Urology reports (St. - Petersburg)

Medical peer-review journal for practitioners and researchers is published quarterly since 2011

Editor-in-Cheif: professor Vladimir Tkachuk
Honored Scientist of the Russian Federation, professor of the Department of Urology of the Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, chairman of the St. Petersburg Society of Urology named after S.P. Fedorov, honorary member of the European Association of Urology).

The journal «Urology reports (St. - Petersburg)» accepts for consideration original manuscripts, which are original articles, scientific reviews, lectures for doctors, clinical observations, as well as materials informing about important dates in the history of urology and the results of past scientific congresses and conferences. The journal publishes the results of experimental and clinical studies presented by domestic and foreign authors regarding epidemiology, etiology, pathogenesis, clinical course, diagnosis, treatment and prevention of urological diseases. The articles touch upon the problems of not only general urology, but also of certain areas of urological science - neurourology, andrology, oncourology, urogynecology, reproductive health of men and others, as well as related specialties.

The journal is published with the assistance of the Department of Urology Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation and St. Petersburg Society of Urology named after S.P. Fedorov.

The journal is intended for urologists, researchers and faculty of medical schools, as well as specialists in related specialties.

Indexing:

  • Russian Science Citation Index
  • Google Scholar
  • Ulrich's Periodicals directory
  • WorldCat
  • CyberLeninka

The journal is issued with the assistance of the Department of Urology in  St.-Petersburg State Pavlov Medical University, and S.P. Fyodorov Saint Petersburg Scientific Urological Society.

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Vol 11, No 1 (2021)

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Original articles

Male autoimmune infertility: analysis of results and prediction of efficacy of low-level laser therapy in infrared spectrum
Potapova M.K., Borovets S.Y., Al-Shukri S.K.
Abstract

INTRODUCTION: Autoimmune infertility is diagnosed in 5–15% of men. Currently applied methods of medical therapy of autoimmune male infertility are not very effective, which requires the development of new ones and creation of predictive algorithms for their efficacy.

The aim of our study was to evaluate the influence of low-level laser therapy (LLLT) in infrared spectrum on MAR-test rate and sperm fertile properties in men with autoimmune infertility, develop ways to predict the efficacy of this therapy.

PATIENTS AND METHODS: 47 men with autoimmune infertility were examined. 31 of them (1st group) underwent course of LLLT in infrared spectrum (10 procedures), and 16 patients (2nd group, comparison) had placebo-laser therapy sessions (10 procedures). MAR-test value, main semen parameters and sperm DNA fragmentation were assessed before and after the treatment. For creation of LLLT efficacy algorithm we used discriminate analysis.

RESULTS: In patients of the 1st group we indicated statistically significant decrease of MAR-test by an average of 19% immediately after the course of procedures, and by 33% – within two months after the end of the treatment, at its initial level 60% or lower. LLLT contributed to improvement of the semen fertile properties, pregnancy developed in the natural reproductive cycle in 19% of couples. We developed math model for prediction the efficacy of LLLT in infrared spectrum of autoimmune male infertility.

CONCLUSION: LLLT in infrared spectrum of male autoimmune infertility leads to MAR-test value decrease at its initial level less than 60%; improves sperm fertile properties. It is appropriate to use before LLLT predictive algorithm of its efficacy developed by us.

Urology reports (St. - Petersburg). 2021;11(1):5-13
pages 5-13 views
Patient with urethral pain syndrome: psychological portrait
Khalak M.E., Molvi M., Lazukin V.F., Bozhkova E.D., Streltsova O.S.
Abstract

The article discusses the psychological characteristics of the patient with chronic pelvic pain syndrome, in particular with its component – urethral pain syndrome. The main specific personality traits inherent in such a patient are highlighted; the factors of development of chronic pelvic pain syndrome are determined, including psychological. Doctors were given recommendations for the management of such patients, in particular, the use of psychological scales and questionnaires directed at identifying markers and specific features.

Urology reports (St. - Petersburg). 2021;11(1):15-26
pages 15-26 views
Neurogenic urinary disorders in patients with tuberculous spondylitis before and after surgical treatment
Gorbunov A.I., Murav’ev A.N., Sokolovich E.G., Yablonsky P.K.
Abstract

ABSTRACT: Tuberculosis inflammation of vertebral column (spondylitis) can lead to neurogenic lower urinary tract dysfunction. There is lack of available publications for neurogenic lower urinary tract dysfunction in spinal tuberculosis.

OBJECTIVE: To evaluate urodynamic disturbances in spinal tuberculosis before and after surgery for spondylitis.

MATERIALS AND METHODS: We observed 19 patients with spinal tuberculosis, who had symptoms of micturition’s impairment. 14 patients (73,6%) were male and 5 (26,4%) were female, average age was 43,7 ± 7,9 years (27–66). Control evaluation was performed after surgery on day 21–28.

RESULTS: Before surgery we found detrusor overactivity in 11 (57,9%) patients and 2 of those with detrusor overactivity had detrusor-sphincter dyssynergia. Detrusor hypo-/acontractility was diagnosed in 8 (42,1%). After surgery 5 patients (26,3%) exhibited improvement, in one case urodynamic disturbances were resolved. One patient developed detrusor overactivity and incontinence de novo and one patient had worsening neurological status, loss of sensitivity and acontractile bladder.

CONCLUSION: Variable lower urinary tract dysfunction can be diagnosed in spinal tuberculosis. Only 26,3% of patients have improvement after surgery. New conditions or worsening of previous neurogenic lower urinary tract dysfunctions can be observed.

Urology reports (St. - Petersburg). 2021;11(1):27-32
pages 27-32 views
Features of the installation of a suprapubic cystostomy for laparoscopic treatment of patients with intraperitoneal bladder rupture
Shanava G.S., Soroka I.V., Mosoyan M.S.
Abstract

INTRODUCTION: In closed intraperitoneal bladder trauma, an alternative to laparotomy is laparoscopy. The rupture is closed with endoscopic sutures, and the bladder is drained with a urethral catheter. In the literature, the issue of the placement of a trocar cystostomy during laparoscopic treatment of patients with intraperitoneal bladder ruptures requiring prolonged drainage is insufficiently covered.

PURPOSE OF THE STUDY: Determination of the optimal trocar cystostomy method during laparoscopic treatment of intraperitoneal bladder rupture.

MATERIALS AND METHODS: Trocar cystostomy was performed in 8 patients with intraperitoneal bladder ruptures, among whom 7 had concomitant diseases of the prostate gland, and 1 had urethral stricture. Trocar cystostomy during laparoscopic surgery was performed in three different ways. Results. In the first method, the rupture of the bladder was initially sutured. Then, through the urethral catheter, the bladder was filled with saline. A trocar cystostomy was inserted through the suprapubic region. The second method consisted in the installation of a trocar cystostomy under the control of a laparoscope even before the suturing of the bladder rupture. In the third method proposed by us (patent No. 2592023), a Foley-type catheter with a balloon capacity of at least 200 ml was inserted into the abdominal cavity through the laparoscopic port. A catheter was inserted from the abdomen through an intraperitoneal rupture into the bladder. Inside the bladder, the catheter balloon was filled with saline. Then, through the suprapubic region, the anterior abdominal wall, the bladder and the inflated balloon of the catheter were pierced layer by layer with a trocar. Another catheter was inserted through the trocar into the bladder. After removal of the catheter with a ruptured balloon, the intraperitoneal rupture of the bladder was sutured.

FINDINGS: According to the results of the study, the third method of inserting a trocar cystostomy turned out to be the most optimal and safe.

Urology reports (St. - Petersburg). 2021;11(1):33-38
pages 33-38 views
Evaluation of the effectiveness of personalized complex therapy in patients with benign prostatic hyperplasia and chronic prostatitis
Barannikov I.I., Kuzmenko A.V., Gyaurgiev T.А., Kuzmenko V.V.
Abstract

PURPOSE OF THE STUDY: to evaluate the effectiveness of personalized complex treatment of patients with benign prostatic hyperplasia (BPH) in combination with chronic prostatitis using a combined physiotherapeutic effect, taking into account the individual chronobiological characteristics of patients.

MATERIALS AND METHODS: We examined 60 patients with benign prostatic hyperplasia and chronic prostatitis who were sent to the TUR of the prostate. Patients were divided into two groups (n = 30). The comparison group (CG) was treated with alpha-blockers and fluoroquinolones for 28 days. In the main group (MG) – personalized complex therapy. The effectiveness of treatment was evaluated at the time of treatment (visit 1), two weeks later (visit 2) and 4 weeks later (visit 3). The severity of lower urinary tract symptoms, prostate volume and residual urine volume, hemodynamic parameters in the gland were evaluated, and a bacterioscopic and bacteriological examination of prostate secretion was performed.

RESULTS: At the end of 4 weeks of therapy, statistically significant differences (p < 0.05) were found in the MG for all the studied parameters. In the bacteriological study of prostate secretions at visit 1 Escherichia coli prevailed in the crops. At visit 2 to the CG bacteria were detected in 11 (36.7%) crops, and in 10 (33.3%) patients in the MG. At visit 3, no microbial growth was detected in both groups based on the results of a bacteriological examination of prostate secretions. Initially, both groups had low hemodynamic parameters in the prostate. After the treatment, a more pronounced dynamics of improvement of blood flow in the gland by visit 2 was noted in the MG than in the GP. By visit 3, statistically significant differences were found in all the studied indicators (p < 0.05).

CONCLUSION: Thus, according to the results, a personalized comprehensive treatment of patients with benign prostatic hyperplasia and chronic prostatitis reduced the severity of lower urinary tract symptoms and manifestations of the inflammatory process in the prostate, improved hemodynamic parameters and increase of efficiency of antibacterial therapy, as evidenced by the results of bacteriological studies.

PURPOSE OF THE STUDY: to evaluate the effectiveness of personalized complex treatment of patients with benign prostatic hyperplasia (BPH) in combination with chronic prostatitis using a combined physiotherapeutic effect, taking into account the individual chronobiological characteristics of patients.

MATERIALS AND METHODS: We examined 60 patients with benign prostatic hyperplasia and chronic prostatitis who were sent to the TUR of the prostate. Patients were divided into two groups (n = 30). The comparison group (CG) was treated with alpha-blockers and fluoroquinolones for 28 days. In the main group (MG) – personalized complex therapy. The effectiveness of treatment was evaluated at the time of treatment (visit 1), two weeks later (visit 2) and 4 weeks later (visit 3). The severity of lower urinary tract symptoms, prostate volume and residual urine volume, hemodynamic parameters in the gland were evaluated, and a bacterioscopic and bacteriological examination of prostate secretion was performed.

RESULTS: At the end of 4 weeks of therapy, statistically significant differences (p < 0.05) were found in the MG for all the studied parameters. In the bacteriological study of prostate secretions at visit 1 Escherichia coli prevailed in the crops. At visit 2 to the CG bacteria were detected in 11 (36.7%) crops, and in 10 (33.3%) patients in the MG. At visit 3, no microbial growth was detected in both groups based on the results of a bacteriological examination of prostate secretions. Initially, both groups had low hemodynamic parameters in the prostate. After the treatment, a more pronounced dynamics of improvement of blood flow in the gland by visit 2 was noted in the MG than in the GP. By visit 3, statistically significant differences were found in all the studied indicators (p < 0.05).

CONCLUSION: Thus, according to the results, a personalized comprehensive treatment of patients with benign prostatic hyperplasia and chronic prostatitis reduced the severity of lower urinary tract symptoms and manifestations of the inflammatory process in the prostate, improved hemodynamic parameters and increase of efficiency of antibacterial therapy, as evidenced by the results of bacteriological studies.

Urology reports (St. - Petersburg). 2021;11(1):39-48
pages 39-48 views
The effect of the phytocomplex Renotineх® on postoperative period after external shock wave lithotripsy in patients with urolithiasis
Neymark A.I., Neymark B.A., Nozdrachev N.A., Gatkin M.Y., Fursa Y.S.
Abstract

INTRODUCTION: Phytopreparations are one of the leading medicines used as preoperative preparation and postoperative management in patients with urolithiasis.

THE AIM of the study was to evaluate the nephroprotective effect of Renotinex® in patients with urolithiasis after extracorporeal shock wave lithotripsy (ESWL).

MATERIALS AND METHODS: The study included 86 patients (43 in the main and the comparison group) with urolithiasis with localization of the stone in the renal pelvis without disturbing the outflow of urine. All patients underwent extracorporeal shock wave lithotripsy (ESWL). After ESWL patients in both groups received spasmodic, anti-inflammatory, antibacterial therapy. Patients of the main group additionally received Renotinex® 2 capsules 3 times a day for 14 days before and 14 days after surgery.

RESULTS: During the observation a more effective discharge of calculus fragments was noted in patients of the main group while taking the phytocomplex Renotinex®, as well as less pronounced damage and faster recovery of the renal parenchyma after ESWL according to the level of enzimuria.

CONCLUSION: The results of the study indicate the feasibility of prescribing the phytocomplex Renotinex® for nephroprotective and lithokinetic therapy in patients after ESWL.

Urology reports (St. - Petersburg). 2021;11(1):49-54
pages 49-54 views
Comparative morphofunctional visualization of the manifestations of chronic bacterial and radiation bladder injuries
Berdichevskyy B.B., Berdichevsky B.A., Barashin B.A., Keln A.A., Naletov A.A., Boldyrev A.L., Gutrova E.I.
Abstract

Comparative morphofunctional and histological visualization of bladder wall lesions in 15 patients with chronic bacterial cystitis and in 15 patients with chronic radiation cystitis using positron emission tomography - computed tomography (PET/CT) was performed. The studies have revealed significant differences in the parameters of blood flow and tissue metabolism in patients with these forms of bladder lesions. In patients with chronic bacterial cystitis, an increase in the frequency of urination was accompanied by a decrease in the capacity of the bladder under conditions of a decrease in the velocity of arterial and venous blood flow in its wall as compared with the control. At the same time, at the cellular-molecular level in the bladder wall, no significant metabolic abnormalities, assessed by the SUVmax indicator, were revealed. Chronic radiation cystitis was characterized by a significant increase in the rate of systolic and diastolic blood flow in the bladder wall, its thickening and hypermetabolism of 18F-FDG.

Urology reports (St. - Petersburg). 2021;11(1):55-62
pages 55-62 views
Application of pantohematogen dry for treatment of discirculatory disorders in chronic prostatitis (experimental and clinical study)
Tihonov I.V., Tityaev I.I., Kasyanov D.S., Chekushin R.H.
Abstract

PURPOSE: To study in experiment and in clinical conditions the effectiveness of the preparation pantogematogen dry, obtained from the blood of a maral, for the correction of dyscirculatory disorders in the prostate gland.

MATERIALS AND METHODS: The experimental and morphological part of the work was performed on 90 male Wistar rats with local venous congestion in the small pelvis due to ligation of the internal iliac veins. Animals of the main group (n = 30) underwent enteral correction with dry pantohematogen (in a daily dose of 10 mg per 100 g of animal weight) starting from the 7th day after modeling the disease, the course was 14 days. The rats of the 2nd group (n = 30) after modeling of venous stasis were not treated. Group 3 consisted of intact animals. During the clinical phase of the study, 61 patients with chronic congestive prostatitis were treated. All patients received standard therapy, and patients in the treatment group (n = 30) additionally received highly dispersed aerosol transrectal irrigation with an aqueous solution of pantohematogen, daily, for a course of 10 procedures.

RESULTS AND DISCUSSION: Morphological examination of the prostate gland of laboratory animals with experimental discirculatory prostatitis and its subsequent enteral correction with panthematogen dry indicated significant differences compared with animals of the 2nd group. A tendency towards restoration of the normal structure of the prostate, its metabolism, regional and organ blood and lymph outflow, improvement of the drainage-detoxification and transport activity of its regional lymph nodes was noted. In the clinical part of the study, the effectiveness of the use of pantogematogen in patients with chronic congestive prostatitis was shown. At the end of the course of treatment in patients of the 1st group, the disappearance of pain (in 72.4% of cases) and dysuric (in 86.2% of cases) syndromes was observed, and in the rest – a decrease in their intensity. According to the TRUS of the prostate in patients of the 1st group, after treatment in 52% of cases, a decrease in the volume of the prostate was noted.

CONCLUSIONS: The results of an experimental clinical study indicate the prospects for the inclusion of pantogematogen in the complex therapy of patients with chronic congestive prostatitis.

Urology reports (St. - Petersburg). 2021;11(1):63-68
pages 63-68 views

Reviews

Biofeedback in the treatment of patients with urine incontinence after radical prostatectomy
Krotova N.O., Ulitko T.V., Kuzmin I.V., Al-Shukri S.K.
Abstract

The review article is devoted to the application of the biofeedback in the treatment of patients with urinary incontinence after radical prostatectomy. The data on the mechanism of urinary continence in men and its damage during surgery are presented, the pathogenetic basis of the therapeutic effect of pelvic muscle training in this patients is highlighted. The analysis of the main russian and foreign clinical studies on the use of the biofeedback in patients with urinary incontinence after prostatectomy has been carried out. It is indicated that biofeedback increases the effectiveness of conservative treatment of urinary incontinence, however the even wider use of this method of treatment is limited by the lack of standard protocols for training pelvic muscles under the control of biofeedback.

Urology reports (St. - Petersburg). 2021;11(1):69-78
pages 69-78 views
Surgical treatment of patients with strictures of the ureteropelvic junction: historical aspects
Al-Shukri A.S., Kostyukov S.V., Kostyukov V.V.
Abstract

The review article is devoted to the history of surgical treatment of the ureteropelvic junction obstruction. The data on the main stages of development and improvement of the operative technique are presented, the main methods of restoring the outflow of urine from the kidney with strictures of the ureteropelvic junction are described. The analysis of modern methods of surgical treatment of this category of patients has been carried out.

Urology reports (St. - Petersburg). 2021;11(1):79-86
pages 79-86 views

Case reports

Purulent-septic complications in patient with renal calyx diverticulum
Zamyatnin S.A., Gonchar I.S., Tsygankov A.V.
Abstract

The calyx diverticulum is a cavity lined with urothelium that communicates through a narrow canal with the renal calyx-pelvis system. Most calyx diverticula are 0.5 to 2.0 cm in diameter and require surgical treatment exclusively for clinical manifestations of associated diseases. The most common complications of this nosology include urolithiasis and recurrent urinary tract infections. This article presents a rare case of a large diverticulum of the middle group of the calyces of the left kidney. The dimensions of the cavity filled with urine were 10 cm, which resulted in recurrent pyelonephritis, paranephritis and urosepsis.

Urology reports (St. - Petersburg). 2021;11(1):87-92
pages 87-92 views

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