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No 3 (2011)


Hyperbaric oxygenation in the treatment of patients with interstitial cystitis: clinical and morphological rationale

Loran O.B., Sinyakova L.A., Seregin A.V., Mitrokhin A.A., Plesovskiy A.M., Vinarova N.A., Loran O.B., Sinyakova L.A., Seregin A.V., Mitrokhin A.A., Plesovsky A.M., Vinarova N.A.


We studied efficacy of hyperbaric oxygenation (HBO) in 8 patients with interstitial cystitis/painful bladder syndrome (IC/PBS). Mean age of the patients was 53 years (35-72 years), mean duration of the disease 7.5 years (6-17 years). Ulcerative IC/PBS was diagnosed in 7 of 8 patients. The patients received combined treatment: surgical (hydrobouginage of the bladder, electrocoagulation of bladder ulcer) and a HBO course in the postoperative period. The efficacy was assessed by clinical and morphological criteria (estimation of histamine level in urethral smears, proliferative activity of bladder mucosa epithelial cells). A HBO course consisted of 10 sessions (40 min, 2 atm). The treatment reduced the number of voidings for 24 hours, increased mean effective bladder volume, lowered a total score by L.Parsons scale, histamine content in urethral smears, stimulated proliferative activity of bladder mucosa epithelium. Thus, HBO proved its safety and effectiveness in combined treatment of IC/PBS.
Urologiia. 2011;(3):3-5
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Phytotherapy in combined treatment of chronic infection of the upper urinary tract in patients exposed to extracorporeal shock-wave lithotripsy

Maksimov V.A., Khodyreva L.A., Dudareva A.A., Serdyuk A.A., Maximov V.A., Khodyreva L.A., Dudareva A.A., Serdyuk A.A.


Multicomponent biologically active additive Uroprofit® made by Russian company Ecomir is used for phytotherapy of urolithiasis and urogenital infectious and inflammatory processes. Of 60 patients with urolithiasis and chronic pyelonephritis exposed to extracorporeal shock-wave lithotripsy (ECSWL), 30 patients received additional anti-inflammatory therapy with Uroprofit®®. As shown by reduction of leukocyturia and crystalluria, increased 24-h diuresis in patients with urolithiasis after exposure to ECSWL, a positive effect was achieved on urethral inflammation. Thus, Uroprofit® phytotherapy has anti-inflammatory, diuretic, lithokinetic effects which makes it appropriate for treatment and prophylaxis of infectious-inflammatory process in the urethra.
Urologiia. 2011;(3):6-9
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Combined treatment of patients with nephrolithiasis complicated with secondary pyelonephritis

Neymark A.I., Nozdrachev N.A., Skopa A.P., Neimark A.I., Nozdrachev N.A., Skopa A.P.


A total of 151 patients with nephrolithiasis participated in the study of efficacy and safety of the drug prolit cepto in conservative treatment of nephrolithiasis patients, preoperative preparation and in postoperative period after extracorporeal shock-wave lithotripsy (ECSWL) or nephrolitholapaxy. It was found that combined treatment of nephrolithiasis complicated by secondary pyelonephritis with addition of prolit cepto raises efficacy in management of inflammation due to a positive action on microcirculation and urine bacteria. Administration of prolit cepto in nephrolithiasis patients exposed to ECSWL or nephrolitholapaxy reduces the risk of infectious and inflammatory complications, has a nephroprotective effect and improves the course of postoperative period.
Urologiia. 2011;(3):9-13
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Chronic cystitis in women of reproductive age

Moskovenko N.V., Moskovenko N.V.


The examination of 112 women suffering from chronic cystitis has detected frequent comorbidity of genital, gastrointestinal, locomotor and pelvic varicose diseases. Myofascial syndrome, hemodynamic disorders and venous congestion play a leading role in development of pain syndrome in women with comorbid diseases of the small pelvis organs. Clinicopsychological investigation of such women has revealed frequent vegetative and psychoemotional disorders with predominance of anxiodepressive conditions. Pain, dysuria and anxiodepressive disorders are among causes of imbalance of the autonomic nervous system which acvitaves regulatory systems and has an impact on quality of life. Women with chronic cystitis show significant deterioration of quality of life. Combined treatment including physical factors and therapeutic exercise reduced treatment duration, frequency of exacerbations, raised cost effectiveness.
Urologiia. 2011;(3):13-18
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The role of functional condition of pelvic inferior muscles and corticospinal tract in patients with urination disorders suffering from prostatic diseases

Glybochko P.V., Alyaev Y.G., Markosyan T.G., Nikitin S.S., Grigoryan V.A., Arzumanyan E.G., Glybochko P.V., Alyaev Y.G., Markosyan T.G., Nikitin S.S., Grigoryan V.A., Arzumanyan E.G.


The article analyses problems of diagnosis and treatment of neurogenic disorders of urination in the group of patients operated for prostatic pathology, the role of the conduction system of the corticospinal tract and conductive potential of perineal muscles in the above patients. Main standard electromyographic parameters were established by the data of examination of 7 controls - latency of the cortical and segmental evoked motor response, time of central motor conduction, amplitude of potentials of motor unities. Fifteen patients with prostatic diseases showed severe disorders of both corticospinal conduction and perineal muscular contraction. Patients with prostatic cancer or adenoma treated with different methods had denervation changes in pelvic inferior muscle in unaffected corticospinal conduction. Denervation changes after surgical treatment for prostatic cancer and delay of reinnervation, recovery of nervous control may be determined not only by the fact of operation but also by the course of the underling disease. Examination of the pelvic inferior muscles demonstrated that HIFU is a traumatic treatment of prostatic cancer because of extention of the physical impact beyond the prostate on muscular-nervous structures. These denervation muscular changes should be taken into consideration in assessment of the patient's condition and choice of treatment policy.
Urologiia. 2011;(3):18-22
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Arterial blood flow in the prostate in the syndrome of chronic pelvic pain/chronic prostatitis

Kogan M.I., Belousov I.I., Bolotskov A.S., Kogan M.I., Belousov I.I., Bolotskov A.S.


Causes and mechanisms of chronic pelvic pain/chronic prostatitis (CPP/CP) syndrome are not well investigated yet. It is suggested that pain in an inflammatory form of this syndrome may be due to tissue inflammation. In the non-inflammatory form pain may result from neurogenic factors. Standard diagnostic methods in the absence of inflammation often fail to detect pathological changes in the prostate. We made duplex mapping of the prostate and obtained quantitative characteristics of arterial hemodynamics of the prostate. Control values of arterial prostatic blood flow were developed after examination of healthy volunteers. These values were compared with similar values of arterial blood flow in CPP/CP syndrome. We found a significant decrease of the peak systolic velocity in patients with non-inflammatory CPP/CP syndrome. There is a direct correlation between intensity of pain syndrome and peak systolic velocity of arterial blood flow. Thus, pain may arise from chronic prostatic ischemia.
Urologiia. 2011;(3):22-28
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Correction of urodynamic disorders and quality of life in patients with prostatic adenoma after hyperthermia

Latysheva V.Y., Ivantsov O.A., Karpovich E.V., Latysheva V.Y., Ivantsov O.A., Karpovich E.V.


Prostatic adenoma gives rise to urodynamic disorders, affects not only sexual function and quality of men's life but also, indirectly, women's health. We have developed indications for concervative treatment of prostatic adenoma with transurethral radiowave hyperthermia (TRH). It was found that TRH has a positive early effect on a general somatic condition and prostatic function. Later, TRH improves working efficiency, emotional and social status of patients with prostatic adenoma and other parameters of their quality of life. TRH proved low-traumatic, safe, it can be performed without anesthesiological aid.
Urologiia. 2011;(3):28-31
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A pharmacological cost-effective analysis of vobenzim use in combined treatment of chronic prostatitis

Moiseeva T.N., Serpik V.G., Kulikov A.Y., Moiseeva T.N., Serpik V.G., Kulikov A.Y.


A pharmacological cost-effective analysis of systemic enzymotherapy combination with fluoroquinolone antibiotics in the treatment of chronic bacterial prostatitis showed cost-effect of such therapy: medical cost efficacy of the treatment of chronic bacterial prostatitis with antibiotic + vobenzim is 2 times higher than of antibiotic treatment only.
Urologiia. 2011;(3):31-35
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Transcutaneous nephrolithotripsy in presenile and senile patients

Trapeznikova M.F., Dutov V.V., Urenkov S.B., Rumyantsev A.A., Ivanov A.E., Podoynitsyn A.A., Rusanova E.V., Popov D.M., Trapeznikova M.F., Dutov V.V., Urenkov S.B., Rumyantsev A.A., Ivanov A.E., Podoinitsyn A.A., Rusanova E.V., Popov D.M.


A total of 323 transcutaneous roentgenoendoscopic operations were made in 212 patients from January 2000 to December 2009 including 96 operations in 81 presenile and senile patients (87 and 9 operations, respectively). Transcutaneous nephrolithotripsy (TCNT) eliminated concrement from the kidney for one session in 59 (72.8%) patients. It proved to be the most sparing treatment in serious clinical situations and provided maximally complete evacuation of the concrement from the kidney. A total complication rate was 14.8%. All the complications were cured with conservative pharmacotherapy. TCNT has the same indications as open surgery, is a method of choice in presenile and senile patients with large, stag-horn and recurrent concrements of the kidney, impacted pelvicoureteral concrements, in impaired renal urodynamics and high bacteriuria. TCNT can be used as a second-line treatment in failure of extracorporeal shock-wave lithotripsy or in combination with it (sandwich-therapy) for complete concrement elimination.
Urologiia. 2011;(3):36-39
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Transurethral contact electroimpulse ureteropyelolithotripsy

Rumyantsev A.A., Dutov V.V., Belyaev V.V., Saakyan A.A., Belyaev D.V., Popov D.M., Rumyantsev A.A., Dutov V.V., Belyaev V.V., Saakyan A.A., Belyaev D.V., Popov D.M.


Transurethral contact electroimpulse ureteropyelolithotripsy (TCEUT) was conducted in 161 patients aged 18 to 84 years (mean age 47±14 years) admitted to the urological department of Zhukovsky city hospital in 2006-2009. Female/male proportion 1.4:1. Overall efficacy of TCEUT was 98%, the concrement was destructed completely during the first TCEUT session in 98%, partially in 2% cases. The method was feasible in all the patients if the instrument could reach the concrement. Duration of the session providing complete elimination of the concrements varied from 1 to 6 months.Contact electroimpulse ureterolithotripsy is conducted with single impulses beginning with low energy (0.45 J).Contact electroimpulse pyelolithotripsy requires a higher initial impulse energy (0.6 J). TCEUT is a highly effective method of the treatment of concrements of the upper urinary tract. Side effects were registered in maximum 5%. Long-term existence of the concrement in the urinary system raises the risk of intraoperative complications.
Urologiia. 2011;(3):40-43
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Laparoscopic and retroperitoneoscopic resection of the kidney

Teodorovich O.V., Gallyamov E.A., Zabrodina N.B., Yankovskaya I.E., Stepakov M.D., Teodorovich O.V., Gallyamov E.A., Zabrodina N.B., Yankovskaya I.E., Stepakov M.D.


The surgeons of the clinic at the chair of endoscopic urology operated 32 patients (18 males, 14 females, age 40-78, mean age 55±0.8 years) with renal carcinoma (RC) from 2007 to 2010: 31 patients had RC stageT1N0M0, 1 patient - T2N0M0, 12 patients had RC of the right kidney, 19 - of the left kidney, bilateral RC was in 1 patient. A laparoscopic transperitoneal approach was used in 14 cases. Indications for such approach were the following: size of the tumor 2.2-4 cm, location of the tumor in the upper anterior segment (n = 13), in the middle segment (n = 1). Ischemia was made in 5 patients. Resection of the kidney via a laparoscopic retroperitoneal approach was made in 11 patients. Indications were the following: size of the tumor 1.1-4 cm, posterior tumor location. Ischemia (17 and 24 min) was used in 2 cases, mean blood loss 118 ml (from 50 to 250 ml). Nine patients were operated with application of YAG:Nd laser (Lazurit) which resected an extraorganic tumor of a small size (1.1-2.2 cm) without ischemia and significant blood loss. Laparoscopic assisted resection of the kidney was performed in 9 cases. Hand assistance was indicated in large tumors (4.3 to 8.9 cm), posterior tumor location (n = 4), upper location (n = 2). One-stage bilateral resection of the kidneys in the middle segment was made in one patient. Hand assistance was also required in one patient for one-stage resection of two tumors of the right kidney. Laparoscopic resection of the kidney is indicated in bilateral tumor, in a single functioning kidney, in affection of the contralateral kidney, or disease with potential contralateral kidney affection. Indications for endovideosurgical methods of treatment need detailed specification and perfection. Choice of one of the above approaches should be based on tumor size and its location.
Urologiia. 2011;(3):43-47
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Program "Reproductive Health of Boys" in Samara region

Danilova Z.B., Terekhin S.S., Pshenichnikova E.Y., Pryanichnikova M.B., Danilova Z.B., Terekhin S.S., Pshenichnikova E.Y., Pryanichnikova M.B.


Because of great importance of early detection of urological pathology in boys, we made a prophylactic examination of boys aged 2-17 years. Pediatric urologists-andrologists examined 20402 boys for 2008-2009. They detected: diseases of the penis (11.1%), of the testicles (6%), anomalies of the kidneys (2.5%), urinary diseases (2.6%). The above urological problems can be corrected with good prospects for reproductive health of the examinees.
Urologiia. 2011;(3):48-49
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Health assessment of newborns with congenital urinary malformation

Yushko E.I., Strotskiy A.V., Dubrov V.I., Tkachenko A.K., Yushko E.I., Strotsky A.V., Dubrov V.I., Tkachenko A.K.


Improvement in diagnosis of prenatal congenital urinary malformations (CUM) resulted in increased detection of CUM cases among newborns. To facilitate medical care for CUM newborns, we have developed an objective method of CUM newborns' health assessment. We studied 40 case histories of newborns with prenatally detected CUM admitted to urological clinics (20 with diagnosis of poor health and 20 with moderate condition severity) and 40 CUM newborns examined outpatiently (moderate health hazard). The computer analysis of the available data has established 13 most informative diagnostic criteria: 4 sonographic criteria, 3 lab criteria and 6 physical exam criteria estimated by 4 points - from 0 to 4. The criteria were pooled to a table which was used as a scale to assess general health condition. After delivery, CUM newborn gets inpatient health assessment by a neonatologist using 13 criteria. According to the total score, the condition is assessed as satisfactory (0-5), moderately severe (6-11), severe ( > 12). Efficacy of such health assessment was proved in a population study of 312 prenatal CUM newborns. Grouping of such newborns helps design of programs of further examination and management.
Urologiia. 2011;(3):49-55
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Ureteral injury caused by an intrauterine loop

Novikov A.I., Nazarov T.N., Novikov A.I., Nazarov T.N.
Urologiia. 2011;(3):55-58
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Treatment of idiopathic retroperitoneal fibrosis

Perlin D.V., Filimonov V.B., Aleksandrov I.V., Vasin R.V., Perlin D.V., Filimonov V.B., Alexandrov I.V., Vasin R.V.
Urologiia. 2011;(3):58-59
pages 58-59 views

Penile fracture

Dzidzariya A.G., Martov A.G., Maksimov V.A., Khromov R.A., Dzidzaria A.G., Martov A.G., Maximov V.A., Khromov R.A.
Urologiia. 2011;(3):60-63
pages 60-63 views

Proteometabolic analysis in urology

Mazin P.V., Martov A.G., Maksimov V.A., Golubev M.Y., Mazin P.V., Martov A.G., Maximov V.A., Golubev M.Y.
Urologiia. 2011;(3):63-68
pages 63-68 views

Recovery of urinary continence in patients after radical retropubic prostatectomy: role of nerve preservation technique

Veliev E.I., Golubtsova E.N., Kotov S.V., Veliev E.I., Golubtsova E.N., Kotov S.V.
Urologiia. 2011;(3):68-71
pages 68-71 views

Urethral amyloidosis

Komyakov B.P., Idrisov S.N., Kim V.E., Komyakov B.P., Idrisov S.N., Kim V.E.
Urologiia. 2011;(3):71-72
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