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No 4 (2014)


Anatomic-clinical criteria for prediction of continence after radical retropubic prostatectomy

Loran O.B., Lukyanov I.V., Al Khariri M.F., Sinitsyn V.E., Motalov V.G., Bakunovich A.V.


A study to identify objective risk factors for development of urinary incontinence in patients with prostate cancer who underwent radical retropubic prostatectomy was conducted. Before surgery, magnetic resonance imaging to assess the length of the membranous segment of urethra and shape of the apex of the prostate was performed in 180 patients with prostate cancer. In addition, for the purpose to determine the effect on the risk of development of stress urinary incontinence after surgery, the authors evaluated such factors as age, body mass index, serum prostate specific antigen, prostate volume, postoperative stage prostate cancer, Gleason score, nerve-sparing surgical technique, surgical margin status. At a median postoperative follow-up of 9 months, the frequency of incontinence was 7.8%. Length of membranous segment of urethra, the shape of the apex of the prostate gland, and the patient’s age had a statistically significant effect on the risk of urinary incontinence after the intervention.
Urologiia. 2014;(4):5-9
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Enteroplasty of extended ureteric stricture of tuberculosis and other genesis

Zuban O.N., Skornyakov S.N., Arkanov L.V., Novikov B.I., Borodin E.P., Chotchaev R.M., Eremeyev D.Y.


48 patients aged 35 to 69 (51,0 + 0,6) years with extended or multiple ureteric strictures of specific (n = 36) and non-specific (n = 12) origin underwent ureteroplasty using intestinal grafts (enterourethroplasty). Before plastic surgery, percutneous pyelonephrostomy followed by assessment of glomerular filtration rate (GFR) was performed in 35 patients. It is shown that in case of baseline GFR less than 10 ml/min, reserve capacity of the kidney in hydrouretheronephrosis of tubercular etiology are exhausted. When creatinine clearance is greater than this value, restoration of function deblocked kidney occurs. The first case is indication for the nephrectomy, or nephroureterectomy, second case - for the reconstructive intervention on the ureter. Ileum was used in 45 patients, appendix - in 3 patients. In 26 (54.2%) patients, only replacement of ureter was performed; in 22 (45.8%) patients - replacement of the ureter and bladder. Enteroplasty of one of ureter was performed in 43 patients, two ureters - in 5 patients. It is established that these operations enable to release patients from lifelong external drainage of kidney in most cases, thereby significantly improving the quality of life (QOL). In the late postoperative period, quality of life significantly improves: particularly important - the mental health component, vitality and role functioning of patients; sustained reduction in pain intensity is observed (P <0.05). The optimum method of reconstruction of the ureter is ileoureteroplasty, if impossible -appendicourethroplasty.
Urologiia. 2014;(4):10-15
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Reconstructive surgery in patients with extended defects of the pelvic ureter

Komyakov B.K., Ochelenko V.A.


A comparison of long-term results of various reconstructive procedures in patients with extended strictures of the pelvic ureter was performed. The study included 175 patients with extended strictures of the pelvic ureter who underwent surgery and were observed in urological clinic of the NWSMU n.a. I.I. Mechnikov in a period from 1998 to 2014. Age of patients ranged from 18 to 69 years. There were 79 (45.2%) men and 96 (54.8%) women. All patients were divided into three groups. The group 1 consisted of 102 (58.3%) patients who underwent ureteroplasty by Boari procedure, the group 2 - 54 (30.1%) patients who underwent intestinoplasty of ureters, and the group 3 - 19 (10.9%) patients who underwent appendicourethroplasty. In the immediate and late postoperative periods, assessment of renal function and function of upper urinary tract was performed according to the results of laboratory, X-ray, radioisotope and endourological methods. Follow-up period ranged from 3 months to 16 years (mean 7.3 ± 0.8 years). It was found that in the group operated by Boari method, early postoperative complications occurred in 5 (4.9%) patients. Late postoperative complications occurred in 13 (12.8%) patients, which was significantly higher than in the comparison groups (P<0.05). Among patients who underwent intestinoplasty of ureters, early postoperative complications occurred in 7 (12.9%) patients. In the late postoperative period, complication rate was 5.6%. Among the 19 patients who underwent appendicourethroplasty, early postoperative complications were not observed. At long-term follow, they occurred in 2 (10.5%) patients, which was significantly lower than in the group of patients who underwent Boari procedure (P<0.05). Intestinoplasty, and in some cases, appendicourethroplasty, allow to replace defects of one or both ureters of any location and extent, and to get good long-term functional results; they are often considered as a safe and effective alternative to replacement surgery of ureter by own tissues of the urinary system.
Urologiia. 2014;(4):16-20
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Bladder leukoplakia - is the surgical aggression justified?

Kulchavenya E.V., Brizhatyuk E.V.


The article compares the results of treatment of patients with urinary bladder leukoplakia who underwent transurethral resection (TUR) - 76 patients; and interstitial laser therapy (ILT) using a YAG-Nd laser (yttrium-aluminum-garnet with neodymium) Medilas Fibertom 5100 («DornierMedTech», Germany) - 32 patients. The advantage of ILT is demonstrated: chronic pelvic pain syndrome after ILT was three times less longer than after TUR (15.6 and 50%, respectively); fibrosis developed in impact area was observed 3.5 times less frequently (18.8 and 67.1%, respectively). A year after intervention, only 19.7% of patients after TUR was satisfied with the outcome of treatment, while those after ILT were 84.4%.
Urologiia. 2014;(4):21-24
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Surgical management of pelvic organ prolapse and stress urinary incontinence in women

Shulgin A.S.


The study was aimed to evaluation of the feasibility of simultaneous transvaginal reconstruction of pelvic floor using mesh implants and loop urethropexy in stress urinary incontinence against the background of pelvic organ prolapse, or arising after reconstructive surgery for pelvic prolapse. The study included 206 patients with III and IV stage pelvic organ prolapse. The first group consisted of 72 women with pelvic organ prolapse accompanied by stress urinary incontinence. The second group included 134 patients with III and IV stage pelvic organ prolapse not accompanied by stress urinary incontinence. In both groups, performed transvaginal pelvic floor reconstruction using mesh implants in combination with or without loop urethropexy was performed. Optimal treatment of patients with stress urinary incontinence, accompanied by genital prolapse or emerged after reconstructive surgery, includes loop urehtropexy approximately 2-3 months after the final fixation of the mesh implant set for correction of pelvic prolapse.
Urologiia. 2014;(4):25-29
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State of innate immunity of mucous membranes in patients with recurrent bacterial cystitis

Perepanova T.S., Gankovskaya L.V., Volkova E.M., Svitich O.A., Grechenko V.V., Berenshteyn A.V.


Uncomplicated urinary tract infections (UUTI) occur in women of reproductive age with anatomically and functionally normal bladder and urinary tract. In 25-40% of women, relapse of UUTI occurs 6-8 months after the first episode. Despite the relatively wide range of antimicrobial agents, various schemes of antimicrobial prophylaxis of recurrence of cystitis, phytotherapy, estrogen therapy, and vaccinotherapy, cystitis yet often recurs. The study was aimed to the evaluation of the components of innate immunity in the epithelial cells of the mucous membrane of the urethra in women with chronic bacterial cystitis and in healthy women at the level of gene expression of Toll-like receptors TLR2 and TLR4 and the antimicrobial peptide produced by the bladder mucosa, β-defensin-1 (HBD1). In 80% of women with chronic recurrent bacterial cystitis, significant increase in the TLR2 and TLR4 gene expression levels compared with a group of healthy donors was found, and HBD1 gene expression in urethral mucosa was reduced in all examined patients. Our study allows to understand the cause of the frequent recurrence of bacterial cystitis and identify ways for search of new drugs and drug-free modalities.
Urologiia. 2014;(4):30-32
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Disorders of venous blood flow as a cause of chronic abacterial prostatitis (chronic pelvic pain syndrome)

Tsukanov A.Y., Lyashev R.V.


Patients with chronic abacterial prostatitis (chronic pelvic pain syndrome) (CAP/CPPS) is one of the most problematic categories of patients. There are some papers on arterial and venous disorders of the prostate as the main cause of this pathology. The present study has assessed the effectiveness of phlebotropic therapy in patients with long-standing CAP/CPPS on the background of pelvic varicose veins. Inclusion criteria were symptoms of CAP/CPPS more than 1 year with failure of the treatment in accordance with the RSU recommendations. The study included 96 patients aged 33.2±5.3 years. Duration of disease was 20.3±4.6 months. The patients were divided into 3 groups depending on the treatment received. In group 1 (n=33), patients have received a comprehensive phlebotropic therapy, in the group 2 (n=31) - phlebotropic therapy and ProstaDoz, in group 3 (n=32) - standard therapy and ProstaDoz. Elimination of regional phlebohypertension led to a marked improvement in all sections of the NIH-CPSI questionnaire, strengthening of intraprostatic blood flow, normalization of fructose and zinc levels in ejaculate, normalization of ejaculate volume, with maintaining the effects after cessation of treatment. Additional treatment with ProstaDoz in group 2 increased therapeutic effect, making the differences in the biochemical analysis of ejaculate to be statistically significant compared with group 1. In the group 3, the effect was significantly less pronounced and unstable, vascular changes were virtually absent.
Urologiia. 2014;(4):33-38
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Role of primary care pediatricians in the organization of pediatric uroandrological service (on the example of Stavropol)

Muravyeva V.N., Zenin V.V., Panchenko I.A.


The article presents the results of the survey of opinions of pediatricians (n = 80, 97.5% of the total number of specialists) in Stavropol city about the role of pediatric primary care in organization of pediatric uroandrological service. Analysis of the results indicates a lack of awareness of pediatricians in matters of pediatric urology, andrology, which is confirmed by 42.5% of respondents who said they did not receive information on the problem during the training courses. The lack of awareness of 22.5% pediatricians about the institutions that specialize in providing pediatric uroandrological care is conspicuous, and 3.8% of specialists treat these diseases themselves, that indicates non-compliance with the existing routing schemes in identifying children with uroandrological diseases. In addition, 11.3% of physicians during primary patronage only in some cases carry out inspections for pediatric uroandrological pathology, and even 6.3% of the specialists do not do it at all, that indicates the low level of suspicion among primary care pediatricians, that can result in negative impact on the reproductive health status of the child population of Stavropol city.
Urologiia. 2014;(4):39-41
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Partial nephrectomy with preliminary superselective embolization of the vessels feeding the tumor

Sorokin N.I., Kondrashin S.A., Shpot E.V., Sirota E.S., Kozmin L.D., Bocharnikova A.V., Martirosyan G.A.


In this work, the effectiveness of the superselective embolization of the arteries feeding the tumor prior to performing partial nephrectomy (open and laparoscopic) was evaluated. The results received show that this method can prevent long-term thermal ischemia of the normal renal parenchyma, and make it possible to perform resection in cases of complex vascular anatomy, when the mobilization of the renal artery and, moreover, segmental vessels is technically difficult or impossible, and in the third, Zero ischemia leads to decrease of intraoperative blood loss. The necessity of performing preoperative three-dimensional modeling of the pathological process is indicated in order to identify nephrometric indicators according to the R.E.N.A.L. scale.
Urologiia. 2014;(4):42-46
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Comparative analysis of results of radical nephrectomy and partial nephrectomy for clinically localized renal cell carcinoma in patients with normal functioning contralateral kidney

Volkova M.I., Skvortsov I.Y., Klimov A.V., Chernyaev V.A., Kalinin S.A., Peters M.V., Matveev V.B.


The study was aimed to the evaluation of the safety and feasibility of partial nephrectomy for clinically localized renal cell carcinoma in patients with a normally functioning contralateral kidney. A comparative analysis of the results of radical nephrectomy (n = 226) and partial nephrectomy (n = 227) in patients with cT1 -2N0M0 renal cancer with normally functioning contralateral kidney was performed. Groups of patients subjected to different extent of operations were matched by sex, age, side of lesion, baseline characteristics of the tumor, and renal function (P> 0.05 for all); pT1a category and degree G1of anaplasia were more often diagnosed in the partial nephrectomy group (P < 0.0001). None of the 453 patients has received additional treatment. Median follow-up period was 50 (12-224) months. It was found that partial nephrectomy is associated with a significant increase in the duration of surgery (P = 0.031), blood loss volume (P <0.000), and the risk of complications (OR = 2.8 (95% CI: 1.64.7); P < 0.0001) compared with radical nephrectomy. Complications of partial nephrectomy do not increase the risk of decline in renal function and death. Partial nephrectomy is comparable to radical nephrectomy in terms of recurrence free survival (HR = 5.9 ( 95 % CI: 0.9-38.3)), specific survival (HR = 0.1 ( 95% CI : 0-12555.9 )) cardiospecific survival (HR = 1.1 ( 95 % CI: 0.3-4.6)), and overall survival (HR = 0.8 ( 95 % CI: 0.2-2.5)), including stratification of patients by demographic characteristics, characteristics of the tumor and postoperative renal function (P> 0.05 for all). Nephrectomy increases the risk of acute renal dysfunction by 1.8 times and reduces the risk of developing stage ≥ 3 chronic kidney disease in the late postoperative period by 1.4 times compared with radical nephrectomy. The effects of extent of operations on the quality of life were not revealed. Thus, the use of partial nephrectomy allows to improve the longterm functional results of surgical treatment for clinically localized renal cell carcinoma, and is associated with an increased incidence of complications that do not lead, however, to a decrease in survival compared with radical nephrectomy. The choice of method of surgical treatment of such patients should be individualized.
Urologiia. 2014;(4):47-55
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The use of the drug vitaprost in patients with chronic prostatitis accompanied by disorders of spermatogenesis

Neimark A.I., Neimark B.A., Davydov A.V., Klepikova I.I., Nozdrachev N.A.


The efficacy and safety of vitaprost in 30 patients with chronic prostatitis accompanied by disorders of spermatogenesis were evaluated. It has been proved that the use of the drug vitaprost rectal suppositories 50 mg followed by 100 mg tablets vitaprost has positive effect on the main parameters of spermatogenesis, as well as on the subjective and objective symptoms of chronic prostatitis.
Urologiia. 2014;(4):56-59
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Prevention of exacerbations of chronic bacterial prostatitis

Kulchavenya E.V., Breusov A.A.


For the evaluation of the effectiveness of combined herbal drug ”prolit super septo” in the prevention of exacerbations of chronic bacterial prostatitis, an open prospective comparative ”case-control” study, which included 54 patients with a diagnosis of chronic bacterial prostatitis was performed. 27 patients received standard etiopathogenic therapy; other 27 patients in addition to standard therapy received prolit super septo 2 capsules twice a day for two months. 6 months after treatment, it was found that exacerbations occurred in 4 (14.8%) patients in the comparison group, and in 2 (7.4%) patients in the main group who received prolit super septo; in other patients sustained remission was achieved. In patients in the comparison group, the pain intensity of 3.2 points has persisted, and 2.8 points - in patients in the study group. A moderate increase of white blood count in the prostate secretion was more than 1.5 times often detected in the control group by than in the group of patients taking a prolit. Clinically significant bacterial growth was not observed in any patient. Quality of life of patients in the study group increased by 4.6 points, and in the comparison group - by 4.2 points
Urologiia. 2014;(4):60-63
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Daily intake of phosphodiesterase type 5 inhibitors - correction of erectile dysfunction and lower urinary tract symptoms in patients with bph

Volkov A.A., Petrichko M.I., Budnik N.V.


Research included 88 patients with benigh prostate hyperplasia (BPH) and the erectile dysfunction (ED). Depending on received conservative therapy patients were divided into three groups. The patients of the 1st group were treated with dutasteride 0.5 mg, tamsulosin 0.4 mg and tadalafil 5 mg, in group 2 patients received dutasteride 0.5 mg and 5 mg tadalafil, in the third group of patients received dutasteride 0.5 mg and tamsulosin 0.4 mg daily. The efficiency of treatment was estimated by patients’ questionnaire before treatment and after 12 weeks of therapy. The analysis of the received results showed the expediency of use of tadalafil 5 mg for daily dose in the scheme of treatment of patients with BPH and ED. When using tadalafil 5 mg was obtained comparable to tamsulosin decrease the symptoms of lower urinary tract and simultaneous improvement in erectile function. It is concluded that in certain groups of patients with BPH and ED may use tadalafil 5 mg with dutasteride without combination with α1-blockers.
Urologiia. 2014;(4):64-68
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Ejaculatory-protective transurethral resection of the prostate

Martov A.G., Andronov A.S., Dutov S.V., Baykov N.A.


Development of retrograde ejaculation is observed in the majority of patients who underwent standard transurethral resection of the prostate (TURP). One of the main causes of this state has always been a damage of the bladder neck during surgery. At the same time, preserving the intact the area around the seminal crest during TURP allows to protect the natural ejaculatory mechanisms. From May to December 2010, 42 patients with infravesicular obstruction caused by benign prostatic hyperplasia (study group) underwent adopted original method of ejaculatory-protective TURP (EP TURP). The control group consisted of 40 patients who underwent standard TURP. Exclusion criteria included: history of surgery on the pelvic organs, the presence of urethral stricture, diabetes mellitus, neurological disease, and erectile dysfunction. Patients in both groups were matched by age, prostate volume, I-PSS and QoL indices, peak flow rate and residual urine volume. The performance of intraoperative and immediate postoperative period, as well as long-term results 12, 24 and 36 months after surgery were evaluated. The mean duration of surgery in the study group was 44.5 ± 19.5 min, in control group - 32.9 ± 16.1 min. In the study group, 32.8 ± 8.4 g of tissue was removed, in the control group - 58.2 ± 6.3 g. In both groups, the positive results achieved by surgery have remained stable for 3 years. Serious intra- and postoperative complications in any of the groups were not recorded. Ejaculatory-protective surgery has allowed to fully preserve the natural ejaculation in 48.7% of patients, and partially - in 25.6% versus 14.3 and 8.6% of patients who underwent the standard method of surgery. The ejaculatory-protective TURP is an effective and safe method of surgical treatment of patients with benign prostatic hyperplasia, wishing to maintain antegrade ejaculation.
Urologiia. 2014;(4):69-75
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Minimally invasive percutaneous nephrolitho-tripsy without nephrostomy

Alyaev Y.G., Grigoryev N.A., Akopyan G.N., Bezrukov E.A., Ali S.K., Ali K.M.


The study included 138 patients with solitary and multiple renal stones. All patients underwent minipercutaneous nephrolithotripsy. The frequency of complete removal of the stones was 98%. Intraoperative complications were not recorded. Postoperative complications were assessed by the modified Clavien system (Dindo-modified). Complications of 0 degree were recorded in 102 (71.8%) cases, II - 38 (26.7%), and IIIa - only in 2 (1.5%) cases. In 80 (56.3%) cases, the upper urinary tract were drained using catheter-stent with an outer excretion through the urethra (group 1), in 58 (40.9%) cases - using catheter-stent with extraction of ligatures for nephrostomy to the lumbar region (2 group). In 4 (2.8%) patients, operation was completed by nephrostomy (group 3). In group 1, the average period of postoperative stay was 3-5 days, in the 2nd group - 3-7 days, in the group 3 - 4-7 days. None of the groups did not require opioid analgesics. Clinical observation is presented. Postoperative complications: in 86 (68%) patients - 0 according to the modified Clavien system (Dindo-modified), in 40 (30%) - II, and only in 2 - IIIa. In 78 (56.5%) cases, the upper urinary tract was drained using catheter-stent with an outer excretion through the urethra, in 56 (40.6%) cases - using catheter-stent with extraction of ligatures for nephrostomy to the lumbar region. In 4 (2.9%) patients operation was completed by nephrostomy. The average postoperative stay was 7.3 days. No patient required the appointment of opioid analgesics.
Urologiia. 2014;(4):76-79
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Does the transscrotal mobilization of processus vaginalis of peritoneum reduce the frequency of testicular atrophy after the second stage of Fowler-Stephens procedure?

Kogan M.I., Sizonov V.V., Orlov V.M., Shaldenko O.A.


Cryptorchidism is the most common abnormality of the male genitalia. Improvement of the technology of the second stage of Fowler-Stephens procedure, the most commonly surgery used in this disease, has allowed to reduce the incidence of postoperative testicular atrophy from 20 to 15 %. However, there are technological resources, which may result in improved results of the intervention. From 2006 to 2013, 167 boys with cryptorchidism (209 nonpalpable testes) underwent surgery in our clinic. Unilateral cryptorchidism was diagnosed in 125 (74.9 %) patients, bilateral cryptorchidism - in 42 (25.1 %). Average age was 53.7 ± 34.7 months. All patients underwent Fowler-Stephens procedure. During the first stage of the operation, abdominally located testes were revealed in 97 (46.4 %) cases, among them long loop of vas deferens was detected in 29 (29.9%); for 36 (37.1%) gonads, the presence of long loop of vas deferens was impossible to reliably exclude; obliterated processus vaginalis was detected in 3 (3.1%) cases. Patients were divided into two groups according to the type of second stage of intervention. The Group 1 included 27 boys (34 testes) who underwent surgery by the standard method; the Group 2 - 51 boys (63 gonads) who underwent surgery by modified technique. In order to evaluate the results of surgery, position and volume of cryptorchidic testes were defined intraoperatively and 6 months after. Testicular atrophy was revealed in 5 (15.2%) and 2 (3.3%) patients at the group 1 and Group 2, respectively (P <0.05). Author’s experience shows the feasibility of a scrotal mobilization of vaginal process of the peritoneum, if any, during the second stage of the Fowler-Stephens procedure, regardless of presence of loop of vas deferens. The use of proposed approach simplifies the mobilization of testes and reduces the incidence of subsequent testicular atrophy.
Urologiia. 2014;(4):80-83
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Positive effect of increasing dosage of selective antimuscarinics on the main symptoms of overactive bladder

Gadzhieva Z.K.


Overactive bladder (OAB) is a heavy urination disorder that affects at least 17% of the population older than 40 years. As a rule, for the treatment of OAB drug therapy is typically used. Currently, the most common drugs for the treatment of symptoms of OAB include preparations that block muscarinic receptors of the bladder. Solifenacin has the highest selectivity for the bladder among all m-cholinoblockers. The studies presented in this article show that the flexible dosing strategy can be effective in improving the symptoms of OAB, with minimal impact on tolerance. According to numerous studies, it is possible to confirm a positive effect of possibility of increasing the dosage of the drug solifenacin (vesicare) in the treatment of major symptoms of OAB, and actualize the need for use of solifenacin 10 mg at the starting of therapy. This drug has no significant effect on cognitive function in elderly patients, in contrast to oxybutynin. Thus, due to the optimal balance of efficacy and safety, solifenacin at a dose of 10 mg provides greater treatment adherence compared to other m-anticholinergics.
Urologiia. 2014;(4):84-89
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Methods of hemostasis in laparoscopic partial nephrectomy

Alyaev Y.G., Bezrukov E.A., Sirota E.S., Shpot E.V., Proskura A.V.


Nephrectomy is the standard method of management of patients with so-called “small tumors.” Sparing surgery on kidney, except neoplastic lesions, are used in the treatment of urolithiasis, urinary tract anomalies, kidney tuberculous, cysts, xanthogranulomatous pyelonephritis, renovascular hypertension and echinococcosis. Any penetrating lesion of parenchyma can cause significant bleeding. In this regard, nephrectomy is such a “wound”, but under controlled conditions. Therefore, hemorrhagic complications after sparing surgery are a major cause of death. This review presents information on existing methods of hemostasis used during partial nephrectomy in the experiment and in the clinical setting.
Urologiia. 2014;(4):90-95
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Effective methods of electrical stimulation and magnetic stimulation in patients with chronic pelvic pain syndrome, and overactive bladder in urological practice (literature review)

Kamalov A.A., Nizov A.N., Khodyreva L.A., Dudareva A.A.


The analysis of the results of studies evaluating the efficacy and safety of methods of electrical, magnetic, and shock-wave stimulation in patients with chronic pelvic pain syndrome (CPPS) was performed. The authors searched the PubMed and EMBASE databases from 1990 to 2014. Despite the ambiguity and inconsistency of data obtained by researchers, there is reason to consider the use of electrical stimulation, in particular magnetic stimulation, as a promising, more secure and portable method of treatment of chronic pain.
Urologiia. 2014;(4):96-99
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Hyperuricemia - risk marker of endothelial dysfunction in the development of erectile dysfunction

Saenko V.S., Vinarov A.Z., Pesegov S.V.


The article presents the modern literature data indicating the importance of evaluation of the role of hyperuricemia as a cause of endothelial dysfunction and oxidative stress in the pathogenesis of cardiovascular diseases (CVD) and erectile dysfunction (ED). It is hypothesized that hyperuricemia can really affect the outcomes of vascular lesions, and the use of diets and medicines aimed at reducing the uric acid levels, therefore, may be a new method of prevention of cardiovascular diseases, erectile dysfunction, and renal glomerular lesions. Further research in this area will soon have to give answers to these questions.
Urologiia. 2014;(4):100-103
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K 75-letiyu Ivana Gerasimovicha Agadzhanyana

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Urologiia. 2014;(4):104
pages 104 views

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