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No 5 (2011)


Gender differences of acute pyelonephritis in the North

Plekhanov V.N., Vasil'chenko M.I., Sergienko N.F., Plekhanov V.N., Vasilchenko M.I., Sergienko N.F.


To investigate results of treatment in patients with acute pyelonephritis (AP) among the population of giving age in the North of Russia for prognostication of the disease and decision on further therapy, we studied 1109 case histories of patients treated for urinary infections (UI) including 794 patients with pyelonephritis (119 with AP). Age of both males and females with AP was younger than of UI patients. AP among female inpatients with UI occurred twice more frequently than in males. Ascending AP was characterized by dysuria, mild lumbar pain, symptoms of general intoxication, leukocyturia, bacteriuria, moderate leukocytosis, elevated leukocytic intoxication index (LII) both in males and females. Hematogenic AP in young males presented with lumbar pain, symptoms of general intoxication, leukocytosis, LII elevation in the absent or mild leukocyturia. The main route of renal infection in population of giving age in the North in AP - ascending. Hematogenic route of infection occurs in young males and is typical for pyodestructive AP.
Urologiia. 2011;(5):4-8
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Experience in phytotherapy of nephrolithiasis patients after extracorporeal shock-wave lithotripsy

Tkachuk V.N., Al'-Shukri S.K., Ammo Rizan -., Tkachuk V.N., Al-Shukri S.K., Ammo Risan -.


Our study of efficacy of Prolit-septo phytotherapy following extracorporeal shock-wave lithotripsy (ESWLT) in patients with nephrolithiasis has demonstrated that Prolit-septo noticeably reduces the time of evacuation from the urinary tract of the destructed stone fragments as well as renal colic incidence and renal inflammation exacerbation.
Urologiia. 2011;(5):8-10
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Combination of interstitial cystitis and adenomyosis in females suffering from chronic pelvic pain syndrome

Neymark A.I., Shelkovnikova N.V., Neimark A.I., Shelkovnikova N.V.


General and endoscopic examinations of 25 patients aged 40-48 years with chronic pelvic pain syndrome (CPPS) revealed combination of two urogenital diseases: interstitial cystitis and adenomyosis of the second-third degree. The complex treatment including a course of lavomax immunocorrection relieved CPPS in 72% (18) patients, reduced the number of recurrences of chronic pelvic diseases in 16%(4) patients. The therapeutic complex proposed may serve an alternative to surgical treatment of adenomyosis of the second-third degree which is uncomplicated with posthemorrhagic iron-deficiency anemia, manifests with pain only and associated with interstitial cystitis.
Urologiia. 2011;(5):10-14
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Complex local and central therapy of interstitial cystitis with devices AMUS-01-INTRAMAG and AMO-ATOS-E

Rokhlikov I.M., Raygorodskiy Y.M., Timoshenko V.O., Otradnov M.V., Rokhlikov I.M., Raigorodsky Y.M., Timoshenko V.O., Otradnov M.V.


A total of 86 females with interstitial cystitis (IC) aged 26-52 years with the disease history over 2.7 years were exposed to intravesical electrostimulation in combination with electromagnetophoresis of heparin-containing mixture of medicines. Relief of pain syndrome and elimination of central hypersensitization were achieved with local procedures on the urinary bladder (UB) alternating (every other day) with procedures of transcranial electrostimulation (TES-therapy, mesodiencephalic modulation). The above treatment proved effective: subjective assessment of pain lowered to "rare" in 60% females, urgency decreased 2-fold, mean effective volume of the bladder increased by 46.2%.
Urologiia. 2011;(5):15-20
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Effects of synthetic materials used for the treatment of genital prolapse on lower urinary tract function

Kasyan G.R., Kayfadzhyan M.M., Malkhasyan V.A., Pushkar' D.Y., Kasyan G.R., Kaifadzhan M.M., Malkhasyan V.A., Pushkar D.Y.


Functional results of surgical correction of genital prolapse were compared with those of transvaginal implantation of the prolift in 26 and 22 women, respectively. Standard protocol required gynecological examination, cough test, complex urodynamic investigation. Patients of both groups were matched by anthropometric parameters. All the patients were reexamined 1, 3 and 6 months after surgery. Comparison of the results showed that most of the urodynamic parameters changed insignificantly in patients treated surgically for prolapse of the urinary bladder. Moreover, there was no significant association between these findings and surgical methods of the prolapse treatment. Stress urinary incontinence arose in 13.64% (3/22) patients who had undergone prolift implantation and in 3.85% (1/26) patients after colporraphy. Postoperative overactive bladder was observed in 9.09% (2/22) and 11.54% (3/26) patients, respectively. No significant difference by the above symptoms between the groups were registered in relation to the operation type. Similar data were obtained in respect of incidence of lower urinary tract infections. Thus, it is found that prolift plastic operations for cystocele do not increase the incidence of urinary incontinence, overactive bladder, lower urinary tract infection. Further studies with greater number of patients and longer follow-up are needed.
Urologiia. 2011;(5):20-23
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Condition of cavernous tissue of the penis after unilateral incomplete proximal intracavernous falloprosthesis

Taruashvili G.I., Medvedev V.L., Chilov S.A., Kochov V.N., Taruashvili I.G., Taruashvili G.I., Medvedev V.L., Chilov S.A., Kochov V.N., Taruashvili I.G.


Unilateral incomplete proximal intracavernous falloprosthesis (UIPIF) was followed by US-dopplerography of the intact penis and penis in medical erection induced by E1 prostoglandin introduction into the intact cavernous body. UIPIF preserves 89-90% of functionally active cavernous tissue with effective blood flow. Investigation 2 months and more after operation demonstrated that systolic blood flow rate in the cavernous artery of the cavernous tissue around the endoprosthersis can reach values registered in normal erection. The conclusion is made that after UIPIF quality of sexual life of the patient improves due to creation of additional density and axial stability of the trunk of the penis.
Urologiia. 2011;(5):24-27
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Selzink plus study in patients with chronic non-infectious prostatitis and abnormal fertility

Sivkov A.V., Oshchepkov V.N., Evdokimov V.V., Keshishev N.G., Shkabko O.V., Sivkov A.V., Oschepkov V.N., Evdokimov V.V., Keshishev N.G., Shkabko O.V.


Correction of subnormal spermatogenesis caused by chronic prostatitis is made with application of different therapeutic schemes. Our aim was to investigate efficacy of selzink medicine which corrects deficiency of trace elements Se and Zn in ejaculate and thus improves spermatogenesis. One-month course of therapy produced no side effects, had a positive effect on low fertility of ejaculate. Therefore, selzink can be recommended in combined treatment of male infertility.
Urologiia. 2011;(5):27-33
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Experience in vitaprost treatment of patients with chronic abacterial prostatitis and prostatic adenoma after prostatic arteries embolism

Yakovets Y.V., Yakovets E.A., Neymark A.I., Karpenko A.A., Arzamastsev D.D., Yakovets Y.V., Yakovets E.A., Neimark A.I., Karpenko A.A., Arzamastsev D.D.


Pain and abnormal spermatogenesis are among symptoms deteriorating quality of life in patients with chronic prostatitis. Rectal suppositories vitaprost have no side effects, relieve pain, correct spermatogenesis. The effect of vitaprost treatment persists for 3 months and longer. Prostatic arteries embolization with vitaprost suppositories as preoperative preparation is a good alternative to surgical treatment in patients with prostatic adenoma.
Urologiia. 2011;(5):33-39
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Correction of immunometabolic disorders in chronic bacterial prostatitis

Shatokhin M.N., Teodorovich O.V., Konoplya A.I., Gavrilyuk V.P., Mavrin M.Y., Krasnov A.V., Shatokhin M.N., Teodorovich O.V., Konoplya A.I., Gavrilyuk V.P., Mavrin M.Y., Krasnov A.V.


Patients with chronic bacterial prostatitis were found to have disorders in blood parameters of complement system activity, neutrophil function and metabolic status. The above disorders are resistant to adequate correction with standard treatment but can be successfully managed with combined use of immunomodulators (ferrovir, galavit), antioxidants (mexidol, olifen) and membranoprotectors (phosphogliv, essentiale). Thus, immunometabolic status in chronic prostatitis can be corrected with the above combined treatment.
Urologiia. 2011;(5):39-42
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Benefit of primary saturational biopsy in detection of localized prostatic cancer after radical prostatectomy

Veliev E.I., Obeyd A., Bogdanov A.B., Veliev E.I., Obeid A., Bogdanov A.B.


We studied diagnostic potential of saturational technique of prostatic biopsy in 1018 males with suspected prostatic cancer (PC). Primary transrectal multifocal prostatic biopsy under ultrasound control was made in all the examinees including 453 procedures with use of saturational technique. The age of the patients varied from 43 to 77 years (median 60 years). A total of 159 patients with diagnosed prostatic cancer have undergone retropubic radical prostatectomy. Saturational biopsy has detected prostatic cancer in 35.1% cases. This technique was employed in hard for PC diagnosis parameters: age median 60 years, PSA 11.9 ng/ml, PSA density 0.23 ng/ml/cm3, prostatic volume 59.7 cm3. The above variant of biopsy detects the highest proportion of localized PC stages, minimal incidence of positive surgical margin, perineural and perivascular invasions, minimal score by Glison/s scale. Thus, the saturational technique of biopsy can be the method of choice in patients under 65 years of age, in a PSA level under 10 ng/ml, PSA density under 0.25 ng/ml/sm3 and prostatic volume over 60 cm3.
Urologiia. 2011;(5):43-45
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Administration of M-cholinoblockers after prostatic surgery

Golubtsova E.N., Veliev E.I., Golubtsova E.N., Veliev E.I.


Some patients after prostatic surgery demonstrate hyperactivity symptoms. These symptoms can be relieved by M-cholinoblockers. We analysed prospectively the results of treatment of 23 patients (mean age 69.8 years) with clinically localized prostatic cancer after radical retropubic prostatectomy. The patients were examined before and after 3 months of treatment. All the patients received tolterodin (urotol) per os in a dose 2 mg twice a day. The results of the therapy showed that M-cholinoblocker tolterodin (urotol) is effective and well tolerated in patients with hyperactive symptoms after radical prostatectomy.
Urologiia. 2011;(5):46-49
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Endoscopic ureterolithotomy in large concrements of the upper third of the ureter

Martov A.G., Teodorovich O.V., Gallyamov E.A., Lutsevich O.E., Zabrodina N.B., Gordienko A.Y., Parkhonin D.I., Martov A.G., Teodorovich O.V., Gallyamov E.A., Lutsevich O.E., Zabrodina N.B., Gordienko A.Y., Parkhonin D.I.


Endoscopic ureterolithotomy was made in 38 patients who had concrements in the upper third of the ureter more than 1 cm in size. Operations were retroperitoneoscopic and laparoscopic in 20 and 18 cases, respectively. Five patients had recurrent stones, 7 patients had prior extracorporeal shock-wave lithotripsy, 2 patients failed contact ureterolithotripsy. In the rest cases endoscopic ureterolithotomy was a first-line treatment. A complete elimination of the stone was achieved in all the cases. Mean time of the operation in a retroperitoneoscopic approach was 149 min, in laparoscopic - 125 min. Mean blood loss was the same. Conversion was performed in one case in the group of retroperitoneal approach. Postoperative stay in hospital in retroperitoneo- and laparoscopic ureterolithotomy was 3 - 16 days. Laparoscopic ureterolithotomy produced a complication in one case - an insignificant injury of the colon. Urinous infiltration and pneumonia developed after retroperitoneoscopic ureterolithotomy in one and one case, respectively. Thus, endoscopic ureterolithotomy in large stones of the upper third of the ureter via retroperitoneal and transperitoneal approach is a safe, low-invasive and effective operation which provides complete stones elimination. Endoscopic ureterolithotomy should be done in uneffective first-line treatment. It is a leading method in the treatment of large and long-standing stones of the upper third of the ureter.
Urologiia. 2011;(5):50-55
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Percutaneous nephrolithotripsy in the concrements of solitary and allotransplanted kidney

Komyakov B.K., Guliev B.G., Alekseev M.Y., Lubsanov B.V., Komyakov B.K., Guliev B.G., Alexeev M.Y., Lubsanov B.V.


Our 10-year studies (2001-2010) were devoted to assessment of efficacy of percutaneous nephrolithotripsy (PNL) in the treatment of nephroliths of the solitary and allotransplanted kidney. PNL was made in 16 patients with large or coral calculi of the solitary and allotransplanted kidney. Of them, 10 patients had solitary kidney, 2 patients had nonfunctioning contralateral kidney, 4 patients - transplanted cadaver kidney. The age of the patients varied from 26 to 74 years (mean age 46.5 ± 14.6 years), 10 (62.5%) males, 6 (37.5%) females. Mean size of the calculi was 28.6 ± 5.7 mm. Single pelvic calculi occurred in 11 patients, multiple - in 2, coral concrements were detected in 3 patients. Five patients had recurrent concrements after extracorporeal lithotripsy, PNL and pyelolithotomy. Serious intraoperative complications were absent. Postoperative fever occurred in 3 (18.7%) patients. Hemoglobin fall under 80-90 g/l demanding hemotransfusion was seen in 4 patients. Lumbotomy because of postoperative complications was not performed. PNL as monotherapy was effective in 12 (75%) of 16 patients. Four patients (25%) had residual stones which were exposed to extracorporeal lithotripsy. Dynamic scintigraphy showed normalization of urodynamics of the upper urinary tract and improvement of renal function. Thus, PNL is a low-invasive and effective surgical treatment of patients with nephroliths of the single and allotransplanted kidney.
Urologiia. 2011;(5):55-60
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Antegrade endopyelotomy in the treatment of patients with pelvicoureteral segment stricture in combination with urolithiasis

Seregin A.V., Egorov M.I., Gabdurkhmanov I.I., Seregin A.A., Seregin A.V., Egorov M.I., Gabdurkhmanov I.I., Seregin A.A.


A total of 17 urolithiasis patients (12 males, 5 females aged 29-65 years, mean 47 ± 8.2 years) with pelvicoureteral segment stricture (PUS) received percutaneous surgical treatment in the clinic of urology and surgical andrology from 2005 to 2009. The treatment consisted in endopyelotomy combined with nephrolithotomy and/or contact lithotripsy. Bilateral concrements were detected in 4 (23.5%) patients. Of them, 1 (5.9%) had PUS strictures in both kidneys. Good short-term results were achieved in 14 (82.4%) patients, satisfactory results - in 2 (11.8%) patients, unsatisfactory - in 1 (5.9%) patient. After long-term follow-up examination (mean follow-up 14 months after the operation) of all 17 patients it was found that 14 (82.4%) patients improved PUS condition (by the data of excretory urography and multislice computed tomography). Urological complaints were absent in 16 (94.1%) patients.
Urologiia. 2011;(5):61-65
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Pilot experience in application of a laser device Urobeam in the treatment of patients with prostatic adenoma in Kazakhstan

Glybochko P.V., Anafin T.G., Shalekenov S.B., Glybochko P.V., Anafin T.G., Shalekenov S.B.


The study included 54 patients with prostatic adenoma exposed to laser photoselective vaporization using Urobeam device. Before vaporization the patients had marked infravesical obstruction, Qmax - under 5 ml/c, PVR > 200 ml, IPSS > 20 points, size of the prostate by transrectal ultrasound investigation - over 80 cm3. Moreover, 63% patients received anticoagulants. The results of the study show that Urobeam vaporization improves such parameters as IPSS score, Qmax, prostatic size in minimal number of complications. Thus, Urobeam laser photoselective vaporization is an effective treatment of prostatic adenoma, it provides fast upgrading of quality of life of prostatic adenoma patients.
Urologiia. 2011;(5):65-67
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Botulinic toxin type A in combined treatment of males with chronic pelvic pain syndrome in combination with bladder emptying dysfunction

Krivoborodov G.G., Shumilo D.V., Vasil'ev A.V., I T.E., Poddubnaya N.V., Krivoborodov G.G., Shumilo D.V., Vasiliev A.V., Tur E.I., Poddubnaya N.V.


The efficacy of various treatment of chronic pelvic pain syndrome in combination with bladder emptying dysfunction was comparatively analysed for 31 male patients. Statistics show that current schemes of medication including antibacterial, nonsteroid anti-inflammatory drugs, alpha-adrenoblockers are not highly effective in such patients. Transrectal microwave hyperthermia is effective in males with chronic pelvic pain syndrome but the response is short - 3 months maximum. The highest and the longest effect in patients with chronic pelvic pain syndrome in combination with bladder emptying dysfunction was achieved after injections of 100 units of botulinic toxin type A into the cross-striated sphincter of the urethra.
Urologiia. 2011;(5):67-72
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Ectopy of the ostium ureteris into the seminal vesicle

Imamverdiev S.B., Bakhyshov A.A., Imamverdiev S.B., Bakhyshov A.A.
Urologiia. 2011;(5):72-74
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Late treatment of combined fracture of the penis

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;(5):74-76
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High-tech medical care for patients with prostatic cancer: an original analysis

Apolikhin O.I., Katibov M.I., Shaderkin I.A., Apolikhin O.I., Katibov M.I., Shaderkin I.A.
Urologiia. 2011;(5):76-82
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Diagnosis of local recurrence after radical prostatectomy

Guspanov R.I., Obeyd A., Okhrits V.E., Guspanov R.I., Obeid A., Okhrits V.E.
Urologiia. 2011;(5):82-87
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Overactive bladder as a cause of sexual dysfunction

Kul'chavenya E.V., Breusov A.A., Kholtobin D.P., Kulchavenya E.V., Breusov A.A., Kholtobin D.P.
Urologiia. 2011;(5):87-89
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Wound complications after radical cystectomy

Atduev V.A., Mamedov K.M., Atduev V.A., Mamedov K.M.
Urologiia. 2011;(5):89-92
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