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No 2 (2017)



Glybochko P.V., Alekseenko S.N., Gubareva E.A., Kuevda E.V., Basov A.A., Sotnichenko A.S., Dzhimak S.S., Gumenyuk I.S., Egiev I.K., Chechelyan V.N., Nakokhov R.Z., Lyasota O.M., Teterin Y.V.


Chronic renal failure (CRF) is one of the most challenging problems of contemporary medicine. Patients with chronic renal failure usually need renal replacement therapy as either hemodialysis, peritoneal dialysis or a kidney transplant. The latter is the most promising option for end-stage kidney disease. However, the shortage of donor organs, the complexity of their delivery, the difficulty in finding an immunologically compatible donor and the need for lifelong immunosuppression triggered advances in modern tissue engineering. In this field, the primary priority is focused on developing bioengineered scaffolds with subsequent recellularization with autologous cells. Using such constructs would allow for solving both ethical and immunological problems of transplantation. The aim of this pilot study was to develop a new method of renal decellularization using small laboratory animals. Materials and Methods. The study investigated the morphological structure of the obtained decellularized matrix and quantitatively tested DNA residues in the resulting scaffold. We proposed a new biophysical method for assessing the matrix quality using the EPR spectroscopy and conducted experiments on the matrix recellularization with mesenchymal multipotent stem cells to estimate cytotoxicity, cell viability and metabolic activity. Results. The obtained decellularized renal matrix retained the native tissue architecture after a complete removal of the cell material, had no cytotoxic properties and supported cell adhesion and proliferation. Conclusion. All the above suggests that the proposed decellularization protocol is a promising method to produce tissue-engineered kidney constructs with possible clinical application in the foreseeable future.
Urologiia. 2017;(2):5-13
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Filimonov V.B., Vasin R.V., Vasina I.V., Kaprin A.D., Kostin A.A.


Aim To compare the results of female genital prolapse (FGP) surgery via vaginal access using lightweight and ultra-lightweight polypropylene mesh. Materials and methods From 2007 to 2011, 93 women aged from 46 to 71 years with II-IV stage FGP (POP-Q classification) were examined and underwent the vaginal extra-peritoneal colpopexy using polypropylene implants in the Department of Urology. Patients were divided into 2 groups. In patients ofgroup 1 (n=50) the surgery was performed according to a newly developed technique using perforated ultra-lightweight (surface density 19 g/m2) domestically manufactured polypropylene implant. In group 2, a standard trocar set with light (surface density of 42.7 g/m2) foreign-made polypropylene implants was used. Results and discussion Long-term follow-up was from 1 to 5 years. General surgical complications (urinary bladder injury, blood loss over 300 ml, perineal and vaginal hematomas) were detected in 2 (4%) patients of group 1 and in 7 (16.3%) patients of group 2. The most common specific mesh-related complication was the vaginal wall erosion, which was observed in 4 (9.3%) patients of group 2 and in 1 (2%) patient of group 1. FGP recurrence was diagnosed in 5 (10%) patients of group 1 in the non-treated part and in 8 (18.6%) patients of group 2. Three patients (7%) in group 2 developed recurrent cystocele due to the shrinkage of the mesh implant which was not observed in group 1. At 12 month follow-up, the results of FGP surgical treatment were estimated as good (full functional Conclusion We have developed a method of vaginal extra-peritoneal colpopexy using a perforated ultra-lightweight polypropylene implant. This technique has resulted in the absence of recurrence in the treated part of FGP, and 4.1, 4.2 and 4.7 fold reductions in the incidence of general surgical complications, vaginal wall erosions and perineal and vaginal hematomas, respectively, compared with FGP patients undergoing the placement of the lightweight polypropylene implant using the standard trocar set.
Urologiia. 2017;(2):14-23
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Pavlyashik G.V., Zharikov A.Y., Kiselev V.I.


Aim to compare the anti-lithogenic activity of biomedical substance derived from freeze-dried porcine kidney and sodium citrate. Materials and methods The experiments were conducted on Wistar rats divided into three groups of 15 animals each: control group (disease control), comparison group (sodium citrate treatment) and experimental group (treatment with biomedical substance from porcine kidneys). Experimental urolithiasis was modeled using the ethylene glycol model. On every 7th day of the 6 week experiment testing was done calcium and oxalate urine concentration and the activity of marker enzymes of renal epithelial damage: lactate dehydrogenase (LDH), γ-glutamyl transferase (GGT), and N-acetyl-β-D-glucosaminidase (NAG). At the end of the experiment, a part of the rats were decapitated and the renal tissue was tested for the oxidant status indicators of (renal thiobarbiturate reactive product content, TBRP, and total prooxidant activity, TPA) and antioxidant enzyme activities: glutathione peroxidase (GPO), superoxide dismutase (SOD) and catalase (CAT). To measure the number and size of calcium deposits formed in the renal papillary area, the Koss histochemical method was used. Results The experimental findings showed developing oxalate nephrolithiasis in the control group, as indicated by urinary supersaturation of oxalate ion, increased activity of marker enzymes, oxidative stress and the formation of numerous calcium deposits in the renal papillary area. In the comparison group, the 3-week use of sodium citrate contributed to a significant decrease in nephrolithiasis: a 3 to 4-fold decrease in the activity of marker enzymes in the urine, a 3.8-fold increase in the concentration of TBRP, normalization of GPO activity; the number and size of urinary calcium deposits decreased by 3.4 and 1.9 times, respectively. In the experimental group, using biomedical substance led to an even greater therapeutic effect. LDH activity and concentration of TPRP showed 1.9 times and by 26.2% greater decrease than in the comparison group, respectively, SOD and CAT activity almost doubled, there were 3.6 times fewer calcium deposits in the field of view and their mean size was 1.7 times smaller than in the comparison group. Conclusion The study findings showed that the porcine kidney derived biomedical substance provide significantly greater antilithogenic effect than sodium citrate.
Urologiia. 2017;(2):24-27
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Martov A.G., Ergakov D.V., Andronov A.S., Dutov S.V., Takhaev R.A., Kil'chukov Z.I., Moskalenko S.A.


Introduction The choice of treatment for the stones of the lower renal calyx is one of the challenging issues of modern urology. The aim of this retrospective and prospective study was to investigate the clinical effectiveness and safety of 3 modern minimally invasive techniques for treating renal stones: percutaneous (PNL) and transurethral (TNL) nephrolithotripsy and extracorporeal shock wave lithotripsy (ESWL) in patients with solitary lower calyx stones sized from 10 to 15 mm. Materials and methods The study included 136 patients with symptomatic stones of the lower calyces, who underwent ESWL, PNL and TNL from November 2010 to the present day. The criteria for inclusion in the study were: the presence of a solitary stone of the lower calyx, the stone size of 10 mm to 15 mm, the performance of the classical (standard) PNL in the prone position (puncture access 28-30 Fr) and the follow-up examination at 3 months after the operation. Forty-six patients underwent ESWL, 49 - PNL, and 41 - TNL. Postoperative follow-up was done at 3 months and included a plain radiography, ultrasound and non-contrast-enhanced computed tomography. The stone free rate (SFR) was used as a criterion for the effectiveness of the intervention, where the stone size of 3 mm was taken as the upper limit for the possible presence of fragments. Besides, the rate of repeat interventions, complications and subjective assessment of patients’ treatment satisfaction (0 to 10) by using visual analogue scale (VAS) were investigated. Results The effectiveness analysis of the three methods for treating the lower calyx stones sized 10-15 mm showed that PNL was no more effective than TNL (SFR 95.9% and 85.4%, respectively), but both methods were significantly more effective than ESWL (SFR 69.5%). 29.3% of patients who underwent TNL required repeat interventions (TNL or ESWL), while among those treated with ESWL, 45.6% required repeat ESWL sessions. PNL resulted in stone clearance in one stage. Postoperative inflammatory complications were most prevalent among patients who underwent TNL (26.8%). Bleeding requiring hemotransfusion was observed only after PNL (14.3%). Obstructive complications were observed in all study groups. For them, internal stenting was most often performed after ESWL (10.9%), puncture nephrostomy - after TNL (7.3%). Statistically significantly higher VAS measured quality of life was found after ESWL (7.9) and PNL (7.0) compared with THL (4.8). Conclusion All three methods (PNL, TNL and ESWL) for treating lower calyceal stones sized from 10 to 15 mm are quite effective. Using them separately or in combination allows most patients to safely achieve a stone-free state.
Urologiia. 2017;(2):28-35
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Malkhasyan V.A., Rasner P.I., Gevorkyan A.R., Semenyakin I.V., Tedeev A.V., Pushkar D.Y.


Aim To investigate factors affecting the compliance of patients with the combination therapy for benign prostatic hyperplasia. Materials and methods Four hundred BPH outpatients treated with combination therapy were surveyed. Results The absolute majority of patients (76.16%) expected a quick positive result. 10.47% viewed their disease as too advanced, did not believe in the effectiveness of medical therapy and believed the surgery to be the only treatment option. 24.42% of patients changed the medication dosage on their own, and 11% were ready to discontinue the treatment without consulting their doctors. 76.16% of patients considered the recommended treatment to be effective, 77.33% fully trusted the doctor. In the opinion of 8.7% of patients, the doctor did not sufficiently inform them about the prescribed drug. 22.67% of patients had doubts about a physician’s competence, and 5.23% believed the doctor complicated their medical treatment and changed prescriptions too often. Conclusions The patients had a high level of trust in doctors and showed psychological adherence to therapy. However, about a quarter of patients changed the treatment regimen on their own. Many patients had exaggerated expectations of the treatment. 8% of patients reported insufficient awareness regarding the nature and appropriateness of drug therapy, and one in five patients had difficulties in perceiving, remembering and following the treatment regimen. Conclusion: streamlining therapeutic regimens, prescribing non-titratable or combined drugs will help improve patients’ therapy compliance.
Urologiia. 2017;(2):36-41
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Sitdykova M.E., Tsyplakov D.E., Sitdykov E.N., Nurtdinov A.R.


Aim To investigate the nature of morphological alterations in the urinary bladder wall in BPH patients receiving pharmacotherapy to establish treatment time limits. Materials and methods The study comprised 120 BPH patients who underwent a transvesical adenomectomy. Prior to the surgery, 110 patients received pharmacotherapy (α-blockers and 5α-reductase inhibitors) lasting from 1-6 months to 5-10 years. Preoperative evaluation included a standard diagnostic algorithm. During the surgery, the urinary bladder wall specimens were taken for morphological examination. Histologic specimens were stained with hematoxylin-eosin and according to van Giesonn, and underwent immunohistochemical examination using desmin, vimentin, CD31, type IV collagen and pancitokeratin monoclonal antibodies. In patients who did not take medications or used them for less than 6 months, the bladder preserved the normal histological structure. Pharmacotherapy lasting 1 to 5 years resulted in microcirculatory alterations characterized by extensive hemorrhages, damage to the endothelium and vessel basal membranes, hypertrophy of the bladder muscle membrane. In patients taking the medications for 6 to 10 years, microcirculatory alterations resulted in the vascular wall sclerosis and thickening, narrowing of the vessel lumen, hypoplasia of the transitional epithelium and muscle layer atrophy. Results The study findings suggest that prolonged (over 1 year) pharmacotherapy can adversely affect the urinary bladder wall and worsen the results of radical adenomectomy.
Urologiia. 2017;(2):42-47
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Komyakov B.K., Ochelenko V.A., Onoshko M.V., Al-Attar T.K., Gaziev A.K.


Aim: To present the results and technical features of forming the ureterointestinal anastomoses in intestinal ureteral substitution. Material and methods From 1998 to December 2016, 168 patients (mean age 51 ± 8.7 years) underwent ureteral substitution using intestinal segments at the Urology Clinic of the I.I. Mechnikov NWSMU. Of them, 76 (45.2%) were males. In 119 (70.8%) patients, intestinal segments were used to replace various parts of the ureters (iliac in 92, colonic in 4, appendix in 23), and in 49 (29.2%) patients ureteroplasty was combined with orthotopic ileocystoplasty. 96 patients underwent isolated ureteral substitution with segments of the small and large bowel. Results Among the 96 patients, early postoperative complications occurred in 8 (8.3%) patients, whereof 5 (5.2%) required reoperations. Among them, 2 (2.1%) had a proximal anastomotic failure. Late postoperative complications occurred in 7 (7.3%) patients whereof 4 (4.2%) required surgical treatment. These patients developed strictures of the proximal ureter-intestinal anastomoses over 3 or more months after the operation. The urinary flow was restored by antegrade dilation. Vesicoureteral reflux occurred in 2 (2.1%) patients. However, it was not clinically evident and was not accompanied by hydroureteronephrosis and recurrent urinary tract infection. Conclusion A perfect ureterointestinal anastomoses should be easy to create and have a low risk of stenosis and reflux. These requirements are met by direct anastomosis, which is associated with a minimal risk of stricture, and with isoperistaltic positioning and sufficient length (not less than 15 cm) of the graft provides antireflux protection. It should be noted that proximal (ureterointestinal) anastomoses are vulnerable in these operations and prone to the stricture formation. Unlike proximal, the distal anastomosis of the graft with the bladder is always wider, and therefore the risk of its narrowing is minimal. Isoperistaltic positioning of the graft prevents reflux formation.
Urologiia. 2017;(2):48-53
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Neimark A.I., Samchuk Y.G., Gatkin M.Y., Momot A.P.


Aim To investigate the effectiveness of cryoprecipitate in the comprehensive conservative therapy of patients with acute purulent pyelonephritis. Materials and methods We conducted a retrospective analysis of medical records of patients who were diagnosed with acute nonobstructive pyelonephritis from 2007to 2015. During this period, a total of 3912 patients with acute non-obstructive pyelonephritis were treated at the Department of Urology. Patients were assigned to either receive or not receive cryoprecipitate in the comprehensive conservative therapy. The comprehensive conservative therapy of both groups included antibacterial agents, detoxification, anti-inflammatory therapy. In the study group, patients received additional treatment with cryoprecipitate. By that way we estimated the number of patients who avoided surgery in both groups. Results There were 3912 patients divided into two groups. The first group included 756 patients (19.3%) who received cryoprecipitate in the comprehensive therapy of pyelonephritis. Of them, 735 patients (97.3%) did not require surgical treatment, and only 21 patients (2.7%) underwent surgery. The second group comprised 3156 patients (80.7%) who did not receive cryoprecipitate. Of them, 2974 patients (94.2%) were treated conservatively without surgical intervention and 182 patients (5.8%) received conservative therapy concurrently with surgical treatment. Therefore, including cryoprecipitate in the comprehensive conservative therapy of acute non-obstructive pyelonephritis results in twice smaller percentage of patients (2.7% vs 5.8%) requiring surgery compared to the comprehensive conservative therapy alone.
Urologiia. 2017;(2):54-59
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Kuz’menko A.V., Kuz’menko V.V., Gyaurgiev T.A.


Aim To investigate the effects of complex therapy with and without phototherapy for an exacerbation of chronic recurrent bacterial cystitis in women at the peaks of chronobiological activity. Materials and methods The study comprised 60 patients (mean age 30.1±5.5 years) with exacerbations of chronic recurrent bacterial cystitis. Patients in the comparison group (n=30) were managed with standard therapy, in the study group (n=30) standard therapy was used concurrently with phototherapy by low-intensity light radiation carried out at the maximum peaks of chronobiological activity. An assessment of the results included estimation of clinical and laboratory outcomes and the chronobiological status of patients in both groups. Results The study findings showed that phototherapy at the peaks of patients’ chronobiological activity icombined with standard treatment resulted in a faster reduction of clinical signs of the disease and desynchronosis.
Urologiia. 2017;(2):60-65
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Cherednichenko A.G., Kulchavenya E.V.


Introduction In the structure of tuberculosis morbidity, urogenital tuberculosis (UGT) ranks second or third only to pulmonary tuberculosis. Every fourth patient has the stage of cavern formation at first presentation. Seventy five percent of nephrotuberculosis cases co-occur with nonspecific pyelonephritis, which excludes «sterile pyuria». We aimed to determine the microbial spectrum of urine and gonadal appendages in patients with suspected UGT and to investigate the susceptibility of the isolated microorganisms to the main antibacterial drugs. Material and methods The study investigated the spectrum of pathogenic microflora isolated from patients admitted to the urogenital clinic of the TB Research Institute from January 1, 2012 to September 30, 2016 to rule out UGT. Microorganism species were identified by time-of-flight mass spectrometry using the microbiological analyzer Phoenix 100 (Becton Dickinson, USA). Antibiotic resistance was determined using the Phoenix 100 microbiological analyzer (Becton Dickinson, USA). Results A total of 3004 bacteriological tests for nonspecific microflora were performed during the analyzed period. In the structure of pathogens, E. coli comprised about half of the cases thus confirming its role as the leading uropathogen. Only piperacillin/tazobactam and nitrofurantoin provided relatively plausible antimicrobial resistance rates, for other antibacterial drugs the rates of susceptible strains progressively decreased and by 2016 dropped to 40% and lower. Conclusion Our findings cannot be extrapolated to the entire population since patients presenting for differential diagnosis receive multiple courses of treatment with various antibacterial drugs, which led to the selection of resistant strains. The findings emphasize the need for a strict selection of antibiotics for urogenital infection empirical therapy. In the absence of response, the patient should be immediately examined for tuberculosis using molecular and genetic diagnostic techniques.
Urologiia. 2017;(2):66-70
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Sinkov A.V., Volosatova I.N., Sin'kova G.M., Nikolaeva L.A.


Aim To determine the prevalence of nephrolithiasis, assess the significance of known risk factors, and identify new risk factors for nephrolithiasis among young rural residents. Materials and methods This cross-sectional study was conducted in 5 settlements of the Irkutsk rural district of the Irkutsk region and involved 408 inhabitants (93 men, 315 women) aged from 18 to 47 years. The selection of candidates for the study was randomized. The response of the population was 81.6%. Diagnostic evaluation included clinical examination, renal ultrasound, urinalysis and questionnaires; drinking water hardness was determined. Results The prevalence of nephrolithiasis was 10.0% (95% CI 7.1-12.9). The men-to-women ratio for the prevalence of nephrolithiasis in was 0.69. No kidney stones were found in participants younger than 20 years, but after 20 years of age, there was a statistically significant (p=0.04) trend in increasing prevalence of nephrolithiasis. Calculi were detected only in participants with acidic urine and were absent in individuals with alkaline urine (p=0.001). A higher prevalence of nephrolithiasis was found in individuals using hard water (12.5%), compared to those using water of medium hardness (1.6%) (p=0.019). The odds ratio of nephrolithiasis in persons using hard water was 8.9 (95% CI 1.2-66.6). Discussion and conclusions 1.The incidence of nephrolithiasis in the Irkutsk rural area was 10.0%, which is comparable to that in populations of Europe and North America; 2. The primary risk factors for nephrolithiasis were age, acidic urine and the hardness of drinking water, which is consistent with the data of other authors; 3. Difficulties in measuring, grading and controlling subjective risk factors for nephrolithiasis (fluid intake, diet, heredity, and past diseases) make it difficult to analyze them in cross-sectional studies and prevent direct comparison with other studies.
Urologiia. 2017;(2):71-75
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Sevostyanova O.A., Boshchenko V.S., Osadchii V.K., Parnachev V.P., Polienko A.K.


Aim. To successfully treat and prevent urolithiasis, the composition and structure of uroliths should be examined using modern analytical techniques. For a long time, studies of the biomineral formation in the human body have been conducted exclusively in the field of medicine. The main attention has been paid to the diagnosis and treatment of diseases leading to the occurrence of pathogenic formations. At the same time, it is quite obvious that it is important to have a clear idea about the causes of pathogenic formations, the mechanisms for their further formation, composition and structure. Currently, these issues are widely studied all over the world by mineralogists, biochemists, geo-ecologists using methods of mineralogical analysis. The aim of this work was to determine the content of the elements that make up uroliths. This value should be normalized by the clarks of the noosphere. Studies on the mineral composition and structure of uroliths in the Tomsk region allowed to calculate the content of elements. It turned out that each medical district has its own specific geochemical series, which depends, probably, on natural and technogenic factors. Materials and methods. The study included urolith samples obtained from residents of 4 medical sub-districts of Tomsk district. 100 samples of different mineral composition were studied. Analytical techniques including crystal-morphological, spectral, X-ray structural, instrumental neutron-activation, electron microscopic analyses were used to investigate the morphology, mineral composition and structure of uroliths. Results. The average content of elements in the uroliths, and the element concentrations normalized by the clark were established. After calculating the concentration, geochemical associative series of elements were formed. Depending on the morphology, drusiform, microspherolite, porous, coral formations, uroliths with a smoothed surface and stones with combined morphology were identified. Three groups of uroliths were defined according to their structural features: crystalline-granular, spherolithic and combined. Conclusion. Studies to determine the mineral composition and structure of the uroliths of the inhabitants of the Tomsk region made it possible to calculate the content of the elements that make up uroliths, normalized by clarks of the noosphere. Each medical sub-district has its own specific geochemical series, which depends on natural and technogenic factors. The increased value of the indicator of the content of elements in uroliths should serve as a warning factor for developing measures to reduce the urolithiasis incidence in the population.
Urologiia. 2017;(2):76-81
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Gamidov S.I., Shneiderman M.G., Pushkar D.Y., Vasil’ev A.O., Govorov A.V., Ovchinnikov R.I., Popova A.Y., Dusmukhamedov R.D.


Aim To improve treatment results in patients after multiple hypospadias repairs by optimizing the postoperative management. Materials and methods Eighty-two patients (mean age 48.1±15.3 years) with urethral strictures secondary to failed hypospadias repairs underwent staged graft urethroplasty using oral mucosa (cheek, lip, tongue) as a grafting material. In 62 patients, at the end of surgery the bladder was drained with a standard Foley catheter. In twenty patients the bladder was drained with a modified silicone urethral catheter, which had an additional channel for delivering drugs and removing the urethral wound effluent, and a second additional channel for inflating a balloon fixed to the catheter tube at different parts of the catheter. Results The mean length of the stricture was 5.4±1.2 cm (from 1 to 16 cm). Twenty-eight patients had postoperative complications. Using the modified catheter resulted in statistically significantly (p<0.05) smaller percentage of complications (10% vs 41.9%) compared to standard Foley catheter. Urinalysis and sperm test on the follow up examination at 12 months showed that only 9 (10.9%) patients had signs of the inflammatory process. Seventy-five patients (91.5%) rated the appearance of the penis as «good»; only 5 (6.1%) and 2 (2.4%) patients considered the result as «satisfactory» and «unsatisfactory», respectively. Eighty patient (97.6%) regarded the treatment result as «good» for the quality of urination and only two (2.4%) considered it «satisfactory». When assessing the strength of urinary stream, 64 (78.1%), 13 (15.8%) and 5 (6.1%) patients rated it as «good», «satisfactory», and «unsatisfactory”, respectively. Conclusion The study findings shows that staged urethroplasty using the oral mucosa restores the urethral patency, reduces the severity of the inflammatory process, thus improving the quality of life of patients after failed hypospadias repair. The proposed modification of the catheter ensures the timely delivery of drugs to the surgical site, evacuation the wound effluent from the urethra and helps prevent strictures by periodically inflating the adjustable balloon-dilator.
Urologiia. 2017;(2):82-87
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Galimov S.N., Akhmetov R.M., Galimova E.F., Bairamgulov F.M., Bikkulova L.R.


Aim To characterize the effect of the Speroton complex on the free radical homeostasis in the ejaculate of males of infertile couples and the likelihood of pregnancy in partners. Materials and methods The study group comprised 30 men aged between 26 and 43 years (mean 33 ± 4.8 years) with idiopathic infertility. All patients received Speroton one sachet once daily during meals for 3 months. The comparison group consisted of 29 men of fertile age having 1 to 3 healthy children. In infertile men, standard semen parameters including the ejaculate volume, sperm concentration, total count and proportion of abnormal forms were within the normal range. Markers of oxidative damage to ejaculate macromolecules were determined using standard diagnostic testing systems. Results The patients with idiopathic infertility were found to have statistically significant changes in the degree of chemical modification of ejaculate biopolymers. The level of lipid hydroperoxides in infertile men was significantly higher than in fertile participants. Taking Speroton resulted in the decrease of lipid hydroperoxides to the level that did not differ from that in the control group. Using Speroton was also accompanied by a decrease in the level of the oxidative damage DNA biomarker 8-oxodGu and a tendency toward normalization of the carbonyl modification of the ejaculate proteins. Five married couples in the treatment group reported achieving pregnancy. Conclusion Taking Speroton was associated with the normalization of the balance of pro- and antioxidant processes in the ejaculate, as indicated by a decrease in the oxidative destruction of sperm biopolymers. The revealed molecular mechanism of the drug action is the basis for restoring the fertilizing ability and increasing the likelihood of pregnancy. The treatment effectiveness was 16.7%. Speroton is a promising drug that improves the functional sperm characteristics and contributes to achieving pregnancy in couples with a male infertility factor.
Urologiia. 2017;(2):88-92
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Madaeva I.M., Berdina O.N., Semenova N.V., Madaev V.V., Gutnik I.N., Kolesnikova L.I.


The article presents the results of a polysomnographic study with simultaneous monitoring spontaneous nocturnal erections - Nocturnal Penile Tumescences (NPT) in 69 men with age-related androgen deficiency (AAD). Of these, 45 patients were diagnosed with obstructive sleep apnea syndrome (OSAS). In 34 of the 45 patients with OSAS, regimens of non-invasive ventilation with positive-positive airway pressure (CPAP) were selected. Titration was carried out using automatic CPAP-devices for 2 months. The control group (n=24) comprised men with AAD, matched by the «copy-pair» type without clinical manifestations of respiratory disturbances during sleep. Extreme fragmentation of sleep with a significant predominance of the 1st and 2nd stages of the slow sleep phase, the deficiency of deep sleep stages and the significant shortening of the fast sleep phase was leveled by using a constant positive pressure in the upper respiratory tract. CPAP-therapy produced the phenomenon of a «rebound» of slow-wave sleep and fast-sleep phase. Before treatment, men with OSAS had a disruptive pattern of NPT (quantitative and qualitative characteristics). CPAP-therapy resulted in its recovery and maximum preservation relative to fast sleep phase time boundaries. However, the trend towards increasing testosterone levels was not significant, which requires additional testosterone replacement therapy concurrently with CPAP therapy in patients with OSAS and AAD.
Urologiia. 2017;(2):93-99
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Khakkulov E.B., Khusankhodzhaev Z.U.


Aim To identify the characteristic MSCT signs of pediatric ureterohydronephrosis allowing to assess the disease severity and differentiate between its various forms. Material and methods Sixty five children with III-IV grade ureterohydronephrosis underwent a comprehensive examination including MSCT urography. The study comprised 40 (61.5%) boys and 25 (38.5%) girls aged 3 months to 14 years (mean age 4.15±3.21 years). Results Obstructive disease was detected in 38 (58.5%) children, 27 (41.5%) patients had vesicoureteral reflux (VUR). Bilateral ureterohydronephrosis was found in 31 (47.7%) patients, unilateral - in 34 (52.3%). Twelve (35.3%) and twenty two (64.7%) patients had the rightsided and left-sided disease, respectively. Comparative analysis of MSCT signs of obstructive ureterohydronephrosis and VUR allowed for defining several distinctive symptoms which afford to accurately differentiate between the two pathological conditions. Conclusion Multispiral computed tomography has a high sensitivity and specificity in detecting malformations of the urinary tract, making it possible to accurately differentiate obstructive ureterohydronephrosis from the VUR which plays an important role in assessing the disease severity and selecting a surgical strategy.
Urologiia. 2017;(2):100-104
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Krivoborodov G.G., Efremov N.S., Bolotov A.D.


Infravesical obstruction (IVO) is an important characteristic of the functional state of male lower urinary tract. It is believed that IVO confirmed by pressure-flow study findings warrants switching from a medical to surgical management of lower urinary tract symptoms (LUTS). Intravesical prostatic protrusion (IPP) is a new indicator for detecting IVO secondary to benign prostatic hyperplasia (BPH). This indicator has several advantages over other non-invasive methods for evaluating IVO. The initial findings on the relationship between IPP and IVO suggest the feasibility of its clinical use as a screening tool in men with obstructive voiding symptoms.
Urologiia. 2017;(2):105-109
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Vinnik Y.Y., Andreichikov A.V., Klimov N.Y.


This review summarizes current evidence of the etiology and diagnosis of prostate cancer. As before, a comprehensive urological examination remains the main method of diagnosing the disease. However, the invasive nature of the multicore prostate biopsy, its high cost and the need for specially trained personnel prompts to seek more state-of-the-art and non-invasive methods for diagnosing prostate cancer. The further research in this direction seems promising.
Urologiia. 2017;(2):110-115
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Glybochko P.V., Olefir Y.V., Alyaev Y.G., Butnaru D.V., Bezrukov E.A., Chaplenko A.A., Zharikova T.M.


In a systematic review, to present an overview of the current situation in the field of tissue engineering of urinary bladder related to the use of cell lines pre-cultured on matrices. The selection of eligible publications was conducted according to the method described in the article Glybochko P.V. et al. "Tissue engineering of urinary bladder using acellular matrix." At the final stage, studies investigating the application of matrices with human and animal cell lines were analyzed. Contemporary approaches to using cell-based tissue engineering of the bladder were analyzed, including the formation of 3D structures from several types of cells, cell layers and genetic modification of injected cells. The most commonly used cell lines are urothelial cells, mesenchymal stem cells and fibroblasts. The safety and efficacy of any types of composite cell structures used in the cell-based bladder tissue engineering has not been proven sufficiently to warrant clinical studies of their usefulness. The results of cystoplasty of rat bladder are almost impossible to extrapolate to humans; besides, it is difficult to predict possible side effects. For the transition to clinical trials, additional studies on relevant animal models are needed.
Urologiia. 2017;(2):116-121
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Pryanichnikova M.B., Zhurkina O.V.


The article describes open surgical modalities for managing patients with severe obliterations of the anterior urethra. The mean age of patients was 70 years. The causes of urethral strictures and obliteration included prostatic adenomectomy, scrotal abscess with pelvic bone osteomyelitis, accidental removal of the bulbar and penile urethra during herniotomy and a prolonged use of an indwelling urethral catheter. Two patients underwent perineostomy (median and trapezoidal). In the third patient, scrotal skin was used to form «scrotal hypospadias» (a modified Johanson’s operation) and the fourth patient underwent Mikhalovskii’s operation. All patients regained normal voiding.
Urologiia. 2017;(2):122-125
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