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AUTORS
  • A.Yu. Kulinich, MD, is with the COMPANY SANOS Ltd., 115162 Moscow, Havskaya St., 1-1, Moscow, Russia (e-mail: kulinich@ boulder.nist.gov). 
  • I.V. Golovacheva is a Professor at St. Petersburg State University, St. Petersburg, 199034 Russia (e-mail: igolovacheva@gmai.com).
  • M.Ye. Zhuravlev is a Professor at St. Petersburg State University, St. Petersburg, 199034 Russia (e-mail: myezhur@gmai.com). Also, he is a leading researcher at Kurnakov Institute of General and Inorganic Chemistry of the Russian Academy of Sciences

Abstract

Vacuum aspiration is an effective method of prostatitis therapy. Bacterial prostatitis leads to duct obstruction. The plug consists of dense acini epithelium and secretions. Vacuum aspiration procedure results in the destruction of the plug. The fact of the destruction has been verified by the analysis of the substance obtained during the procedure. This method is used in a few medical institutions. Meanwhile, the physical principles of the procedure have never been investigated.  We analyze plausible physical mechanisms of purification of prostatic acini and ducts by means of transurethral vacuum aspiration. A mechanical model is offered to describe the process of plug destruction during vacuum aspiration procedure. The majority of medical practitioners believe that the plug is extracted as a whole during such procedure. However, our theoretical research demonstrates that the sucking of a plug as a whole, previously viewed as the most likely mechanism, is not consistent with the experimental data. 

 Keywords — vacuum aspiration, physical model, prostatitis, plugged acini.  


INTRODUCTION

VACUUM aspiration [1,2] is a method widely used in various branches of medicine, such as otorhinolaryngology, urology, general and gynecology surgery. 

In vascular and heart surgery, the vacuum aspirators are applied to remove the thrombi [3,4]. Also, vacuum aspirators occupy a prominent place among the tissue sample devices (See, e.g., [5]). In pregnancy termination, the vacuum aspiration is the most common method [6].  

Vacuum aspiration is based on the suction of liquid or solid fraction from a cavity by means of generated negative pressure. The negative pressure can remain constant during a certain time interval. Also, it can oscillate between atmospheric pressure and some negative (reduced) value of pressure. The choice of the value of negative pressure depends on the specific aim of the procedure. 

In fact, medical practitioners have a rather vague idea of how vacuum aspiration devices perform. Yet, advanced medical equipment requires detailed understanding of the physical processes which underlie such therapeutic procedures. Therefore, an adequate model of such physical processes appears to be indispensable. Such model would be also indispensable for the analysis of collected clinical data.  

 In the present article, we analyze feasible physical mechanisms of purification of prostatic acini and ducts by means of transurethral vacuum aspiration. Though the most common treatment is with anti-biotics and anti-inflammatory medicaments [7], the preliminary physiotherapy can also be very useful. In particular, vacuum aspiration applied at the first stage of the treatment makes subsequent antibacterial medication much more efficient. In particular, such method allows doctors to shorten treatment period as well as reduce the dosage of anti-bacterial drugs due to a much more efficient transportation of the latter to the acini and ducts previously drained by vacuum aspiration. A detailed explanation of physical processes underlying vacuum aspiration of secretions from plugged acini and ducts is, undoubtedly, valuable for further development of this method – considering the fact that prostatitis affects at least 40% of men aged 35-50 years. 

The paper is organized as follows. Section II offers the description of the device used for the treatment of bacterial prostatitis by vacuum aspiration. The method [8,9] was developed by A. R. Guskov and his collaborators at the Central Aviation Scientific-Research Hospital (Moscow, Russia). At present, it is used in a few medical institutions. In Section III we discuss two radically different physical mechanisms underlying the performance of the device, offering the mathematical analysis of one of them. The final section summarizes the conclusions concerning the actual physical processes involved in the discussed mechanisms.

VACUUM ASPIRATION FOR THE TREATMENT OF PROSTATITIS 

In this section, we briefly describe general principles of vacuum aspiration as applied to the treatment of prostatitis. Fig. 1 presents the scheme of the prostate which consists of stroma and glands (acini). Acini drain into urethra by means of prostatic acini. The scheme below shows only several healthy and plugged acini, whereas the total number of acini is about forty and their size is significantly smaller compared to the size of the prostate. Bacterial prostatitis leads to duct obstruction. The plug consists of dense acini epithelium and secretions. It occludes the passage connecting the acinus to the urethra. Vacuum aspiration procedure results in the destruction of the plug. The fact of the destruction is verified by the analysis of the substance obtained during the procedure. 

At Central Aviation Scientific-Research Hospital, at the medical center “SANOS” and other institutions which borrowed this method for the treatment of prostatitis, there are used the machines providing the pressure oscillating between 1 atm (10.1 N/cm2) and 0.5 atm (5.05 N/cm2) at frequency ω= 20 Hz. These parameters have been determined as the most efficient ones over the course of many clinical experiments.  

Прочитать статью в полнотекстовом виде можно прочитать здесь: /Andrei Yu. Kulinich_Physical Principles of the Vacuum Aspiration for Prostatitis Treatment.pdf
Read the full-text article here:  /Andrei Yu. Kulinich_Physical Principles of the Vacuum Aspiration for Prostatitis Treatment.pdf


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