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No 5 (2004)
- Year: 2004
- Articles: 20
- URL: https://journals.eco-vector.com/1728-2985/issue/view/6576
Articles
Nephrureterectomy with endoscopic resection of the urinary bladder,ureteral ostium and terminal part in papillary tumors of the upperurinary tracts
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
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Morphological changes in prostatic tissue of patients with benign prostatic hyperplasia treated with permixon®
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
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Urogenital tuberculosis: problems of present-day diagnosis and treatment
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
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Antibacterial therapy of complicatedurinary infections in outpatients
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
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Naiz (nimesulid) incombined treatment of patients with chronic bacterial prostatitiswith chronic pelvic pain syndrome
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
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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
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
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Ejaculate microflora sensitivity to lactoferrin in chronic prostatitis
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
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Extracorporeal shock-wave therapy inPeyronie's disease
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
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Viagra, sialis, impase -which of them, to whom, when and how?
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
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A new pathogenetic approach and amethod of erectile dysfunction treatment and prevention - modulated erectile oxygenation of penile cavernous tissue
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
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Immune male infertility: correction with efferent therapy
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
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Gastrointestinal hormones inthe blood serum of patients with chronic renal failure
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
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Peritonealdialysis in the treatment of chronic renal failure
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
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The TVT operation in injury of thepelvic ring
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
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Vesico-appendicularfistula
Urologiia. 2004;(5):64-65
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Treatment of prostatic cancerstage T3N0M0
Urologiia. 2004;(5):65-68
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Application of paline® (pipemidine acid) in urological practice
Urologiia. 2004;(5):68-70
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Tadenan (Pygeum africanum extract) in the treatment of patientswith benign prostatic hyperplasiaЫ
Urologiia. 2004;(5):70-72
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Present-day hypothesesof prostatic cancer etiology and pathogenesis
Urologiia. 2004;(5):72-76
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The subject of urology in the light of current specification of state and legal regulationof medical relations
Urologiia. 2004;(5):76-78
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