (PVR) (wild type: variant type = 47 ± 53mL: 58 ± 77mL, P = 0.04) and voiding time on uroflowmetry (wild type: variant type = 29 ± 15s: 33 ± 17s, P = 0.04) were significantly increased in the variant type. The Trp64Arg variant of the β3-adrenoceptor gene significantly increased PVR and voiding time in men. However, it was not significantly associated with the emergence of LUTS. Thus, since the effect of β3-adrenoceptor gene polymorphisms on the genitourinary organs might be weak, whether men possess the Trp64Arg variant of the β3-adrenoceptor gene might not critically affect urinary quality of life, but modestly affect the lower urinary tract function.

REGULARITIES OF MORPHOLOGICAL CHANGES IN THE ORGANS OF THE MALE URINARY AND GENITAL SYSTEM IN CASE OF CRYPTOSPORIDIOSIS (generalized research materials)

The aim of the study was to investigate the structural and functional changes in the male genitourinary system in the development of cryptosporidiosis.Material and methods. The study was based on biopsies and necropsies, based on histological methods.Results. The article is devoted to the study of structural and functional changes in the male genitourinary system in the development of cryptosporidiosis. The authors of the study emphasize the features of the nomenclature profile of cryptosporidiosis, its low certainty, the place among modern protozoal infections. The paper draws attention to the emergence of the disease, the specifics of its clinical course, the characteristics of the most accessible and effective methodological (histological) algorithm. The publication presents data on structural and functional changes of the urethra, testicles, kidneys of children with cryptosporidiosis (proven participation of the inflammatory component, destructive processes, trophic disorders). Researchers have focused on the peculiarities of the structure of the mucous membranes of the genitourinary organs in terms of cryptosporidiosis, destruction of the epithelium, microcirculation disorders. It is assumed that the factors of influence / strengthening of the latter were the activation of lysosomal (hydrolytic) enzymes capable of cleaving lipid - protein complexes of membranes.As a result, the opinion is expressed about the role of cryptosporidiosis in the development of male infertility.Conclusions. In the case of cryptosporidiosis, the most vulnerable structures of the male genitourinary system are cells of mesenchymal origin (epithelium).They are characterized by atrophy, desquamation, destructive-degenerative changes, necrosis. The destruction of the endothelial layer of microvessels leads to defects in the layers of the walls of the latter, thrombosis, the development of stasis, impaired microcirculation and trophism

Multiple Expression Assessments of ACE2 and TMPRSS2 SARS-CoV-2 Entry Molecules in the Urinary Tract and Their Associations with Clinical Manifestations of COVID-19.

BackgroundSince December 2019, the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first spread quickly in Wuhan, China, then globally. Based on previously published evidence, ACE2 and TMPRSS2 are both pivotal entry molecules that enable cellular infection by SARS-CoV-2. Also, increased expression of pro-inflammatory cytokines, or a “cytokine storm,” is associated with multiple organ dysfunction syndrome often observed in critically ill patients.MethodsWe investigated the expression pattern of ACE2 and TMPRSS2 in major organs in the human body, especially in specific disease conditions. Multiple sequence alignment of ACE2 in different species was used to explain animal susceptibility. Moreover, the cell-specific expression patterns of ACE2 and cytokine receptors in the urinary tract were assessed using single-cell RNA sequencing (scRNA-seq). Additional biological relevance was determined through Gene Set Enrichment Analysis (GSEA) using an ACE2-specific signature.ResultsOur results revealed that ACE2 and TMPRSS2 were highly expressed in genitourinary organs. ACE2 was highly and significantly expressed in the kidney among individuals with chronic kidney diseases or diabetic nephropathy. In single cells, ACE2 was primarily enriched in gametocytes in the testis and renal proximal tubules. The receptors for pro-inflammatory cytokines, especially IL6ST, were notably concentrated in endothelial cells, macrophages, spermatogonial stem cells in the testis, and renal endothelial cells, which suggested the occurrence of alternative damaging autoimmune mechanisms.ConclusionThis study provided new insights into the pathogenic mechanisms of SARS-CoV-2 that underlie the clinical manifestations observed in the human testis and kidney. These observations might substantially facilitate the development of effective treatments for this rapidly spreading disease.

Urogenital System Damaging Manifestations of 3 Human Infected Coronaviruses.

At present, there are no comparative studies on the damage of the 3 coronaviruses infections to the urinary system. Therefore, we reviewed the correlations and differences between invading mechanisms and resultant urogenital system damage by the 3 kinds of coronaviruses in an effort to help doctors in the prevention and treatment of these damages, which will be of significance in improving prognosis and quality of life after rehabilitation. We searched PubMed® for English language articles published since 2003 with the key words "Coronavirus disease 2019 (COVID-19)," "severe acute respiratory syndrome-2 (SARS-CoV-2)," "severe acute respiratory syndrome (SARS)-CoV" and "Middle East respiratory syndrome (MERS)-CoV "with "semen" and "kidney." We also used relevant data from websites including the World Health Organization and Centers for Disease Control and Prevention. Recent studies have revealed that both SARS-CoV and SARS-CoV-2 invade target cells through a membrane-bound angiotensin-converting enzyme 2, an important component of the renin-angiotensin system, which maintains human homeostasis, whereas MERS utilizes host cells' receptor dipeptidyl peptidase 4 for entry. While pneumonia is the most prominent symptom in patients infected by coronaviruses due to the transmission through respiratory droplets, the urogenital system can also suffer from infection with coronaviruses, resulting in renal failure, testicular atrophy etc. The impairments of the genitourinary system would be different with the 3 coronavirus infections but they still have a strong correlation. The pathogenesis and clinical symptoms of SARS-CoV, MERS-CoV and SARS-CoV-2 coronaviruses in the genitourinary system are comparable. All 3 coronaviruses have been found to affect kidney and testicular function. Therefore, both urologists and nephrologists should pay attention to the damage caused by coronavirus infection to the genitourinary system, especially monitoring renal and semen function.

Chronic endometritis in patients of reproductive age: individualized treatment capabilities

Introduction. Inflammatory diseases of the pelvic organs represent one of the lead causes affecting health status in women of childbearing age. The pathogenetic mechanisms of chronic endometritis (CE) have been extensively studied, but many issues remain debatable. This disease manifests in various clinical pictures, including relapsing course, so a need to conduct combination individualized treatment rises no doubts.Aim: to assess effectiveness of combination individualized therapy of CE.Materials and Methods. A comprehensive analysis of clinical data was performed in 107 patients with morphologically verified CE, examining microflora composition in the uterus, cervical canal, urinary tract, and intestine by using a wide range of laboratory research methods; assessing cell subset composition of peripheral blood lymphocytes by using immunocytochemistry (CD3+, CD4+, CD8+, CD19+, CD95+, CD3+CD4+, CD3+CD8+, CD3+CD95+), measuring level of serum cytokines – interleukin-1β, tumor necrosis factor-α, interleukin 8, and interleukin 10. For this, all patients were subdivided into 2 groups: 53 patients (group I, main received treatment according to the original protocol (antibiotics and bacteriophages, immune preparations, herbal medicines), 54 patients (group II, control) received conventional therapy (antibiotics, immunomodulatory drugs, hormones).Results. It was found that urogenital tract microbiota was profoundly altered in patients with CE, also featured with dysregulated immune system. In addition, associated changes in the leukocyte-lymphocytic arm of the immune system and features of clinical and anamnestic data were obtained, which is important in combination treatment of patients with this pathology. Composition microflora in the vagina, cervical canal and uterine cavity was markedly improved that was confirmed by bacteriology data, vaginal pH value and menstrual function were by 2-fold more often in group 1 vs. group 2. A 12-month follow-up revealed in group 1 no complaints of pelvic pain requiring pain killers, with pronouncedly lowered amount of doctor visits due to inflammatory pathology of the urinary tract additionally confirming effectiveness of individualized treatment.Conclusion.The data of the study evidence about a need to individualize diagnostic and therapeutic approaches while managing patients with CE. The treatment strategy for patients of childbearing age with CE should be based on minimizing drug aggression, taking into account concomitant pathologies, features of microbiota composition in the genitourinary organs and changes in the immune system. An combination and individualized therapeutic approach provides an opportunity to substantially better results after treatment of CE.