Balabanyk V. Clinical-pathogenetic features of development of acute epididymitis and the rationale for rational tactics of treating patients.

The dissertation presents a theoretical generalization and a new solution of an actual scientific problem - improvement of diagnosis and improvement of treatment for the patients with acute epididymitis by means of comprehensive study of the features of macro- and microelement exchange, antioxidant protection, the state of endothelial function, and the argumentation of the offered complex scheme of therapy with the confirmation of its effectiveness.In the dissertation work the results of the examination and treatment of 120 patients aged 18 to 60 years with acute unilateral epididymitis are presented (the average age is 34.2±2.1 years). The study consisted of two stages. At the first stage, according to the results of the survey, a group of patients was formed, in which the diagnosis of acute epididymitis was confirmed. The criteria for inclusion in the study were: the stationary patients with acute unilateral epididymitis and the informative agreement to conduct research.It is proved that in order to assess clinical-functional, bio-elemental, metabolic disorders and to predict the severity of the disease in the complex of diagnostic measures, it is necessary to determine the state of processes of peroxide oxidation of proteins for the content of the active products of oxidative modification of proteins in the blood; antioxidant protection systems for the level of catalase and superoxide dismutase enzymes; micronutrient homeostasis for the content of zinc, copper. To diagnose endothelial dysfunction, it is useful to determine the concentration of an early endothelin-1 marker in blood serum to predict the course of the disease, to monitor the effectiveness of the treatment performed and to prevent destructive complications. The study of the effectiveness of the offered treatment scheme for patients with acute epididymitis indicated the following: in the basic treatment schemes, the inclusion of ofloxacin, l-arginine, suppository, containing of 15000 million units of streptokinase and 1250 million units of streptodornase can reduce the duration of clinical manifestations of the disease, stabilize the activity of peroxide oxidation of proteins, and optimize the antioxidant protection of the body and achieve the physiological level of zinc and copper in the blood serum, improve endothelial function, resulting in an increase in the effectiveness of treatment