A K. Clinic-pathogenic features of chronic bacterial prostatitis and results of complex treatment of patients

Thesis aims at solving current problem of clinical urology - increase of efficiency of treatment for patients with chronic bacterial prostatitis (CBP) by means of comprehensive study of clinic-pathogenic processes to demonstrate new approaches to their correction and working-out on these basis additional preventive measures and treatment recommendations for such patients.Thesis is based on comparative results of examination of 120 patients with chronic bacterial prostatitis and 25 healthy persons as a control group. Research comprised two stages. Based on the results of examination at the first stage of research was formed group of patients with confirmed diagnosis chronic bacterial prostatitis. On the second stage patients were divided into subgroups based on the treatment applied. Research paper proves significance of the complex of changes of the oxidative and immune systems, bioelements, endothelial function of vessels as composite elements of the mechanism of chronic bacterial prostatitis development. Diagnostic value of evaluation of the level of inflammatory markers in ejaculate of patients with CBP was ascertained for the first time. It was discovered, that determination of the level of CRP in ejaculate allows continuous monitoring of clinical course for the purposes of diagnostics, predication and appraisal of the efficiency of therapy. It was ascertained, that level of CRP in ejaculate considerably exceeds its content in blood serum. Complex assessment of the level of cytokines (IL-6, IL-8, TNF-a), that are considered to be the main inducers of the release of CRP in ejaculate, was taken; it allowed to learn more about pathogenic stages of development of local inflammatory response in the prostatic gland. For the first time it was ascertained, that increase of oxidative protein modification (OPM) of patients with CBP happens against the decrease of ferments of antioxidant system, which helps to enlarge the insight of the stages of pathogenic link. For the first time complex analysis of the level of zinc and cuprum in blood of patients with CBP was conducted. Hypozincemia of such patients was confirmed as well as its role in disbalance of the state of OPM-AS systems and increase of activity of local inflammatory response. It was pathogenically substantiated and suggested to improve scheme of complex treatment of patients with CBP by means of extension of existing treatment by adding medicine with antioxidant and immunomodulating effect to correct detected process of the disease development mechanism.