Objective: Until recently the generally accepted paradigm implied that urine of healthy people is sterile. In the present study, urine of healthy subjects was investigated by extended bacteriological methods. Material and Methods: Three midstream urine samples from 52 healthy subjects each (24 females, 28 males; 18-25 years of age) were investigated by an extended set of culture media for identification of facultative aerobic (FAB) and nonclostridial anaerobic bacteria (NCAB). Ward's method (Euclidean distance) was used for similarity analysis. Results: The bacterial count of FAB in urine was usually low (≤10² colony-forming units/ml) in both groups. In contrast, the bacterial count of NCAB was higher (≥10³ colony-forming units/ml), at least in some species, with significant differences between genders. The average number of bacterial species found was 5.8 in female and 7.1 in male urine. Half of the females were assigned to a specific ‘female' microbial spectrum, different from that of males. In the mixed-gender clusters, the males showed a greater similarity among themselves. Conclusions: As also shown by other investigators, urine of healthy people is normally not sterile. The role of the routinely not cultivated bacteria in healthy and diseased subjects needs to be established. It may alter the diagnostics of infectious and inflammatory diseases of the urogenital tract.

Резюме. В статье представлен обзор литературы, отражающий современные представления о клиническом значении возрастного андрогенного дефицита и необходимости его коррекции. Обобщены результаты исследований, продемонстрировавшие эффективность и безопасность заместительной гормональной терапии. Авторы указывают на необходимость врачей всех специальностей понимать и видеть преимущества заместительной терапии. Но приоритет в назначении и мониторинге терапии должен оставаться за урологом и эндокринологом.

To explore the influence of the microbiota of prostate secretion on the clinical status of patients with chronic bacterial prostatitis. Methods: This was an observational, single-center, comparative study. We evaluated the survey cards of 230 outpatients aged 18-45 years with a history of prostatitis from 2012 to 2019. As a result, 170 outpatients were selected for the study. All patients underwent an assessment of symptoms using International Prostate Symptom Scorequality of life, National Institutes of Health-Chronic Prostatitis Symptom Index, International Index of Erectile Function, pain visual analog scale. A bacteriological study (after the Meares-Stamey test) of post-massage urine was carried out on an extended media set. The following parameters were determined in each patient: leukocyturia and bacteriuria, serum testosterone and total prostate-specific antigen levels. Uroflowmetry, transrectal prostate ultrasound with color duplex mapping and ejaculate analysis were also carried out. Results: Aerobic-anaerobic bacterial associations were identified in all patients. Three comparison groups were identified depending on the microbiota's spectrum (in postmassage urine): aerobes prevailed in group 1 (n = 67), anaerobes prevailed in group 2 (n = 33), and the levels of aerobic and anaerobic bacteriuria were higher than ≥10 3 colony-forming units per mL in group 3 (n = 70). It was found that the severity of clinical symptoms (urination disorders, sexual dysfunction etc.) of chronic bacterial prostatitis, laboratory and instrumental changes (testosterone, prostate-specific antigen, prostate volume etc.) in groups 2 and 3 were significantly higher than in group 1. Conclusion:In patients with chronic bacterial prostatitis, a predominance of anaerobes or a combination of aerobes and anaerobes in a titer of ≥10 3 colony-forming units per mL in post-massage urine is associated with worse clinical status.

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