[Correction of local immunometabolic disturbances combined with chronic prostatitis in prostatic adenoma].

We compared local immunometabolic effects of two dosage forms of longidase in patients with prostatic adenoma (PA) in combination with chronic prostatitis (CP) in the postoperative period. Transurethral resection (TUR) of the prostate was conducted in 81 patients aged 50-70 years suffering from PA and CP. All the patients after TUR were divided into three groups by postoperative treatment: group 1 (n = 25) received standard pharmacotherapy, group 2 (n = 28)--standard pharmacotherapy and longidase injections, group 3--standard pharmacotherapy plus longidase suppository. Immunological parameters were studied in biological material (urine) obtained before operation, after it and after treatment course. By changes in immunometabolic status (concentrations of cytokines TNFalpha, IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, receptor antagonist IL-1 Ra, complement components C3-, C3a-, C4-, C5-, C5a, regulators of the complement system factor H, C1-inhibitor) and sIgA, content of acylhydroperoxides, malonic dialdehyde, stable metabolites of hitric oxide, catalase and superoxiddismutase activity it is shown that PA patients with CP have pretreatment disturbances of local immunity and oxidant status (high levels of proinflammatory cytokines, subnormal IL-10, activated complement system, lipid peroxidation, low sIgA, NO-synthetic activity of capillary endothelial activity). TUR aggravates shifts of local immunometabolic status. Standard postoperative pharmacotherapy does not correct the disturbances adequately. The addition of longidase to standard postoperative treatment was effective in correction of immune and oxidant status. Thus, longidase injections and, especially, suppositories correct disturbances of local immunity and oxidant status in patients with PA and CP in postoperative period.