Prostatic Secretion Research Articles

Efficacy and Safety of Guihuang Formula in Treating Type III Prostatitis Patients with Dampness-Heat and Blood Stasis Syndrome: A Randomized Controlled Trial.

ObjectiveTo observe the efficacy and safety of Guihuang Formula (GHF) in treating patients with type III prostatitis and Chinese medicine syndrome of dampness-heat and blood stasis.MethodsSixty-six patients diagnosed with type III prostatitis with dampness-heat and blood stasis syndrome were randomly divided into the treatment group (GHF) and the control group (tamsulosin) using a random number table, with 33 cases each group. The treatment group received GHF twice a day, and the control group received tamsulosin 0.2 mg once daily before bedtime. Patients in both groups received treatment for 6 weeks and was followed up for 2 weeks. The outcomes included the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, Chinese Medicine Symptoms Score (CMSS), expressed prostatic secretions (EPS) and adverse events (AEs).ResultsAfter treatment, the NIH-CPSI total score and domain scores of pain discomfort, urination and quality of life decreased significantly from the baseline in both groups (P<0.05). The CMSS score decreased in both groups (P<0.05). The WBC count decreased and lecithin body count increased in both groups (P<0.05). GHF showed a more obvious advantage in reducing the pain discomfort and quality of life domain scores of NIH-CPSI, reducing the CMSS score, increasing the improvement rate of the WBC and lecithin body counts, compared with the control group (P<0.05). There were no significant differences in decreasing urination domain score of NIH-CPSI between two groups (P>0.05). In addition, no serious AEs were observed.ConclusionGHF is effective in treating type III prostatitis patients with dampness-heat and blood stasis syndrome without serious AEs. (Registration No. ChiCTR1900026966)Electronic Supplementary MaterialSupplementary material (Appendices 1–3) is available in the online version of this article at 10.1007/s11655-022-3467-1.

Altered small non-coding RNA expression profiles of extracellular vesicles in the prostatic fluid of patients with chronic pelvic pain syndrome.

Chronic pelvic pain syndrome (CPPS) and chronic prostatitis (CP) is difficult to distinguish from each other, herein termed CP/CPPS. The present study aimed at gaining further insight into the change in extracellular vesicles (EVs) in the prostatic fluid of males with CPPS. From December 2019 to November 2020, after clinical screening, 24 patients with CPPS without obvious urinary symptoms and 13 healthy male participants were included. EVs were isolated from expressed prostatic secretion (EPS) of all subjects. The small non-coding ribonucleic acid (sncRNA) expression of EVs was sequenced, analyzed, and validated by quantitative real-time polymerase chain reaction (qPCR) assays. The results showed that numerous sncRNAs were differentially expressed between the patients and healthy participants. Further qPCR assays validated that several chronic pain-related miRNAs, including miR-204-5p, let-7d-3p, let-7b-3p, let-7c-3p, miR-146a-5p, and miR-320a-5p, were differentially expressed. Series sncRNAs including several chronic pain-related miRNAs were altered in EVs in prostatic fluid of patients with CPPS, which may serve as diagnostic markers for CPPS.

Cross-sectional study on the etiological diagnosis of the patients with chronic prostatitis-like symptoms by application of the urine-prostate-semen test.

Background and AimsThe prostatic secretion was considered to be the most important and even only specimen in diagnosis and differential diagnosis of chronic prostatitis like symptoms, but little attention has been paid to other genital organ infections. A urine‐prostate‐semen test (U‐EPS‐S test) was used to investigate the microbial flora of internal genital organs in patients with chronic prostatitis‐like symptoms and their influence on the diagnosis and treatment of the patients.Materials and MethodsWe randomly selected the patients with chronic prostatitis‐like symptoms for this study and used a U‐EPS‐S test to collect urine, prostatic secretion, and semen specimens. The specimens were inoculated respectively into a suitable culture medium for bacteriological/fungal detection, and the number and distribution of colonies in each isolation culture were observed before and after the therapy.ResultsAll of the specimens from the internal genital organs of these patients were shown as microbe‐positive isolation and the infection rate was 100%. Of these, prostatic secretion with microbe‐positive isolation was obtained in 66 cases (33%), semen with microbe‐positive isolation was obtained in 34 cases (17%), and both prostatic secretion and semen with microbe‐positive isolation were obtained in 100 cases (50%). In the isolates, Gram‐positive microbes were shown as the most common pathogens, accounting for 91.1%. In 200 patients, 95 patients were infected with one microbial species infection, of them 36 were prostatic secretion positive‐isolation (18%), 20 were semen sample positive‐isolation (10%), and 39 were positive‐isolation both prostatic secretion and semen samples (19.5%); 104 patients were infected with two microbial species, of them 30 were prostatic secretion positive‐isolation (15%), 14 were semen sample positive‐isolation (7%), and 60 were positive‐isolation both prostatic secretion and semen samples (30%); one patient was infected with three microbial species and them were isolated from the semen sample (0.5%). In the patients with chronic prostatitis‐like symptoms, the multiple microbial infection (MMI) was accounted for 53.5%, and the multiorgan infection (MOI) was accounted for 67%.ConclusionsThe U‐EPS‐S test is not only helpful to accurately identify the pathogens and contaminants in the culture isolates, but also the diagnosis and differential diagnosis and also evaluation of the treatment efficacy of the infection in different genital organs. In the patients with chronic prostatitis symptoms, Gram‐positive microbes were the most common causative agents, and MMI and MOI caused by resistant strains of different microbial species have a high incidence.

Study of changes in proteolytic systems of rats under conditions of experimental chronic prostatitis

The aim of our research – to analyze the mechanisms of regulation of the body's proteolytic systems during inflammation, detection of inflammation markers in blood and prostate secretions in the simulation of chronic prostatitis (CP) in rats. 1. The leading link in the pathogenesis of many diseases is a change in the structure and functions of biological membranes – membranopathy, the consequence of which is a violation of histochemical barriers, which is manifested in an increase in the excretion of certain metabolites in the extracellular fluid. In the case of experimental CP in rats, the appearance in the secretion of the prostate gland of the components of KKS, which are determined in the secretion of the normal prostate in trace amounts, was noted. Inflammatory damage to the prostate was also evidenced by an increase in the proteolytic potential of prostate secretion due to an increase in kallikrein activity on the 21st day by 807.1% (р˂0.05), which leads to massive kininogenesis. Depletion of the adaptive and compensatory potential of the prostate gland was evidenced by a decrease in prekallikrein by 21.7% (р˂0.05) compared to the intact group of animals. A sharp increase in the activity of kallikrein in CP is probably compensated by an increase in the activity of its specific inhibitor – α2-macroglobulin, the level of which in the secretion of the CP increased on 225 % on the 21st day of the experiment compared to intact rats, and the increase in proteolytic potential – by an increase of 125 % in the inhibitory activity of α1-PI, a protein of the acute phase of inflammation. An increase in the content and activity of KKS components in the secretion of the prostate testifies to its inflammatory damage and violation of the permeability of the hematoprostatic barrier, which can be an important diagnostic criterion.

Adenoprosin in the complex treatment of lower urinary tract symptoms in combination with prostatitis of category III

Introduction.The problem of effective and safe therapy of patients with benign prostatic hyperplasia and prostatitis of category III remains relevant, despite the numerosity of the drugs used in different groups. Under these conditions, the search for new pharmacological agents continues.The study objectivewas to evaluate the efficacy of Adenoprosin in the treatment of lower urinary tract symptoms and erectile dysfunction in patients with chronic pelvic pain syndrome and prostate hyperplasia.Materials and methods.The 90-day study included 60 patients aged 40 to 60 years with chronic pelvic pain syndrome and erectile dysfunction on the background of benign prostatic hyperplasia. Patients of the main group received alfa-1-adrenoreceptor blocker tamsulosin for 30 days in combination with the nonsteroidal anti-inflammatory drug nimesulide for 5 days and Adenoprosin suppositories. The men of the control group took tamsulosin for 30 days and nimesulide for 5 days. Over the next 60 days, the dynamics was evaluated based on the data from the NIH-CPSI (National Institutes Health Chronic Prostatitis Symptom Index), IPSS (International Prostate Symptom Score), QoL (Quality of Life Scale), AMS (Aging Male Symptoms), IIEF-5 (International Index of Erectile Function); urination diary analysis; general urine analysis; blood test for the level of prostate specific antigen, glucose; prostate secretion analysis; transrectal ultrasound examination of the prostate gland with measurement of residual urine; uroflowmetry.Results.Urinary frequency decreased at day 30 in the treatment group from 12.7 ± 1.4 to 7.3 ± 1.8 micturitions per day, in the control group from 13.1 ± 1.8 to 9.6 ± 1.1; subsequently (on days 60 and 90) positive effect persisted in the treatment group, while in the control group urinary frequency increased. Per the NIH-CPSI questionnaire, symptoms decreased at day 30: in the treatment group from 25.4 ± 2.1 to 12.3 ± 1.9 points, in the control group from 24.3 ± 1.7 to 17.6 ± 0.4 points; in the treatment group the trend towards symptom decrease remained, while in the control group symptoms increased at day 90. IPSS score at day 30 decreased in the treatment group from 12.9 ± 0.5 to 5.2 ± 1.4, in the control group from 14.1 ± 0.7 to 8.2 ± 0.9; further decrease was observed in both groups at day 60, but at day 90 the score increased (higher in the control group). Quality of life (QoL) improved in both groups at day 30 (in the treatment group 1.4 ± 0.6 points, in the control group 3.1 ± 0.8). Erectile function improved per the IIEF-5 questionnaire: in the treatment group from 11.5 ± 1.1 to 18.9 ± 1.4 points at day 30 with further positive tendency, in the control group from 10.7 ± 1.4 to 15.3 ± 1.1 points with subsequent negative dynamics. Uroflowmetry showed positive dynamics of Qmaxat the end of treatment in the treatment (from 8.3 ± 1.5 to 14.7 ± 1.1 mL/s) and control (from 8.8 ± 1.3 to 13.1 ± 1.6 mL/s) groups, with its further decrease. Prostate volume in the treatment group was about 33.5 ± 3.1 cm3at day 90 (with baseline volume 42.6 ± 2.5 cm3), in the control group it was 41.6 ± 1.9 cm3(with baseline volume of 43.1±1.4 cm3). No significant changes in urine tests, prostatic fluid, prostate-specific antigen level, and blood glucose were observed during the treatment.Conclusions.The study shows that administration of tamsulosin with Adenoprosin in patients with BPH and category III prostatitis is advantageous compared to administration of only alfa-1-adrenoreceptor blockers.

Роль ангиотензинпревращающего фермента и рецепторов ангиотензина ii второго типа в патогенезе пролиферативных заболеваний предстательной железы

Angiotensin converting enzyme, angiotensin II, angiotensin II receptors of the first and second types represent the "classical" axis of regulation of the renin-angiotensin system. OBJECTIVE: to analyze the role of the components of the renin-angiotensin system in the pathogenesis of proliferative lesions of the prostate glan MATERIALS AND METHODS: The study included 63 patients who underwent transrectal prostate biopsy. The first group consisted of 19 patients with benign prostatic hyperplasia, the second group consisted of 19 men whose prostate cancer was detected during repeated biopsy, the third group consisted of 25 men with prostate cancer detected during primary prostate biopsy. The expression of angiotensin II type II (AT2-R) receptors in prostate tissue was evaluated using primary polyclonal antibodies Angiotensin II Type 2 Receptor and the EnVision FLEX imaging system (Dako, Denmark) according to a standard technique. The activity of angiotensin converting enzyme (ACE) was determined in the secret of the prostate gland, RESULTS: It was found that the activity of ACE in the secret of the prostate gland in proliferative diseases is significantly higher than in the "healthy" prostate. The highest activity of ACE was noted for benign prostatic hyperplasia, and the minimum - for prostate cancer. The expression of AT2-R in prostate tissues in proliferative diseases of the prostate gland has its own characteristics. The expression of AT2-R in the prostate stroma turned out to be the same, in the nuclei of epithelial cells, the level of expression of AT2-R decreased in the range of BPH-PIN-CP. Thus, an increase in the activity of ACE, the accumulation of angiotensin II in prostate secretions in proliferative prostate diseases against the background of a deficiency of AT2-R is the metabolic basis of malignant transformation of the prostate gland. CONCLUSION: The levels of ACE activity in prostate secretion and the expression of AT2-R in prostate tissue during primary prostate biopsy can be considered as promising prognostic tools for early detection of prostate malignancy.

A Combined CRISP3 and SPINK1 Prognostic Grade in EPS-Urine and Establishment of Models to Predict Prognosis of Patients With Prostate Cancer.

BackgroundProstate cancer (PCa) is characterized by significant heterogeneity. Thus, novel prognostic indicators are required to improve prognosis and treatment.MethodsCysteine rich secretory protein 3 (CRISP3) and serine peptidase inhibitor Kazal type 1 (SPINK1) levels in expressed prostatic secretion (EPS)-urine collected during digital rectal examination of 496 patients histologically diagnosed with PCa were detected via enzyme-linked immunosorbent assay. A combined CRISP3 and SPINK1 prognostic grade (CSPG) was defined using cut-off values from receiver operating characteristic curves. Log-rank Kaplan-Meier survival curves investigated differences in prognosis between groups. Univariate and multivariate Cox analyses investigated the CSPG relationship with biochemical recurrence (BCR), cancer-specific survival (CSS), and overall survival (OS). Three prognostic models were developed and validated.ConclusionsCRISP3 and SPINK1 levels increased with Gleason score progression, pathological T stage, and metastasis status. CSPG in EPS-urine, which was an effective independent prognostic variable, accurately predicted the prognosis of patients with PCa. Three clinical prognostic models using the CSPG for BCR, CSS, and OS were developed and validated.

Optimization of small extracellular vesicle isolation from expressed prostatic secretions in urine for in-depth proteomic analysis.

The isolation and subsequent molecular analysis of extracellular vesicles (EVs) derived from patient samples is a widely used strategy to understand vesicle biology and to facilitate biomarker discovery. Expressed prostatic secretions in urine are a tumor proximal fluid that has received significant attention as a source of potential prostate cancer (PCa) biomarkers for use in liquid biopsy protocols. Standard EV isolation methods like differential ultracentrifugation (dUC) co‐isolate protein contaminants that mask lower‐abundance proteins in typical mass spectrometry (MS) protocols. Further complicating the analysis of expressed prostatic secretions, uromodulin, also known as Tamm‐Horsfall protein (THP), is present at high concentrations in urine. THP can form polymers that entrap EVs during purification, reducing yield. Disruption of THP polymer networks with dithiothreitol (DTT) can release trapped EVs, but smaller THP fibres co‐isolate with EVs during subsequent ultracentrifugation. To resolve these challenges, we describe here a dUC method that incorporates THP polymer reduction and alkaline washing to improve EV isolation and deplete both THP and other common protein contaminants. When applied to human expressed prostatic secretions in urine, we achieved relative enrichment of known prostate and prostate cancer‐associated EV‐resident proteins. Our approach provides a promising strategy for global proteomic analyses of urinary EVs.

Assessment of Diagnostic Equivalence of Biological Secretions in Men with Chronic Prostatitis /Chronic Pelvic Pain

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common treatment-resistant condition with symptoms of prostatitis, lack of evidence of a bacterial infection in expressed prostatic secretions, urine post-prostatic massage, or semen. When there is a high content of leukocytes in these secretions, an inflammatory ?PPS (National Institutes of Health (NIN) category IIIA) is diagnosed, whereas if they are normal a non-inflammatory CPPS (NIN category IIIB) is diagnosed.

Периферійна нейропатія при хламідійному реактивному артриті

Актуальність: периферійна нейропатія (ПНП) при реактивному хламідійному урогенітальному артриті (РХА) описується у вигляді поодиноких спостережень, і багато клініко-патогенетичних аспектів такого ураження нервової системи залишаються нез’ясованими. Мета дослідження: оцінити частоту й характер перебігу ПНП при РХА, взаємозв’язок нервових та суглобових ушкоджень, вивчити питання патогенетичних побудов цієї нейропатії, виділити чинники ризику. Матеріал і методи. Під наглядом перебував 101 хворий на РХА, середній вік яких становив 32 роки, тривалість захворювання — 4 роки, а співвідношення чоловіків і жінок — 1 : 1. У 90 % спостережень РХА виявлено Chlamydia trochamatis у секреті передміхурової залози, зіскобах з уретри, шийки матки, стінок піхви, у 83 % — позитивні серологічні тести на хламідійну інфекцію. Результати. При РХА ознаки ПНП мають місце в 19 % хворих у співвідношенні мононейропатія/полінейропатія як 1 : 1, із моторними, сенсорними і змішаними розладами в пропорції 1 : 3 : 6, наявністю вегетативних змін у кожного другого пацієнта та частішою дистальною локалізацією процесу в руках, на що впливають тяжкість перебігу суглобового синдрому, високі рівні протихламідійних антитіл у крові, а на аксональні й демієлінізуючі показники електронейроміографії — вираженість уражень урогеніталій і наявність синдрому Гійена — Барре. Високий показник темпів прогресування артриту є прогнознегативною ознакою перебігу ПНП у хворих на РХА. У патогенетичних побудовах ПНП беруть участь запальні імунні білки, порушення ендотеліальної функції судин та фізико-хімічні поверхневі реологічні властивості сироватки. Висновок. ПНП має місце в кожного п’ятого пацієнта з РХА, взаємопов’язана з клініко-лабораторними ознаками уражень суглобів, а в майбутньому буде корисним активне виявлення такої патології нервової системи для подальших своєчасних реабілітаційних заходів, причому серопозитивність РХА за антитілами до циклічного цитрулінового пептиду є чинником ризику такої ПНП.

MMCP7, a Mouse Ortholog of δ Tryptase, Mediates Pelvic Tactile Allodynia in a Model of Chronic Pelvic Pain.

Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) is a condition that affects a large number of men and has unknown etiology. We have previously demonstrated the presence of elevated levels of mast cell tryptase in expressed prostatic secretions (EPS) of CP/CPPS patients. In a murine model of CP/CPPS, we showed tryptase and its cognate receptor PAR2 as critical to the development of pelvic pain and lower urinary tract symptoms. Here, we extend these observations to demonstrate that an isoform of tryptase called delta (δ)-tryptase, is elevated in the EPS of patients with CP/CPPS and is correlated with pelvic pain symptoms. Using an Escherichia coli (CP1) -induced murine model of CP/CPPS, we demonstrated a differential response in C57BL/6J and NOD/ShiLtJ mice, with C57BL6/J mice being resistant to an increase in pelvic tactile allodynia, despite having equivalent levels of activated mast cells in the prostate. Activated tryptase+ve mast cells were observed to be in closer apposition to PGP9.5+ve nerve fibers in the prostate stroma of NOD/ShiLtJ in comparison to C57BL/6J mice. The mouse ortholog of δ-tryptase, mouse mast cell protease 7 (mMCP7) has been reported to be unexpressed in C57BL/6J mice. We confirmed the absence of mMCP7 in the prostates of C57BL/6J and its presence in NOD/ShiLtJ mice. To evaluate a role for mMCP7 in the differential allodynia responses, we performed direct intra-urethral instillations of mMCP7 and the beta (β)-tryptase isoform ortholog, mMCP6 in the CP1-infection model. mMCP7, but not mMCP6 was able to induce an acute pelvic allodynia response in C57BL/6J mice. In-vitro studies with mMCP7 on cultured mast cells as well as dissociated primary neurons demonstrated the ability to induce differential activation of pain and inflammation associated molecules compared to mMCP6. We conclude that mMCP7, and possibility its human ortholog δ-tryptase, may play an important role in mediating the development of pelvic tactile allodynia in the mouse model of pelvic pain and in patients with CP/CPPS.

Integration of Automatic Text Mining and Genomic and Proteomic Analysis to Unravel Prostate Cancer Biomarkers.

Prostate cancer (PCa) is the most prevalent noncutaneous cancer among men. The limited accuracy and/or invasive nature of the current diagnostic tools have driven the demand for new and noninvasive biomarkers. Urine as a noninvasive sample that contains prostatic secretions is a promising source of PCa markers. The automatic text-mining functionality of VOSviewer was used to retrieve and create co-occurrence networks of terms associated with PCa. These results were complemented with DisGENET data, a repository of PCa associations, and with a recent bioinformatic analysis integrating all differentially expressed proteins identified in tumor tissue and urine from PCa patients to address the limited term selection of VOSviewer. Afterward, the results were integrated with gene expression data from the Gene Expression Omnibus database to correlate gene and protein levels. This study suggests AXIN2, GSTM2, KLK3, LGALS3, MSMB, PRTFDC1, and SH3RF1 as important entities in PCa context. KLK, LGALS3, and MSMB proteins are common to a previous bioinformatic analysis, and a concordance was found between the levels of gene and protein expression. The applicability of the pipeline presented here was validated by showing altered urinary levels of galectin-3 protein in PCa patients compared to noncancer subjects.

Состояние мочеполовой системы у мужчин промышленного предприятия по результатам углубленного урологического осмотра

The purpose to study the state of medical activity and analyze the results of targeted examinations of men working at an industrial enterprise, at various age periods. Material and methods. An enhanced urological examination of 360 employees of an industrial enterprise aged 20 years and older was carried out. The scope of the study included: a questionnaire, a clinical examination of the external genitalia, a rectal finger examination, a clinical analysis of urine and prostate secretion (PJ), a blood test for common prostate-specific antigen (PSA), a transrectal ultrasound of the pancreas (TrUS), a urologist consultation and, by indications, an oncologist. Results. Determination of the PSA level in blood revealed pathology in 11.5% of employees. TUS revealed an increased size of the pancreas in 72% of the subjects. In 38% of the subjects, changes in the pancreas secretion indicated the presence of an inflammatory process. Conclusions. The voluntary urological examination of employees indicates their concern for health. An effective solution to the problem of the genitourinary system morbidity in men is regular end-to-end medical examinations and organization of further therapeutic and preventive measures. The conducted survey not only shows the true prevalence of urological diseases at this enterprise, but also helps to prevent the diseases of the genitourinary sphere in men at various age periods.

Protein Profile and Glycosidase Activities of Prostate and Bulbourethral Glands Secretion in Camels (Camelus dromedarius)

Protein Profile and Glycosidase Activities of Prostate and Bulbourethral Glands Secretion in Camels (Camelus dromedarius)

Reproductive Toxicity of Carlina gummifera L. Incense Inhalation in Adult Male Wistar Rats.

ABSTRACTBackground:Burning incense of Carlina gummifera L. is a traditional practice in North African countries for religious or ritual intentions.Aim:The aim of this study was to investigate the effects of smoke incense of this plant on the reproductive function in adult male rats.Setting and Design:This study was conducted in the Integrated Physiology Laboratory.Materials and Methods:Plant roots were collected, dried and finely ground in powder form. Adult Wistar rats were randomly assigned to treated groups exposed daily during 60 min for 15 consecutive days to smoke incense at 2, 4 and 6 g and a control group was subjected to the same conditions in the absence of smoke.Statistical Analysis Used:Statistical analysis was performed using one-way analysis of variance followed by Tukey's multiple comparison as the post hoc test.Results:Exposure to the incense of Carlina gummifera L. seriously affected dose dependently the reproductive function in male rats. It was found that in treated groups, the testicle relative weight decreased, while those of seminal vesicles and prostate increased when compared to the untreated group. Carlina gummifera L. incense inhalation reduced the total number, viability and mobility of epididymis spermatozoa compared to control. Furthermore, incense exposure induced various histological changes in the testes, prostate and seminal vesicles, including in particular a decrease in the number of gametes in the seminiferous tubes, the reduction of prostatic secretions and the macrophagic resorption of the seminal secretions. The effect of Carlina incense on the antioxidant system was evaluated by assaying the two antioxidant enzyme activities catalase and superoxide dismutase as well as thiol group levels in the testicles. Our results showed that fumigation affected these parameters, suggesting that the morphological and functional modifications in the male reproductive system induced by Carlina gummifera L. incense may be related, in part, to the alteration of the oxidative balance in the testicle.Conclusion:Smoke incense of Carlina gummifera L. caused marked reproductive toxicity in adult male rats associated with induced oxidative stress.

Antibiotic therapy of chronic bacterial prostatitis is more effective considering antibiotic susceptibility of all pathogens isolated.

PurposeBecause of the insufficient efficacy of the current treatment of chronic bacterial prostatitis (CBP), it is justified to search for a more effective antibiotic therapy (ABT).Materials and MethodsThis single-centre prospective observational comparative study was conducted in 2012 to 2019 (patients: 60 men with CBP; age: 20–45 y). The clinical examination was performed on admission and at 1, 3, 6, or 12 months. All patients underwent the Meares–Stamey test to obtain expressed prostatic secretion (EPS) and/or post-massage urine (PMU) samples for extended bacteriological examination. The patients were randomly divided into 2 treatment groups (30/30 patients): group I, fluoroquinolones (FQs); group II, a combination of FQs with cephalosporins/macrolides with a treatment duration of 1 month.ResultsPatients of both groups had severe symptomatic CBP with an average duration of 4 years. Twenty-three microorganisms (15 aerobes, 9 anaerobes) were identified in PMU. At 3 months follow-up, a positive clinical effect was noted in both groups, which was significant (p<0.05) only in group II concerning NIH-CPSI questionnaire, leukocyturia, prostate volume, maximum urine flow, and decreased pathospermia. At 6 months follow-up, in group II the frequency of Escherichia coli and Enterococcus spp. decreased significantly. In group I aerobes changed only insignificantly from the initial level, but anaerobes increased significantly. In group II the titers of both, aerobes and anaerobes, were significantly lower (p<0.05) at 6 months follow-up as compared to initial values.ConclusionsABT targeting all taxa in EPS/PMU is a more effective alternative to standard therapeutic regimens for CBP.

The state of the microflora of prostate secretions in healthy individuals and in acute bacterial prostatitis

Relevance. Acute bacterial prostatitis is one of the urgent problems in urology. According to the data presented in the literature, the number of men who have been diagnosed with this disease ranges from 10 to 40 %. At the same time, the main etiological factor in the development of this pathology is most often assigned to the bacterial microflora. However, most of the works are devoted to the study of the microflora in chronic prostatitis, and the state of the microflora in acute bacterial prostatitis remains insufficient. The aim of the study is to evaluate the state of prostate secretion microflora in a comparative aspect in healthy individuals and in patients with acute bacterial prostatitis. Materials and Methods. The study included a comparative analysis of microbiological cultures in prostate secretion of 30 people. All examined were divided into two groups: the first included 15 people without established urological pathology, the second - 15 people with an established diagnosis of acute bacterial prostatitis. Results and Discussion. As a result of the study, it was found that when sowing prostate secretion in persons without established pathology, the absence of microorganism growth was not observed in 60 % of observations, while in 40 % of cases, microorganisms growth was obtained. In the group of examined without established urological pathology, the growth of microorganisms of the following was noted: Escherichia coli - in 58 % of observations; Staphylococcus epidermidis - in 10 % of observations; Staphylococcus warnerii - in 6 % cases and Enterobacter spp. - in 26 %. At the same time, the number of detected microorganisms did not exceed 104 CFU/ml. At the same time, the presence of microbial associations was not recorded. In patients with acute bacterial prostatitis, the sterile prostate secret was 13,3 %, and in 86,7 % of people, microflora growth was obtained. Most often, in the group examined with acute bacterial prostatitis, Escherichia coli was obtained - in 45 % of the observations; Klebsiella spp. - in 23 % cases and Proteus spp. - in 19 %. Less often Staphylococcus epidermidis - in 8 % of observations; Enterobacter spp. - 3,2 %. Serratia spp. - 1,1 % and Staphylococcus warnerii - in 0,7 % cases were the least obtained. At the same time, 86 % of observations in this group revealed microbial associations. Conclusion . Comparison of the state of microflora of prostate secretions in healthy individuals and patients with acute bacterial prostatitis revealed that in patients with acute bacterial prostatitis, the absence of inoculated microflora in prostate secretions was 3 times less than in healthy individuals (13.3 % and 40 %, respectively.), and Escherichia coli was the most common microorganism in the group of patients with acute bacterial prostatitis.

Сondition of urogenital tract microbiotes and pro- and antioxidant system in male azoospermia

Over the past 20 years, there has been a clear trend to increase in the number of infertile men in Ukraine, their percentage reaches 50% in infertile couples. There is a significant percentage of male infertility caused by azoospermia – the lack of sperm in the ejaculate. In male infertility, azoospermia is found in 10–15% of patients, among other forms of pathospermia. Given the ambiguity of ideas about the etiology, pathogenesis and treatment and diagnostic approaches for various types of infertility, it remains important to clarify the relationship of urogenital infections with the regulatory systems of cells, including the state of the pro- and antioxidant system and the search for additional markers. 119 patients with various forms of azoospermia were examined. All patients underwent the following studies: spermogram, infectious screening, inhibin B, lipid peroxidation, activity of enzymes of the glutathione antioxidant system in sperm plasma and blood serum. Infectious screening included analysis of urethral secretions, bacteriological examination of sperm or prostate secretion, assessment of the species and quantitative composition of the microflora of the male urogenital tract. According to the results of spermogram and other diagnostic methods, a non-obstructive form of azoospermia was detected in 69 patients. In obstructive azoospermia, ejaculate as such was absent. It is suggested that inhibin B may be an important medical diagnostic test for azoospermia. As a result of the conducted researches the importance of determining the concentration of inhibin B as a marker of azoospermia was demonstrated and a negative correlation of moderate strength between the content of inhibin B and testosterone level in the plasma of men with non-obstructive azoospermia was revealed. It was found that Ureaplasma pervum and Ureaplasma urealyticum infect the male genitourinary system to the greatest extent among a number of microorganisms, both in non-obstructive and obstructive forms of azoospermia. Enterococcus faecalis is more pronounced in the sperm fluid in the non-obstructive form of azoospermia and prostate secreton in the obstructive form of azoospermia. In the non-obstructive form of azoospermia in the seminal plasma and serum, the processes of lipid peroxidation intensify, the concentration of reduced glutathione decreases and the activities of the enzymes of the glutathione antioxidant system (glutathione peroxidase and glutathione transferase) decrease. It can be considered that an important diagnostic test for the nonobstructive form of azoospermia is the ratio of reduced glutathione to oxidized glutathione in sperm plasma.

Analysis of the Effectiveness of Various Types of Conservative Therapy for Chronic Bacterial Prostatitis

Analysis of the Effectiveness of Various Types of Conservative Therapy for Chronic Bacterial Prostatitis

Direct N-Glycosylation Profiling of Urine and Prostatic Fluid Glycoproteins and Extracellular Vesicles.

Expressed prostatic secretions (EPS), also called post digital rectal exam urines, are proximal fluids of the prostate that are widely used for diagnostic and prognostic assays for prostate cancer. These fluids contain an abundant number of glycoproteins and extracellular vesicles secreted by the prostate gland, and the ability to detect changes in their N-glycans composition as a reflection of disease state represents potential new biomarker candidates. Methods to characterize these N-glycan constituents directly from clinical samples in a timely manner and with minimal sample processing requirements are not currently available. In this report, an approach is described to directly profile the N-glycan constituents of EPS urine samples, prostatic fluids and urine using imaging mass spectrometry for detection. An amine reactive slide is used to immobilize glycoproteins from a few microliters of spotted samples, followed by peptide N-glycosidase digestion. Over 100 N-glycan compositions can be detected with this method, and it works with urine, urine EPS, prostatic fluids, and urine EPS-derived extracellular vesicles. A comparison of the N-glycans detected from the fluids with tissue N-glycans from prostate cancer tissues was done, indicating a subset of N-glycans present in fluids derived from the gland lumens. The developed N-glycan profiling is amenable to analysis of larger clinical cohorts and adaptable to other biofluids.