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Here you can find some materials from the Russian experience in using ozone therapy in the urological practice incl. mechanisms of therapeutic action of ozone therapy on the pathogenetic links and main clinical symptoms of the most widespread urological diseases as well as recommended methods of ozone therapy and expected clinical results.

 

Chronic Pyelonephritis

 

In the treatment of chronic pyelonephritis medical ozone is used as an anti-inflammatory and anti-infective agent. Although the gram-negative bacteria are less sensitive to ozone than the gram-positive ones, ozone therapy has proved to be highly effective, particularly in medical conditions where medicinal treatment fails.

 

The bactericidal action of ozone involves stimulation of phagocytosis through an increase in the generation of hydrogen peroxides by leukocytes while in chronic infections no H2O2 or too little of it is formed. The influence of ozone on the lymphocytes and monocytes induces an increase in their energy properties i.e. an increase not only in the phagocytic properties, but also in the production of cytokines, in particular interleukines. The latter normalize the cellular and humoral immunity, which is disturbed in chronic pyelonephritis. It comes to the increased formation of T-killers indicating the efficiency of the cellular immunity, the optimized formation of T-helpers and T-suppressors regulating the activity of B-lymphocytes, which are responsible for synthesis of immunoglobulins. So, by this way ozone therapy produces an immunomodulating effect. Ozone directly affects the bacteria by destroying their membrane integration owing to the oxidation of phospolipids and lipoproteins, it penetrates into the microbial cell, reacts with the substance of cytoplasm, in particular DNA, and disturbs the proliferation of bacteria. Moreover, the toxity towards the infectious agents, but not towards the patient is explained so that the bacteria have not the enzymatic antioxidant mechanisms, which are characteristic of higher organisms.

 

In case of latent, lightly manifested chronic pyelonephritis ozone therapy can be used both as a monotherapy and in combination with anti-inflammatory agents. In the period of aggravation the complex treatment is preferable. It is important to know that under the action of ozone the microorganisms are more sensitive to medicinal agents such as antiseptics and antibiotics.

 

Recommended methods of ozone therapy:

  • Intravenous drop-by-drop infusions of ozonated saline solution;

  • Rectal ozone insufflations;

  • Major autohaemotehrapy with ozone;

  • Minor autohaemotherapy with ozone;

  • Intranodular (in the field of groin glands) drop-by-drop infusions of ozonated saline solution.

 

Already on the 2nd day most of the patients report about an improvement of general condition, disappearance of weakness, a decrease in dysuriac disturbances. After 4-5 procedures it comes to a distinct decrease in leukocyturia and bacteriuria, normalization of blood indices, a decrease in misbalance of helper-suppressor relationship, activation of phagocytosis. Good results of treatment were received using intravenous infusions of ozonated physiological saline before and after lithotripsy (V.V. Kuzmenko etc, 1998).

 

Cystitis

 

The antimicrobic and detoxication properties of ozone are successfully used in the treatment of acute and chronic cystitis.

 

The intravesical use of ozonated crystalloids produces a well-manifested sanative and anti-inflammatory effect by suppressing the growth or considerably decreasing the concentration (colony-forming units/ml) of enterococcus, Proteus, colibacillus and completely eliminating dysuriac disturbances.

 

Recommended methods of ozone therapy:

  • Bladder irrigations with ozonated saline solution through a Foley 3-way-catheter.

 

The close results showed a 100% healing of primary infectious focus, diffuse, acute and chronic cystitis. Already after one procedure most of the patients reported about a decrease in dysuriac disturbances, disappearance of pain sensations, improvement of general state, increase in workability. After the treatment course in 75% of patients pathogenic flora was not found out in the urine, and in 18% the microbiological investigation showed an increase in the sensitivity of microflora to the well-known and mostly used antibiotics.

 

The histological investigation conducted after 3 procedures of bladder irrigations in 36 patients pointed out morphological signs of bactericidal, anti-adhesive and hydromassage action of this method. The assessment of received results showed an improvement in both primary and postprimary cystitis of infectious genesis.

 

The intracavitary use of ozonated saline solution has proved to be particularly effective when cystitis is caused by microorganisms, which are resistant to most of available antibiotics as well as in case of long-drawn-out cystitis after the surgery on open bladder when there is a washing drainage system in the cavity (O.V. Firsov, B.V. Semenov, 1995).

 

Renal Failure (Nephrism)

 

As a criterion for disturbances of morphological renal substrate and different functional disorders is considered the activity of destructive-necrotic changes in renal tissue induced by sharp circulatory disorders, direct toxic exposure to poison, obstruction of urethral ways, infection.

 

The disturbances of the secretory and excretory functions of kidneys lead to involvement of other organs and systems into the compensatory process which efficiency is insignificant. The connecting role is performed by blood system. Metabolic processes in health and disease are realized through its functions. That's why, ozone therapy characterized by detoxication and immunocorrection ability can be successfully used in renal failure (nephrism).

 

Recommended methods of ozone therapy:

  • Major autohaemotherapy with ozone;

  • Intravenous drop-by-drop infusions of ozonated saline solution.

 

Significant improvement and normalization of the main clinical-laboratory indices were achieved thanks to the original method of daily intravenous drop-by-drop infusions of ozonated saline solution. Along with positive dynamics of clinical analysis it came to a fast decrease in average indices of urea and creatinine. It came to an improvement of oxidoreduction processes confirmed by normalization of transminases AcT and AlT. In blood plasma there was a decrease and even approach to norm in the indices of carbohydrate metabolism enzymes: phosphofructokinase (PFK); aldogenase (AD) and hexokinase (HK). It came to a credible improvement of the both qualitative and functional indices of the main links of immunity. So, ozone therapy is recommended for treatment of patients with renal failure incl. nephrolithiasis, aggravation of intermittent and terminal stages of chronic renal failure as a method of detoxication and immunomodulation.

 

Diseases Transmissible by Sexual Way

 

The most frequent in the general structure of human infectious pathology are the diseases of reproductive system. The so-called "diseases of second generation" - urogenital chlamydiosis, mycoplasmosis, ureoplasmosis, viral diseases take the leading place among the reasons for disturbances of generative function and marital infertility. More than 20 causative agents transmissible through sexual contacts induce the diseases transmissible by sexual way. The main forms of localized chlamydiosis in male patients are: urethritis - in 30-50%, urethroprostatitis - in 26-46%, and in young men epididymitis - in 35-50%. In women primary chlamydeous infection in 30-60% of cases develops in cervical canal and/or urethra and in case of its rising transmission leads to endometritis, adenixitis, salpingitis, oophoritis and primary or postprimary infertility, spontaneous abortion.

 

The complexity of diagnostics and treatment of chlamydia is explained by its four kinds known today: Chlamydia trachomatis, C.psittaci, C.pneumouiae, C.pecorum. Urogenital clones of chlamydia adapted to epithelial cells of mucous membranes of urogenital organs C.trachomatis have 15 immunotypes, and C.psittaci - 10 immunotypes. The use of traditional transformating agents-antibiotics can lead to formation of anomalous, similar with L-forms bacteria, chlamydeous forms with different defects of cell wall. The most important is the ability of chlamydia to survive in cells of immune system - polymorphonuclear leukocytes and macrophages.

 

The typical for urogenital infection suppression of cellular immunity and disturbance of digestive function of leukocytes leads to endobiocytosis of gonococcus, its L-forms, trichomonad and chlamydia that is considered the reason for disease relapses.

 

The complex ozone therapy leads to improvement in the immunity indices, restoration of the functional activity of immunocompetent cells, normalization of biocenosis, inhibition of lipid peroxidation processes, activation of the organism's own antioxidant mechanisms that results in the liquidation of aggravations of chronic inflammatory urogenital processes and elimination of causative agent.

 

Recommended methods of ozone therapy:

  • Intravenous drop-by-drop infusions of ozonated saline solution;

  • Minor autohaemotherapy with ozone;

  • Urethra rinsing with ozonated saline solution;

  • Ozonized olive oil for local applications or microenemas

 

In the course of treatment it comes to fast and stable positive clinical-laboratory dynamics in approx. 97% of cases. After 4-5 procedures it comes to disappearance of pathological symptomatics (pain, lancinating pain, urethral itch, urethral secretion). Along with disappearance of subjective symptomatics it comes to remission of mucous-suppurative endocervicitis, acute and chronic endometritis, adnexitis, chronic prostatitis. It comes to a considerable increase in the T-lymphocytes through T-helpers, an increase in immunoglobulin titer, an increase in the phagocytic activity of neutrophile granulocytes, a considerable decrease in the plasma level of circulating immune complexes that results in the activation of immunity. It has been established a decrease in the blood level of end products of lipid peroxidation and growth of antioxidant activity. It has been observed an increase in the sensitivity of microflora to the well-known and most used antibiotics. After the performed course of ozone therapy it comes to stable remission.

 

Chronic Prostatitis

 

In the pathogenesis of chronic prostatitis infection aggression plays an important role. The appearance of antibiotic resistant clones of microorganisms considerably decreased the efficiency of treatment performed, so there is a need for new methods of action on the pathological focus.

 

One of the most promising method for suppression of bacterial aggression and elimination of pathological state is the use of medical ozone.

 

Recommended methods of ozone therapy:

  • Intravenous drop-by-drop infusions of ozonated saline solution;

  • Rectal ozone insufflations;

  • Instillations of ozonized olive oil into the back urethra by simultaneous massage of the prostate and further rectal introduction of ozonized olive oil.

 

The efficiency of treatment performed was evaluated according to regression of clinical symptoms, absence of microflora growth in prostatic juice, dynamics of ultrasound results and changes in the viscosity of prostatic secretion.

 

It was established that thanks to ozone therapy it came to positive dynamics of both clinical and laboratory indices, and the treatment time of chronic prostatitis was reduced by 3-6 days. After all, one of the main links in the pathogenesis of chronic prostatitis is a disturbed diversion of stagnant prostatic secretion due to obstruction of out-flow canals of the prostate and circulatory disorders of the prostate. Therefore, in order to achieve a positive result in the treatment of prostatitis it should include the methods able to restore the passability of out-flow canals of the prostate, diversion of stagnant prostatic secretion (drainage) and local microcirculation.

 

The new method of treatment of chronic prostatitis provides a simultaneous transurethral and transrectal effect on the prostate. For optimization of drainage stagnant prostatic secretion and administration of optimal therapeutic effect of ozone this method ensures transrectal introduction of ozone/oxygen gas mixture with simultaneous massage of the prostate. As a massage agent is the wall of rectal ampulla fluctuating due to portional filling of rectal ampulla with ozone/oxygen gas mixture. Along with mechanical effect on the prostate the portional filling of rectal ampulla with gas mixture ensures optimal ozone resorption and systemic effect of this therapeutic agent. The synchronism of frequency of rectal ampulla filling and patient's pulse allows on the best way to normalize microcirculation of the prostate and ensure the maximum resorption of ozone as a therapeutic agent.

 

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