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The present manual is intended for the graduate medical specialists who completed a training course in urology, and urology, and physiotherapy based at the state-funded educational institutions and have the relevant certificates. Also, the manual is designed for the specialists engaged in scientific research on urology, restorative medicine, medical rehabilitation, and physiotherapy. The manual expounds indications and contraindications for ultrasound therapy of the patients presenting with pathospermia. Such treatment of genital glands was shown to be effective in 96.8% of the patients with pathospermia. Moreover, its advantages over alternative therapeutic modalities were demonstrated. The criteria for its choice (for differential application and prognosis of effectiveness) include the excretory form of grade I, II, and III pathospermia, the secretory form of grade I, II, and III pathospermia, the combined form of pathospermia, the presence or absence of moderate anatomical and functional changes in the testicles, the presence or absence of partial obstruction of the vas deferens.

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Ultrasound treatment in combination with laser irradiation of the blood and antibacterial therapy is known to exert strong anti-inflammatory, antibacterial, and analgesic effects, stimulate metabolism of sex hormones, and improve spermatogenesis in the patients presenting with chronic bacterial vesiculitis (CBV). This treatment is indicated to the patients with CBV at the stage of latent inflammation, to those recovering after acute vesiculities, and to the patients with chronic prostatovesiculitis at the stage of latent inflammation. This therapeutic modality is contraindicated in the cases of acute vesiculitis, acute prostatitis, acute bleeding hemorrhoids, rectal fissures and tumours, and general contraindications for physiotherapy. The above treatment resulted in the substantial or moderate improvement of clinical condition in 42 (82.4%) of the patients in group 1 and in 5 (50.0%) ones in group 2. During the 6 month follow-up period, remission of CBV was documented in 10 (83.3%) of the patients in group 1 and in 1 (33.3%) patient in group 2.

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This lecture is based on the review of the literature data concerning the application of physical factors (including sinusoidal modulated currents, laser radiation, ultrasound, medicamental ultrafonophoresis, ozonotherapy, etc) for the rehabilitative treatment of patients presenting with chronic bacterial prostatitis.

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Patients with chronic bacterial prostatitis complicated by erectile dysfunction received combined rehabilitative treatment based on the use of various combinations of physiobalneotherapeutic factors, such as ultrasound, local negative pressure, white and yellow turpentine or sodium chloride baths, supplemented by basal medicamentous therapy in the form of rectal suppositories. Efficiency of therapy involving sodium chloride, white and yellow turpentine baths was estimated at 85, 60, and 75% respectively.

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Combined application of ultrasound, modulated sinusoidal currents (MSC), and iodine-bromine baths is known to be a highly efficacious method for the rehabilitative treatment of patients with chronic cystitis in the phase of latent inflammation. The present study has demonstrated that combination of ultrasound with electrotherapeutic sleep and iodine-bromine baths exerts pronounced anti-inflammatory effect and bacteriostatic action whereas modulated sinusoidal currents combined with electrotherapeutic sleep and iodine-bromine baths significantly improve urodynamics in the lower urinary tract and produce marked anesthetic effect. Evaluation of the immediate and long-term results of the treatment of 16 patients presenting with chronic cystitis revealed the absence of exacerbation of infectious and inflammatory processes in the bladder within 6 months after physiotherapy

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The study was made of the action of electromagnetic decimetric waves (DMW) of mild and strong heat power and placebo on intraorganic circulation using functional polyrheography and morphological examination of the kidneys with infectious-inflammatory process. DMW of the above power have a marked hemodynamic action via stimulation of the circulation of the intermediary zone with an effect of redistribution of the intrarenal blood flow. Weak heat DMW in experimental pyelonephritis exhibit a distinct antiinflammatory effect while strong DMW impact aggravates vascular reaction associated with inflammation. This deteriorates the inflammation and gives rise to hyperimmune reactions. The findings provide pathogenetic grounds for DMW therapy. It is recommended for treatment of patients with chronic pyelonephritis with dynamic obstruction of the upper urinary tracts allowing for the power of the impact and activity of the inflammation.

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The experimental study investigated action of electromagnetic waves (84 mW/cm2 and 395 mW/cm2) on functional-morphological features of healthy kidney of female rats. A marked hemodynamic effect of decimetric waves is shown which operates via stimulation of intermediary zone with redistribution of intrarenal circulation. Disturbance of circulation occurs in dysregulation of the intrarenal blood flow under overstimulation of the organ circulation with 395 mW/cm2 decimetric waves. This entails disorders of hemodynamics, flebostasis, stromal edema, dystrophy of tubular epithelium, periglomerular sclerosis causing aseptic interstitial inflammation. This is also proved by levels of prostaglandin E2 in tissue of renal papillae. These findings should be considered in administration of decimetric waves in patients with renal inflammation.

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The authors believe that chronic pyelonephritis patients operated for infravesical obstructions need staged postoperative rehabilitation. In antibacterial postoperative treatment, a significant response was seen in 7.9%, a partial response in 18.4% and no response in 73.7% of patients. After combined physiotherapy--in 38%, 41.7% and 20.3% of patients, respectively.

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The exposure of the lumbar region to interference currents in combination with radon baths conducted in 37 patients with chronic pyelonephritis inhibited activity of the inflammation, hypercalciuria and hyperoxaluria, improved function of the kidneys. The same clinical effects were achieved in 32 patients who had received interference therapy in combination with intake of radon water.

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30 patients were exposed to interference currents (IC) alone (group 1) versus 34 patients treated with IC plus iodobromine baths (group 2). After IC action on the region of the kidney projection patients of group 1 experienced positive changes in cellular and humoral immunity providing an antiinflammatory effect. In group 2, the improvement was seen in renal and urinary functions, 24-h urinary excretion of oxalates and calcium diminished. Interference current proved beneficial in chronic pyelonephritis patients with latent inflammation. The combined therapy was effective in patients at high risk of lithogenesis.

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After exposure to sinusoidal modulated currents and iodinebromine baths there was a decrease in serum levels of calcium, alanin aminotransferase, lactate dehydrogenase and urinary calcium, oxalates, leukocytes, red cells, acceleration of radiopharmaceutical accumulation (Tmax) and elimination from the kidneys (T1/2), urolith fragments (1-5 mm in size) elimination from the upper urinary tract in 21 (48.9%) out of 43 patients. The above physiotherapeutic complex is indicated for urolithiasis patients with associated diseases (hyperesthesia, causalgia).

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The authors have developed combined therapy of secondary chronic pyelonephritis with immune and urodynamic dysfunctions. The treatment includes physical factors: decimeter microwaves, gangleron-electrophoresis with sinusoidal modulated currents, sodium chloride baths, oral mineral water Moskovskaia. The adjuvant use of the above physical factors proved advantageous.

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The paper covers the experiment's details and the results obtained at stimulation of the kidney projection region and upper ureter with remote-controlled impulse magnetic field (IMF). It was found that IMF activates impulse activity of ureteral smooth muscles in 100% of cases. The technique is detailed of managing ureterolith fragments using IMF combined with iodobromine baths. The results of the proposed treatment are given. A single therapeutic course produced effect in 62.9% of the patients.

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