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No 4 (2010)


Vascular endotheliAL growth factor and vascular endotheliAL growth factor receptor 2 in the blood serum, tumor and renal parenchyma of patients with renal cell carcinoma

Trapeznikova M.F., Glybin P.V., Tumanyan V.G., Gershteyn E.S., Dutov V.V., Kushlinskiy N.E., Trapeznikova M.F., Glybin P.V., Tumanyan V.G., Gerstein E.S., Dutov V.V., Kushlinsky N.E.


Serum, tumor and renal parenchyma levels of VEGF and VEGFR2 were compared in patients with renal carcinoma (RC) with reference to basic clinicomorphological characteristics of the disease. VEGF and VEGFR2 were estimated in 37 RC patients and 57 healthy controls (serum levels only). VEGF and VEGFR2 were detected in all the samples. Their concentrations in the serum were the same in the patients and controls. The tumor tissue contained more VEGF than renal parenchyma. In unfavorable clinicomorphological features the tumor contained higher content of VEGF, higher VEGF/VEGFR2, lower VEGFR2. Thus, angiogenic factors studied closely correlate with clinicomorphological characteristics of renal carcinoma: primary tumor size, stage of the disease, tumor differentiation, tumor pseudocapsule invasion.
Urologiia. 2010;(4):3-7
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Surgical treatment of vesicovaginal fistulas

Galeev R.K., Galeev S.R., Malygin A.N., Galeev R.K., Galeev S.R., Malygin A.N.


To improve surgical outcomes in patients with complicated recurrent, radiation-induced, giant and multiple vesicovaginal fistulas, we have developed a new combined method of fistuloplasty (patent 21350999). The method was used in 12 of 32 operations made in 1997-2007 in the urological clinic of the Kazan Medical University for vesicovaginal fistula in patients aged 19 to 72 years. The technique was applied in women with vesicovaginal fistula located close to the ureteral orifice. Good results of the operation were achieved due to leak-proof sutures, accurate dissection of the bladder from the vagina and intact blood supply of the tissues. Two surgical approaches were used: transvesical and vaginal. Neither complications nor relapses occurred in all 12 patients operated by the proposed technique of combined fistuloplasty which proved to be effective in recurrent, complicated, combined fistulas and is a method of choice in complicated, recurrent, radiation-induced, giant and multiple fistulas.
Urologiia. 2010;(4):7-11
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Surgical correction of overactive bladder resistant to standard therapy

Zuban' O.N., Lebedev A.A., Zuban O.N., Lebedev A.A.


Surgical treatment was given to 45 patients with overactive bladder: transurethral detrusorotomy was made in 21 patients (group 1), bladder hydrodilation (BH) was made in 24 patients (group 2). Detrusorotomy was performed by transurethral median cut of the bladder posterior wall by needle electrode leading to destroyment of intramural sympathic and parasympathic nervous fibres. Hydrodilation of the bladder was made under intravesical pressure equal to systolic arterial pressure with 2 min exposure. On day thirty after the operation regress of the lower urinary tract symptoms was registered in 20 (95.2%) patients of group 1 and 11 (45.8%) patients of group 2. Urge to voiding (UV) disappeared in 90.5% patients of group 1 and in 45.8% of group 2 (p < 0.05), the number of patients with miction pain reduced 6-fold and 1.9-fold, with UV - 8.5 and 1.2-fold, respectively (p < 0.05). The number of diurnal mictions in group 1 decreased 3.2-fold vs 1.9-fold in group 2. The bladder size in urgency in group 1 patients increased 2.5-fold, the pressure fell also 2.5-fold. In group 2 these parameters changed only 1.2 times (p < 0.05). Cystometry recorded recurrent detrusor overactivity in 13 (54.2%) patients after hydrodilation and only in 3 (14.3%) - after cut of the bladder wall (p < 0.05). Thus, transurethral detrusorotomy in overactive bladder resistant to conventional treatment is much more effective than hydrodilation. The operation is low invasive and is well tolerated. Simple performance and good short-time results are advantages of this technique.
Urologiia. 2010;(4):11-15
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Clinicourodynamic rationale of the overactive bladder neurophysiological model

Danilov V.V., Danilova T.I., Danilov V.V., Danilov V.V., Danilova T.I., Danilov V.V.


The analysis of 58 cases of overactive bladder has shown that detrusor activity is not linked with clinical symptoms but is caused by supra segmentary lesion of the nervous system. The clinical picture of overactive bladder fits the proposed neurophysiological model where ischemic damage of the association neuron located in the lumbar spinal marrow triggers miction disorders leading to preganglionary detrusor denervation. Combined therapy with alpha1-adrenoblocker and M-cholinolytic is pathogenetically sound. Trospium chloride (spasmex) was used for long-term treatment of the patients as it produces minimal number of side effects and enables dose and schedule variation.
Urologiia. 2010;(4):15-20
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Treatment of overactive bladder in women with vitaprost® forte

Gomberg V.G., Nad' Y.T., Gomberg V.G., Nad Y.T.


We treated 40 women aged 49-80 years (mean age 63.6±1.5 years) with overactive bladder (OB). All the patients used suppositoria vitaprost forte once a day before going to bed for 30 days. Miction was assessed before treatment, on treatment day 15 and 30, 30 days after the treatment course. The patients responded to questionnaires on disturbance and discomfort because of miction disorders and kept diary records on miction 3 days before visit to a doctor. The treatment lowered the number of imperative urges by 46%, episodes of urgent incontinence - by 69%. Dyscomfort due to imperative symptoms reduced 2.1-fold, anxiety - by 70%, effects of bladder symptoms on everyday life - by 48%. Satisfaction with treatment results reached 74%. One month after vitaprost forte treatment the subjective and objective miction improvement continued. After the treatment we observed a 20-40% increase in bladder capacity in different urges. This is explained by reduced detrusor ischemia which plays an important role in OB pathogenesis.
Urologiia. 2010;(4):20-25
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Efficacy of combined treatment of women with chronic cystitis associated with intracellular infections

Kul'chavenya E.V., Breusov A.A., Kulchavenya E.V., Breusov A.A.


Forty female patients with urethrocystitis received sparfloxacin in a daily dose 400 mg for 20 days in combination with canefron H (50 drops three times a day for 8 weeks). Twenty patients received one more course of canefron H 4 months after etiopathogenetic therapy. The analysis of the treatment results allows the conclusion that sparfloxacin is highly effective in urethrocystitis associated with intracellular infections. Sparfloxacin provides complete urine sterility. 97.5% females after the combined treatment had no recurrences for a year while before the treatment remission lasted for 4.1±1.7 months. A preventive administration of canefron H improves microcirculation in the bladder wall and prevents recurrence in patients with urethrocystitis associated with intracellular infections given basic sparfloxacin therapy.
Urologiia. 2010;(4):25-29
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Combined treatment of chronic cystitis in postmenopausal women with application of AMUS-01-INTRAMAG device and RECTOMASSAGER attachment

Shaplygin L.V., Segedin R.E., Raygorodskiy Y.M., Rokhlikov I.M., Samsonov A.V., Onishchenko O.V., Shaplygin L.V., Segedin R.E., Raigorodsky Y.M., Rokhlikov I.M., Samsonov A.V., Onischenko O.V.


Sixty eight postmenopausal women with chronic recurrent cystitis received local antibacterial treatment consisting in bladder ionophoresis and vaginal exposure to estrogens and vibromagnetic action of RECTOMASSAGER attachment and AMUS-01-INTRAMAG device. This local treatment proved superior to systemic one as 1-year follow-up registered a 3.1-fold reduction in recurrence rate vs control patients.
Urologiia. 2010;(4):29-33
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Surgical policy in acute epididymitis in children

Pavlov A.Y., Nechaeva T.N., Shchedrov D.N., Pavlov A.Y., Nechaeva T.N., Schedrov D.N.


Differentiated surgical policy was applied in the treatment of 147 children aged under 18 years with acute epididymitis. Basing on laboratory, clinical and ultrasound characteristics, three treatment methods were used: conservative treatment, puncture of the scrotum, revision of the scrotum. Puncture treatment of acute epididymitis appeared effective in accurate diagnosis of indications for this therapy and due performance. Ultrasound potential is shown in differential diagnosis in acute scrotum syndrome.
Urologiia. 2010;(4):33-36
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Choice of treatment in erectile dysfunction associated with hypogonadism

Alyaev Y.G., Vinarov A.Z., Akhvlediani N.D., Alyaev Y.G., Vinarov A.Z., Akhvlediani N.D.


A study was made in the urological clinic of I.M. Sechenov Moscow Medical Academy with participation of 96 patients (mean age 48.24±9.19 years) with erectile dysfunction (ED) associated with hypogonadism. The patients were divided into three groups. Group 1 (n = 30) received 1 intramuscular injection of testosterone undecanoate. Group 2 (n = 34) received on-demand monotherapy with vardenafil for 6 weeks. Group 3 (n = 32) received combined treatment with the above modalities in the same doses and duration. Before and 6 weeks after treatment the patients responded to IIEF-5 questionnaire. All the patients showed a significant improvement of the erectile function. Overall AMS score after the treatment rose more in patients of groups 1 and 3 (p < 0.001). In group 2 the changes were weaker but significant (p = 0.005). The domain of psychological AMS symptoms reduced insignificantly after treatment in group 2 (p = 0.535), but significantly in groups 1 and 3, respectively (p = 0.013 vs p = 0.001). Androgenic deficiency regressed in groups 1 and 3 but enhanced in group 2 (p = 0.001). Domain of sexual symptoms of the AMS scale reduced more significantly in patients of groups 2 and 3 (p < 0.001). Percentage of patients satisfied with the treatment results was 68.85, 70,6 and 90,6% in groups 1, 2 and 3, respectively. Thus, combined treatment of erectile dysfunction in patients with hypogonadism (parenteral testosterone undecanoate and vardenafil) is more effective than monotherapy with androgen-containing drugs or inhibitors of phosphodiesterase of type 5.
Urologiia. 2010;(4):37-42
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Treatment of prostatic ADENOMA

Borisov V.B., Borisov V.B.


We used lymphotropic therapy in addition to standard treatment in 116 of 232 patients with benign prostatic hyperplasia. The effect was evaluated in the course of treatment and followed up for a year. Improvement in general condition of the patients, symptoms of infravesical obstruction, size of the prostate, urinary flow rate demonstrated high efficacy of lymphotropic therapy leading to a higher rate of persistent remission and higher quality of life.
Urologiia. 2010;(4):42-44
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Immunocorrecting therapy of chronic bacterial prostatitis

Novikov A.I., Zaezzhalkin V.V., Kucherov V.A., Frolov S.Y., Novikov A.I., Zaezzhalkin V.V., Kucherov V.A., Frolov S.Y.


A total of 55 patients aged 20-59 years with recurrent chronic bacterial prostatitis (RCBP) entered a trial of immunomodulator panavir. The study group consisted of 40 patients. They were given standard treatment and panavir. The control group (n = 15) matched by all the studied characteristics received standard treatment only. Blood count, bacteriological characteristics of prostatic secretion, immunological status, subjective parameters were studied. RCBP patients were diagnosed to have marked disorders of interferon status. The addition of panavir to standard treatment of RCBP patients significantly improved treatment results. Therefore, panavir is recommended as an adjuvant in combined RCBP treatment.
Urologiia. 2010;(4):44-48
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Sexual rehabilitation of men with pituitary tumors

Rozhivanov R.V., Kurbatov D.G., Rozhivanov R.V., Kurbatov D.G.


A prospective trial of the methods of sexual rehabilitation of 31 men with pituitary tumors has shown that therapy with testosterone and chorionic gonadotropin effectively corrects hypogonadism and sexual disorders. In insufficient efficacy normalization of sexual function is achieved with tadalafil. Both methods of treatment had no negative effect on the size of the prostatic gland and PSA level except 2 patients with somatotropinoma on testosterone. In the course of chorionic gonadotropin treatment pituitary tumor increased in size in 3 patients.
Urologiia. 2010;(4):48-53
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Sergienko N.F., Vasil'chenko M.I., Begaev A.I., Shchekochikhin A.V., Shershnev S.P., Reynyuk O.L., Lototskiy M.M.
Urologiia. 2010;(4):61-63
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Kviatkovski M., Reker F., Khuber A., Sergeeva N.A., Brinkmann T.
Urologiia. 2010;(4):64-67
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Martov A.G., Lisenok A.A., Andronov A.S., Dutov S.V.


Одним из распространенных оперативных методов лечения камней почек наряду с дистанционной литотрипсией является чрескожная нефролитотрипсия. В настоящее время при создании чрескожного доступа к почке основным способом укладки на операционном столе является положение пациента на животе. Однако нередко в связи с положением больного на животе выполнение чрескожной нефролитотрипсии становится затруднительным или невозможным у пациентов с ожирением, костными заболеваниями и деформациями, сопутствующими заболеваниями легких, сердечно-сосудистой системы. В статье приведено клиническое наблюдение выполнения перкутанной нефролитотрипсии в положении на спине у больного с незавершенным остеогенезом, наследственным заболеванием, характеризующимся патологической ломкостью костей с развитием костных деформаций. Результатом операции явилось полное удаление множественных камней правой почки, что отразило высокую эффективность выбранного метода оперативного лечения.
Urologiia. 2010;(4):68-71
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Glybochko P.V., Popkov V.M., Kvetnoy I.M., Blyumberg B.I.
Urologiia. 2010;(4):72-75
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Radnaev L.G., Govorov A.V., Pushkar' D.Y.
Urologiia. 2010;(4):75-79
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