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No 1 (2005)

Articles

Criteria of efficacy of adjuvant immunotherapy of surface cancer of the urinary bladder

Loran О.В., Medvedev V.L., Budnik N.V.

Abstract

Assessment of prognostic significance of interIeukine-8 (L-8) urine levels was made in 12 patients with verified surface cancer of the urinary bladder (SCUB) on adjuvant intravesical immunotherapy. Quantitative enzyme immunoassay identified IL-8 in the urine before intravesical injection of BCG vaccine and 6 hours later. A total of 192 urine samples were studied ("Multiskan-Jems", 405 nm). Adjuvant immunotherapy raises an L-8 level in the urine of the patients. After 8-week immunotherapy IL-8 elevated from 169.4 pg/ml to 326 pg/ml. Four patients with minimal difference in IL-8 urine levels (120 pg/ml, on the average) before and 6 hours after intravesical injection of BCG vaccine developed recurrence. Thus, quantitative assessment of IL-8 in urine of SCUB patients given intravesical BCG therapy can serve as one of prognostic criteria of adjuvant immunotherapy efficacy.
Urologiia. 2005;(1):3-5
pages 3-5 views

Argentophilic nucleolar organizers and prognosis for patients with surface and locally advanced transitional cell cancer of the urinary bladder

Korneev I.A.

Abstract

The aim of the study was to estimate distribution of the nucleoli and argentophilic nucleolar organizers in surface and locally advanced transitional cell tumors of the urinary bladder (TCTUB), to analyse correlation between this distribution, tumor recurrence and survival of the patients. The data on primary examination and 5-year followup of 61 patients (47 male and 14 female, mean age 64 x 1 year) with surface and locally advanced TCTUB were studied retrospectively. AH the patients were radically operated on, 5-year progression-free survival made up 62%, recurrences of the urinary bladder tumors were detected in 61% patients. In addition to the standard morphological examination, tumor tissue was stained with silver nitrate according to the Howell and Black technique and the number of the nucleoli and argentophilic granules in them was counted in magnification lOOO.The findings were compared with the invasion depth, grade of cancer differentiation, tumor recurrence and 5-year survival. The count of argentophilic granules increased with reduction of differentiation grade and an increase of cancer invasion depth. Distribution of the nucleoli and granules significantly differed in the subgroups of patients with recurrent and recurrence-free course of the disease, depending on 5-year survival without progression. Probable duration of the recurrence-free period was estimated best by coefficient of variation of argentophilic granules distribution (p = 0.001). Parameters of distribution of the nucleoli and granules allowed specification of the risk of tumor progression for 5 years for all the patients (p = 0,035) and patients with surface tumors (p = 0.007) irrespective of categories T and G. Thus, the number of nucleoli and argentophilic nucleolar organizers increases with lowering of differentiation and deepening of tumor invasion. The analysis of nucleoli and argentophilic granules distribution provides additional information on recurrence and transient cell carcinomas probability.
Urologiia. 2005;(1):5-9
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Treatment of renal tuberculosis

Kamyshan I.S., Mams A.N.

Abstract

Three groups of parameters of 4 tuberculostatics effects on tuberculosis of the kidneys and general condition were singled out basing on comparative efficacy of 3 and 4 mycobacterial drugs: more effective, equally effective and negative. Higher efficacy manifested with greater number of cases of leukocyturia elimination and conversion ; of cultivable mycobacteria into uncultivable ones, more obvious mor) phological signs of tuberculous inflammation involution. Equal efficacy of 3 and 4 drugs was characterized by the same rate of mycobacteriuria continuation and detection of mycobacteria in caverns from the removed tuberculous kidney. The negative effect of medication consisted in increased intolerance of the drugs, involvement 5 of the liver and kidneys, toxico-allergic reactions. Indications for initial use of 4 mycobacterial drugs in new cases of tuberculosis are early forms of tuberculosis of the kidneys in normal nitrogen-excretory function and absence of hepatic insufficiency. This treatment must be recommended with caution for old patients. The conclusion is made that WHO recommendation to use initially four drugs for treat, ment of urogenital tuberculosis is not well grounded and physicians should decide on the treatment regimen after consideration of the individual characteristics of the patients.
Urologiia. 2005;(1):9-12
pages 9-12 views

Treatment of benign prostatic hyperplasia in patients with ischemic heart disease

Alyaev Y.T., Fiev D.N., Kopylov F.Y., Lokshin K.L., Demidko Y.L., Svet A.V., Vinarov A.Z., Syrkin A.L.

Abstract

The aim of the study was to elucidate influence of alphalA adrenoblocker tamsulosine (omnique) on ischemic heart disease (IHD) symptoms in patients with benign prostatic hyperplasia (BPH). As shown by Holter monitoring, 15 patients of group 1 having IHD, BPH and impaired miction, demonstrated ECG changes before voiding (ST depression, higher rate of supraventricular and ventricular extrasystoles); 28 patients of group 2 had ECG changes unrelated to miction. Subjective and objective effects were registered in a month in all the patients. ECG parameters improved in 11 and 20 patients of group 1 and 2, respectively. Patients without ECG improvement had severe cardial pathology (threevessel affection of the coronary arteries, effort angina of a high functional class, cardiac failure). Thus, miction impairment due to BPH aggravate IHD. Early administration of tamsulosine (omnique) for BPH improves the course of concomitant IHD in 72% patients.
Urologiia. 2005;(1):12-18
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Diagnosis of localized cancer of the prostate

Petrov S.В., Kharchenko P.V.

Abstract

The study was made to improve preoperative diagnosis of the stage of prostatic cancer (PC) to raise efficacy of subsequent treatment. A total of 152 patients entered the study who had undergone in 19972002 a radical prostatectomy for local PC. Basing on pathomorphological findings, the patients were divided into two groups: with localized CP (68 patients) and spread CP (84 patients). The comparison of clinical and pathomorphological diagnosis in the same patients demonstrated that there is a correlation between them, therefore it is possible to predict pathomorphological diagnosis at the stage of clinical diagnosis. The formula of establishment of a pathomorphological stage of the disease has been developed and its efficacy was tested in 30 control patients. The mathematical model of complex evaluation of the symptoms allows in 81% of cases to correctly determine the spread of CP while examination of separate symptoms provides a correct diagnosis in less than half the cases. The model can prognosticate radicality of the future operative intervention and duration of recurrence-free course and, consequently, to reduce the rate of intra- and postoperative complications and design further treatment policy.
Urologiia. 2005;(1):19-2
pages 19-2 views

Intervenous anastomoses and occlusive operations in varicocele

Strakhov S.N., Burkov I.V., Bondar Z.M., Kosyreva N.B.
Urologiia. 2005;(1):22-29
pages 22-29 views

Levitra-test in diagnosis of vasculogenic erectile dysfunction

Mazo E.В., Gamidov S.I., Zhuchenko T.D., Andranovich S.V., Ovchinnikov R.I., Iremashvili V.V.

Abstract

Dopplerography in artificial erection induced by intracavemous injection of drugs is now the most common method of diagnosis in examination of patients with erectile dysfunction (ED). We studied possibility of inducing erection by the novel potent and selective oral drug levitra (vordenafil) from the group of inhibitors of phosphodiesterase of the 5th type. The comparison of the dopplerographic results of two methods (erection induced by intracavemous injection of prostaglandin E and levitra) showed no statistical differences between the two methods. Thus, levitra-test is a highly informative technique in diagnostic examination of patients with erectile dysfunction with the same pharmacodopplerographic efficacy as intracavemous injection of vasoactive drugs.
Urologiia. 2005;(1):29-32
pages 29-32 views
pages 32-35 views

Epidemiology and causes of autoimmune male infertility

Bozhedomov V.A., Teodorovich О.V.

Abstract

To study epidemiology and etiopathogenesis of male autoimmune infertility, we examined ejaculate samples from 3660 males of reproductive age, clinico-laboratory data on 560 males from infertile couples with antispermal antibodies (ASAB), 647 males without ASAB and 40 fertile males. Ejaculate was tested according to WHO recommendations, ASAB were identified by mixed agglutination reaction (MAR) and flow cytofluorometry (FCFM), infections of the reproductive tract (IRT) - by polymerase chain reaction (PCR). Experiments were made on 136 white non-inbred mature male rats and 40 mature female rats: 1/3 of the only testis was removed in male rats, then morphology of the operated on testis was studied as well as real fertility. ASAB were detected in 18% males of reproductive age. Factors of risk of antispermal immunity are the following: IRT (52%), varicocele (35%), blunt scrotal injuries without orchitis (21%) and previous epididymoorchitis (6%), obstruction (3%), cryptorchism and anejaculation (1 %). Absolute risk of immune infertility makes up 67% after orchitis and epididymoorchitis, 66% after blunt scrotal injuries without clinical orchitis, 39-43% in clinical and previously operated varicocele, 32% after IRT. Combination of the risk factors raises immune infertility probability 1.2-4.1 fold. The efficacy of antibiotic therapy for bacterial IRT in ASAB is described. It is shown than it is possible to preserve spermatogenesis after testicular trauma by stimulation of its regeneration. Immunological mechanisms of male autoimmune infertility are analysed. Thus, main causes of male autoimmune infertility are mechanical, infectious or other affection of the testis leading to impairment of hematotesticular barrier, varicocele increases the risk of autoimmune reactions and orchitis after traumas; cross-over interaction between antigenic determinants of sperm and IRT; obstruction of the ejaculatory tract; specific features of antiinfectious immunity.
Urologiia. 2005;(1):35-44
pages 35-44 views

The role of alphal-adrenoblocker alfuzosine in diagnostic-therapeutic algorithm of hyperactive urinary bladder management in women and selection of patients for treatment with M-cholinergic antagonists

Danilov V.V., Volnykh I.Y., Danilova T.I., Abdullaeva S.K.

Abstract

In management of patients with hyperactive urinary bladder (HAUB) it is necessary to take into consideration the fact that long, term intake of M-cholinergic antagonists may result in obstructive micjtion because of low contractile activity of the urinary bladder. Use of M-cholinergic antagonists also problematic in detruzor dysfunction leading to slowing down of the urinary flow. In view of these possible complications, an algorithm of urodynamic diagnosis is proposed based on non-invasive registration of miction disorders using home uroflowmetry. Correction of detruzor contractility with dalfas combines well with cholinoblockers. In some cases administration of nontitrated all phablockers has no alternative especially in long-term treatment with mediators suppressing nonadapted detruzor contractions as it happens in HAUB. The above diagnosticotherapeutic algorithm of female miction disorders management which regards urine flow rates and comprises intake of alfusozine if necessary allows treatment of females with small urinary bladder when cholinergic antagonists are low-effective.
Urologiia. 2005;(1):44-47
pages 44-47 views

Double-blind placebo-controlled study of terazosin in patients with chronic abacterial prostatitis

Sivkov A.V., Oschepkov V.N., Egorov A.A.

Abstract

A double-blind placebo-controlled trial of teraosin efficacy (Kornam, Lek, Slovenia) was made in 51 patients with chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) of category Ilia according to NIH. All the patients were given a 2-week induction course of placebo followed by teraosin treatment (5 mg/day, n = 29) or placebo (n = 22) for 8 weeks. The participants of the study were followed up for 12 months. Pretreatment differences between the groups by NIH-CPSI system, symptoms frequency scale, leukocyte count of the prostate and uroflowmetry were insignificant. Teraosin and placebo patients showed a noticeable improvement (39.7 and 9.9% by symptoms frequency scale, respectively; by 36.4 and 6.6% by the linear scale, respectively). The drug reduced pain and dysuria, improved quality of life considerably (by 36.2%). Maximal urine flow accelerated by 22.96 and 10.01% in teraosin and placebo groups, respectively. Leukocyte count fell two-fold in the study group and lowered insignificantly in the placebo group. The recurrence-free interval was 25 and 9 weeks, respectively. Thus, teraosin monotherapy improves quality of life in CAP/CPPS patients, significantly relieves symptoms and prolongs recurrence-free interval vs placebo.
Urologiia. 2005;(1):47-53
pages 47-53 views

Effects of pressure and flow rate of irrigation liquid on hydrodynamics of the upper urinary tract in contact ureterolithotripsy

Golubchikov V.A., Sitnikov N.V., Sidorov O.V., Ponomarev V.K.

Abstract

We studied the influence of pressure and rate of irrigative liquid flow on hydrodynamics of the upper urinary tracts in contact pneumatic lithotripsy (Litoclast lithotriptor) in 68 patients with ureteroliths and nephrostomic drainage. To a nephrostome the device was attached on which the linear change of pressure inside the pelvis was measured at the moment of visualization of the stone, its destruction and final ureteroscopy. 45 patients had nephrostome with a pelvis curl. In this group of patients at the moment of stone destruction the pressure inside the pelvis and the speed of irrigative flow were increased. In patients with marked local inflammatiion on the place of stone location the pressure inside the pelvis was the highest. The effect of communicating vessels was seen. The stone was completely destroyed in 34 (75.5%) patients, in 9 (20%) patients the stone was destroyed partially. In 2 cases the stone migrated in the cavitary system of the kidney. A nephrostome-intubator was placed antegradely in 23 patients. The balloon-obturator was placed in the ureter above the stone through the nephrostome. The pressure inside the pelvis during contact lithotripsy was not increased. Full destruction of the stone was achieved in 26 patients (92.8%), migration of the stone in the cavitary system and partial destruction of the stone was observed in 2 (2.2%) patients.
Urologiia. 2005;(1):53-56
pages 53-56 views

Endoscopic correction of neuromuscular ureteral dysplasia in children

Pugachev A.G., Kudryavtsev Y.V., Martov A.G., Lisenok A.A.

Abstract

The authors present pathogenetic rationale for using endoscopic intervention in neuromuscular ureteral dysplasia in children. A positive effect of this treatment occurs primarily in patients with a small area of sclerosis focus in the ureter. Such patients have high percentage of leiomyocytes with a great regenerative potential. This explains a response to endoureterotomy.
Urologiia. 2005;(1):56-59
pages 56-59 views

Quality of life in endoscopic treatment of varicocerle

Tsukanov A.Y.

Abstract

A total of 46 patients with varicocele aged 15-28 years (mean age 17.1 + 1.3 years) were operated endoscopically by means of ligation of the internal seminal vein from an open gas-free mini-approach. The intervention was on the left side (n = 45) and right side (n = 1). Varicocele of the first, second and third degree was diagnosed in 2 (4.3 ± 3.0%), 35 (76.0 ± 6.3%) and 9 (19.6 ± 5.9%) patients, respectively. There were no conversions. Duration of the operation was 28.4 ± 2.7 min. Early after surgery anesthesia with ketorolac trometamine (2.1 ± 1.1 injections, on the average) was made in 37 (80.4 ± 5.9%) patients. Seven (15.2 ± 5.3%) patients refused anesthesia. Control examination was made on day 7. Hydrocele developed in one case (2.2 ± 2.2%). It was managed conservatively. A mean length of the scar was 2.8 ± 0.34 cm. The second postoperative examination was conducted 6.7 ± 1.6 months after the first one. The recurrence arose in one patient (2.1 ± 2.1%). The patient was reoperated from an open mini-approach. A mean level of pain syndrome was 1.8 + 0.5 points. It had no influence on the patients' condition. On postoperative day 3-5 the patients were discharged. Thus, good quality of life in use of the proposed endoscopic operation of ligation of the internal seminal vein from an open gas-free approach makes this surgery an operation of choice in surgical treatment of varicocele.
Urologiia. 2005;(1):60-63
pages 60-63 views

Laparoscopic testiculectomy in testicular feminization syndrome

Dubrovin V.N., Melnik G.A., Pankova M.V., Agroskin L.S., Baranova О.A.
Urologiia. 2005;(1):63-65
pages 63-65 views

Treatment of progressive prostatic cancer after local therapy

Morozov A.V.
Urologiia. 2005;(1):65-70
pages 65-70 views

Professor T. P. Mochalova

Dovlatyan A.A.
Urologiia. 2005;(1):70-70
pages 70-70 views
pages 71-71 views
pages 72-72 views

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