


№ 1 (2009)
- Год: 2009
- Статей: 21
- URL: https://journals.eco-vector.com/1728-2985/issue/view/6610
Статьи
Николай Алексеевич Лопаткин (85 лет со дня рождения)
Урология. 2009;(1):3-5



Маргарита Федоровна Трапезникова (80 лет со дня рождения)
Урология. 2009;(1):6-7



Клиническое значение физико-химического исследования состава мочевых камней и мочи
Аннотация
We have examined composition of uroliths (qualitative and quantitative x-ray tests) and measured 24-h excretion of electrolytes (Cl-, NO2-, NO3-, SO42-, PO43-, cytrate, isocytrate and uric acid) using ion-exchange chromatography with a conductometric detector. We revealed correlations between ion characteristics, their concentration in the urine before and after treatment and composition of disintegrated uroliths and clinical data. This allowed us to identify some urinary ions which indicate activity of urolithogenesis, predisposition to urolithiasis, production of certain uroliths, reflect some processes running in patients with urolithiasis. We give concentrations of some urinary ions which can be considered normal and deviations which may indicate urolithogenesis.
Урология. 2009;(1):8-12



"Мягкий" уретральный катетер-стент в диагностике причин нарушения опорожнения мочевого пузыря у мужчин с неврологическими заболеваниями
Аннотация
The new device - CoreFlowTM Soft Stent - was used for diagnosis of causes of incomplete bladder emptying (IBE) in 19 men with neurogenic diseases. Group 1 consisted of 8 men with IBE and prostatic adenoma. Group 2 consisted of 11 men with IBE but no prostatic adenoma. The CoreFlowTM Soft Stent comprises an introducer and a stent. Different active lengths of the stent are available to match it to the length of the prostatic urethra. The stent has an anchoring balloon situated in the bladder and a second anchor located distally to the external sphincter. CoreFlow was introduced in a similar way as an ordinary Foley catheter. The bladder was filled with 200 ml of saline solution through the introducer and the stent. The introducer part was then separated from the stent part positioned in the prostatic urethra. The stent part is connected to the integral "pull-thread" device which runs through the urethra ending outside the meatus. Reposition of the stent using the special thread opens the striated urethral sphincter. Out of 8 patients with prostatic adenoma and neurogenic diseases 4 could urinate with the stent part positioned in the prostatic urethra indicating that prostatic adenoma was the cause for IBE. These patients have undergone TUR. The other 4 patients of group 1 and 11 patients of group 2 could urinate only using Valsalva manoeuvre and after reposition of the stent for opening the striated urethral sphincter. This allowed us to conclude that these 15 patients suffered from detrusor underactivity. Our experience indicates that CoreFlowTM Soft Stent is a simple device for diagnosis of the causes of IBE in men with neurogenic diseases.
Урология. 2009;(1):13-15



Трансуретральная пиелокаликолитотрипсия и литоэкстракция - новый метод лечения камней почек
Аннотация
Transurethral pyelocalycolithotripsy (TUPCL) was made in 87 patients (36 males and 51 females, age 7-82 years) with solitary uroliths from April 2007 to April 2008. Of 51 pelvic and ureteropelvic nephroliths, 24 (47%) had the size of 0.5-1 cm, 22 (43%) - 1.1-2 cm, 5 (10%) - over 2 cm. Nineteen stones of the upper segment calyx were of less than 1 cm in size, 6 (32%) - 1.1-2 cm, 4 (21%) - more than 2 cm. Nine stones of the middle segment calyx were less than 1 cm in size (44%), 4 - 1 to 2 cm (44%). One patient had the stone of more than 2 cm in size. Transurethral contact pyelolithotripsy was performed in all 87 patients. The rigid ureteropyeloscope was employed in 64 (74%) cases, fibropyelocalycolithotripsy was made in 23 (26%) cases. Indications for TUPCL were failure or aftereffects of extracorporeal pyelolithotro[sy (50 cases, 65%), suspected stricture under the stone (10 cases, 12%), ligature stones (7 cases, 6%). Pelvic stones were detected at diapevtic ureteropyeloscopy in 11 (17%) patients suspected of calycopelvic papillary tumor. In 8(9%) patients nephroliths were destructed with the electromechanic probe (Medline, Russia), pneumatic contact lithotripsy was made in 22 (25%) cases (Lithoclast Master, EMS, Switzerland), Ho laser lithotripsy was made in 41 patients (WaveLight Laser Technologie AG, Germany) with a 365 mcm waveguide in 14 (17%) cases and a 600 mcm waveguide in 27 (31%) cases. Pyelocalycolithoextraction was conducted in 16 (18%) patients. Elimination of the nephroliths was achieved in 71 (81.6%) patients. This shows that TUPCL is effective and comparable by efficacy with such methods as extracorporeal lithotripsy, percutaneous nephrolitholapaxy. Rigid ureteropyeloscopy eliminated nephroliths in 53 (83%) patients, fibropyeloscopy - in 18 (77%) patients. The experience of the authors and literature data allowed them to formulate indications for TUPCL: cacycopelvic nephroliths up to 2 cm in size in their location in the pelvis and upper segment calyx and up to 1 cm in size in their location in the calyces of the middle and lower segments irrespective of renal dysfunction degree and dilation of the calycopelvic system in failure or contraindications for extracorporeal lithotripsy and percutaneous nephrolitholapaxy. In nephroliths more than 2 cm in size TUPCL can be used as a method of choice in patients with morbid obesity, anomaly of the kidneys, upper urinary tract and the spine, hemostatic disorders. In large calycopelvic stones the patients should be informed about possible staged treatment or extracorporeal lithotripsy in the postoperative period.
Урология. 2009;(1):16-23



Улучшение результатов оперативного лечения больных аденомой предстательной железы посредством применения препарата "Ликопрофит" в послеоперационном периоде
Аннотация
We studied efficacy and safety of likoprofit pharmacotherapy in patients early after transurethral resection (TUR) of the prostate. The drug was well tolerated - no withdrawals were noted. Likoprofit showed high efficacy early after TUR for prostatic adenoma in correction of irritative disorders of urination (frequent voiding, urges, painful urination with small urine portions). This means a significant improvement in quality of life in patients after TUR.
Урология. 2009;(1):24-28



Применение таблеток препарата витапроста для профилактики обострений хронического абактериального простатита
Аннотация
Active substance of vitaprost® is a complex of water-soluble biologically active peptides isolated from bovine prostate. The prostatic extract has an organotropic action in relation to the prostate. As all peptide bioregulators, prostatic extract has antiaggregant and anticoagulant properties, enhances synthesis of antihistamine and antiserotonine antibodies, improves microcirculation in the prostatic gland. This accounts for its ability to reduce edema in prostatic inflammation. This clinical trial demonstrated that vitaprost® tablets decreases twice probability of chronic prostatitis exacerbation, of development of secondary exacerbations. A prophylactic intake of vitaprost® relieves symptoms of chronic prostatitis, first of all pain (discomfort), improvement of quality of life by NIH-CPSI, including exacerbation and significantly reduces size of the prostate. Vitaprost tablets can be effectively used prophylactively in chronic prostatitis for reducing probability of the disease exacerbations and their severity.
Урология. 2009;(1):29-34



Современные тенденции в медикаментозном лечении аденомы предстательной железы: роль нового α-адреноблокатора камирена XL в решении проблемы
Аннотация
The aim of our study was assessment of clinical efficacy and safety of a new alpha-adrenoblocker kamiren XL in patients with prostatic adenoma (PA) with or without acute retention of urine (ARU). Seventy PA patients were divided into two groups. Group 1 (n = 35) patients had no ARU. They received kamiren XL in a dose 4 mg/day for 1 month. Group 2 (n = 35) patients received the same doses of kamiren XL in addition to urethral catheterization for 3-7 days. In group 1 efficacy of the pharmacotherapy reached 91.4%. Overall symptoms score fell by 45.2% (from 18.5 ± 6.9 to 10.2 ± 5.9), quality of life - by 36.5% (from 3.7 ± 1.5 to 2.4 ± 1.4), volume of residual urine diminished by 54.9% (from 35.2 ± 42.1 to 15.9 ± 24.4 ml), Qmax rose by 37.7% (from 9.6 ± 2.7 to 13.3 ± 4.6 ml/s). Side effects (weakness - 11.4%, vertigo - 8.6%, sleepiness - 5.7%) were registered in 5 (14.3%) patients. The drug produced significant changes neither in systolic, diastolic blood pressure nor heart rate. In group 2 urination resumed in 25 (71.4%) patients. Of them, 45.7% patients considered their voiding satisfactory, control ultrasound investigation detected that their residual urine was less than 50 ml while Qmax was over 5 ml/s. Difficulties in urination were experienced by 25.7% patients who demonstrated residual urine in the range 10-210 ml and Qmax under 5 ml/s. Side effects were seen in 14.3% patients. Thus, alpha-adrenoblocker kamiren XL (doxasozine retard) is a highly effective and safe drug for treatment of PA patients including those with ARU.
Урология. 2009;(1):35-39



Эффективность ингибиторов фосфодиэстеразы в лечении больных органической эректильной дисфункцией: сравнительное исследование
Аннотация
Currently available three highly selective and effective PDE-5 inhibitors (sildenafil, tadalafil and wardenafil) are comparable by PDE-5 inhibition and selectivity of action on PDE-5 but their differences in activity, interaction with food and alcohol, biological half-life and other characteristics make their use individual for certain clinical situations. Our trial with participation of 575 patients (mean age 57.73 ± 12.33 years) with arteriogenic erectile dysfunction and great number of vascular risk factors has shown that wardenafil was most popular among our examinees as it is more effective and begins acting faster. Further studies in optimization of the above drugs administration may perfect treatment of erectile dysfuncion.
Урология. 2009;(1):40-45



Анкета интегральной оценки мужской сексуальности
Аннотация
We propose an original questionnaire for determination of male sexual activity in the course of male sexual life. The questionnaire contains 34 questions involving the following characteristics of male sexuality: the age of libido arousal, age of the onset and duration of onanism, age of the first coitus, sexual drive, regularity and duration of coitus, sexual excesses, prolongations of coituses before marriage, during marriage(s), at present. Self-rating was made according to 5-point system. Interpretation of the questioning results implies referral of the responders to three groups by the level of sexuality: normo-, hypo- and hypersexuality. Sexual history was determined retrospectively using the above questionnaire for 64 patients aged 50-78 years: 31.3, 31.3 and 37.4% examinees entered normo-, hypo- and hypersexuality groups, respectively. The proposed questionnaire can serve as a tool for studies of male sexuality in relation with different pathological processes: prostatic adenoma and cancer, metabolic syndrome, erectile dysfunction and others.
Урология. 2009;(1):46-49



Профилактика и лечение поздних осложнений после кишечной пластики мочевого пузыря
Аннотация
The study of urodynamics, microcirculation, bacterial contamination and metabolism in 119 patients after intestinoplasty of the urinary bladder has shown that postoperative management of the patients including less aggressive surgery, phytotherapy with prolit, use of agents improving microcirculation decreased the number of late postoperative complications after intestinoplasty of the urinary bladder: acute and chronic pyelonephritis from 15.8 to 6.4%, urolithiasis from 40.3 to 16.1%, urinary bladder dysfunction from 21.1% to 6.5%, metabolic acidosis from 3.5 to 1.6%. Due to this approach it was possible to prevent progression of the stricture of urethrovesical anastomosis.
Урология. 2009;(1):50-55



Клинико-биохимическое исследование диагностической значимости панели из 10 потенциальных белковых маркеров рака простаты
Аннотация
We tested diagnostic value of the panel of 10 specially selected proteins - potential markers of prostatic cancer. A double blind method and proteomic technologies were used in complex clinicobiochemical examination of 20 patients with benign and malignant tumors. The same diagnosis were obtained by clinicomorphological criteria and protein markers in 13 (65%) cases. The highest diagnostic efficacy was achieved in prostatic cancer - 11 cases (79%) vs 14 by clinicomorphological criteria.
Урология. 2009;(1):56-57



Дистанционная литотрипсия в лечении уролитиаза у детей
Аннотация
Extracorporeal shock wave lithotripsy (ESWL) was performed in 1451 children with urolithiasis aged from 7 months to 16 years. A total of 2464 sessions were made. Low-energy impulses in ESWL were effective in 98.8% children with concrements up to 2.0 cm in size and in 98.8% of those with stones larger than 2.0 cm. We believe that main factors of high efficiency of ESWL in children are: more friable structure of stones, small depth of stone location, faster evacuation of the stone fragments. ESWL with low energy impulses is highly effective and is not accompanied with traumatic complications. Renal parenchyma is not affected.
Урология. 2009;(1):58-62



Эндоскопическая электроэксцизия доброкачественных новообразований уретры у детей
Аннотация
Endoscopic treatment was performed in 17 boys aged 4 months - 16 years with benign newgrowths of the posterior urethra: false polyps (n = 11), fibroepithelial polyps (congenital - 4, acquired - 1), fetal rabdomyoma of the urethra and urinary bladder (n = 1). Acquired fibroepithelial polyp was detected in a patient who previously had resection and urethral anastomosis for posttraumatic stricture and long-term preventive catheterization. A leading symptom of the disease in 8 patients was infravesical obstruction. Most complete diagnostic information was provided by urethroscopy. All the patients were treated with endoscopic electroexcision of the tumors with coagulation of their bases. In a child with fetal rabdomyoma a vesicular part of the tumor was removed transvesically. Histological examination of the false polyps identified epithelium-covered granulation tissue. Fibroepithelial polyps were represented with mature connective tissue covered with urothelium. Recovery was achieved in all the patients. Benign urethral tumors should be considered in differential diagnosis in children as one of rare causes of infravesical obstruction. Most of the neoplasms are represented by congenital and acquired polyps of connective tissue of various maturity covered with transitory epithelium. False polyps may be an initial stage of the development of fibroepithelial acquired polyp. Factors of a higher risk of acquired urethral polyps are secondary trauma of urethral mucosa in device investigations and manipulations as well as chronic inflammation. A method of choice in the treatment of benign urethral neoplasms is endoscopic electroexcision which in some cases can be made with transvesicular approach.
Урология. 2009;(1):63-65



Артериальная гипертензия, вызванная кистой почки небольших размеров
Урология. 2009;(1):66-67



Кишечная пластика мочевого пузыря и родственная пересадка почки
Урология. 2009;(1):68-69



Хронический простатит - одна болезнь?
Урология. 2009;(1):70-74



Пренатальная урология: вчера, сегодня, завтра
Урология. 2009;(1):75-80



Воспаление предстательной железы и хронические тазовые боли: диагностика и лечение
Урология. 2009;(1):81-83



О безопасности длительного непрерывного (более 1 года) приема экстракта Serenoa repens (пальмы сабаль) у больных аденомой предстательной железы
Урология. 2009;(1):84-86



Знаменательные и юбилейные даты в истории урологии и пограничных областей в 2009 г.
Урология. 2009;(1):87-87


