Experience in the use of a synthetic immunostimulant in the outpatient practice of a urologist

Inflammation of the prostate occurs in men of all age groups. The incidence is comparable to that of diabetes mellitus, coronary heart disease and hypertension. Chronic prostatitis significantly reduces the quality of life of patients, disrupts copulative and generative functions. According to modern data, up to 35% of men aged 20 to 40 suffer from prostate inflammation. Thus, chronic prostatitis is not only a medical but also a social problem. The results of treatment of 48 patients with a diagnosis of «chronic prostatitis», a concomitant diagnosis of «chronic recurrent chlamydia, papillomavirus infection, human papillomavirus» were analyzed. For the analysis, three groups of 48 patients were formed who received complex etiopathogenetic treatment and symptomatic therapy in accordance with Methodological recommendations number 14 of 2019, developed on the basis of the Moscow State Budgetary Healthcare Institution «City Clinical Hospital named after S. I. Spasokukotsky» of the Department of Health of the City of Moscow, Federal State Budgetary Educational Institution of Higher Education «Moscow State Medical and Dental University named after A.I. Evdokimov» of the Ministry of Health of the Russian Federation. Patients received antibacterial therapy with fluoroquinolone and tetracycline drugs in combination with an immunomodulator. As a result of treatment of a chronic inflammatory process in the prostate gland, a stable remission was achieved, and in some cases, a complete recovery of patients, confirmed by a significant decrease in the index of the scale of symptoms of chronic prostatitis and pelvic pain syndrome in men (CP-CPPS) according to the US National Institutes of Health NIH-CPSI, as well as instrumental and laboratory data. In the treatment of concomitant diseases (persistent chlamydial and papillomavirus infection), patients showed complete elimination of the pathogen and a decrease in viral load according to the enzyme immunoassay and polymerase chain reaction analysis. There were no significant side effects during treatment.

1. Alyayev Yu. G., Vinarov A. Z., Demidko Yu. L., Spivak L. G. Treatment of chronic prostatitis as a prevention of the possible development of prostate adenoma // Urologiya. 2012; 2: 39-40.

2. Лаврова С. А., Ткаченко П. М. Ультразвуковая диагностика заболеваний предстательной железы // Новости лучевой диагностики. 1999; 1: 11-14.

3. Пушкарь Д. Ю. Функциональная урология и уродинамика / Под ред. Д. Ю. Пушкаря, Г. Р. Касяна. М.: ГЭОТАР Медиа, 2013. 376 с.

4. Винник Ю. Ю., Кузьменко А. В., Гяургиев Т. А. Лечение хронического простатита: современное состояние проблемы // Урология. 2021; (4): 138-144.

5. Bozhedomov V. A., Semenov A. V., Konyshev A. V. i dr. Reproductive function of men in chronic prostatitis: clinical anamnestic and microbiological aspects // Urologiya. 2015; 1: 70-78.

6. Bozhedomov V. A., Semenov A. V., Patsanovskaya G. M. i dr. Reproductive function of men in chronic prostatitis: clinical, anamnestic and microbiological aspects // Urologiya. 2015; (1): 70.

7. Krupin A. V. Chronic bacterial prostatitis. Clinical aspects of pathogenetic therapy. // Avtograf. dis. kand. med. nauk. Nizhniy Novgorod, 2017. 151.

8. Tyuzikov I. A. Chronic prostatitis as a neuroendocrine syndrome and new potential pharmacotherapeutic options for managing the problem // Farmakologiya i farmakoterapiya. 2021; (1): 58-66.

9. Vinarov A. Z., Stoylov S. V., Kozyrev S. V. i dr. Treatment of patients with prostatitis with doxycycline (Unidox Solutab®) and/or josamycin (Vilprafen®) in real clinical practice. Results of the observation program TAURUS // Urologiya. 2015; (3): 75-78, 80-83.

10. Shatokhin M. N., Teodorovich O. V., Mykolayenko T. V. i dr. Correction of complement system disorders in patients with chronic prostatitis // Urologiya. 2011; 4: 29-32.

11. Kul'chavenya Ye. V., Shevchenko S. Yu., Cherednichenko A. G., Breusov A. A., Vinitskiy A. A. New possibilities for the use of hyaluronidase in chronic prostatitis // Urologiya. 2020; (3): 56-62.

12. Shoskes D. A., Nickel J. C., Dolinga R., Prots D. Clinical phenotyping of patients with chronic prostatitis/chronic pelvic pain syndrome and correlation with symptom severity // Urol. 2009; (73): 538-542; discussion 542-543.

13. Bitti V. L., Morrison R. P., Birn D. I. Chlamydia persistence: from cell cultures to the pathogenesis of chlamydial infection // ZPPP. 1995; 6: 3-18.

14. Krieger J. N., Thumbikat P. Bacterial prostatitis: bacterial virulence, clinical outcomes, and new directions // Microbiol Spectr. 2016; 4 (1).

15. Zhang J., Liang C., Shang X., Li H. Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A disease or symptom? Current perspectives on diagnosis, treatment, and prognosis // Am J Mens Health. 2020.

16. Zhang W., Fang Y., Shi M., Zhang M., Chen Y., Zhou T. Optimal acupoint and session of acupuncture for patients with chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis // Transl Androl Urol. 2021; 10 (1): 143-153.

17. Magri V., Wagenlehner F., Perletti G., Schneider S., Marras E., Naber K. G., Weidner W. Use of the UPOINT chronic prostatitis/chronic pelvic pain syndrome classification in European patient cohorts: sexual function domain improves correlations // J . 2010; 184 (6): 2339-2345.

18. Konoplya A. I., Teodorovich O. V., Shatokhin M. N. i dr. Chronic prostatitis, prostate adenoma and immunity: disorders and correction // Urologiya. 2013; 4: 99-103.

19. Nickel J. C. Chronic prostatitis/Chronic pelvic pain. The biomedical model has failed! So, what’s next Contemp // Urol. 2006; 6: 31-39.

20. Kalinina S. N., Tiktinskiy O L., Aleksandrov V. P. Clinical and Topical theme immunological disorders in patients with chronic prostatitis caused by urogenital infection // Urologiya. 2006; 3: 74-79.

21. Mazzoli S., Salts S., Cosco E., Pogialli C. Production of IL6 in vivo and anti Chlamydia trachomatis specific immune response in patients affected by prostatitis. The 2nd European Congress ESIDOG & the 4th World Congress Infect Dis Obstet Gynecol & Infect Dis Urol Dermatol Oct. 29 — Nov. 5, 1995, Marbella, Spain Programs & Abstracts 1995; 134.

22. Tyuzikov I. A., Grekov Ye. A., Kalinchenko S. Yu., Martov A. G. Optimization of the diagnosis of inflammatory diseases of the prostate gland based on an interdisciplinary approach // Eksperimental'naya i klinicheskaya urologiya. 2013; (1): 44-51.

23. Bragina Ye. Ye., Dmitriyev G. A. Morphological features of the structure of elementary and reticular bodies of chlamydia in persistent chlamydia. // Tezisy dokladov nauchno-prakticheskoy konferentsii, posvyashchennoy 75-letiyu TSNIKVI. M., 1996. S. 12-13.

24. Górski A., Jończyk-Matysiak E., Łusiak-Szelachowska M., Międzybrodzki R., Weber-Dąbrowska B., Borysowski J., et al. Phage therapy in prostatitis: recent prospects // Front Microbiol. 2018; (9): 1434.

25. Morrison R. P., Belland R. J., Lyng K., Caldwell H. D. Chlamydial disease pathogenesis: the 57-kD chlamydial hypersensitivity antigen is a stress response protein // J. Exp. Med. 1989: 170: 1271-1283.

26. Su H., Caldwell H. D. CD4(+) T-cells play a significant role in adoptive immunity to Chlamydia trachomatis infection ofrhe mouse genital tract. Infect // Immun. 1995; 63: 3302-3308.