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No 6 (2015)


PLGA mesh-collagen hybrid scaffold and tissue-engineered product in substitution urethroplasty: experimental validation

Glybochko P.V., Alyaev Y.G., Shekhter A.B., Vinarov A.Z., Istranov L.P., Istranova E.V., Aboyants R.K., Lyundup A.V., Krasheninnikov M.E., Guller A.E., Butnaru D.V., Marisov L.V., Kantimerov D.F., Kurkov A.V., Safronova E.I., Vorob’eva E.A., Iritsyan M.M.


Urethral strictures are a pressing issue in modern medicine. Substitution urethroplasty is considered one of the most effective treatment methods. However, despite the surgery showing good results, many problems remain unresolved, one being substitute material deficiency in extensive or recurrent strictures, as well as in cases requiring multistage surgeries, including those used to treat hypospadias. Graft removal also leaves the donor area prone to diseases and increases the length of surgery leading to a higher risk of intra- and postoperative complications. Tissue engineering (namely tissue-engineered products comprised of scaffolds and cells) may be a useful tool in dealing with these issues. The authors assessed the characteristics of a novel hybrid scaffold created from “reconstructed” collagen and a poly(lactic-co-glycolic acid) mesh. The resulting composite product showed good mechanical properties and functional performance. The hybrid scaffold was non-cytotoxic and provided an adequate base for cell adhesion and proliferation. Biodegradation resulted in the scaffold being replaced by urothelium and urethral mucosa. The newly formed tissues possessed adequate structural and functional properties. Only one rabbit out of 12 developed urethral stricture at the site of scaffold implantation. The abovementioned facts suggest that the novel hybrid scaffold is a promising tissue-engineered product with potential implication in substitution urethroplasty.
Urologiia. 2015;(6):5-13
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On prevention of post-surgery acute urinary retention

Spivak L.G., Mel'nikov A.V.


The article highlights the issues of prevention of acute urinary retention after surgery. The authors present results of a study on the efficacy and safety of α1-blockers for the prevention of acute urinary retention after surgery. The results imply that the use of α1-blockers in pre- and postoperative period can significantly reduce the risk of postoperative ischuria, contribute to independent urination after a single urinary catheterization in patients who experience urinary retention, improve the postoperative period and promote recovery of patients.
Urologiia. 2015;(6):14-19
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Use of Vitaprost® (tablets and rectal suppositories) for patients’ rehabilitation after invasive diagnostic urological interventions

Ergakov D.V., Martov A.G.


The successful experience with the drug Vitaprost ® in the treatment of chronic prostatitis, and the emerging research evidence on the use of the drug in the treatment of urinary disorders served as a prerequisite to conduct a prospective study comparing the effectiveness of the combined application of rectal suppositories Vitaprost® forte and Vitaprost® tablets (production of JSC Nizhpharm, STADA CIS) in the rehabilitation of patients who had undergone invasive urologic procedures. 90 patients who underwent prostate biopsy (63) and urethrocystoscopy with bladder biopsy (27) were followed from January to July 2015. All patients were randomized to the control group (n=50) and the intervention group (n=40). Patients assigned to the control group were treated with standard anti-inflammatory therapy, and intervention group besides standard therapy received rectal suppositories Vitaprost ® forte for 10 days with the transition to Vitaprost® pills also for 10 days. Treatment efficacy was evaluated by comparing the subjective and objective measures before and after biopsy in both groups, and rates of complications and adverse events. The both formulations of Vitaprost® were well tolerated. Objective parameters (Qmax, prostate volume) in groups at 1 month did not differ significantly. However, there was a statistically significant greater reduction in subjective indicators (I-PSS, QoL) in the study group (12,4±1,1 and 2,1±0,4 points, respectively) compared with the control group (15,8±1,9 and 3,2±0,6 points, respectively). Also, patients treated with Vitaprost®, had significantly higher scores in IIEF and Well-Being Index on a visual analog scale. Vitaprost ® use resulted in reduced risk of acute urinary retention and frequency of hematospermia. To conclude, the combined use of Vitaprost ® forte and Vitaprost ® in the rehabilitation of patients after invasive urologic interventions is beneficial in terms of improvement of patients’ subjective and objective indicators.
Urologiia. 2015;(6):20-25
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Initial experience with shock wave therapy in men with chronic pelvic pain syndrome

Rudenko V.I., Rapoport L.M., Gazimiev M.A., Demidko Y.L., Bayduvaliev A.M.


In article experience of application of low-energy shock and wave therapy for men with a chronic pelvic pain syndrome is described.
Urologiia. 2015;(6):26-29
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Assessment of the specific characteristics of urethral stricture according to records of medical republican institution of Uzbekistan

Akilov F.A., Rakhmonov O.M., Alidjanov J.F., Mirkhamidov D.K., Tukhtamishev M.K., Lazzeri M., Barbagli G.


Urethral stricture in men is a common disorder, negatively affecting the health and therefore the quality of patients’ life. The aim of the study was to evaluate the nature of the stricture in various segments of male urethra and the incidence rate of urethral stricture in the Republic of Uzbekistan. The study presents the analysis of medical records of 195 men (mean age 40,6±13,1 years) who underwent urethroplasty in the Republican Specialized Centre of Urology between February 2013 and March 2015. 46.7% and 53.3% of patients had anterior and posterior urethral strictures, respectively. The most common causes of stricture were trauma (38.5%) and infections (22.6%); 18% of strictures were considered idiopathic, 19% - iatrogenic. In 13.3% of cases, stricture located within the pendulous urethra, in 42.7% - within the bulbar urethra, in 32% - within the posterior urethra. In 28.7% of patients the length of the stricture was more than 6 cm, in 25.6% - 2 cm or less.
Urologiia. 2015;(6):30-34
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Combined treatment of genital human papillomavirus infection in men

Al'-Shukri S.H., Kuz'min I.V., Slesarevskaya M.N.


This study aimed to assess the efficacy of treatment of genital human papillomavirus infection in 107 men. Patients in group 1 (n=51) underwent laser ablation of genital warts, patients in group 2 (n=56) were treated with laser ablation in conjunction with the administration of an immune system medication izoprinozin. During the first 9 months post-treatment, human papillomavirus infection relapse rate in group 1 was 23,5% and in group 2 - 5,4%. It was likewise observed that the combined treatment of genital warts resulted in reduced incidence of infective complications and the time of wound epithelialization after laser papilloma ablation.
Urologiia. 2015;(6):35-39
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To the issue of local treatment in combination therapy of chronic urethritis, associated with sexually transmitted infections

Abdrahmanov R.M., Fajzullina E.V., Abdrahmanov A.R., Haliullin R.R.


The article shows the high efficacy of the additional local use of the drug Miramistin* in combination therapy of chronic urethritis, associated with sexually transmitted infections (STIs). In accordance with the principles of evidence-based medicine, patients were assigned to the study group (n=110) treated with conventional therapy and Miramistin*, and the comparison group (n=40) treated with conventional therapy only. The between-group comparison of treatment effectiveness was carried out by matching results of the etiological healing, the changes of the endoscopic picture of the urethra, and basic clinical manifestations of STI: the degree of inflammatory reaction of urethral mucous membrane, dysuria, pain and sexual syndrome.
Urologiia. 2015;(6):40-46
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Extracorporeal photochemotherapy as prevention of graft rejection, coupled with declining infectious complications rates in urological patients

Fedulkina V.A., Vatazin A.V., Kil'dyushevskiy A.V., Zul'karnaev A.B., Kantariya R.O.


This study presents results of extracorporeal photochemotherapy (EPCT) application in 24 renal allograft recipients (RAR), who suffered chronic kidney disease (CKD) caused by urological diseases. The comparison group treated only with chemical immunosuppression comprised 24 recipients who received transplants from the same donors as intervention group patients. It was found that EPCT reduces not only the number of RAR rejections, but also the incidence of infectious complications. The effectiveness of EFHT was confirmed by clinical, laboratory and immunological data, and by protocol biopsy results. Possible mechanisms of preservation of anti-infectious protection in the setting of chemical immunosuppression when using EPCT are discussed.
Urologiia. 2015;(6):47-51
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Periprostatic inflammation as a risk factor for the development of vesico-urethral stenosis after radical prostatectomy

Chibichyan M.B., Kogan M.I., Lapteva T.O., Belousov I.I., Ivanov A.G., Chernogubova E.A.


This article presents results of a study conducted to identify the causes of stenosis in the region of vesico-urethral anastomosis (VUA) after radical prostatectomy (RP). Tissue specimens from removed prostates were evaluated in 115 prostate cancer patients with a favorable postoperative period (group 1) and 5 patients who develop VUA stenosis between 6 months to1 year after RP. It was found that in the group 1 inflammatory infiltration did not basically affect tumor growth zones, was mild and did not spread beyond the prostate. Patients of the group 2 had maximum inflammation, with the inflammatory infiltration localized in the prostate regions, both affected and not affected by the tumor, and periprostatically. Taking into account more severe inflammatory response in the prostate with extracapsular extension of the process and the involvement of periprostatic structures in patients who developed VUA stenosis after RP, compared to those without VUA stenosis, we can consider this phenomenon as a risk factor for stenotic complications in the vesico-urethral segment after RP.
Urologiia. 2015;(6):52-57
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Prostadoz - opportunity for prostate cancer prevention?

Alyaev Y.G., Rapoport L.M., Tsarichenko D.G., Ganzha T.M., Krupinov G.E.


Prevention of prostate cancer (PCa) is a vital problem dictated by the obvious benefit of prevention compared to the complexity of treatment. To date, a tremendous amount of research both in vitro, and in vivo assessment of different prophylactic measures has been published. They included consumption of protein, carbohydrate, fat, fiber, vegetable extracts and other solid products, and combinations thereof in the diet, vitamins, minerals, and biologically active substances, medicaments. The optimal preventive agent has not been found, and that prompted us to conduct our own research of dietary supplement ProstaDoz. The study was performed on a group of 58 patients with elevated prostate-specific antigen and the results of the histological study confirming the absence of prostate cancer and the presence of a high degree PIN. After 6 month course of ProstaDoz histological analysis of repeated biopsy samples revealed a significantly lower incidence of prostate cancer and atypical small acinar proliferation in the group receiving ProstaDoz (10.4%) compared to control group (20,7%; p <0,024), and in some cases even regression of PIN (32%) in the study group (p = 0.5). Also, there was a significant reduction in prostate-specific antigen after receiving ProstaDoz. These data show the potential effectiveness of ProstaDoz use as a means of PCa chemoprevention.
Urologiia. 2015;(6):58-67
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Clinical and pathomorphological features of chronic prostatitis in chemical industry workers

Neimark A.I., Kiptilov A.V., Lapiy G.A.


During periodic screening on the chemical industry, an increased incidence of chronic prostatitis in workers at sulfuric acid section was revealed. Detailed examination has revealed features of the clinical picture of the pathological process that develops in the prostate gland of workers exposed to harmful labor conditions. Complex pathomorphologic analysis of prostate biopsies of workers with chronic abacterial prostatitis found fundamental differences of morphological manifestations observed in other forms of chronic prostatitis. They include the prevalence of dystrophic and atrophic changes of glandular components with the presence of focuses of simple and small acinar atrophy, reduction of the microvasculature vessels, progressive fibrosis of the stroma with the phenomena of periglandular and perivascular sclerosis, as a rule, in the absence of inflammatory cell infiltration. Doppler ultrasound data indicated a change in hemodynamics, accompanied by a decrease in blood flow in the prostate gland.
Urologiia. 2015;(6):68-73
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Spermatogenesis recovery following allogeneic transplantation of undifferentiated Sertoli cells in experimental model of bilateral abdominal cryptorchidism

Kulibin A.Y., Malolina E.A., Jacyk S.P., Zhamynchiev J.K., Kuzin G.V.


This study explores the effect of transplantation of undifferentiated Sertoli cells in the testicular tissue of an experimental animal model of bilateral abdominal cryptorchidism. Effectiveness of undifferentiated Sertoli cell transplantation was assessed after 1 and 3 months after injection. Partial restoration of seminiferous tubules was found to occur after transplantation. In a third of them germ cells of all stages of the differentiation were discovered while they were not found in the control group.
Urologiia. 2015;(6):74-81
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Penile dimensions in type 2 diabetes

Belousov I.I., Kogan M.I., Ibishev H.S., Vorobyev S.V., Khripun I.A., Gusova Z.R.


The current literature provides a wide range of publications on the anthropometry of the penis specifying the relationship between penile dimensions and sex hormones, weight, height and erectile function. But most of the studies involved healthy volunteers or young patients with erectile dysfunction. Our study was conducted in patients with type 2 diabetes. Penile measurements obtained in the present study were compared those of the average Russian man. The patients were divided into groups with preserved and impaired erectile function. Erectile function was also studied relative to the variability of penile dimensions. The effect of DM duration on erectile function was defined. Comparative analysis revealed the relationship between penile anatomical dimensions and erectile function. We studied the effect of type 2 diabetes on the anatomical dimensions and elasticity of the penis, established the relationship between penile dimensions and elasticity of the penis. The correlation between the severity of erectile dysfunction and serum testosterone levels on one side, and penile dimensions on the other was found. The effect of penile dimensions on erectile function in DM patients was also examined. Determining penile dimensions and their variability due to various pathological conditions or processes, may eventually lead to better result of ED management.
Urologiia. 2015;(6):82-86
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The features of erectile dysfunction in type 2 diabetes and serum testosterone deficiency

Kogan M.I., Belousov I.I., Ibishev H.S., Vorobyev S.V., Khripun I.A., Sizyakin D.V., Cherniy A.A., Morgunov M.N., Paleniy A.V.


The current literature is lacking sufficient coverage of the relationship between erectile dysfunction (ED) and diabetes mellitus (DM), and age-related hypogonadism. At the same time, the mutual impact of cardiovascular and endocrine systems on men erectile function and the resulting damage of male sexual organs are being studied and debated. This prospective, randomized, simple comparative study examined the erectile function of 1З1 men with type 2 DM and age-related hypogonadism, tested the effects of DM on serum testosterone, formed an idea of possible relationship between DM, severity of ED and testosterone levels, degree of endothelial dysfunction and the involvement of the testicles. The study results showed the impact of testosterone level on the compensation of DM and frequency of ED. Correlations were observed between testosterone levels, peak systolic velocity of blood flow in the of capsular arteries of testes and testicular size. The interrelation between testicular size, reduction of testicular blood flow, and DM-related endothelial dysfunction and variability of serum testosterone levels was found. The findings suggest the need for revising existing reference ranges for serum testosterone upward to 15 nmol/L.
Urologiia. 2015;(6):87-92
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Dynamic transperineal ultrasonography as indication criteria for biofeedback therapy in children with dysfunctional voiding

Sottaeva Z.Z., Menovshchikova L.B., Gurevich A.I., Dzhavathanova R.I.


Disorders of pelvic organs' evacuation function, manifested by difficulty in urination and constipation, in conjunction with incontinence, and childhood stool smearing is an urgent medical and social problem. The study presents results of treatment of 36 children (mean age 7,2 ± 2,3 years) with non-neurogenic variants of pelvic organ dysfunction. The choice of treatment was based on an attempt to form managed urination. Indications to treatment were defined both by traditional methods, and by transperineal ultrasonography - the method developed by the authors. Increased rear urethrovesical angle at rest and during functional tests with retention and straining, the deviation of the bladder neck and urethra to sacrum, shortening of urethra and bladder neck, lack of bladder neck and urethra movement, or the inability to perform volitional exercises were seen as signs of pelvic floor paradoxical movements. Analysis of the results of clinical trials showed, that the method is a reliable, non-invasive and does not require expert class ultrasound equipment. The treatment consisted of biofeedback therapy sessions performed in outpatient settings. 25 children were found to have positive changes, 7 of them fully recovered from voiding dysfunction.
Urologiia. 2015;(6):93-97
pages 93-97 views

Prospects for application of stem cells from adipose tissue in treating erectile dysfunction

Chaliy M.E., Glybochko P.V., Epifanova M.V., Krasnov A.O.


Although phosphodiesterase type 5 inhibitors are the first-line treatment of ED, some patients remain unresponsive to any pharmacotherapy. To date, the use of stem cells is considered as a new treatment modality for erectile dysfunction. The validity of this assumption has been experimentally proved in preclinical and clinical studies. The main focus is on the stem cells derived from adipose tissue, due to advantages over other sources.
Urologiia. 2015;(6):98-103
pages 98-103 views

Use of flexible needles and ways to control their placement in robot-assisted prostate brachytherapy

Lopota A.V., Gryaznov N.A., Senchik K.Y., Kharlamov V.V., Nikitin S.A., Kireeva G.S.


The article provides an overview of developments in the field of flexible needles and methods of control over their behavior in the human body as a part of modern robotic systems for prostate cancer brachytherapy. The authors describe the advantages of flexible needles over standard ones, features of their design, and results of their tests in phantom models.
Urologiia. 2015;(6):104-108
pages 104-108 views

Importance of «surgery of quick recovery» program for surgical treatment of bladder tumors

Darenkov S.P., Kotov S.V., Proskokov A.A., Jusufov A.G., Belomytcev S.V., Badovskaya E.V., Gubaidullin R.R., Pinchuk I.S.


The article presents an analytical review of literature outlining the prospects for the use of the program "Surgery of quick recovery" in the surgical treatment of the bladder malignant tumors. The multi-modal program "Surgery of quick recovery" was found to reduce the number of postoperative complications and shorten recovery of patients with bladder cancer.
Urologiia. 2015;(6):109-115
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Laser lithotripsy

Platonova D.V., Zamyatina V.A., Dymov A.M., Kovalenko A.A., Vinarov A.Z., Minaev V.P.


The article describes the diverse methods of stone destruction in urolithiasis patients, including laser lithotripsy as the least traumatic and most efficient method of demolition of all types of urinary stones. Different types of lasers for intracorporeal lithotripsy have different mechanisms of stone fragmentation depending on the type of laser and its radiation parameters. The latest researches showed that new and promising laser modalities for lithotripsy are devices based on thulium (Tm) doped fiber laser, which can not only increase by several times the speed of the of stone fragmentation, but also minimizes the risks of surgical complications, due to the peculiarities of interaction between radiation and biological tissues.
Urologiia. 2015;(6):116-121
pages 116-121 views

Simulation-based robot-assisted surgical training

Kolontarev K.B., Govorov A.V., Rasner P.I., Sheptunov S.A., Prilepskaya E.A., Maltsev E.G., Pushkar D.Y.


Since the first use of robotic surgical system in 2000, the robot-assisted technology has gained wide popularity throughout the world. Robot-assisted surgical training is a complex issue that requires significant efforts from students and teacher. During the last two decades, simulation-based training had received active development due to wide-spread occurrence and popularization of laparoscopic and robot-assisted surgical techniques. We performed a systematic review to identify the currently available simulators for robot-assisted surgery. We searched the Medline and Pubmed, English sources of literature data, using the following key words and phrases: «robotics», «robotic surgery», «computer assisted surgery», «simulation», «computer simulation», «virtual reality», «surgical training», and «surgical education». There were identified 565 publications, which meet the key words and phrases; 19 publications were selected for the final analysis. It was established that simulation-based training is the most promising teaching tool that can be used in the training of the next generation robotic surgeons. Today the use of simulators to train surgeons is validated. Price of devices is an obvious barrier for inclusion in the program for training of robotic surgeons, but the lack of this tool will result in a sharp increase in the duration of specialists’ training.
Urologiia. 2015;(6):122-129
pages 122-129 views

Comprehensive rehabilitation of a patient after penile amputation by the methods of augmentation reconstruction of corpora cavernosa, urethra and glans penis

Kurbatov D.G., Lepetukhin A.E., Dubskiy S.A., Aliev R.T.


The article presents a unique clinical case of social, psychological and sexual rehabilitation of a patient who had undergone amputation of the penis due to penile cancer, without recurrence. The patient was submitted to comprehensive reconstruction of the lost parts of the sexual organ (corpora cavernosa, urethra, glans penis) using both conventional techniques and the ones performed for the first time in reconstructive plastic surgery.
Urologiia. 2015;(6):130-135
pages 130-135 views

A giant ureteral stone: case report and literature review

Hayrli G., Balpukov U., Ainaev E., Gaipov A., Abdugalimov S., Zhienbaev E.


The article reports a case of a 68-year-old female patient with a giant ureteral stone of 12 cm in length, localized at the upper and middle third of the right ureter. The patient had undergone right ureterolithotomy with DJ-stent placement. Her postoperative period was uneventful. The distinctive feature of this case was that the patient had neither obstruction of urine flow through the urinary tract, nor metabolic disorders that could cause the formation of the giant ureteral stone.
Urologiia. 2015;(6):136-138
pages 136-138 views

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