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No 1 (2014)


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Potential biochemical factors for the development of urolithiasis in patients with spinal cord injuries

Stogov M.V., Shchurova E.N., Blyudenov D.N.


A comparative analysis of biochemical parameters of blood serum and daily urine in patients with urolithiasis developed after spinal cord injury (study group - 35 patients) and patients without development of the disease (comparison group - 20 patients) was performed. It was found that patients after spinal cord injury have developed productive azotemia, which led to the disruption of renal excretory function (accumulation of urea and creatinine in blood, and lowering their clearance). Against this background, there is violation of excretion of uric acid, magnesium, decreased sensitivity of the renal tubules to aldosterone (in patients with nephrolithiasis K/Na ratio in urine was lower). As a result, patients have decreased reabsorption of sodium and water retention, increased urine osmolality; against the background of electrolyte imbalance in urine, this leads to the formation of stones. In patients with spinal cord injuries, main trigger mechanism of formation of urinary stones was excessive posttraumatic azotemia. The high concentration of the products of protein-nitrogen catabolism in the serum of patients in the acute and early periods of spinal cord injury may be unfavorable criterion determining the significant risk of developing of kidney stones.
Urologiia. 2014;(1):10-15
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Impact of plasmapheresis on intraorgan blood flow of the transplanted kidney in the early postoperative period

Vatazin A.V., Sinyutin A.A., Zulkarnaev A.B., Kantaria R.O., Krstich M.


Kidney transplant is inevitably subjected to ischemic and reperfusion injury. In many cases, this is due to a violation of intraorgan hemodynamics. Severity of such damage can be reduced using different methods of extracorporeal hemocorrection. The aim of the study was to examine the intraorgan blood flow of kidney transplant and assess the impact of plasmapheresis on its primary function in the early postoperative period. Plasmapheresis with replacement from 1,25 to 3,5 liters of plasma was applied in 40 recipients of the Group 1; in 40 recipients of Group 2 plasmapheresis was not performed. High resistance index (Ri> 0,9) at low flow velocities in the interlobular arteries at the first day after surgery is an informative criterion for the diagnosis of acute tubular necrosis and indicates the inadequate blood supply of kidney. Plasmapheresis has promoted the normalization of renal hemodynamics. Immediate graft function in patients of Group 1 was observed in 36 patients, whereas only in 19 patients of Group 2. In the Group 1, there were no patients with primary non-functioning graft, while there were three such patients in Group 2. Thus, plasmapheresis in the early postoperative period, no later than 3-5 h after reperfusion of the graft, has a positive effect on the functional status of the transplanted kidney.
Urologiia. 2014;(1):16-19
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Urination disorders. Do we know all about them?

Gadzhieva Z.K., Kazilov Y.B., Alyaev Y.G., Aboyan I.A., Kazilov B.R.


The article presents the results of the pilot questionnaire survey of doctors of various specialties, living in some cities in the Southern Federal District, in the diagnosis and treatment of various urination disorders. The survey involved 101 urologists, 33 obstetricians, 37 internists, 35 surgeons, 9 neurologists and 1 infectiologist. Inadequate training of doctors of various specialties regarding the diagnosis and treatment of various disorders of urination of inflammatory and non-inflammatory nature should be noted. Misunderstanding of differential diagnosis of various forms of urinary incontinence and tactics of management of each of them come under notice. Most urologists (95.46%), obstetricians (92.3%), physicians (100%), neurologists (66.6%), and surgeons (88.58%) did not have a thorough knowledge about the symptoms of overactive bladder (OB). Only 63.37 % of the entire group of respondents, and 81% of urologists using conservative therapies, has prescribed M-anticholinergics for the treatment of OB. In the treatment of urgent forms of urinary incontinence, only 64.5% of urologists use M-anticholinergics. Excessive use of M-anticholinergics for the treatment of stress urinary incontinence still persists - 38 % of urologists. а- blockers are the main group of drugs (96.6%) used in medical treatment of LUTS in benign prostatic hyperplasia. However, there is reduced (14.8%) understanding of the need to designate combination therapy with M-cholinergic antagonists when indicated. The issues of therapy of patients with lower urinary tract infections, namely the choice of antibiotics without considering antibiotic sensitivity and antibiotic resistance and knowledge of Russian and national guidelines and recommendations of the European Association of Urology are of particular concern. Curiously enough, there is underestimation of this issue by urologists (23%) compared to obstetricians (45%) and physicians (40.7%). These findings can determine the need for education programs for professionals in different areas of medicine, because patients with urination disorders occur in practice of doctors of various related specialties.
Urologiia. 2014;(1):20-27
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Positional changes of the magistral blood flow of the left kidney in men with varicocele and infertility

Alekseenko S.N., Medvedev V.L., Tatevosyan A.S., Tonyan A.G., Pomortsev A.V., Zhdamarova O.I., Medvedev A.V.


This paper proves the correlation between characteristics of blood flow rate in the renal veins and resistance indices of the renal arteries. As a result of polypositional assessment of venous blood flow, it was found that the violations of magistral venous blood flow in the left kidney can affect the formation and progression of varicocele, and the severity of disorders of spermatogenesis. The necessity of assessment of testicular veins and the pressure in left renal vein not only in clin- and orthostasis or Valsalva maneuver, but in the six static positions is discussed; this can allow to register the violations of magistral renal blood flow at the early stages important for fertility disorders, improve the efficiency of diagnosis and treatment of patients with varicocele.
Urologiia. 2014;(1):28-32
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Perineal saturation biopsy of the prostate

Sadchenko A.V., Govorov A.V., Pushkar D.Y., Sidorenkov A.V., Vasilyev A.O., Kovylina M.V., Prilepskaya E.A.


The effectiveness of perineal biopsy for the detection of prostate cancer (PC) using an array for brachytherapy/cryotherapy was evaluated. It is shown that perineal saturation biopsy provides high detection rate of prostate cancer in patients with suspected cancer after negative transrectal biopsies, does not increase the detection of clinically insignificant cancer and incidence of complications, but requires a lot of time and cost.
Urologiia. 2014;(1):33-36
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Three-year results of the treatment of localized prostate cancer using high-intensity focused ultrasound

Fomkin R.N., Voronina E.S., Popkov V.M., Maslyakova G.N., Blumberg B.I.


The study was aimed to the assessment of the effectiveness of treatment for prostate cancer using high-intensity focused ultrasound on the basis of clinical, radiation, laboratory data, and results of morphometric and immunohistochemical study of postoperative prostate biopsies. 112 sessions of HIFU-ablation of the prostate in 112 patients with localized prostate cancer were performed. Average number of impulses of action - 634+176, the average volume of tissue exposed - 34,6±15,2 cm3 per 1 session. The operative time ranged from 90 to 165 min (mean 125 min). The postoperative hospital stay ranged from 7 to 14 days (average 10±0,8 days). Intraoperative complications during HIFU-ablation were not observed. The average level of prostate-specific antigen 1,5 months after surgery was 0,7 ( 0,12-3,67 ) ng/ml. Minimum level of prostate-specific antigen was reached 20±2 weeks after treatment, and the average level was 0,26+0,01 ng/ml. 6 months after, prostate volume decreased by an average of 49%; 10-12 months after intervention, prostate volume was 6,5±2,2 cm3. Morphological analysis after treatment included studies with standard and immunohistochemical staining using the following antibodies: PCNA, Bcl2, AMACR, E-cadherin, ANDR. Recurrence-free course was observed in 96 (85,8 %) patients. Recurrences were detected in 16 (14,2%) patients, with biochemical progression in 11 (9,82 %) patients. Local recurrence (morphologically confirmed) was diagnosed in 5 (4,46 %) patients.
Urologiia. 2014;(1):37-43
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Scanning electron microscopy of resected ureters in children with ureterohydronephrosis

Akilov K.A., Beknazarov Z.B., Khakkulov E.B., Baybekov I.M.


Using scanning electron microscopy, various portions of the ureter in reflux and obstructive ureterohydronephrosis in children were evaluated. In the first case, architectonics of the distal portions is preserved, while in the second case connective tissue is proliferated. Differences in the structure of proximal and distal portions in both forms of ureterohydronephrosis consist in inflammatory changes and violation of the integrity of the epithelial lining, edema and infiltration of the underlying layers, especially the inner muscle layer of the distal portion. The wall of the ureter in proximal part is much thinner, especially the muscular and mucous layers.
Urologiia. 2014;(1):44-47
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Lower urinary tract symptoms in men

Krivoborodov G.G.


Симптомы нижних мочевыводящих путей (СНМП) часто встречаются в клинической практике, особенно среди мужчин пожилого возраста. Основное внимание при первичном обращении мужчин с жалобами на нарушение акта мочеиспускания следует уделять оценке их тяжести на основании опросника IPSS. Важно выявить преобладающие симптомы, что определяет тактику лечения. В отсутствие абсолютных показаний к оперативному лечению клинической формы аденомы предстательной железы (АПЖ) следует использовать медикаментозное лечение. В случаях преобладания обструктивных СНМП препаратами первой линии лечения являются α-адреноблокаторы. При наличии признаков прогрессирования АПЖ (объем простаты >40 см 3 и ПСА Ю >1,5 нг/мл целесообразно комбинированное применение α-адреноблокаторовв в сочетании с ингибиторами 5α-редуктазы. Комбинированное медикаментозное лечение в виде α-адреноблокаторов и М-холиноблокаторов оправданно при ирритативных СНМП у мужчин с АПЖ.
Urologiia. 2014;(1):48-54
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Topical issues of antibiotic therapy of prostatitis

Lokshin K.L.


В первой части обзора представлены результаты наиболее интересных и крупных исследований, посвященных проблеме лечения бактериального простатита и опубликованных после 2010 г. Во второй части изложены ключевые положения современных клинических рекомендаций Европейской ассоциации урологов по антибиотикотерапии простатитов, опубликованных: в 2011 г. и базирующихся на исследованиях, проведенных до 2010 г. включительно.
Urologiia. 2014;(1):55-61
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The use of vitaprost in the treatment of patients with prostate diseases

Demidko Y.L., Gazimiev M.A., Bayduvaliev A.M., Lachinov E.L., Saenko V.S.


Inflammatory diseases of the prostate are common among men. These diseases are frequently characterized by long-term course and relapses. Prostatitis-associated symptoms significantly reduce the quality of life of patients. Due to the lack of generally accepted criteria for the diagnosis of prostatitis, the frequency of inflammatory diseases of the prostate is difficult to establish. Inflammatory diseases of the prostate should be differentiated from chronic pelvic pain syndrome. The mainstay of treatment of infectious and inflammatory processes in the prostate are antibacterial drugs (generations III and IV fluoroquinolones). The recommended course of treatment includes 4-6 weeks. Prostate peptides from bovine (cytomedines) have proven efficacy in the treatment of patients with prostatitis; cytomedines influence the differentiation and proliferation of prostate cells, have anti-inflammatory and immunomodulatory properties. In clinical trials, high efficiency of cytomedines in prostatitis and prostate adenoma, as well as long-term remission of the diseases is demonstrated.
Urologiia. 2014;(1):62-67
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An 18-year follow-up of the patient with four asynchronous malignant tumors of the urogenital system

Alferov S.M., Grishin M.A., Odintsov S.V., Chuprik-Malinovskaya T.P.
Urologiia. 2014;(1):68-72
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Comparative characteristics of the results of current surgical treatments in patients with prostate adenoma

Sergienko N.F., Kudryashov O.I., Bratchikov O.I., Begaev A.I., Shchekochikhin A.V., Shershnev S.P., Reinyuk O.L., Lototsky M.M.
Urologiia. 2014;(1):73-78
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Laparoscopic pyeloplasty

Komyakov B.K., Guliev B.G., Aliev R.V.
Urologiia. 2014;(1):79-83
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Modern hypotheses of development of bladder cancer

Pryanichnikova M.B.
Urologiia. 2014;(1):88-91
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