№ 4 (2009)

In administration of tamsulosine (focusin, Zentiva, Czech Republic) in combined treatment of urolithiasis concrement evacuation after extracorporeal lithotripsy occurred in 83% cases in patients with the concrement stay in the ureter for less than one month. The size of the concrement after successful lithotripsy had no significant effect on subsequent stone-eliminating therapy but long-term stay of the concrement in one place promoted inflammatory and urodynamic disturbances in the ureter treated surgically. The comparative analysis of the contractile function of the distal ureteral comparment in patients given tamsulosin showed a less active (amplitude of the contractions) and passive (tonicity) resistance to urine flow than in patients given a standard therapy. These changes were accompanied with lower pressure in the renal pelvis and suppression of enzymuria. Thus, tamsulosin addition to combined treatment of urolithiasis has a positive effect on ureteral urodynamics, concrement evacuation and functional structures of the kidney by indirectly lowering intrapelvic pressure.

There is much evidence that tulozin promotes recovery of spontaneous urination, Qmax and is effective in combined treatment of patients with acute retention of urine caused by prostatic adenoma. Tulozin produces positive changes in the lower urinary tract symptoms. Rare occurrence of side effects enables long-term treatment and achievement of good therapeutic response. Tulozin is recommended for patients of younger age, with minimal comorbid pathology, hypotonic with orthostatic reactions, history of side effects in the treatment of other alpha-adrenoblockers, in comorbid hypertention, hypercholesterolemia, retrograde ejaculation, low potention, overactive bladder, prostatitis, after prostatic TUR, transvesical adenomectomy.

A protective effect of lithium chloride (LC) in thermal ischemia of the kidney of different duration was studied in rats. LC efficacy was estimated by functional activity of ischemic kidney in early and late reperfusion period, by damage to mitochondria of tubular epithelial cells and production of active oxygen forms (AOF) and nitric oxide (NO). LC has a marked anti-ischemic effect. In thermal renal ischemia for 40 and 60 min LC provides functional safety of the ischemic organ. In longer ischemia, 50% of the animals died. The mechanism of the protective action of LC is related to reduction of APK production, support of a high transmembrane potential of mitochondria and NO synthesis redistribution in the cells of tubular epithelium cells.

Ureteral endoprosthesis results are presented for 22 patients (9 males and 13 females) with long strictures of the upper urinary tract (UUT). Stenosis was caused by rectal tumor in 2 patients, by cancer of the uterine cervix in 5 patients. In a female with Burneville-Pringle disease metallic prosthesis was set in the pyeloureteral segment (PUS) of the solitary right kidney. Six patients had long strictures of the abdominal part of the ureter, 4 had PUS strictures, 3 - of the ureter of the transplanted kidney and 1 had stricture of ureterocalicoanastomosis after Neivert operation. Endoprosthesis was established by a retrograde approach in 13 cases, via percutaneous antegrade approach - in 9 cases. In postoperative period 2 patients had exacerbation of chronic pyelonephritis, they received anti-inflammatory treatment. Patancy of the ureter was reestablished in all the cases and persisted for all the follow-up period (4-62 months). Late after operation a patients with Burneville-Pringle disease developed UUT obstruction because of ureteral compression by enlarged angiolipomatous nodes under endoprosthesis. Therefore, one more nitinol stent was set in the upper third of the right ureter retrogradely. Thus, ureteral endoprosthesis in long and recurrent strictures of the ureter, ineffective plastic surgery on the UUT is an operation of choice.

Combined treatment of patients with chronic abacterial prostatitis and chronic pelvic pain syndrome including vibrothermomagnetic impacts on the perineum from the device AVIM-1 proved effective in relation to all aspects of the disease pathogenesis. The comfort and simple conduction of the procedures make the device use perspective not only in the treatment but also for prophylaxis of exacerbations.

Effects of exogenic and endogenic epidemiological factors on the onset of urinary bladder cancer (UBC) were studied with application of regression and correlation analyses. Evidence obtained with these two methods was almost similar. A complex of the most significant independent factors for men and women was determined. These factors underlie an original mathematic model of UBC development and relevant computer program. The method can define the risk of UBC for men and women and propose prophylactic measures.

A total of 110 children aged from 5 to 15 years with different forms of congenital obstructive uropathy and secondary pyelonephritis received standard combined treatment (n = 71) or standard treatment combination with photon therapy 3 months after discharge from hospital. Postoperative combined treatment including photon therapy promoted uneventful course of the postoperative period, normalized immunological indices, achievement of persistent remission.