Metabolic syndrome and chronic prostatitis

Kulchavenya E.V.; Breusov A.A.; Stovbun S.V.

doi:https://doi.org/10.17116/repro202026051141

Close metadata

OBJECTIVE

To determine the effectiveness of immunomodulatory therapy in the complex treatment of patients with CP with comorbidity of MS.

MATERIAL AND METHODS

An open, prospective, comparative, randomized, single-center study included 214 men meeting criteria for MS. Patients completed the Russian-language version of the symptom scale on their own CP (NIH-CPSI). CP was diagnosed in 148 (69.2%) men. All underwent a standard clinical and laboratory study, microbiological examination of the secretion of the prostate, performed a spermogram. The diagnosis of MS was established according to international consensus recommendations. Excluded from the study were 23 (15.5%) patients with prostate secretions no pathogenic agent has been identified. Patients with bacterial CP (n=125) were randomized into 2 groups: the main group (MG) - 36 patients and the comparison group (GC) - 89 patients. Basic etiopathogenetic therapy in both groups was identical; patients with MG additionally received intravenous bolus Panavir according to the following scheme: the first three injections after 24 hours, then two more with an interval of 48 hours.

RESULTS

CP was diagnosed in 148 (69.2%) of 214 patients with MS. In 23 (15.5%) pathogenic microflora was not found, and in 125 (84.5%) confirmed the bacterial nature of CP. In patients with MG, the effectiveness of CP treatment is statistically significantly higher. In addition, a pronounced positive dynamics of lipid metabolism indicators was found. Analysis long-term results demonstrated a prolonged effect of Panavir against both CP and MS. In patients with OH, a significant improvement was achieved in almost all parameters of the spermogram.

CONCLUSIONS

The use of Panavir in the complex of etiopathogenetic therapy of patients with chronic bacterial prostatitis in combination with metabolic syndrome statistically significantly improves the results of treatment of chronic prostatitis, indicators of lipid metabolism, increases the fertility of the ejaculate. There were no adverse reactions to the drug. Should include Panavir in the standard of therapy for patients with chronic bacterial prostatitis.

Keywords:

prostate

metabolic syndrome

infertility

sperm

ejaculate

immunoactive substances

Authors:

Kulchavenya E.V.

Novosibirsk Research Institute of Tuberculosis;
Novosibirsk State Medical University

Breusov A.A.

Medical center Biover

Stovbun S.V.

Semenov Institute of Chemical Physics

Received:

25.05.2020

Accepted:

27.07.2020

Close metadata

References:

Kulchavenya EV, Kholtobin DP, Shevchenko SYu, Potapov VV, Zulin YaV. Frequency of chronic prostatitis in the structure of outpatient urological treatment. Eksperimental’naya i klinicheskaya urologiya. 2015;1:16-19. (In Russ.).
Eckel RH, Alberti KG, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2010;375(9710):181-183. https://doi.org/10.1016/S0140-6736(09)61794-
Corona G, Rastrelli G, Vignozzi L, Mannucci E, Maggi M. Testosterone, cardiovascular disease and the metabolic syndrome. Best Practice and Research. Clinical Endocrinology and Metabolism. 2011; 25(2):337-353. https://doi.org/10.1016/j.beem.2010.07.002
Corona G, Rastrelli G, Morelli A, Vignozzi L, Mannucci E, Maggi M. Hypogonadism and metabolic syndrome. Journal of Endocrinological Investigation. 2011;34(7):557-567. https://doi.org/10.3275/7806
Xia BW, Zhao SC, Chen ZP, Chen C, Liu TS, Yang F, Yan Y. The underlying mechanism of metabolic syndrome on benign prostatic hyperplasia and prostate volume. The Prostate. 2020;80(6):481-490. https://doi.org/10.1002/pros.23962
Xia BW, Zhao SC, Chen ZP, Chen C, Liu TS, Yang F, Yan Y. The association of pathogenic factors of metabolic syndrome on serum prostate-specific antigen levels: a pilot study. BMC Urology. 2019; 19(1):119. https://doi.org/10.1186/s12894-019-0549-2
Gao X, Bao T, Yang H, Lei Y, Jiang X, Huang Y, Huang W, Tang H. The association of metabolic syndrome and its components with serum prostate-specific antigen levels. European Journal of Cancer Prevention. 2020;29(1):36-41. https://doi.org/10.1097/CEJ.0000000000000508
Morlacco A, Dal Moro F, Rangel LJ, Carlson RE, Soligo M, Karnes RJ. Impact of metabolic syndrome on functional outcomes and complications of surgical treatment of prostate cancer. Journal of Surgical Oncology. 2019;120(8):1505-1507. https://doi.org/10.1002/jso.25762
Park JS, Koo KC, Kim HK, Chung BH, Lee KS. Impact of metabolic syndrome-related factors on the development of benign prostatic hyperplasia and lower urinary tract symptoms in Asian population. Medicine. 2019;98(42):e17635. https://doi.org/10.1097/MD.0000000000017635
Li J, Peng L, Cao D, Gou H, Li Y, Wei Q. The association between metabolic syndrome and benign prostatic hyperplasia: a systematic review and meta-analysis [published online ahead of print, 2020 Jun 2]. The Aging Male. 2020;1-12. https://doi.org/10.1080/13685538.2020.1771552
Leisegang K, Sengupta P, Agarwal A, Henkel R. Obesity and male infertility: Mechanisms and management [published online ahead of print, 2020 May 12]. Andrologia. 2020;e13617. https://doi.org/10.1111/and.13617
Lotti F, Corona G, Vignozzi L, Rossi M, Maseroli E, Cipriani S, Gacci M, Forti G, Maggi M. Metabolic syndrome and prostate abnormalities in male subjects of infertile couples. Asian Journal of Andrology. 2014;16(2):295-304. https://doi.org/10.4103/1008-682X.122341
Leisegang K, Henkel R, Agarwal A. Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system. American Journal of Reproductive Immunology. 2019;82(5):e13178. https://doi.org/10.1111/aji.13178
Saltevo J, Laakso M, Jokelainen J, Keinänen-Kiukaanniemi S, Kumpusalo E, Vanhala M. Levels of adiponectin, C-reactive protein and interleukin-1 receptor antagonist are associated with insulin sensitivity: a population-based study. Diabetes/Metabolism Research and Reviews. 2008;24(5):378-383. https://doi.org/10.1002/dmrr.831
Fibbi B, Penna G, Morelli A, Adorini L, Maggi M. Chronic inflammation in the pathogenesis of benign prostatic hyperplasia. International Journal of Andrology. 2010;33(3):475-488. https://doi.org/10.1111/j.1365-2605.2009.00972.x
Lotti F, Corona G, Mancini M, Filimberti E, Degli Innocenti S, Colpi GM, Baldi E, Noci I, Forti G, Adorini L, Maggi M. Ultrasonographic and clinical correlates of seminal plasma interleukin-8 levels in patients attending an andrology clinic for infertility. International Journal of Andrology. 2011;34(6 Pt 1):600-613. https://doi.org/10.1111/j.1365-2605.2010.01121.x
Shcherban MN, Kulchavenya EV, Brizhatyuk EV. Diagnostics, prevention and treatment of reproductive disorders in men with pulmonary tuberculosis. Tuberkulez i bolezni legkikh. 2010;87(10):31-36. (In Russ.).
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of The National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Journal of the American Medical Association. 2001;285:2486-2497.
Aboyan IA, Aboyan VE, Zinkovskaya OV, Sknar VA, Kucherov VA, Stovbun SV, Safronov DYu, Litvin AA. Panavir in the complex treatment of chronic cystitis with hyperplastic changes in the urinary bladder mucosa. Urologiya. 2011;6:25-29. (In Russ.).
Igonkina SI, Grafova VN, Smirnova VS, Kukushkin ML. Analgesic properties of the Panavir immunomodulator. Rossijskij zhurnal boli. 2011;2(31):10. (In Russ.).
Novikov AI, Zaezhalkin VV, Kucherov VA, Frolov SYu. Immunocorrective therapy for chronic bacterial prostatitis. Urologiya. 2010; 4:44-48. (In Russ.).
Kulchavenya EV, Breusov AA, Cherednichenko AG, Stovbun SV. The need for an integrated approach to the examination and treatment of patients with chronic abacterial prostatitis. Eksperimental’naya i klinicheskaya urologiya. 2017;3:84-89. (In Russ.).
Kucherov VA. Features of antiviral therapy for genital herpes combined with papillomavirus infection of the genitals. Ural’skij meditsinskij zhurnal. 2012;1(93):134-139. (In Russ.).
Abdrakhmanov RM, Abdrakhmanov AR, Misbakhova AG, Khaliullin RR, Stovbun SV. Expanding treatment options for urogenital herpesvirus infection. Klinicheskaya dermatologiya i venerologiya. 2017;16(2):48-52. (In Russ.).
Ibishev KhS, Krakhotkin DV. Topical issues in the diagnosis of recurrent lower urinary tract infections of human papillomavirus etiology. Vestnik urologii. 2017;5(3):62-67. (In Russ.). https://doi.org/10.21886/2308-6424-2017-5-3-62-67
Ibishev KhS, Lapteva TO, Krakhotkin DV, Ryabenchenko NN. The role of human papillomavirus infection in the development of recurrent lower urinary tract infections. Urologiya. 2019;5:136-139. (In Russ.). https://doi.org/10.18565/urology.2019.5.136-139
Katkhanova OA, Katkhanov AM, Petrenko SI, Stovbun SV. Modern treatment options for genital papillomavirus infection. Klinicheskaya dermatologiya i venerologiya. 2016;15(6):85-88. (In Russ.). https://doi.org/10.17116/klinderma201615685-88
Kuznetsova YuN, Evstigneeva NP, Oboskalova TA. Complex therapy of manifest manifestations of papillomavirus infection of the urogenital tract. Sovremennye problemy dermatovenerologii, immunologii i vrachebnoj kosmetologii. 2009;3(3):27-31. (In Russ.).
Bagramova GE, Gureeva MA, Khlebnikova AN, Molochkov AV, Kucherov VA, Stovbun SV, Safronov DYu, Bagaeva MI. Complex treatment of genital papillomavirus infection. Klinicheskaya dermatologiya i venerologiya. 2012;10(2):66-69. (In Russ.).
Dolnikova OA, Letyaeva OI, Antimirova EA, Prokopyev DS. Experience of using Panavir in the treatment of recurrent genital herpes. Rossijskij immunologicheskij zhurnal. 2016;10(19-3):249-251. (In Russ.).
Lukashov MI, Olisova OYu, Pismennaya EV. A rational approach to the treatment of herpes infection with genital localization. Rossijskij zhurnal kozhnykh i venericheskikh boleznej. 2017;20(2):101. (In Russ.).
Yunusova EI, Danilova OV, Gizatullina RD, Stovbun SV, Korobkova EV, Kiselev AV, Petryanina EV, Kucherov VA. Panavir in the treatment of patients with recurrent papillomavirus infection of the urogenital tract. Dnevnik Kazanskoj meditsinskoj shkoly. 2016;2(12): 115-121. (In Russ.).
Dolnikova OA, Letyaeva OI. Complex therapy of recurrent genital herpes in men with metabolic disorders. Dermatologiya v Rossii. 2017;1:20-21. (In Russ.).