UROLOGICAL DISEASES AND THEIR MEDICAL TREATMENT: A COMPREHENSIVE SCIENTIFIC REVIEW
Anorov Sirojiddin Nozimjon o’g’li
A student of the Faculty of Medicine, Alfraganus University
Abstract: This comprehensive review explores common urological conditions—urinary tract infections (UTIs), urinary incontinence, benign prostatic hyperplasia (BPH), kidney stones, neurogenic bladder, and urological fibrosis syndromes—and their evidence-based medical and minimally invasive treatments. We summarize current pharmacological therapies, endo-urologic procedures, and emerging interventions while highlighting prevention strategies and future research directions.
Keywords: Urological diseases; Urinary tract infections; BPH; Urinary incontinence; Kidney stones; Neurogenic bladder; Pharmacotherapy; Endo-urology; Minimally invasive procedures; Urological fibrosis
Introduction: Urological diseases significantly impact global health, affecting over 26 million individuals annually and causing more than \$11 billion in healthcare expenditures.Effective management of these conditions is critical to improving patient quality of life and reducing the burden on health systems.
COMMON UROLOGICAL DISEASES & THEIR MEDICAL MANAGEMENT
Urinary Tract Infections (UTIs)
UTIs remain one of the most common infections in primary and hospital care, especially in women
Antibiotic therapy: remains first-line but contributes to increasing antimicrobial resistance
Non-antibiotic adjuncts(cranberry products, D-mannose, probiotics, NSAIDs, estrogens, immunotherapy) show promise but evidence lacks to fully replace antibiotics
Probiotics: with anti-inflammatory and microbiome-modulating effects, are gaining attention for UTI prevention and recurrence reduction .
Urinary Incontinence: Urinary incontinence (UI) encompasses stress, urge, overflow, and functional types and significantly impairs quality of life.
Conservative method: pelvic floor exercises, lifestyle adjustments, absorbent aids.
Pharmacotherapy: anticholinergics and β3-agonists for urge UI.
Surgery/devices: slings, tension-free tape, artificial sphincters, particularly when conservative methods fail.
Benign Prostatic Hyperplasia (BPH): BPH affects >60% of men over 50 and causes lower urinary symptoms such as frequency, urgency, weak flow, and nocturia.
α1-blockers (tamsulosin, alfuzosin) and 5α-reductase inhibitors (finasteride, dutasteride) are first-line therapies.
Minimally invasive procedures: Transurethral microwave thermotherapy (TUMT) offers symptomatic relief with fewer complications, though with higher retreatment rates than TURP.
Surgical gold standard: Transurethral resection of the prostate (TURP) is highly effective, albeit with risks.
Kidney stones are commonly managed with non-invasive or minimally invasive approaches:
Extracorporeal shock wave lithotripsy (ESWL) is the standard therapy for stones <20 mm, achieving 80–85% success, with risks of renal hematoma and trauma.
Adjunct α-blockers post-ESWL enhance stone passage.
Endoscopic and percutaneous options** include ureteroscopy, laser lithotripsy, and percutaneous nephrolithotomy .
Neurogenic Bladder
Neurogenic bladder arises from neurological disorders (spinal injury, MS, Parkinson’s) and causes retention, incontinence, recurrent UTIs, stones, and renal damag .
Management involves clean intermittent catheterization, behavioral interventions, botulinum toxin injections, antimuscarinics, and surgical reconstruction for refractory cases .
Urological Fibrosis Disorders: Conditions such as Peyronie’s disease and urethral strictures involve fibrotic scarring.
Antifibrotic agents (collagenase injections, mitomycin C, verapamil, interferon) reduce fibrosis and recurrence, with collagenase (CCH) approved for Peyronie’s disease.
CONCLUSION: Urological disorders span infections, functional dysfunction, obstructive, calculi, neurogenic, and fibrotic etiologies. Treatment strategies range from lifestyle modification and antibiotics to pharmacotherapy, minimally invasive procedures, advanced surgeries, and emerging therapies like robotics and tissue engineering. A multidisciplinary, evidence-based, patient‑centered approach is essential to optimize outcomes, enhance quality of life, and reduce health-care costs.
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