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No 5 (2004)

Articles

Nephrureterectomy with endoscopic resection of the urinary bladder,ureteral ostium and terminal part in papillary tumors of the upperurinary tracts

Martov A.G., Ergakov D.V., Krendel В.М., Guschin В.L.

Abstract

Short- and long-term results of endoscopically assisted nephrureterectomy were studied in 15 patients (7 males and 8 females aged 31-79 years) with papillary tumours of the upper urinary tracts (UUT). Of them, 11 patients have undergone transurethral endoresection of the urinary bladder, ostium and terminal part of the ipsilateral ureter followed by nephrureterectomy from the lumbotomic approach (technique 1) and 4 patients had nephrureterectomy followed by endoscopic intervention (technique 2). Results of standard open nephrureterectomy with resection of the bladder were analyzed retrospectively for 25 patients with papillary tumors of the UUT taken as control. It was found that transurethral endoscopic resection of the bladder, ostium and terminal part of the ipsilateral ureter in nephrureterectomy for papillary tumors of the UUT facilitates the perform- ance, decreases duration and aggression of surgical intervention, diminishes number of complications, shortens hospital stay of the patients and their rehabilitation. Technique 1 is thought more ablastic and simple in performance.
Urologiia. 2004;(5):3-10
pages 3-10 views

Morphological changes in prostatic tissue of patients with benign prostatic hyperplasia treated with permixon®

Sivkov A.V., Kudryavtsev Y.V., Medvedev А.A., Razumov S.V., Kochetov S.A.

Abstract

A pilot trial has been performed to assess effects of permixon on prostatic tissue in patients with benign prostatic hyperplasia (BPH). A total of 49 BPH and control patients entered the trial. 36 patients of the study group were randomized into 3 subgroups of 12 patients each. Permixon was taken in a standard dose of 320 mg/day for 3, 6 and 12 months, respectively. Mean duration of BPH was 3.7 years (0-8 years). Mean value of PCA was 6.0 ng/ml. The control group of 13 patients were not given permixon. Multifocal prostatic biopsy was performed in all the patients before and after the treatment or follow-up. Stromal-parenchymatous correlation in the study group significantly increased (by 59%) - from 3.28 (0.25-9.61) to 5.22 (1.20-10.67) (p = 0.0002). For the control group this correlation was insignificant. Permixon-treated patients demonstrated inhibition of prostatic epithelium proliferative activity by 32% (p = 0.0001) and a rise in the stage of proliferative centers development from stage II-III to IV-V. Intensity of inflammation in prostatic tissue decreased by 53% in the study group and insignificantly in the control group. Thus, permixon treatment of BPH leads to a significant rise in stromal-parenchymatous correlation due to inhibition of proliferative activity of prostatic epithelium and attenuation of inflammation.
Urologiia. 2004;(5):10-16
pages 10-16 views

Urogenital tuberculosis: problems of present-day diagnosis and treatment

Batyrov F.A., Nersesyan A.A., Merkuryeva Y.A.

Abstract

The analysis of 4904 cases with tuberculosis admitted to the urological department of Moscow tuberculosis hospital N 7 in 1996-2002 showed increased incidence of new-onset and recurrent urogenital tuberculosis - the share has risen from 2.1 to 7.8%. Of 267 new cases, 49.4% had severe destructive forms. The disease manifested with chronic cystitis in 35 (13.11%), subacute orchoepidydimitis in 35 (13.11%), anatomofunctional alterations of the kidneys (hydronephrotic transformation, non-functioning kidney, ureteritis, etc.) in 76 (28.46%) patients. Bacterial discharge occurred in 52% of new cases. The diagnosis was based on clinical and x-ray data in 48%. Isolated genital tuberculosis, isolated nephrotuberculosis and their combination were revealed in 14.23, 59.57 and 26.2% patients, respectively. Among the patients with advanced destructive forms 75% got disabled completely. This fact indicates the importance of early diagnosis and adequate etiotropic therapy. Active urogenital tuberculosis was treated surgically in 51% patients, most of the operations were made for marked destructive processes in the kidneys. The organ-removing operations were conducted in 73% of them. Preoperative tuberculostatic therapy reduced frequency of postoperative complications. In early diagnosis, the organ was saved in operations in 9.38%. It is recommended to refer patients to the phthisiourologist to be examined for urogenital tuberculosis if they have long-standing urogenital infection, destructive lesions of the upper urinary tracts, calculous prostatitis
Urologiia. 2004;(5):16-25
pages 16-25 views

Antibacterial therapy of complicatedurinary infections in outpatients

Rafalsky V.V., Strachunsky L.S., Kogan M.I., Petrov S.В., Grinev A.V., Shevelev A.N.

Abstract

The term complicated urinary infections (CUIs) includes infections developing in the presence of anatomic anomalies, metabolic or hormonal disorders, immunodeficiency or infection with atypical microorganisms. Complicating factors diminish efficiency of antibiotic treatment, raise probability of recurrence. CUIs account for 45.2% of all cases of outpatient urinary infections in adults in Russia. Nephroliths, diabetes meUitus and renal cysts are most prevalent complicating factors. CUIs causative agents' spectrum is wider and resistance bacteria isolation is more frequent compared to uncomplicated urinary infections. In addition to antibiotic therapy, CUIs treatment should be focused on detection and elimination of the complicating factor. If complicating factors are unremovable, antibiotic therapy should be directed to management of clinical symptoms of urinary infection, prevention of complications and damage to renal parenchyma. CUIs demand longer courses of antibiotics than uncomplicated urinary infections: 7-14 days in infection of the lower urinary tracts, at least 14 days in infection of the upper urinary tracts and 4-6 weeks in failure of the standard course. Fluoroquinolones are drugs of choice in adults.
Urologiia. 2004;(5):25-31
pages 25-31 views

Naiz (nimesulid) incombined treatment of patients with chronic bacterial prostatitiswith chronic pelvic pain syndrome

Neimark A.I., Yakovets Y.V., Aliev R.T.

Abstract

Naiz (nimesulid) was given to 46 patients (age 24-52 years) with chronic abacterial prostatitis suffering from chronic pelvic pain syndrome (CPPS) which appeared from 20 to 3 years before the treatment. Microscopy of prostatic secretion showed normal count of leukocytes. Transrectal ultrasound investigation with dopplerography has found normal echostructure of the prostate but blood flow parameters were subnormal. Naiz was given in a dose 100 mg (1 tablet) twice a day for 15-20 days. The treatment relieved pain in 68-87% patients (mean 77.5%). The control ultrasound investigation detected much better circulation. Quality of life improved significantly. Side effects were mild. The effect persisted for 3 months of the follow-up. Thus, the addition of such nonsteroid antiinflammatory drug as naiz (nimesulid) to treatment of patients with chronic abacterial prostatitis is justified. The drug improves quality of life, induces side effects rarely and can be used for a long time with a persistent efficacy.
Urologiia. 2004;(5):31-34
pages 31-34 views

Application of the device «АЭЛТИС-СИНХРО-02-"ЯРИЛО" andvacuum laser therapeutic urologic massager АМВЛ 01-"ЯРОВИТ" in the treatment of chronic prostatitis and concomitant copulative dysfunction

Shaplygin L.V., Koval A.M., Pavlenko A.V., Kazachenko A.Y.

Abstract

There are three directions in pathogenetic treatment of chronic prostatitis (CP) which is conducted in parallel to etiotropic one (antimicrobial): general immunological; improving arterial inflow and venous outflow; creation of prostatic secretion outflow and that of seminal vesicles by means of contractions of the pelvic and perineal muscles, muscular fibers of the prostatic gland. The latter two directions can be managed with physiotherapy. It is proposed to use combination of drugs with physiotherapy conducted by means of the devices АЭЛТИС-СИНХРО-02-"ЯРИЛО" and АМВЛ 01-"ЯРОВИТ'.
Urologiia. 2004;(5):34-37
pages 34-37 views

Ejaculate microflora sensitivity to lactoferrin in chronic prostatitis

Nikolaev A.A., Boiko O.V., Lutsky D.L., Vybornov S.V.

Abstract

To determine an antimicrobial action of lactoferrin on bacterial flora of ejaculate in chronic prostatitis, we examined 124 patients with various diseases of male reproductive system at the age between 17 and 56. A total of 280 strains were used as test microorganisms (MO). Sensitivity of the latter to lactoferrin was studied with a human lactoferrin apoform. MO isolated from patients with marked dysbiosis were resistant to lactoferrin (94%). MO, not leading in cenosis, were more sensitive to lactoferrin than MO of the main colonies grown after seeding. Reproductive dysfunction was accompanied by higher occurrence of strains resistant to lactoferrin. The least sensitivity to lactoferrin was registered in asthenozoospermia. Lactoferrin resistance of MO may raise MO pathogenicity. When lactoferrin-resistant strains predominate in microbiocenosis, it is an unfavourable prognostic sign in relation to development of complications, primarily subfertility.
Urologiia. 2004;(5):37-39
pages 37-39 views

Extracorporeal shock-wave therapy inPeyronie's disease

Aboyan I.A., Mitusov V.V., Pakus O.I., Grachev S.V., Pavlov S.V., Shestel A.N.

Abstract

The aim of the study was to validate clinical methodology on application of shock-wave impact on plaques in Peyronie's disease (PD). We studied short- and long-term results of extracorporeal shock-wave therapy (ESWT) in 54 patients 3, 6 and 12 months after the exposure. We performed ESWT sessions on different lithotriptors using different mechanisms of shock wave mechanism (hydromechanical and piezoelectric). Choice of the ESWT technique was based on the thickness and density of the plaque. The proposed ESWT method provides an effective treatment of the disease basing on the initial angle of penis deformation in erection.
Urologiia. 2004;(5):39-42
pages 39-42 views

Viagra, sialis, impase -which of them, to whom, when and how?

Mazo E.В., Gamidov S.I., Ovchinnikov R.I.

Abstract

The study has been performed of the efficacy in the treatment of erectile dysfunction (ED) of oral drugs affecting nitric oxide: impase and phosphodiesterase-5 (PDE-5) inhibitors - sildenafil citrate (viagra), tadalafil (sialis) - alone and in combination with impase. A total of 218 ED patients aged 21-73 years (mean age 58.1 + 13.2 years) were divided into 3 groups comparable by the number of the patients, age, suspected etiology, pathogenesis and ED severity. Group 1 (n = 81) took viagra in the individually adjusted dose for 6 months; group 2 (n = 64) received sialis in a dose 20 mg for 6 months;
Urologiia. 2004;(5):42-48
pages 42-48 views

A new pathogenetic approach and amethod of erectile dysfunction treatment and prevention - modulated erectile oxygenation of penile cavernous tissue

Segal A.S., Pushkar D.Y.

Abstract

The analysis of sexual activity of 185 male Muscovites has revealed an age-related sharp progressive shortening of adequate and spontaneous erections. A novel, pathogenetically sound approach and a method of therapy and prevention of erectile dysfunction has been developed (RF patent N 2228754). The method, called "Modulated Erectile Oxygenation of Penile Cavernous Tissue" (MEOPCT), consists in erection activation by behavioral measures and/or erectogenic drugs which induce adequate, nocturnal spontaneous and/or artificial erections adequate in frequency and duration for providing such oxygenation of cavernous bodies that warrants maintenance of their normal structure and function. There is no continuous close correlation between sexual activity and erections, on the one side, and ejaculation and orgasm, on the otherside. Application of MEOPCT in 43 patients demonstrated the method ability to improve erection and cavernous hemodynamics without negative side effects
Urologiia. 2004;(5):48-52
pages 48-52 views

Immune male infertility: correction with efferent therapy

Tiktinsky O.L., Korenkov D.G., Alexandrov V.P., Mikhailichenko V.V., Marusanov V.E.

Abstract

Effects of plasmapheresis and hemosorption on efficacy of the treatment of autoimmune male infertility (AMI) were studied in 289 AMI males with oligoasthenozoospermia aged 19 to 37 years. The males were divided into three groups by the levels of antisperm antibodies (ASAB) in the blood and ejaculate. The study was made of cellular and humoral immunity, intensity of protein and lipid free radical oxidation and antioxidant defense. Patients of group 1 with high ASAB in the blood but low in ejaculate received a course of plasmapheresis. Patients of group 2 with high ASAB both in the blood and ejaculate were subjected to hemosorption and plasmapheresis in one contour. Group 3 patients with high ASAB in ejaculate but low in the blood received efferent therapy only after medication and photomodification of the blood. The treatment reduced elevated levels of ASAB in the blood and ejaculate, normalized free radical oxidation, cellular and humoral immunity, antioxidant defense. This resulted in improvement of spermogram parameters, efficacy of assisted reproductive technologies, higher probability of natural pregnancy in the patients' wives.
Urologiia. 2004;(5):52-56
pages 52-56 views

Gastrointestinal hormones inthe blood serum of patients with chronic renal failure

Dzhavad-Zade M.D., Karaev M.E.

Abstract

Content of gastrointestinal hormones (gastrin, insulin, glucagon, C-peptide), (^-microglobulin, glomerular filtration rate (GFR) were studied in 65 patients with nephrolithiasis (NL) and in 73 patients with chronic renal failure (CRF). It was found that NL with GFR under 80 ml/min runs with elevated insulin, glucagon and C-peptide while CRF with CRF under 30 ml/min is characterized by aggravated disorders of hormonal homeostasis (gastrin, insulin, glucagons, C-peptide elevation). As gastrointestinal hormones in patients with CRF are high, it is recommended to combine medication with diet containing low amount of carbohydrates easy for digestion which is important in the treatment of CRF.
Urologiia. 2004;(5):56-58
pages 56-58 views

Peritonealdialysis in the treatment of chronic renal failure

Kazimirov V.G., Butrin S.V., Bekov R.R., Sapozhnikov A.D., Kharitonov B.I., Smolyakov A.M., Detinenko I.N.

Abstract

Fifty-four patients were treated with peritoneal dialysis for terminal chronic renal failure. Clinical-laboratory indices were assessed in patients on chronic peritoneal dialysis. Advantages of continuous ambulatory peritoneal dialysis over hemodialysis are analysed in terms of social rehabilitation of the patients. Complications of chronic peritoneal dialysis as a method and algorithms of their treatment are outlined. The role of peritoneal dialysis as a preparatory stage before transplantation of the kidney is assessed
Urologiia. 2004;(5):58-62
pages 58-62 views

The TVT operation in injury of thepelvic ring

Bazaev V.V., Bychkova N.V.

Abstract

The authors report a case of a woman with combination of stress urinary incontinence (SUI) with posttraumatic rupture and divergence of the pubic joint. The latter led to relaxation of the pelvic base and urethral ligaments resultant in SUI. The patient was treated surgically (a modified TVT operation). This rare case demonstrates possibility of SUI development consequently to trauma of the pelvic ring and a TVT operation efficacy made in non-standard setting.
Urologiia. 2004;(5):62-64
pages 62-64 views

Vesico-appendicularfistula

Zakrillaev Z., Mirzhanov K., Norov S.T.
Urologiia. 2004;(5):64-65
pages 64-65 views

Treatment of prostatic cancerstage T3N0M0

Loran О.В., Tomkevich B.A.
Urologiia. 2004;(5):65-68
pages 65-68 views

Application of paline® (pipemidine acid) in urological practice

Derevyanko I.I.
Urologiia. 2004;(5):68-70
pages 68-70 views

Tadenan (Pygeum africanum extract) in the treatment of patientswith benign prostatic hyperplasiaЫ

Medvedev A.A., Sivkov A.V., Razumov S.V., Oschepkov V.N.
Urologiia. 2004;(5):70-72
pages 70-72 views

Present-day hypothesesof prostatic cancer etiology and pathogenesis

Gubanov E.S., Pryanichnikova M.B.
Urologiia. 2004;(5):72-76
pages 72-76 views
pages 76-78 views

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