Aims:The aims of this study were to determine the frequency and clinical significance of individual urodynamic signs, which revealed on the basis of the results of comprehensive urodynamic examination of patients with the idiopathic overactive bladder (IOAB), to produce definitions of these features, and to describe any necessary remedial action.Materials and Methods:To identify the most common features and artifacts, we conducted a combined urodynamic examination of 137 patients with IOAB (105 women and 32 men). Age, comorbidities, and urodynamic parameters were analyzed to determine the association between bladder sensation and contractility.Results:It was found that most patients suffer from the same type of bladder function impairment, often related to the decrease in the average effective capacity of the bladder, frequent urination, urgency urination, and urgent urinary incontinence events. Imperative nature of urination in patients with IOAB leads to the reduction maximum cystometric capacity in 75.9% of patients, increased bladder sensitivity threshold in 70.8%, detrusor overactivity in 35.8%, change in bladder compliance in 43.1%, and urethral instability in 24.8% of patients.Conclusions:Decreased ability of the bladder to accumulate and hold the urine under the normal or low intravesical pressure and frequent association of bladder instability with signs of obstructive urination are major peculiarities of the impaired urodynamics of the lower urinary tract in patients with IOAB.

The existing data indicate the multifactorial mechanisms of development of the overactive bladder (OAB) symptom, but the issue of OAB pathogenesis remains unclear. In more recent times, the neurogenic theory of OAB genesis has being accompanied by the increasing attention to the study of morphological changes that occur in the smooth myocytes of the detrusor and their interaction with the extracellular matrix. Therefore, the objective of our study became the evaluation of distribution of interstitial Cajal cells (ICC) and basophilic granulocytes (BG) in the structural elements of the bladder wall under stress urinary incontinence and its overactivity before and after treatment with Mirabegron, Spasmex, Quercetin and combination thereof with testosterone and estradiol, using histochemical and immunohistochemical methods. The experimental models of OAB and stress urinary incontinence (SUI) presented the increase in the amount and functional activity of BG revealed by histological and immunohistochemical methods, as well as ICC at all terms of OAB monitoring, while the SUI presented with high concentration and functional activity of BG only after 14 days of the experiment. After 28 days, we observed a sharp decrease of the parameters, indicating decompensation and depletion of the functional activity. The number of ICC decreased under SUI after both 14 days and 28 days of the experiment. The group of experimental animals receiving Spasmex and its combination with hormones, presented no significant effect on the quantitative and qualitative composition of BG and ICC at OAB and SUI on Day 14 of the experiment, but the combination with testosterone demonstrated statistically reliable (p<0.001) reduction of BG and ICC expression in the muscle layer of the bladder after 14 days, and unreliable after 28 days of the experiment (p>0.05). The administration of Mirabegron alone and especially its combination with testosterone and estradiol presented positive trends in histochemical and immunohistochemical expression of BG and ICC. The experiment proved high efficacy of Quercetin in combination with testosterone and estradiol under OAB and SUI, confirmed by stabilization of the functional activity of BG and ICC quantitative composition.

According to literature data, in the conditions of the balance of pro- and anti-inflammatory factors, the development of the infectious-inflammatory process tends to progress and more severe with subsequent transformation into chronic inflammation with corresponding morphofunctional effects. Under such critical conditions, an apoptosis is likely to play a crucial protective role, which can eliminate the excessive accumulation of aggressive inflammatory effects and effectively eliminate them, which in the future prevents the probable transformation into a persistent form. The aim of the work was to study the features of the early dynamic processes of apoptosis in the tissues of the kidneys under simulation conditions in the experiment of acute pyelonephritis and concomitant diabetes mellitus type I and II. The purpose of the study was to study the features of the early dynamic processes of apoptosis in the tissues of the kidneys under simulation conditions in the experiment of acute pyelonephritis and concomitant type I and type II diabetes. The work was performed on 300 adult Wistar rats, which were divided into 4 groups. Fragments of animal’s kidneys were studied and photographed in an electron microscope PEM-100-01. The results showed that after modeling in the animals of pyelonephritis in the nephrons there were no significant ultrastructural changes. The structure of the podocytes of the outer sheet was almost the same as the structure of the podocytes of the control material, and in some cells there were signs of activation of their metabolic activity. In the structure of the podocytes of the inner leaf of the capsule, dystrophic changes of the internal membrane of the mitochondria were established. In kidney medulla, the structure of the glomerulus was more preserved than in the cortical. Pathological changes of the proximal and distal tubular podocytes, as well as interstitial tissue, are more pronounced than the renal glomeruli. Under the modeling of the common model of pyelonephritis and type 1 diabetes, more pronounced morphological changes occur: destructive changes in the endothelial cells of the glomerular capillaries, the homogenization of the structure of the basement membrane occurs and the mesangial tissue is significantly enlarged. In nephrons and tubules of cortex, changes are manifested to a much greater extent than in the kidney medulla. When studying in clinical conditions the pathogenetic features of acute pyelonephritis in conditions of concomitant diabetes mellitus it is expedient to carry out electron microscopic research with the aim of choosing the optimal corrective therapeutic effect and preventing the unfavorable course of infectious and inflammatory process and its transformation into persistent form. EM (electron-microscopic) studies are highly informative in the study of pathological changes and early dynamic processes of apoptosis in renal tissues in the design of acute pyelonephritis and concomitant diabetes mellitus I and II in the experimental conditions.

Introduction Expression level of the cell proliferation marker Ki-67 correlates with the degree of differentiation of tumor cells and stage in primary patients with non-muscle-invasive bladder cancer (NMIBC), but the marker is currently not used in assessing the efficacy of adjuvant intravesical therapy and risk stratification in patients with recurrent bladder tumors. Material and methods A retroprospective study included 107 patients with high-risk NMIBC; the patients were divided into 2 groups. The first group included patients who received adjuvant therapy after transurethral resection of the bladder using the Bacillus Calmette-Guérin (BCG) vaccine (BCG therapy group; n = 54), the second group consisted of patients who received hyperthermic intravesical chemotherapy (HIVEC ® therapy group; n = 53) using the device for local hyperthermia Combat BRS HIVEC ® . Results Tumor recurrences were recorded in 21 (39%) patients receiving intravesical BCG therapy and in 9 (17%) patients after intravesical hyperthermic chemotherapy (p = 0.012). The expression level of Ki-67 in primary tumors did not differ; in recurrent tumors it was significantly different in both groups (32.05 ±13.80 vs 11.00 ± 6.86). The frequency of recurrence-free survival (RFS) in patients receiving chemohyperthermia was significantly higher than in patients after the BCG therapy (log-rank test result: p = 0.048). Conclusions Assessment of Ki-67 expression in recurrent tumors can be a criterion for the effectiveness of intravesical bladder-preserving treatment. The use of hyperthermic chemotherapy can reduce the number of radical cystectomies in a separate group of patients with NMIBC.

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