Open Access Open Access  Restricted Access Access granted  Restricted Access Subscription or Fee Access

No 4 (2013)


Analysis of the results of treatment of urinary incontinence in women using the free suburethral synthetic sling: the experience of 1000 operations

Kasyan G.R., Gvozdev M.Y., Godunov B.N., Prokopovych M.A., Pushkar D.Y.


The study presents an analysis of the experience of treatment of urinary incontinence in women using free synthetic suburethral sling. Between 2001 and 2008, 1081 patients underwent surgery. Of these, 841 (77,8%) suffered from stress urinary incontinence, 202 (18,62%) suffered from the mixed form of urinary incontinence with a predominance of the stress component, and 38 (3,52%) had recurrent urinary incontinence. Group 1 included patients with stress urinary incontinence who underwent surgery using suburethral synthetic sling with retropubic access (TVT operation); Group 2 included patients, who underwent surgery using suburethral sling implanted with transobturator access (TVT-O operation). Group 3 consisted of patients with mixed urinary incontinence, who underwent TVT-O operation. Retropubic suburethral TVT sling was implanted in 273 (25,25%) patients, transobturator TVT-O sling - in 740 (68,45%) patients, and other synthetic suburethral slings - in 68 (6,3%) patients. The average follow-up period was 50.1, 31.1 and 32,6 months in each group, respectively. Cough test was used for the objective evaluation of the effectiveness, and visual analogue scale - for the subjective evaluation of effectiveness. In the TVT group, the negative cough test in the postoperative period remained at 85,58% of the patients, and in in TVT-O group - in 84,36% of patients. Analysis of the frequency of intraoperative complications showed that the probability of occurrence of complications was not associated with age, body mass index and obstetric history of patients. It was noted that the perforation of the bladder and pelvic hematoma were more likely to occur when using the retropubic access. Transobturator access is associated with a higher risk of injury of the lateral vaginal fornix, although bladder injury is not ruled out. Objective and subjective indicators of efficacy of treatment of mixed form ofurinary incontinence were 86.15 and 87.69%, respectively. The study suggests that the operations using suburethral TVT and TVT-O slings are safe and effective methods of treatment of stress urinary incontinence in women.
Urologiia. 2013;(4):5-11
pages 5-11 views

Erosions of the vaginal, bladder and urethral mucosa after transvaginal correction of genital prolapse and stress urinary incontinence with the use of synthetic materials

Nechiporenko A.N., Nechiporenko N.A.


The article presents the results of treatment of 13 women with erosion of the vaginal mucosa with an exposure of the part of prosthesis and 4 women with the migration of fragments of the prosthesis into the lumen of the bladder or urethra after surgical correction of genital prolapse and stress urinary incontinence with the use of synthetic materials (Prolift, TVT operations). Interventions included the removal of part or all prosthesis from zone of erosion of the vaginal mucosa and removal of prosthesis migrated into the lumen of the bladder or urethra. Good results of operations were achieved in all cases. 8-12 months after surgery, recurrence of erosion and migration of prosthesis into the lumen of urinary organs were not observed.
Urologiia. 2013;(4):12-15
pages 12-15 views

The microbial spectrum of urine and bladder bioptic samples in women with chronic recurrent cystitis

Naboka Y.L., Gudyma I.A., Kogan M.I., Ibishev K.S., Chernitskaya M.L.


The evaluation of urine and bladder bioptic samples (bacteriological examination and polymerase chain reaction) of 28 women with chronic cystitis was performed. In 85,7% of cases, mixed infections with predominance of nonclostridial anaerobes in the urine was detected. Herpes simplex virus type 1 was detected in 7,1% of cases. In the same manner as in urine, predominance of nonclostridial anaerobes in bladder bioptic samples (85,7%) was observed. Identical bacteria in urine and bladder bioptic samples were revealed in 64,3% of patients. Herpes viruses and papillomaviruses were frequently registered (p <0,05) in the bioptic samples.
Urologiia. 2013;(4):16-18
pages 16-18 views

Rehabilitation of patients with urolithiasis after minimally invasive procedures on kidneys

Avdoshyn V.P., Andryukhin M.I., Kiryukhina T.A., Zaitseva I.V.


Minimally invasive surgeries in patients with urolithiasis are not always successful. Prevention of inflammatory and cicatrical-sclerotic complications in the postoperative period plays an important role. 49 patients with urolithiasis divided into two groups were followed-up. The study group included 25 patients who underwent percutaneous puncture nephrolitholapaxy. The control group consisted of 24 patients with a history of percutaneous puncture nephrolitholapaxy. In postoperative period, active prevention of inflammation and cicatrical-sclerotic complications using drug Longidaza® in combination with magnetic-laser therapy was performed in study group. The control group received standard treatment. 6 months after surgery, 1 (4%) patient in the study group had pyeloectasis ~2 cm and obstruction of UPJ of operated kidney, which required re-treatment with Longidaza®. In the control group, pyeloectasis and violation of passage through the upper urinary tract were recorded in 4 (16,7%) patients. These data allow to recommend a comprehensive prevention of postoperative inflammation and cicatrical-sclerotic complications using Longidaza and magnetic-laser therapy in patients undergoing minimally invasive surgery of the kidney.
Urologiia. 2013;(4):19-23
pages 19-23 views

The structure of urological disorders in athletes

Shirshov V.N., Doronchuk D.N., Obolonkov V.Y., Shatirishvili O.K., Konstantinova I.M., Lebedev Y.I., Charushina I.M.


According to the data of preventive medical examinations since the end of 2009 to April 2012, data on the urological incidence in 654 athletes surveyed during this period were collected and analyzed. Among the diseases identified in athletes, the main place is occupied by varicocele (5,35%), urethritis (5,04%), urolithiasis without clinical manifestation of acute inflammation (1,37%).
Urologiia. 2013;(4):24-27
pages 24-27 views

Efficiency of uroprofit in women with chronic cystitis

Sizov K.A., Neymark A.I., Razdorskaya M.V., Yurova V.A.


From September 2011 to December 2011, 40 women aged 20-68 years with chronic cystitis were examined. All patients were divided into two groups of 20 people depending on the type of treatment. Control group of patients received monotherapy with fosfomycin (monural), main group of patients - complex therapy with fosfomycin and biologically active supplement uroprofit. The results were evaluated at 1 and 2 months after initiation of therapy. Before and after treatment, all patients were examined, including standard laboratory tests, uroflowmetry, cystometry, and cystoscopy. It was shown that patients in main group have a rapid normalization of clinical manifestations and laboratory parameters, improvement of dynamics of the endoscopic picture. Thus, uroprofit has antibacterial, anti-inflammatory action, contributes to the normalization of urodynamics of the lower urinary tract, reduces the risk of relapses of chronic cystitis and can be recommended as a component of the treatment of acute exacerbations of chronic cystitis, as well as a drug for the prevention of disease in the disease-free interval.
Urologiia. 2013;(4):28-31
pages 28-31 views

The results of the 10-year study of efficacy and safety of Serenoa repens extract in patients at risk of progression of benign prostatic hyperplasia

Alyaev Y.G., Vinarov A.Z., Demidko Y.L., Spivak L.G.


The article presents the results of an open, noncomparative, observational study of the efficacy and safety of continued use of the Serenoa repens (prostamol uno®) plant extract at a dose of 320 mg 1 time a day for 10 years in 38 patients with early manifestations of BPH and the risk of its progression. The results of study showed the absence of progression, both on subjective criteria (IPSS, and QoL scores), and objective criteria (prostate volume, the rate of urination, residual urine volume). Furthermore, patients had no undesirable effects directly related to the use of this drug.
Urologiia. 2013;(4):32-36
pages 32-36 views

Experience of male transobturator AdVance sling implantation in patients with stress urinary incontinence after radical prostatectomy

Veliyev E.I., Golubtsova E.N., Tomilov A.A.


For the period from April 2008 to March 2012, 12 men with mild-to-moderate and severe stress urinary incontinence underwent transobturator AdVance sling implantation. In the preoperative period, all patients underwent assessment, including history taking, physical, and instrumental and laboratory examination. Daily pad test was used as an objective method for the assessment of the degree of urinary incontinence. The use no more than one pad a day was considered as recovery, no more than 2 pads or reduction of the loss of urine by more than 50% - as an improvement. Median follow-up period was 28 months. The success of the operation was achieved in 91,7% of cases. Implantation of the sling led to the significant decrease of urine loss, the number of used pads and improvement of quality of life of patients. Infectious and inflammatory complications of acute urinary retention were not observed. Implantation of male transobturator AdVance sling is effective and safe treatment for patients with stress urinary incontinence after radical prostatectomy.
Urologiia. 2013;(4):37-41
pages 37-41 views

Application of udenafil for the correction of endothelial disorders in patients with stress-induced erectile dysfunction

Neymark B.A., Neymark A.I., Tishchenko G.E.


The study was aimed to the evaluation of vascular endothelium status in patients with stress-induced arterial hypertension, coupled with erectile dysfunction (ED). 51 patients underwent examination. Laurent - Segal Male Copulative Function Questionnaire (MCF), and International Index of Erectile Function (IIEF) were used for the detection of ED and assessment of its severity. Microcirculation in penile vessels was evaluated by laser Doppler flowmetry. Markers of endothelial function - endothelin 1 and asymmetric dimethylarginine-were measured. For the correction of violations identified, the drug udenafil (zydena) was used at a dose of 50 mg daily for 1 month. Against the background of therapy with udenafil, restoration of function of endothelial cells was detected. This suggested the functional nature of the violations in the genital sphere, and was regarded as a manifestation of stress-induced ED. Elimination of endothelial dysfunction led to significant reduction in ED symptoms.
Urologiia. 2013;(4):42-46
pages 42-46 views

Experience of the use of silodosin in acute urinary retention caused by benign prostatic hyperplasia

Neymark A.I., Nozdrachyov N.A.


For the treatment of acute urinary retention (AUR) as one of the most serious complications of adenoma of the prostate (BPH), α-adrenoblockers are widely used. The article presents an experience of the use of the new uroselective α-adrenoblocker silodosin approved for the treatment of patients with urination disorders caused by BPH. Its pharmacological profile has a number of advantages, including the highest uroselectiveness at the present day, immediate action, the potential for the use of standard dose of 8 mg 1 time a day, which does not require a correction depending on the age, and the possibility of the simultaneous application with antihypertensive drugs.
Urologiia. 2013;(4):47-51
pages 47-51 views

Endothelium-dependent and endothelium-independent vasodilation in patients with chronic prostatitis

Polunin A.A., Miroshnikov V.M., Voronina L.P., Polunin A.I.


Using laser Doppler flowmetry, basal blood flow in patients with chronic prostatitis was evaluated. 90 men with chronic prostatitis and 30 healthy men of reproductive age underwent examination. For the assessment of endothelial vasomotor function, ionophoretic tests with 5% acetylcholine and 5% sodium nitroprusside were performed. Results of the study suggested a violations of the skin vasomotor activity in patients studied, which indicated a decrease in reserve capacity of the microvasculature both in bacterial and abacterial genesis of chronic prostatitis.
Urologiia. 2013;(4):52-54
pages 52-54 views

Destructive changes in the mice testes in retrograde infection with herpes simplex virus

Malolina E.A., Kulibin A.Y., Tyulenev Y.A., Kusch A.A.


Herpes simplex virus (HSV) causes inflammatory diseases of the genitourinary system of males, infects male sex cells, and its presence in the ejaculate is associated with infertility. However, information on the pathways of HSV in the testicles, the extent of damage of spermatogenic tissue and the effect on spermatogenesis are insufficient. This work was aimed to the evaluation of effect of HSV on mice spermatogenesis in retrograde infection with the virus. Molecular (RT-PCR), virologic, morphological and immunohistochemical methods were used. Analysis showed that after virus inoculation directly into seminiferous tubules the viral protein is found in all layers of seminiferous epithelium. On the third day of infection the proportion of tubules containing HSV protein was 4,9%, reached a maximum on day 6 - 23,5 and 18% for the high and low doses of HSV, respectively, and then decreased; viral protein was not detected on 21th and 45 th day. HSV DNA was detected in the testes at all stages of infection. Since the 14th day after infection, testes weight was significantly reduced compared to the control: 7,9-fold decrease at 45th day with a high dose of HSV, and 4,9-fold decrease with low dose. The infection with HSV led to the development of orchitis and considerable destructive changes in the spermatogenic tissue. The proportion of morphologically normal tubules was reduced to 6 and 15% at day 14 and remained at a low level up to 45th day. Approximately half of the seminiferous tubules (46,5%) at the 14th and 21th day had no somatic Sertoli cells needed for the restoration of spermatogenic tissue. These data suggests that retrograde infection of male gonads with HSV leads to the structure damage of testis and death of germ and somatic cells, indicating the irreversibility of degenerative changes in infected testes.
Urologiia. 2013;(4):55-59
pages 55-59 views

Extracorporeal partial nephrectomy for neoplasm

Komyakov B.K., Zamyatnin S.A., Novikov A.I., Kurkov A.S., Popov S.V., Tovstukha D.V., Tsigankov A.V.


The results of 11 extracorporeal partial nephrectomies for neoplasm with subsequent autologous transplantation of kidney are presented. In 4 patients, resection was performed ex vivo in the presence of a large centrally located tumor in a solitary kidney. Another two patients had bilateral tumor process. In 2 patients, a large, centrally located tumor in solitary kidney was the indication for extracorporeal resection. 3 patients had elective indications for the operation. Early postoperative complications occurred in 5 patients. 3 patients had oligoanuria. One patient developed postoperative bleeding; one patient developed obliteration of the upper third of ureter. Recurrence of renal cell cancer has not been identified; the functional state of the kidney vessels and vessels of upper urinary tract was regarded as satisfactory. Good results of these operations indicate the feasibility of expanding the indications for extracorporeal organ-sparing surgery.
Urologiia. 2013;(4):60-63
pages 60-63 views

Laparoscopic transperitoneal and retroperitoneal partial nephrectomy

Baranov A.V., Biktimirov R.G., Parkhonin D.I.


The article presents a modern approach to partial nephrectomy, and evaluation of individual results of laparoscopic partial nephrectomies. The study included 38 patients who underwent laparoscopic partial nephrectomy in the period from 2006 to 2011. Kidney cancer was diagnosed in 30 patients, other diseases - in 8. Mean duration of surgery was 225 min. Warm ischemia time was less than 36 minutes. The average postoperative period was 8,7 days. Despite the technical difficulties in the development and implementation of laparoscopic partial nephrectomy, the benefits of minimally invasive techniques are obvious, and the operation can comply with all the principles of oncology and become an alternative to open surgery.
Urologiia. 2013;(4):64-68
pages 64-68 views

Laparoscopic partial nephrectomy using local ischemia

Perlin D.V., Alexandrov I.V., Zipunnikov V.P., Kargin K.A.


Oncological outcomes of laparoscopic partial nephrectomy are no worse than those after open sparing operation for kidney cancer. However, laparoscopic procedures are accompanied by a longer warm ischemia. In order to reduce the ischemic injury, local ischemia by isolation and temporary clamping of the individual branches of the renal artery was used. From January 2009 to June 2012, 60 laparoscopic partial nephrectomies were performed in the clinic, including 34 resections with temporary clipping of renal artery and 26 resections with temporary clipping of secondary and tertiary segmental and subsegmental branches. Functions of affected kidney were evaluated before and after surgery in both groups of patients. At 3 months after surgery, significantly lower decline of the function of affected kidney was observed in patients who underwent resection with the use of local ischemia compared with patients who received the intervention accompanied by a temporary clamping the renal artery. Partial nephrectomy using local ischemia can significantly expand the indications for laparoscopic and retroperitoneoscopic sparing operation for renal cell cancer.
Urologiia. 2013;(4):69-73
pages 69-73 views

The use of laser vaporization for the treatment of benign prostatic hyperplasia

Ustinov D.V., Kholtobin D.P., Kulchavenya E.V., Aizikovich B.I.


Results of use of UroBeam laser diode in 72 patients with benign prostatic hyperplasia (BPH) were analyzed. Average prostate volume was 67,29+26,72 cm3, the duration of vaporization - 69,2±23,7 min. Blood loss was minimal. In the period from 2 weeks to 4 months after surgery, 9 patients have developed acute urinary retention. In the early postoperative period, acute prostatitis was diagnosed in 7 patients and was jugulated using drug treatment. The laser vaporization of BPH led to a three-fold reduction in the severity of urinary disorders and increase the urinary flow rate. The combination of laser vaporization of the prostate with transurethral resection of the prostate allow to improve the recovery of urination after surgery
Urologiia. 2013;(4):74-79
pages 74-79 views

Potentials for the conservative therapy in the complex treatment of varicocele in adolescents

Popov I.S., Neymark A.I., Gazamatov A.V.


The article presents the results of the evaluation of the influence of varicocele on the reproductive system of adolescents from the perspective of involvement of periprostatic venous plexus and prostatovesicular complex in the pathological process. The study involved 90 adolescents 16-18 years old with left varicocele and disturbances in ejaculate parameters, of which 60 had pelvic congestion. Patients and control group received a comprehensive treatment, including preoperative trophic and flebotonic therapy, laparoscopic surgical clipping of the internal spermatic vein and post-operative rehabilitation. Patients of the study group along with this treatment received prostatotropic drug Vitaprost. According to the results of study, it was found that in patients with varicocele, attention should pay to the status of the venous outflow from the pelvic organs, which leads to the pelvic congestion and causes degenerative changes in the prostate in half of cases, which in turn negatively affects the spermogram parameters and increases the risk of subfertility. The use of prostatotropic drugs in the treatment of patients suffering from varicoceles with pelvic congestion is appropriate and pathogenetically justified, as it promotes a more rapid restoration of the structure and function of the prostate.
Urologiia. 2013;(4):80-84
pages 80-84 views

Suprapubic transvesical adenomectomy of external glands of prostata with blind suture of bladder

Sitdykov E.N., Zubkov E.A.


The article presents the experience of 524 open suprapubic transvesical prostatectomies with blind suture of bladder and hemostasis of adenoma bed by removable catgut ligatures. The advantages of this type of operation include early recovery of urethral urination (2 to 4th day), the normalization of urodynamic parameters, the restoration of anatomical and functional status of the upper urinary tract (91% of patients), rapid epithelialization of adenoma bed and low incidence of inflammatory and obstructive complications.
Urologiia. 2013;(4):85-89
pages 85-89 views

Retrograde nephrolithotripsy in patient with an abnormality of the urinary system

Trapeznikova M.F., Bychkova N.V., Urenkov S.B., Podoynitsyn A.A., Ivanov A.E.
Urologiia. 2013;(4):90-92
pages 90-92 views
pages 93-98 views

Chronic prostatitis, benign prostatic hyperplasia and immunity: the violations and correction

Konoplya A.I., Teodorovich O.V., Shatokhin M.N., Gavrilyuk V.P., Mavrin M.Y.
Urologiia. 2013;(4):99-103
pages 99-103 views

Incidental renal cell carcinoma

Tyan P.A., Dutov V.V.
Urologiia. 2013;(4):104-108
pages 104-108 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies