RU2376003C1 - Method of treating patients with chronic vesiculitis - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention relates to medicine, in particularly to urology, and concerns treatment of patients with chronic vesculitis. For this purpose patient's lower part is daily placed in pressure chamber and sealed, including area of hypogastrium and pelvis. During 15 minutes pressure influence is performed. During first 5 days patient is exposed to influence with reduced pressure -0.10-0.25 kg/cm2. In following 5 days - increased pressure +0.10-0.25 kg/cm2 is alternated with said reduced pressure from 3 to 5 times per session. Simultaneously with pressure influence antibiotic is drop-by-drop introduced intravenously. Additionally oxytocin at dose 5MU is introduced intramuscularly, once per day, every second day. ^ EFFECT: in short time method provides efficient eradication of pathogenic microflora from seminal vesicles and total recovery of their functions for long time. ^ 1 ex, 1 tbl

Description

The present invention relates to medicine, namely to urology, and can be used in the treatment of patients with chronic vesiculitis.

It is known that chronic vesiculitis is characterized by a long and relapsing course, leading to decreased performance, worsening sexual, reproductive functions in most patients.

A known method of treating patients with chronic prostatitis, including in addition to antibiotic therapy, and the use of various physiotherapeutic agents that improve microcirculation in the prostate gland (Boychenko O.A. A method of treating patients with chronic prostatitis. Patent of Russia No. 2119187, M. C. A61N 5/06, A61N 1/36, A61N 2/06, Applic. 1994.02.28., Publ. 1998.08.27). The known method includes electrical stimulation of the prostate gland, in addition to which irradiation is carried out with a laser light flux and a stationary magnetic field. In this case, electrical stimulation is carried out every other day for 15-20 minutes; irradiation with a laser light flux - daily at a radiation power of 6-60 mW, also for 15-20 minutes; a stationary magnetic field is exposed daily for 60 minutes.

The disadvantages of this method of treatment include the fact that each of these factors affects only the prostate gland and does not affect the seminal vesicles. The authors do not describe a control laboratory study of the secretion of the prostate and ejaculate after treatment.

Closest to the technical nature of the proposed is a method of treating chronic vesiculitis by conducting complex therapy, including the use of anti-infective drugs, including antibiotics, and physiotherapy in the pelvic area. Physiotherapeutic treatment is carried out with the Yarilo apparatus, which combines a helium-neon laser acting on the striated muscles of the perineum and pelvis, and electrical stimulation. The therapeutic effect is achieved by improving the flow of arterial blood with dosage forms, and the anti-inflammatory effect is due to laser beams. Complex therapy is carried out in 2-week courses with an interval of 5-7 days, taking into account the time of growth and development of the microorganism. (Tiktinsky O.L., Mikhaylichenko V.V. Andrology. - St. Petersburg: Media Press, 1999. - P.120-121).

The disadvantages of this method, as well as similar, include the fact that in the treatment of chronic prostatitis, the effect is only on the prostate gland and does not take into account the condition of the seminal vesicles, the infection in which remains.

The task of the invention is to develop a method for the treatment of patients with chronic vesiculitis.

The technical result of the proposed method is to increase the effectiveness of treatment due to the eradication of pathogenic microflora from the seminal vesicles and the restoration of their functions.

The technical result is achieved in that a method of treating patients with chronic vesiculitis involves the introduction of antibiotics and physiotherapy in the pelvic area.

Distinctive techniques of the proposed method are that within a 10 day course of treatment, oxytocin is administered intramuscularly at a therapeutic dose of 5 IU once a day, i.e. the patient receives 5 injections per course of treatment.

A distinctive technique of the proposed method is also the fact that daily carry out zonal barotherapy on the area of the hypogastrium and pelvis with simultaneous intravenous drip of an antibiotic acting on an infectious agent.

The difference of the proposed method also lies in the fact that in the first 5 days, zonal bar exposure is carried out under reduced pressure - (0.10-0.25) kg / cm ² , and in the next 5 days - in alternating mode, alternating high pressure + ( 0.10-0.25) kg / cm ² and reduced pressure - (0.10-0.25) kg / cm ² , repeating the change of pressure from 3 to 5 times per session. The time for bar exposure is 15 minutes.

A comparative analysis of the proposed technical solution and prototype shows that the inventive method differs from the known methods. These differences allow us to conclude that the claimed technical solution meets the criteria of the invention of "novelty."

A search for solutions known in medicine showed that the distinguishing features of the proposed method were not found in the known solutions for the treatment of patients with chronic vesiculitis.

The authors of the proposed method found that the introduction of oxytocin contributes to the eradication of infection from the seminal vesicles. Clinical observations of the authors indicate the effectiveness of the treatment of chronic vesiculitis with the use of oxytocin in the specified dose and its administration schedule. The authors are not aware of the use of oxytocin to eradicate infection from the seminal vesicles.

According to the control examination after 3, 6, 12 and 24 months after treatment, no pathological changes were observed in the secretion of the prostate, ejaculate.

Conducting zonal bar exposure in the first 5 days under reduced pressure - (0.10-0.25) kg / cm ² provides an increase in the concentration of intravenously administered antibiotic in the pelvic area due to increased blood flow.

Conducting zonal bar exposure in the next 5 days - in alternating mode, alternating high and low pressure at the same values, helps to eliminate venous stasis and restores normal blood supply in the pelvis.

The regimen, magnitude of pressure, and the time of compression and decompression were established by the authors during clinical observations as the most optimal for obtaining the best results in the treatment of patients with chronic vesiculitis. The studies conducted by the authors showed that the so-called "tide effect" lasts about 24 hours.

The inventive method ensures the achievement of the technical result perceived by the applicant, namely, increasing the effectiveness of treatment by eradicating pathogenic microflora from the seminal vesicles and restoring their functions. The above allows us to conclude that the technical solution meets the criterion of "inventive step".

The method comprising the claimed invention is intended for use in healthcare. The possibility of its implementation is confirmed by the methods and means described in the application, which meets the criteria of the invention "industrial applicability".

The inventive method of treating patients with chronic vesiculitis is as follows. During the course of treatment, the patient every other day is injected intramuscularly with oxytocin in a therapeutic dose of 5 ME once a day. Daily for 15 minutes, a zonal bar effect on the area of the hypogastrium and pelvis is carried out.

For each patient, the parameters of bar exposure are selected individually depending on the value of blood pressure, pulse rate, degree of dilatation of the genitourinary venous plexus and the level of its compensation detected by the Valsalva test.

To effect bar exposure, the lower body of the patient is placed in a pressure chamber and sealed. During the first 5 days, the decompression mode is carried out at pressure parameters - (0.10-0.25) kg / cm. In the next 5 days, bar exposure is carried out in a variable mode: from + (0.10-0.25) to - (0.10-0.25) kg / cm ² . During bar exposure, the patient was given intravenous antibiotics, which were pre-selected depending on the sensitivity of the ejaculate microflora to them.

The proposed method for the treatment of patients with chronic vesiculitis is illustrated by an example of a specific implementation.

Patient A.S., 37 years old, was examined and treated with a diagnosis of Chronic non-specific prostatitis. Chronic vesiculitis, pain form. The patient for 12 years (on average 2 times a year) received various courses of treatment for exacerbation of this disease. The last course of treatment was about 2 months ago. I asked for help in connection with a progressive deterioration in well-being, consisting in an increase in a pain symptom in the perineum and with ejaculation, increased erectile dysfunction, an episode of hemospermia.

During the examination of the patient: collection of complaints; physical examination; microscopic examination of the discharge of the urethra, prostate secretion; spermatogram examination; bacteriological seeding of ejaculate; transrectal biplane ultrasound examination of the prostate and seminal vesicles. The patient excluded sexually transmitted diseases. On a scale of quantitative assessment of male copulative function (MKF scale) (Laurent O.B., Segal S.I., Urology and Nephrology, Moscow, 2001. P. 24-27), the patient scored 40 points out of 60, which indicated moderate violation of copulative function. When answering questions 7, 8, and 9 on this scale regarding the function of seminal vesicles, the patient scored 9 points out of 15, which, according to the authors, indicated a significant violation of their function.

According to US data, seminal vesicles are enlarged, asymmetrical (right - 8.6 × 5.7 cm, left - 5.8 × 4.5 cm). In the secret of the urethra and prostate revealed an increased number of white blood cells (up to 30-40 in the field of view). In the spermatogram, moderate abnormalities - oligoastenozoospermia, white blood cells up to 80-120 s / s, increase in viscosity up to 20 mm. When seeding the ejaculate, Staphylococcus haemolyticus, Enterococcus faecium, Enterococcus faecalis, Corynebacterium seminale, Micrococcus lylae were revealed. Their total titer was 10 ⁵ -10 ⁶ CFU per ml. Sensitivity to levofloxacin was revealed.

The patient was treated according to the proposed method, which included intramuscular injection of oxytocin at 5 ME (1 ml) every other day, No. 5. Zonal bar exposure was carried out as follows. The lower body, including the area of the hypogastrium and pelvis, was placed in a pressure chamber and sealed. Air was pumped out of the pressure chamber by a vacuum pump to a pressure level of -0.10 kg / cm ² . The duration of exposure to negative pressure (decompression) was 15 minutes. Over the next 4 days, taking into account the value of blood pressure and the subjective state of the patient, the value of negative pressure was gradually reduced to -0.25 kg / cm, the exposure time also varied from 10 to 15 minutes.

In the next 5 days, variable bar exposure was performed. The duration of the decompression was from 3 to 5 minutes at a pressure of from -0.10 to -0.25 kg / cm ² . Then, air was injected for 1.5-3 minutes to a positive pressure from +0.10 to +0.25 kg / cm ² .

During one treatment session, negative and positive pressure was changed from 3 to 5 times, depending on the patient's well-being. The temperature in the chamber during the procedure was maintained at a level of 20-25 ° C. Along with the variable zonal bar exposure, the patient received antibiotic therapy, intravenous drip of tavanic (ampoule form of levofloxacin) of 1000 mg.

After 3 days of treatment, the patient's pain symptoms disappeared, but discomfort remained during ejaculation. By the 7th day of treatment, the pain symptom was completely stopped.

At the end of treatment, according to the ultrasound diagnosis, seminal vesicles of normal sizes (right - 3.8 × 1.4; left - 3.5 × 1.6 cm). Microscopic examination of the secretion of the urethra, prostate, ejaculate identified single white blood cells. In the seeding of ejaculate - Staphylococcus haemolyticus in a titer of 10 ² , which is regarded as non-pathogenic value. According to the ICF scale, the patient scored 58 points, while answering questions 7, 8, 9 - 15 points. Copulative function is regarded as good.

During the follow-up examination after 1, 3, 6, 12 and 24 months, the patient had no complaints, good parameters of the parameters of the secretion of the prostate, ejaculate, echographic normal parameters of the size of the seminal vesicles were preserved.

Currently, the claimed method treated 108 patients with chronic vesiculitis. For comparison, a group of 54 patients who received conventional treatment was formed (antibiotics taking into account seeding of ejaculate, prostate massage, magnetotherapy). All patients excluded sexually transmitted diseases.

During the follow-up examination a month later, patients of the traditional treatment group remained complaining of discomfort during ejaculation, episodes of hemospermia, the number of leukocytes in the secretion of the prostate (up to 40 in the s / s) and ejaculate (up to 80 in the s / s) remained, when the ejaculate was inoculated pathogenic microflora was detected in the titer of 10 ⁵ CFU. According to the ultrasound data, changes from the side of the seminal vesicles persisted: asymmetry, increased sizes. According to the ICF scale, these patients scored 43 points out of 60, and when answering questions 7, 8, 9 - 9 points out of 15. After examination of this group of patients, it was proposed to undergo treatment according to the claimed method.

Treatment by the proposed method were 108 patients.

In this group, the pain syndrome was stopped on the 7-10th day. An ultrasound scan performed on day 10 established the restoration of seminal vesicle function. According to the follow-up examination, 3, 6, 12 and 24 months after treatment, patients of this group did not observe any pathological changes in the secretion of the prostate, ejaculate; when assessing copulative function according to the MKF scale, no decrease in scores was recorded. The ultrasound scan also showed no signs of inflammation of the seminal vesicles even after 2 years of observation.

The effectiveness of long-term treatment in patients treated by the present method was 98.1% (106 out of 108 patients). In 2 patients, remission could not be tracked, because they did not appear for follow-up examinations, although after treatment, complaints and pathological changes in laboratory studies were not detected.

Comparative data for 2 groups of patients are presented in the table.

Thus, the proposed method allows in a short time to ensure effective eradication of pathogenic microflora from seminal vesicles. The use of oxytocin in the treatment of vesiculitis helps to increase the effect of eradication of microflora from the seminal vesicles. The proposed method completely restores the function of seminal vesicles for a long time. Reducing the duration of treatment and achieving long-term remission contributes to a significant improvement in the quality of life of patients.

Terms of treatment Complaints The number of leukocytes in the ejaculate Title CFU Changes s.p. on the UZS ICF points (total) ICF points (7, 8, 9 cents) Spermogram abnormalities The number of leukocytes in prostate secretion Patient groups one 2 one 2 one 2 one 2 one 2 one 2 one 2 one 2 Before treatment + + 120 110 10 ⁶ 10 ⁵ + + 41 40 8 9 + + 40 40 After 1 month ± - 80 7 10 ⁵ 10 ² + - 43 57 9 fourteen + - 40 5

Claims (1)

A method of treating patients with chronic vesiculitis, including the administration of antibiotics and physiotherapy to the pelvic area, characterized in that they inject intramuscularly oxytocin in a dose of 5ME once a day, every other day, while daily placing it in a pressure chamber and sealing the lower body of the patient, including the area of the hypogastrium and pelvis, and for 15 minutes perform barotherapy: the first 5 days are affected by reduced pressure -0.10-0.25) kg / cm, and the next 5 days alternate increased pressure + (0.10-0.25) kg / cm and indicated reduced yes Leniye from 3 to 5 times per session, concurrently with barovozdeystviem intravenously administered antibiotic.