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No 3 (2005)

Articles

Renal tumors and pregnancy

Pereverzev A.S., Schukin D.V., Ilyukhin Y.A., Yaroslavsky V.L., Mysko S.Y., Megera V.V.

Abstract

The article presents a retrospective analysis of literature data on combination of renal tumors with pregnancy, three cases are reported. The diagnostic algorithm in such patients is based, first of all, on ultrasonography, in complicated cases MR imaging is used. Therapeutic policy depends on the tumor stage and size, pregnancy term. Urgent radical nephrectomy is recommended in trimester I and III. Follow-up with delivery may be employed upon 28 week pregnancy in trimester II. Basic therapeutic algorithm of renal angiomyolipoma is follow-up. To make a final conclusion on efficacy of therapeutic policy, it is necessary to conduct a multicenter prospective trial aimed at assessment of long-term results of each therapy.
Urologiia. 2005;(3):3-6
pages 3-6 views

Three-dimentional echography in diagnosis and staging of urinary bladder cancer

Mazo E.В., Gazhonova V.E., Chepurov D.A.

Abstract

The role of USI and three-dimentional volumetric reconstruction was studied in diagnosis of urinary bladder cancer diagnosis. 69 UBC patients were examined. Examination included renal USI of the kidneys, urinary bladder, prostate, echoureterography, cystoscopy, CT, MRT. The number of the tumors, volume, area, invasion were studied in 3D mode. US angiography assessed resistance index and tumor vascularization by degrees 0-3. US1 findings were compared with those of MRT, cystoscopy, histomorphology of the biopsies. 2D US1 technique proved effective in detection of urinary bladder cancer at stage Tl in 66%, 3D - in 100. At stage T2a-b informative value of both techniques reached 87%. Overall informative value of 2D in detection of urinary bladder cancer was 81 %, three-dimentional echography - 96%. USI proved effective in diagnosis and staging of urinary bladder cancer. Use of 3D ultrasonic angiography facilitates the choice of more effective surgical policy in the treatment of urinary bladder cancer patients.
Urologiia. 2005;(3):6-12
pages 6-12 views

Transurethral ablation (Presicion Plus) in the treatment of patients with benign prostatic hyperplasia

Mazo E.В., Krivoborodov G.G.

Abstract

Benign prostatic hyperplasia (BPH) is a common condition among elderly men. Transurethral needle ablation of the ptostate (TUNA) is a minimally invasive procedure for treatment of BPH. With TUNA, the inner region of the prostate is selectively ablated with temperatures approaching 90-100 °C while prostatic urothelium is preserved. The TUNA (Precision Plus) was used in 9 patients with BPH: 1 patient had acute urinary retention, 6 ones had suprapubic catheter and 2 patients had lateral and median lobes. The patient with acute urinary retention and 4 patients with suprapubic catheter resumed voiding after TUNA. Two patients with lateral and median lobes showed improvement of subjective and objective parameters. The size of the prostate did not change one month after TUNA. Thus, TUNA is a safe and effective therapy for treatment of BPH that can be performed with local anaesthesia.
Urologiia. 2005;(3):12-15
pages 12-15 views

Combined therapy of voiding irritative disorders after surgical treatment of benign prostatic hyperplasia with Andro-Gin

Loran О.В., Lukiyanov I.V., Markov A.V.

Abstract

The results of operative and rehabilitative treatment of benign prostatic hyperplasia (BPH) was analysed for 69 BPH patients with postoperative irritative disorders of voiding. The patients were divided into four groups by rehabilitative therapy: group 1 received antibacterial therapy; group 2 -antibacterial therapy+alpha-adrenoblockers; group 3 - antibacterial therapy+ transrectal laser and magnetic physiotherapy; group 4 - antibacterial therapy+alpha-adrenoblockers+transrectal laser and magnetic physiotherapy. The worst result was obtained in group 1, the best one - in groups 3 and 4 (the response was compatible). Thus, the addition of physiotherapy to the complex of postoperative rehabilitation of patients operated for BPH is justified and provides treatment improvement.
Urologiia. 2005;(3):15-18
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Sexual dysfunction in males with concomitant urological diseases

Al-Shukri S.K., Korneev I.A.

Abstract

A clinical data was studied for 117 males without complaints for copulative disorders admitted to urological clinic electively for benign prostatic hyperplasia (BPH) - 44 (37.6%), urolithiasis - 25 (21.4%), external genital diseases - 17(14.5%), renal cyst and hydronephrosis - 16(13.7%), renal and vesical tumors - 15(12.8%). Mean age of the patients was 56.2 ±16.1 years. The patients filled in IPSS and IIEF questionnaires. Mean score set (±SD) for IIEF and IPSS was 35 + 23 and 12 + 10, respectively. The majority of the patients (n = 61) were not sexually active. Erectile dysfunction (ED) was detected in 23 (19.7%) patients: mild and moderate in 19 (16.2%) and 4 (3.4%), respectively). 24 (73%) patients with normal erectile function, 10 (44%) patients with ED and the majority (n = 37) of sexually inactive men were satisfied with their sexual activity. Those males who needed improvement of sexual life quality had higher (p < 0.05) parameters of erectile function and sexual satisfaction. Age of the patients (R2 = 33.l;p< 0.0001) and IPSS index (p < 0.015) were leading indices in determining condition of the copulative function. IIEF correlated with tumors of the kidney or urinary bladder (p < 0.004) and benign prostatic hyperplasia (p < 0.015). Erectile dysfunction in men with urological diseases was closely related with age and severity of lower urinary tract symptoms. Other sexual disorders may be due both to general causes and urological diseases.
Urologiia. 2005;(3):18-22
pages 18-22 views

Mixed forms of urinary incontinence in women: diagnosis and treatment

Pushkar D.Y., Schaveleva О.В.

Abstract

In our clinic we encountered a mixed form of urinary incontinence (UI) in 27% patients. The urodynamic examination has detected hyperactive urinary bladder in 42.2% patients with mixed UI. The patients received conservative therapy in combination with replacement hormone therapy and exercise strengthening pelvic fundus muscles. A response was achieved in 69% cases. If the imperative component was not confirmed by urodynamic testing, the patient was treated surgically. 12 patients (21%) developed imperative disorders of voiding in early postoperative period, 8 (14%) patients' condition deteriorated. Thus, in mixed incontinence much attention should be given to clinical manifestations of the disease to avoid recurrent imperative disorders of voiding after operative treatment.
Urologiia. 2005;(3):22-26
pages 22-26 views

Kornam in the treatment of imperative urine incontinence in females

Danilov V.V., Volnykh I.Y., Danilova T.I., Abdullaeva S.K.
Urologiia. 2005;(3):26-28
pages 26-28 views

Causes of erectile dysfunction after transurethral resection of hyperplastic prostate and its prevention

Alyaev Y.G., Vinarov A.Z., Chaly M.E., Demidko Y.L., Akhvlediani N.D.

Abstract

The study was made of 60 sexually active patients with prostatic hyperplasia after monopolar transurethral operations (mean age 61.3 years). 30 patients entered a control group, 30 ones - the study group. The latter received 10 mg vardenafil each other day for 7 weeks after the intervention. The patients filled in questionnaire, underwent dopplerography and electromyography of the penis. Questionnaire said that erection was worse after operation in 6 (20%) patients (p < 0.01) of the control group and none of the study group. The latter also showed better circulation. All the men with postoperative erectile dysfunction (ED) had electromyographic signs of impaired autonomic innervation of the penis. Thus, ED after transurethral operations for prostatic hyperplasia is primarily neurogenic and is seen in 20% operated patients. Early vardenafil therapy is effective in prevention of postoperative ED.
Urologiia. 2005;(3):28-32
pages 28-32 views

Incomplete unilateral intracavernous prosthetic reconstruction in Peroni's disease

Taruashvili I.G., Tatevosyan A.S., Taruashvili G.I., Porodenko V.E., Simonenko E.V., Zhuk N.V., Melyukhova N.E.
Urologiia. 2005;(3):32-34
pages 32-34 views

Cystourethroanastomosis in extended obliterations and strictures of the posterior urethra in men

Mitusov V.V., Aboyan I.A.

Abstract

The authors review short- and long-term clinical results of surgical treatment of extended urethral strictures and obliterations. A new vesicourethral anastomosis was created by novel technique with longitudinal suturing of the neck of the urinary bladder. A scheme of the operation is presented. Causes necessitating this plastic intervention are analysed. Variants of possible urine incontinence after operation depending on etiological cause of the stricture or obliteration of the posterior urethra in males are considered.
Urologiia. 2005;(3):34-38
pages 34-38 views

Surgical treatment of neuromuscular ureteral dysplasia

Dovlatyan A.A.

Abstract

Ten clinical cases of neuromuscular dysplasia of the ureter (NMDU) are reported. Eight patients were young (24-38 years), two - of the middle age (41-58 years). NMDU was bilateral in two patients. Ureteral achalasia of the congenital solitary kidney occured in one case. One 28-year-old female with megaureter of the solitary kidney had interstitial cystitis. Clinical picture of the disease was characterized primarily with acute pyelonephritis, pain and secondary urolithiasis. Surgical treatment consisted in resection of the affected part of the ureter with modeling of the lumen of the latter on the drainage and Boari plastic repair. Bilateral Boari operation was made in 2 patients. In one case of ureteral achalasia and ureterocele direct ureterocystoanastomosis was created with good result. Sigmocystoplasty with transplantation of the solitary kidney ureter into the intestinal transplant was made in the patient with scar contracture of the detrusor and megaureter. Functional result of the operation was good. Complications were registered in 4 patients, 2 of which were reoperated. In nine patients of ten good and satisfactory functional results were obtained.
Urologiia. 2005;(3):38-43
pages 38-43 views

Urodynamic parameters of fetal lower urinary tract in physiological pregnancy

Chekhonatskaya M.L., Glybochko P.V., Demidov V.N.

Abstract

The study of urodynamic parameters in 76 fetuses in physiological course of pregnancy at gestation term from 20 to 40 weeks has shown that urodynamics of the lower urinary tract in the prenatal period directly correlate with embryon and fetus formation. Urodynamic indices of fetal lower urinary tract have 13 significant correlations out of possible 43, indicating a distinct interactions of various organs and strictures of fetal urinary system. The analysis of the structure of correlations between different urodynamic indices of the lower urinary tract of the fetus demonstrates that they vary greatly in pregnancy trimester II and remain constant in trimester 111. Thus, interrelations between basic urodynamic parameters of the lower urinary tract get established to the end of trimester II.
Urologiia. 2005;(3):44-47
pages 44-47 views

Treatment of ureterocele in children

Dzhavad-Zade M.D., Dzhavad-Zade S.M., Guseinov E.Y.

Abstract

Twenty six patients (15 children and 11 adults) with ureterocele were treated. Heterotopic ureterocele prevailed over common forms in children while in adults - vice versa (66.7 and 33.3% versus 27.3 and 72.7%, respectively). Recurrences of ureterocele are rather frequent. Modified surgical correction of ureterocele is proposed which consists in intravesical mobilization of ureterocele together with a terminal part of the ureter followed by resection and its transverse reimplantation with antireflux defense. Such therapeutic policy facilitates performance of the operation and enhances reliability of the closing antireflux mechanism. Endoscopic correction of ureterocele with one-stage lithoextraction was made in 7 adult patients who had undergone transverse dissection of ureterocele, in large ureterocele - partial resection of the lower part. The residual upper part operates as a closing valve in filling of the urinary bladder. Long-term results (3-year follow-up maximum) were studied in 23 patients. Dissection of ureterocele with ureterocystoneostomy was associated with recurrences in 37.6% patients. The best results were achieved in plastic modified operations and endoscopic correction of ureterocele. A persistent clinical effect was seen in all the patients.
Urologiia. 2005;(3):47-51
pages 47-51 views
pages 52-54 views

Original experience in plastic surgery of pelviureteral segment in hydronephrosis in children

Kogan M.I., Sknar A.A., Sizonov V.V., Klyuka I.V., Makarov G.A., Novikova L.V.

Abstract

The study of postoperative urodynamics of the upper urinary tract was made in 339 patients with obstruction of the pyeloureteral segment and on experimental animals (morphological tests). This study revealed factors deteriorating functional capacity of anastomosis in early postoperative period. The findings allow the surgeons to update the technique of the pyeloureteral segment resection and ureteropyeloanastomosis, to determine indications for applying nonsteroid anti-inflammatory drugs in the postoperative period, to reveal advantages and establish indications for drainage-free pyeloplasty. Thus, use of drainage-free modified technique of pyeloplasty in certain indications is a safe and less traumatic method of the patients' management which increases efficacy of Anderson-Hines operation.
Urologiia. 2005;(3):54-58
pages 54-58 views

A contractile function of various megaureter forms in infants and its pharmacological regulation

Kazanskaya I.V., Mudraya I.S., Kirpatovsky V.I., Sabirzyanova Z.R., Babanin I.L.

Abstract

A total of 43 infants under 3 years of age with organic, functional and reflux obstructive megaureter were studied. The function of the upper urinary tract was examined with dynamic pyeloureterosonography with diuretic load. Contractility of isolated fragments of megaureters and possibility of its pharmacological regulation were studied in patients after surgery in vitro. Different urodynamic variants of the response of refluxing and obstructive megaureters and those with functional obstruction on stimulation of diuresis were established at dynamic pyeloureterosonography with diuretic load. The differences concerned the strength and kind of the reaction, frequency, amplitude and performance of the megaureters (15-30-45 min). In vitro studies confirmed functional differences between the forms of megaureters. The data obtained show preservation of functional reserves of the wall of the refluxing megaureter in children, suppression contractions and reaction of the megaureters with organic obstruction in the ureterovesical anastomosis while functionally obstructive megaureters are able to contract slowly and have reactivity according to the state of the smooth muscle wall. Pharmacological impact on ureteral function by metabolic drags (picamilone) is determined. A direct action of lasix on the smooth muscle (weakening of high toxic reaction) is proved.
Urologiia. 2005;(3):58-63
pages 58-63 views
pages 63-66 views

Risk, incidence rate and prevention of ureteral injuries in clinical practice

Komyakov B.K., Guliev B.G.
Urologiia. 2005;(3):66-69
pages 66-69 views
pages 70-70 views
pages 71-71 views

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