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No 3 (2009)

Articles

Low-invasive techniques in the treatment of urolithiasis with application of innovative equipment made in Russia

Trapeznikova M.F., Podoynitsyn A.A., Urenkov S.B., Ivanov A.E., Andreev Y.G., Trapeznikova M.F., Podoinitsyn A.A., Urenkov S.B., Ivanov A.E., Andreev Y.G.

Abstract

A total of 1100 sessions of extracorporeal shock wave lithotripsy (ESWL) were made in 720 patients with urolithiasis in the last decade with application of LGK-Compact lithotripter which generates shock waves electrodynamically and has no focusing lens. Such lithotriptor allows ESWL in patients with a high anesthesiological risk. Fitting the LGK-Compact lithotriptor with an endourological complex ENDO-MIT tooled for low-invasive interventions under X-ray control enabled treatment of 467 patients with urolithiasis aged 30-80 years. Most of the patients (66.04%) were at the productive age of 18-50 years. ESWL on the LGK-Compact lithotriptor was made in 182 patients (mean number of sessions was 2.1). Six and 12 month follow-up examinations registered complete elimination of the fragments in 169 patients. Thirty-four patients with concrements of the intramural ureter were exposed to 1 to 3 sessions. The fragments eliminated for 1-14 days after the session in 25 patients. Three patients developed stone path which evacuated spontaneously in two cases. For 3 years transcutaneous nephrolithotripsy was conducted in 214 patients. The concrements were removed during one operation in 156 (72.9%) patients, 58 (26.1%) patients had residual fragments. Reoperation was made in 34 patients 7-12 days after the first intervention. In the rest 24 cases (11.2%) residual fragments were removed by means of ESWL on LGK-Compact. Thus, ESWL is a leading technique in management of uncomplicated uroliths maximum 2 cm in size. When indications to ESWL are limited or this method is not effective, the role of roentgenoendoscopic interventions, such as transcutaneous nephrolithotripsy and transurethral contact ureterolithotripsy, takes on special significance. Such clinical innovation as endourological complex ENDO-MIT with lithotripter LGK-Compact made in Russia opens new perspectives of the treatment of urolithiasis and other urological diseases due to introduction of novel highly effective domestic technologies leading to a significant reduction in the number of postoperative complications and time of treatment, to 1.5-2 fold reduction in costs of equipment compared to foreign analogues.
Urologiia. 2009;(3):3-7
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Comparison of the results of MR-urography and other examination methods in patients with iatrogenic injuries of the ureter and pelvioureteral segment

Martov A.G., Gurbanov S.S., Tokareva E.V., Shcherbinin S.N., Kornienko S.I., Martov A.G., Gurbanov S.S., Tokareva E.V., Scherbinin S.N., Kornienko S.I.

Abstract

MR urography was made in 25 patients (age 24-70, mean age 48.6 years, 20 females, 5 males) with iatrogenic injury of the upper urinary tract (UUT). A comparison group consisted of 15 patients without nephrostomic drainage who had no contraindications for intravenous contrast preparations. MR urography was performed in frontal and sagittal projections. The examination was made before and 20 min after intravenous injection of 20 mg diuretic. Five patients received additionally excretory MR urography with intravenous injection of magnevist (0.2 ml/kg, 3 ml/s just before the examination). Mean duration of urography was 21 (18-23) min. The results were compared to findings of ultrasound or x-ray investigations, diapevtic ureteroscopy or open surgical intervention. The results were similar to those of x-ray CT. In patients with ureteral obliteration MR urography was less informative than joint antegrade and retrograde ureteropyelography as the ureter could not be visualized beneath the injury. In 2 patients examined with intravenous urography and x-ray CT, definite length of ureteral stricture was obtained only with MR urography. In 5 patients with hydronephrotic transformation MR urography was much more informative than excretory urography. MR urography provided information sufficient for diagnosis. Sensitivity of MR urography and that with diuretic load was 86.8 and 92.3%, respectively. MR urography, even without contrast enhancement, provides images with high resolution sufficient for visualization of the ureter distally of the stricture and is a method of choice in patients with subnormal renal function, intolerance to iodine-containing contrast media, with hyperthyroidism and pregnant women after the first trimester.
Urologiia. 2009;(3):7-13
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Phytotherapy in the treatment of uroliths

Tkachuk V.N., Tkachuk I.N., Dubinskiy V.Y., Trachuk V.N., Tkachuk I.N., Dubinsky V.Y.

Abstract

Phytotherapy with prolit was given to 95 patients with ureteroliths (size of the concrrements 0.4-0.6 cm). A 40-day treatment resulted in elimination of the concrements from the ureter in 89 (93.7%) patients. Prolit had a positive action on metabolism in urolithiasis patients: lowered hypercalciuria, uric acid in the blood, oxalates and uric acid in urine. This is important for prevention of recurrent lithogenesis which for 3 years after the treatment occurred only in 4 (4.2%) patients.
Urologiia. 2009;(3):13-15
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Clinical characteristics and risk of urolithiasis in metallurgists

Egorova A.M., Egorova A.M.

Abstract

A complex investigation of the urogenital system in 200 metallurgists and 190 workers (a control group) has shown that 35.0% metallurgists and 15.7% controls had urogenital pathology. Urolithiasis was detected more often in metallurgists (72.8 and 14.9%, respectively, p < 0.001). An elevated level of blood uric acid, aciduria, decreased diuresis were also more frequent in metallurgists than in the control group. Metallurgists had a higher relative risk and an etiologic factor of urolithiasis (RR = 7.0-7.9; EF = 85.5-87%). Incidence of urolithiasis in metallurgists can be reduced after prophylactic programs. Therefore, urologic examination and ultrasonic scanning should be included in regular medical check-ups of metallurgists.
Urologiia. 2009;(3):15-18
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Norfloxacine efficacy in acute cystitis in the region with 10% resistance of E.coli to fluoroquinolones: a comparative randomized study

Rafal'skiy V.V., Malev I.V., Derevitskiy A.V., Kozlov S.N., Galkin V.V., Rafalsky V.V., Malev I.V., Derevitsky A.V., Kozlov S.N., Galkin V.V.

Abstract

We have conducted a clinicomicrobiological study the first stage of which consisted in collection of information on uropathogens resistance to fluoroquinolones in 89 females with uncomplicated urinary infections (UI). Sensitivity to antibacterial drugs was determined by the agar dilution test (CLSI, 2007). At stage two of the study we made a prospective multicenter randomized trial including 108 females aged 18-55 years with acute uncomplicated cystitis. The patients were randomized into two groups: group 1 (n = 55) received norfloxacin (400 mg twice a day for 3 days); group 2 (n = 53) received phosphomycin (a single 3.0 g dose). Clinical and microbiological assessment of efficacy and safety was performed before the treatment, on treatment day 5, 10 and 28. Isolation of E.coli strains in the region highly and moderately resistant to cyprofloxacine was rather high - 10 and 1.1%, respectively. Before the treatment E.coli was isolated from the urine in 82.4% cases, E. faecalis - 5.9%, S. saprophyticus - 3.9%, Staphylococcus spp - 2.0%, others - < 1%. No significant differences by bacteriological and clinical efficacy were found between the groups. Eradication of the agent and persistent bacteriological response were seen in 100 and 95.2%, 95.8 and 100% patients of groups 1 and 2, respectively. Complete and partial responses were registered in 68.5 and 76%, 76 and 98% patients of groups 1 and 2, respectively. Thus, treatment with norfloxacin in a dose 400 mg twice a day for 3 days and with phosphomycin in a 3.0 g single dose have high clinical and microbiological efficacy in uncomplicated cystitis. Norfloxacin retains clinical and microbiological efficacy in acute uncomplicated cystitis even in conditions of 10% prevalence of fluoroquinolone-resistant strains. We think that there are reasons for revision of criteria of interpretation of uropathogens sensitivity to fluoroquinolones in the treatment of uncomplicated UI.
Urologiia. 2009;(3):18-22
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Effects of mangesium salts and their combination with vitamin B6 on oxalates crystalluria in alimentary deficiency of piridoxine

Spasov A.A., Iezhitsa I.N., Kharitonova M.V., Kravchenko M.S., Spasov A.A., Iezhitsa I.N., Kharitonova M.V., Kravchenko M.S.

Abstract

We studied the effects of oral magnesium (Mg) salts either alone or in combination with pyridoxine hydrochloride in rats on pyridoxine-deficient diet. Fifty-four male rats were randomized into two groups and were fed either a standard diet or a pyridoxine-deficient diet for 3 weeks. A significant rise of the EGOT index ( > 1.5), oxaluria (from 74.8 ± 5.2 to 117.9 ± 12.3 mcM/l, p = 0.035), and crystalluria in rats fed with pyridoxine deficient diet were revealed. Oral Mg chloride, Mg L-aspartate either alone or in combination with pyridoxine in comparison with magnesium sulfate, magne B6 (Mg lactate with pyridoxine) and pyridoxine alone were administered (50 mg of magnesium and/or 5 mg of pyridoxine per kg body weight). Magnesium salts in combination with pyridoxine lowered an oxalate level and crystalluria whereas magnesium salts alone reduced only crystalluria. Antilithis effects of Mg L-aspartate and Mg chloride in combination with pyridoxine were comparable with those observed in magne B6 or pyridoxine treatment and were significantly higher than in magnesium sulfate treatment.
Urologiia. 2009;(3):22-26
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Specific activity and safety of the drug "Urokam" in experiment

Terekhov A.Y., Dorkina E.G., Terekhov A.Y., Dorkina E.G.

Abstract

The article presents the results of the study of nephroprotective activity of the drug urokam in experimental toxic affection of rat kidneys and general toxicity in long-term administration.
Urologiia. 2009;(3):26-29
pages 26-29 views

Blood lymphocytes and mast cells of the detrusor as diagnostic markers of overactive urinary bladder and its immune inflammation

Pisarev S.A., Pisarev S.A.

Abstract

To identify clinico-laboratory symptoms and pathogenetic factors of overactive bladder syndrome (OBS), we used cytochemical analysis of peripheral blood lymphocyte enzymes in 88 males and females aged 50-75 years with this syndrome (70 patients) and control (18 subjects). Biopsy of the anterior wall of the bladder with examination of detrusor myocytes was made in 28 of 70 patients. OBS patients were found to have reduced aerobic respiration in blood lymphocytes and detruzor cells, dystrophy and atrophy of myocytes, moderate interstitial cell infiltration of the detrusor in increasing number and activity of mast cells, T-lymphocytes (CD4, CD8) and macrophages (CD11). We came to the conclusion that development and symptoms of OBS are caused by low energetic activity of the detrusor in line with dysfunction of the bladder mast cells and immunity factors. This is important for diagnosis of OBS severity and choice of energotropic therapeutic measures.
Urologiia. 2009;(3):29-33
pages 29-33 views

Results of surgical and radiotherapy of prostatic cancer T1-4N0-1M0

Matveev V.B., Tkachev S.I., Volkova M.I., Mitin A.A., Kalinin S.A., Shelepova V.M., Matveev V.B., Tkachev S.I., Volkova M.I., Mitin A.A., Kalinin S.A., Shelepova V.M.

Abstract

To compare the results of radical prostatectomy and conformal radiotherapy in prostatic cancer T1-4N0-1M0, we made a retrospective study of 306 patients with prostatic cancer T1-4N0-1M0 of whom 144 (47.1%) were treated surgically (radical prostatectomy) while 162 (52.9%) were exposed to extracorporeal conformic radiotherapy. Follow-up median was 30.7 ± 29.8 months. Five and 10-year overall, specific and PSA recurrence free survival in 306 patients was 94.0% and 90.1% (median was not achieved), 96.6% and 94.3% (median was not achieved), 66.1 and 49.2% (median was 84.0 ± 4.4 months). In multifactorial analysis significant prognostic factors of PSA recurrence free survival were T category (p = 0.021) and Glisons sum (p = 0.002). In the subgroup of patients with local prostatic cancer there was a significant superiority of the operated patients by PSA recurrence free survival over irradiated group in baseline PSA < 10 ng/ml (p = 0.015), Glisons index < 7 (p = 0.071) and combination of these factors (p = 0.018). A favourable prognosis factor of PSA recurrence free survival in operated patients was operative Glisons index < 7 (p = 0.001), among operated patients - nadir PSA < 1 ng/ml (p = 0.003). Surgical and radiation treatment of local and locally advanced prostatic cancer provided satisfactory results. In the group of good prognosis (cT1-2N0, PSA < 10 ng/ml, Glisons sum < 7) radical prostatectomy gives advantage of PSA recurrence free survival. In patients with prostatic cancer cT > T2, N+, Glisons index > 7 and PSA > 10 ng/ml surgical treatment and remote radiotherapy are equally effective in respect to survival free of biochemical recurrence.
Urologiia. 2009;(3):33-39
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Radical nephruretercystectomy

Komyakov B.K., Sergeev A.V., Novikov A.I., Fadeev V.A., Strokova L.A., Komyakov B.K., Sergeev A.V., Novikov A.I., Fadeev V.A., Strokova L.A.

Abstract

The results of radical nephrouretercystectomy (NUCE) are presented for 13 patients (9 males and 4 females, age 44-70 years, mean age 58 ± 1.7 years). One-stage NUCE was made in 11 patients, two- or three-stage - in 2 patients. Indications for NUCE were the following: urothelial cancer, urogenital tuberculosis, microcystis, neurogenic dysfunction of the urinary bladder complicated by definite renal dysfunction. Postoperative complications arose in 3 patients. Lethal outcomes were absent. The results presented say in favour of extended surgery in involvement of the kidney, ureter, urinary bladder, prostate, urethra. Radical NUCE is primarily indicated in cancer of the renal pelvis, ureter with muscular invasion into the bladder wall, non-functional kidney due to ureteral obstruction with a tumor or scar.
Urologiia. 2009;(3):39-42
pages 39-42 views

Renal tumor size. Clinicomorphological correlations

Seregin A.V., Loran O.B., Ashugyan V.R., Seriogin A.V., Loran O.B., Ashugyan V.R.

Abstract

To reveal correlations between a renal tumor size and its clinical and morphological characteristics, we retrospectively analysed 263 case histories of patients with renal cell cancer. At a univariate analysis a maximal renal tumor size as a continuous variable significantly correlated with tumor differentiation, histological involvement of regional lymph nodes, presence of tumor necrosis, venous thrombosis, invasion into the collecting system, severity of clinical symptoms, 3- and 5-year cancer-specific survival. An increase of a tumor size, either as a continuous variable or a categorical one is accompanied with enhancement of tumor properties determining the outcome. The inclusion of a tumor size as a continuous parameter in the staging systems may have in the future a significant impact on accuracy of prediction of a renal cell cancer course and outcome, on specification of indications for various treatments.
Urologiia. 2009;(3):42-48
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Continent heterotopic derivation of urine in a partially isolated segment of the sigmoid intestine after cystprostatectomy

Bavil'skiy V.F., Saetov M.N., Plaksin O.F., Plaksin V.V., Salaznikov A.V., Bavilsky V.F., Saetov M.N., Plaksin O.F., Plaksin V.V., Salaznikov A.V.

Abstract

From 1992 to 2006 cystprostatectomy with continent heterotopic urine derivation in a partially isolated segment of the sigmoid intestine was made in 37 males aged 39-78 years. The patients had the following tumor stages: 2 patients with T2NXM0, 20 patients with T3NXM0, 6 patients with T3N1M0, 9 patients with T3-4N1MX. Thirty patients (81%) had no complications in an early postoperative period, 7 (19%) had complications: purulent pyelonephritis (n = 2), wound suppuration (n = 3), intestinal eventration (n = 1), interintestinal abscess (n = 1). There were two lethal outcomes early after operation: one patient died of bilateral purulent pyelonephritis and the other one - of acute cardiac failure. For 3 years 27 (77%) of 35 patients had satisfactory quality of life. Thus, urine derivation by simple methods one of which is creation of a partially isolated reservoir from a sigmoid segment with transanal urine derivation is indicated after cystprostatectomy for elderly males with a high risk of postoperative complications and lethality (stage T2-T3NXMX) and unclear distant metastases.
Urologiia. 2009;(3):48-52
pages 48-52 views

Cancer of the urinary bladder: prognosis of the outcome

Zimichev A.A., Pryanichnikova M.B., Maklakov V.N., Zimichev A.A., Pryanichnikova M.B., Maklakov V.N.

Abstract

It is shown that the results of organ-salvage treatment of bladder cancer depend on epidemiological, clinical and morphological characteristics of the tumor. A correlation-regression analysis revealed a complex of the most significant independent prognostic factors which were used for design of a mathematic model of urinary bladder cancer prognosis and computer program for assessment of survival of patients with bladder cancer. This method can be applied for development of measures of tertiary prophylaxis of cancer of the bladder.
Urologiia. 2009;(3):52-54
pages 52-54 views

Vitaprost® plus in the treatment of chronic bacterial prostatitis

Lopatkin N.A., Kamalov A.A., Mazo E.B., Kozdoba A.S., Popov S.V., Efremov E.A., Dorofeev S.D., Mel'nik Y.I., Okhobotov D.A., Lopatkin N.A., Kamalov A.A., Mazo E.B., Kozdoba A.S., Popov S.V., Efremov E.A., Dorofeev S.D., Melnik Y.I., Okhobotov D.A.

Abstract

Our study has demonstrated that compound medicine vitaprost plus in therapy of chronic bacterial prostatitis (CBP) reduces intensity of prostatic inflammation, significantly relieves symptoms of chronic prostatitis and pain syndrome. The absence of unwanted side effects, significant changes in clinical and biochemical blood and urine parameters evidences for good tolerance and safety of the drug. Thus, rectal suppositories vitaprost plus can be recommended for treatment of chronic bacterial prostatitis caused by both gram-positive and gram-negative bacteria in patients of different age and clinical symptoms.
Urologiia. 2009;(3):54-62
pages 54-62 views

Experience in setegis (terasosine) administration in early postoperative period after TUR of the prostate

Teodorovich O.V., Zabrodina N.B., Bochkarev A.B., Teodorovich O.V., Zabrodina N.B., Bochkarev A.B.

Abstract

TUR of the prostatic gland for prostatic adenoma was made in 93 patients aged 54-81 years (mean age 64.4 ± 7.5 years). The patients were divided into two groups. Patients of group 1 (n = 31) received no alpha-adrenoblockers, those of group 2 (n = 62) received terasosine in pre- and postoperative period. Group 2 patients demonstrated significant improvement in clinical parameters, postoperative hospital stay for them decreased by 11.3%, side effects were insignificant, their residual urine early after operation was 26.3 ± 8.6 cm3 while 4 weeks after TUR it was 16.3 ± 6.9 cm3. Thus, terasosine (setegis) can be recommended for use in early postoperative period after TUR of the prostate for prostatic adenoma as an effective and safe drug improving postoperative outcome.
Urologiia. 2009;(3):62-65
pages 62-65 views

Correlation between erectile function and urination disorders in male population of Dagestan

Kogan M.I., Savzikhanov R.T., Kogan M.I., Savzikhanov R.T.

Abstract

One of common urological problems in middle-aged and old male population is urination disorders and erectile dysfunction. We studied these problems in male population of Dagestan. We found that erectile dysfunction occurs in 38%, moderate and severe urination disorders in 22% males in Dagestan. Each 8-9th man in Dagestan suffers from combination of these disorders.
Urologiia. 2009;(3):65-67
pages 65-67 views

Administration of Afala in urological practice

Neymark A.I., Isaenko V.I., Yakovets Y.V., Simashkevich A.V., Aliev R.T., Neimark A.I., Isaenko V.I., Yakovets Y.V., Simashkevich A.V., Aliev R.T.

Abstract

Our studies of afala in patients with prostatic adenoma demonstrate that afala reduces irritative disorders of urination. Effect of this drug is seen in 98.3% patients during 4 weeks of its use. In longer intake the effect becomes stronger. The dose of 6 tablets a day significantly improves life quality. Three times a day dose is more effective in elimination of nicturia, enhances urine flow rate. Thus, choice of afala dose depends on the symptoms. Afala is indicated for prophylaxis in patients with initial stage of prostatic adenoma and as an alternative to expectation policy.
Urologiia. 2009;(3):67-70
pages 67-70 views

Ureteral anomalies: succession of decisions

Trapeznikova M.F., Dutov V.V., Sobolevskiy A.B., Vishnyakova M.V., Vinogradov A.V., Trapeznikova M.F., Dutov V.V., Sobolevsky A.B., Vishnyakova M.V., Vinogradov A.V.
Urologiia. 2009;(3):70-77
pages 70-77 views

Hypothesis of biochemical mechanisms of nephroliths formation

Borodulin V.B., Glybochko P.V., Dudakova Y.S., Borodulin V.B., Glybochko P.V., Dubakova Y.S.
Urologiia. 2009;(3):77-82
pages 77-82 views

Cardiological aspects of tadalafil safety

Talibov O.B., Talibov O.B.
Urologiia. 2009;(3):82-86
pages 82-86 views

Sperm DNA defects and male infertility

Abubakirov A.N., Abubakirov A.N.
Urologiia. 2009;(3):86-91
pages 86-91 views
pages 91-94 views
pages 94-95 views
pages 95- views

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