Urology reports (St. - Petersburg)

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

  • Since 2018 selected papers are translated and published in English
  • Since 2020 - in Chinese.
  • Special Issues (conference proceedings) are published in Russian.

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.

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The journal is issued with the assistance of the Department of Urology in  St.-Petersburg State Pavlov Medical University

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Vol 12, No 1 (2022)

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Original articles

Impact of the COVID-19 pandemic on the work of urological departments
Kulchavenya E.V., Kholtobin D.P., Telina E.V.
Abstract

BACKGROUND: The pandemic of a new coronavirus infection has had a significant impact on the work of the entire medical service, including urological departments.

AIM: to assess the impact of the COVID-19 pandemic on the work of urological departments in private and public medical institutions.

MATERIALS AND METHODS: We assessed the impact of the restrictions imposed by the pandemic on the work of the urology department of a private clinic (MC Avicenna, Novosibirsk) and the urogenital department of the Novosibirsk Research Institute of Tuberculosis for 2019 and 2020. We assessed the change in the range of surgical interventions, as well as the structure visits to the urologist.

RESULTS: The urogenital department of the Novosibirsk Research Institute of Tuberculosis in March 2020 was redesigned into an observational one. The Avicenna Medical Center also established the procedure for anti-epidemic measures, which made it possible not only not to reduce, but in a number of positions to increase the volume of surgical care provided.

CONCLUSION: Thus, thanks to anti-epidemic measures: separation of flows, introduction of mandatory testing of patients, early detection of patients and carriers among employees, mask regimen, opening of an observational department, single rooms, lack of contact between patients, short stays, it was possible to prevent an outbreak of infection among patients and staff. Both in the municipal and private urological clinics, well-organized work did not allow the negative impact of the pandemic to manifest itself.

Urology reports (St. - Petersburg). 2022;12(1):5-12
pages 5-12 views
Opportunities of drugs based on D-mannose and herbal components in the treatment and prevention of recurrent lower urinary tract infections in women
Shormanov I.S., Solovyov A.S., Chirkov I.A., Shchedrov D.N., Krasnyak S.S., Shaderkin I.A.
Abstract

BACKGROUND: Recurrent cystitis is a common form of urinary tract infections. In the treatment of this disease antibacterial drugs are usually used. At the same time, there are plant components that can be a worthy substitute for antibiotic therapy.

AIM: To evaluate the efficacy and safety of the biologically active complex Cystalis, containing D-mannose, grape seed extract and bearberry extract, in the treatment and prevention of recurrent cystitis in women.

MATERIALS AND METHODS: The study included 60 women with recurrent cystitis. All patients answered the Acute Cystitis Symptom Scale (ACSS). The patients were divided into 2 groups of 30 people each. Patients of the 1st group received standard antibiotic therapy for recurrence of cystitis in accordance with the results of bacteriological examination of urine, followed by observation for 6 months. Patients of the second group instead of antibiotic therapy received the biologically active complex Cistalis one capsule (350 mg) 2 times a day for 3 months, followed by observation for 3 months.

RESULTS: Before the start of treatment Escherichia coli was detected in 26 patients (86.7%) in the 1st group and in 28 (93.3%) patients in the 2nd group. At a follow-up visit 30 days after the initial examination the total score on the ACSS scale in patients of the 1st group decreased from 6.6 ± 1.4 to 0.03 ± 0.18 points (p < 0.001), in patients of the 2nd group – from 6.4 ± 1.3 to 0 (p < 0.001). The sum of scores in the Quality of Life (QoL) domain in the representatives of the 1st group decreased from 6.3 ± 1.3 to 0 (p < 0.001), and in the 2nd group decresead from 5.6 ± 1.0 also to 0 (p < 0.001). In patients of both groups, the level of leukocytes and erythrocytes in the urine significantly decreased. During the 6-month follow-up period 8 recurrences of UTIs were registered in patients of the 1st group, and only 2 recurrences in patients of the 2nd group. The probability of developing a recurrence of cystitis in patients of the 2nd group was significantly lower than in patients of the 1st group (χ2 = 4.603, p = 0.032).

CONCLUSIONS: An analysis of the results of the study showed the high efficiency of using the Cystalis complex for the treatment of cystitis and the prevention of its recurrence.

Urology reports (St. - Petersburg). 2022;12(1):13-20
pages 13-20 views
Clinical and anthropometric parallels in the diagnostics of pyelonephritis in pregnant women
Neymark A.I., Kapsargin F.P., Sindeeva L.V., Dugarzhapova T.O., Firsov M.A.
Abstract

BACKGROUND: The most dangerous disease in the structure of urinary tract infections during pregnancy is pyelonephritis. Favorable ground for its occurrence is created by anatomical and physiological changes in the urinary system in pregnant women against the background of gestational restructuring of the body. It seems very relevant to study the constitutional features of pregnant women with pyelonephritis and reference points - markers associated with the risk of developing pyelonephritis, the individual characteristics of its course and the effectiveness of therapy using the fundamental basis of clinical anthropology.

AIM: Evaluation and comparative analysis of anthropometric and bioelectrical impedance body parameters in pregnant women with pyelonephritis.

MATERIALS AND METHODS: The study included 94 pregnant women with pyelonephritis hospitalized in the urological department of the Clinical Regional Hospital (Krasnoyarsk) from 2019 to 2021. In addition to traditional tests, anthropometric and bioelectrical impedance analysis was carried out to assess the constitutional features and criteria of normal and pathological variability boundaries of pregnant women with pyelonephritis. The control group included 39 women with physiological course of pregnancy without urological diseases.

RESULTS: The constitutional identification in the group of women with pyelonephritis in pregnancy was dominated by the mesomorph body type, with a smaller proportion presenting the endomorph type and the rarely detected central and ectomorph types. Vector analysis of soma components in pregnant women with pyelonephritis are characterized by high mesomorph scores reflecting the degree of skeletal and muscular development compared to the control group, with the lowest ectomorph values. According to bioelectrical impedance analysis, most patients have significant differences in a number of body composition parameters. Morphometric features of the pelvicalyceal system on the affected side are most prominent in the representatives of endomorph and central body types. There are significant correlations between the degree of pelvicalyceal system dilatation on the affected side and anthropometric and bioimpedance parameters of body composition.

CONCLUSION: The study revealed a number of clinical and anthropometric parallels and constitutional features of pregnant women with pyelonephritis with the characteristics of the component body composition. Relationships have been established between various indicators, which at first glance are not related to each other, but have a significant impact on the clinical manifestations of gestational pyelonephritis. The results of the pilot study and further development of the methodology will make it possible to determine the most significant constitutional predictors of the development of pyelonephritis in pregnancy and the possibility of conducting preventive therapy.

Urology reports (St. - Petersburg). 2022;12(1):21-32
pages 21-32 views
A new method for posterior pelvic reconstruction with autologous tissue in robot-assisted radical prostatectomy
Mosoyan M.S., Shelipanov D.A., Fedorov D.A., Aysina N.A., Vasil'ev A.A.
Abstract

BACKGROUND: Despite the improvement of surgical techniques and a significant improvement in the functional results of surgical interventions for prostate cancer urinary incontinence after radical prostatectomy remains the most important factor that negatively affects the quality of life of patients.

AIM: Evaluation of the effectiveness and safety of a new technique for posterior reconstruction using autologous tissue an endopelvic fascia flap in robot-assisted radical prostatectomy.

MATERIALS AND METHODS: 28 patients with localized prostate cancer who underwent modified robot-assisted radical prostatectomy at one medical center were included in the study. During the operation after removal of the prostate a posterior reconstruction of the small pelvis was performed by excising a flap of the endopelvic fascia on one side, placing it behind the bladder neck and urethrocystoanastomosis, followed by fixing this flap to a similar structure on the opposite side in the form of a loop, strengthening the anastomosis from behind. The main intraoperative parameters, oncological and functional results were evaluated.

RESULTS: Analysis of the results of the study confirmed the high efficiency of the proposed surgical technique. The average operation duration was 145 min (120–170 min), average console time was 68 min (55–102 min), the average duration of the posterior reconstruction stage was 6 min (3.5–8.5 min). Average intraoperative blood loss was 55 ml (25–175 ml). The urethral catheter was removed on the 7th day after the operation in all patients. During surgery there were no conversions and any complications of III–V groups according to the Clavien – Dindo classification. Immediate urinary continence was noted in 23 (82.1%) patients (82,1%), early urinary continence was noted in 26 (92.8%) patients.

CONCLUSIONS: The results of the study showed that the use of a new technique for posterior reconstruction in robot-assisted radical prostatectomy using endopelvic fascia flaps is effective and safe, showing good early functional results, in particular, immediate urinary continence without compromising oncological outcomes.

Urology reports (St. - Petersburg). 2022;12(1):33-40
pages 33-40 views
Ejaculate parameters and the results of in vitro fertilization treatment in infertile couples with overweight and obese men
Korneyev I.A.
Abstract

BACKGROUND: Infertility and obesity are actual and at the same time occurring problems of many couples. Conflicting data have been obtained on ejaculate parameters and the results of infertility treatment using in vitro fertilization treatment (IVF) in overweight and obese men.

AIM: To evaluate the results of examination and treatment using ART, depending on the body mass index (BMI) of men in infertile couples.

MATERIALS AND METHODS: A retrospective analysis of the results of treatment at the International Center for Reproductive Medicine in 368 infertile couples was carried out. The mean age of men and women was 36.4 ± 6.2 and 33.9 ± 5 years, respectively. Previous treatment for varicocele, sexually transmitted infections, prostatitis and cryptorchidism was performed in 58 (15.7%), 43 (11.7%), 42 (11.4%) and 11 (2.9%) men, respectively. Height and weight were measured for all patients, and BMI was calculated. The ejaculate was processed using a gradient medium (SupraSperm, Origio), IVF or ICSI were used in 110 (29.9%) and 258 (70.1%) couples, respectively, signs of good embryo quality were determined according to recommendations of professional societies for reproductive medicine. The onset of pregnancy was confirmed by the results of ultrasound sonography of the uterus. The results were subjected to statistical analysis.

RESULTS: The BMI mean was 27.4 ± 4.4 kg/m2, overweight and obesity of the 1st and 2nd degrees were observed in 161 (43%), 58 (15.8%) and 23 (7%) men respectively. Higher BMI values of men corresponded to higher BMI values of women (p < 0.001), BMI values did not depend on ejaculate volume, concentration, total number and number of motile spermatozoa, proportion of high-quality embryos, and pregnancy rate. The highest pregnancy rate was noted after treatment of couples with younger women and higher values of the total number, concentration and number of progressively motile spermatozoa and ejaculate volume (p = 0.037, p = 0.028, p < 0.001, p = 0.003, p < 0.0001, respectively).

CONCLUSIONS: Overweight and obese men prevail in infertile couples seeking IVF treatment. IVF treatment can overcome infertility in couples with overweight and obese men.

Urology reports (St. - Petersburg). 2022;12(1):41-48
pages 41-48 views
Choice of access for endoscopic treatment of patients with proximal ureter calculi. Our experience
Topuzov M.E., Basok S.M., Kustov P.V., Abinov O.A.
Abstract

BACKGROUND: Urolithiasis is an actual problem of urology. Over the past 20 years, the tactics of treating patients with urolithiasis has changed significantly. However, there are currently no standardized algorithms for choosing the most effective treatment for a particular patient.

AIM: To evaluate the efficacy and safety of using a mininephroscope in comparison with the use of a flexible ureterorenoscope when performing percutaneous antegrade ureterolithotripsy in the treatment of patients with proximal ureteral calculi.

MATERIALS AND METHODS: A retrospective analysis of case histories of 61 patients with calculi in the proximal ureter was performed. All patients for surgical treatment were hospitalized in a planned manner with a previously installed nephrostomy drain 12Ch. All patients underwent percutaneous antegrade ureterolithotripsy – 15 using a mininephroscope (Group 1) and 46 using a flexible ureterorenoscope (Group 2).

RESULTS: The clinical performance of the mininephroscope and the flexible ureterorenoscope for ureterolithotripsy is similar. In patients of the 1st and 2nd groups, the average duration of the operation (59 ± 10 min and 63 ± 9 min, respectively, p > 0.1) and the Stone Free Rate (SFR) on the first day after surgery (respectively 93.3% and 95.7%) did not significantly differ. There were no intraoperative complications in any of the patients. The frequency of postoperative complications in patients of the 1st and 2nd groups was low, all complications corresponded to the 1st degree according to the Clavien–Dindo classification. The duration of postoperative hospital stay in patients of the 1st and 2nd groups was the same and averaged 3 days.

CONCLUSIONS: Performing percutaneous antegrade ureterolithotripsy using a nephroscope and a flexible ureterorenoscope ensures the achievement of SFR in the same short time, the minimum duration of surgery and the duration of the postoperative bed-day, as well as a low incidence of postoperative complications.

Urology reports (St. - Petersburg). 2022;12(1):49-54
pages 49-54 views
Cryoablation of localized renal cancer on the MKS cryotherapy unit with liquid nitrogen as a cryogen: functional and oncological efficiency of the method
Shchekuteev N.A., Nosov A.K., Prohorov G.G., Burovik I.A.
Abstract

BACKGROUND: Ablation is a method of destroying a pathological focus using a controlled temperature or other effect. The most promising ablative treatment for localized kidney cancer today is cryoablation.

AIM: To analyze functional and oncological results of cryoablation of localized kidney cancer using liquid nitrogen as cryogen.

MATERIALS AND METHODS: Between 2017 and 2020, 56 patients with suspected localized kidney cancer were observed and treated at the N.N. Petrov National Medical Research Center of Oncology. With morphological verification, renal cell carcinoma was detected in 19 (65.5%) patients, chromophobe renal cell carcinoma – in 3 (10.4%), oncocytoma – in 3 (10.4%), in 4 (13.8%) cases the tumor was not detected in morphological material. All patients underwent cryoablation using the MKS cryotherapy unit with liquid nitrogen as a cryogen (ultrasound-guide cryotherapy was performed in 4 (7.1%) cases, CT-guide – in 46 (82.1%), laparoscopically – in 6 (10.7%) patients).

RESULTS: Renal function in this study was assessed by creatinine level and glomerular filtration rate (GFR) before and after cryoablation. The creatinine level before cryoablation was 101 ± 18 µmol/l, after – 113.8 ± 18 µmol/l (p = 0.21), GFR before cryoablation – 63 ± 13 ml/min, after – 65 ± 13 ml/min. These differences were not significant (p = 0.87). Local disease control was achieved in 100% of cases. The overall and specific survival rate were 100% (one patient died from synchronous primary multiple cancer at 4 years of observation), the survival rate to recurrence was 90.9 ± 3.9%, and the event-free survival was 70.2 ± 6.6%. During the follow-up period, 9 (16%) recurrences of the disease were diagnosed.

CONCLUSIONS: Cryoablation makes it possible to maintain a large volume of renal parenchyma, thereby not reducing the functional ability of the kidney. In addition, the outcomes and survival rates are quite high, making it an alternative option for other nephron-saving operations.

Urology reports (St. - Petersburg). 2022;12(1):55-62
pages 55-62 views
Assessment of blood flow in the prostate before and after transuretral enucleation of benign hyperplasia prostate
Vydrin P.S., Kalinina S.N., Korenkov D.G.
Abstract

BACKGROUND: Transrectal Doppler ultrasound is the leading method for studying blood flow in the prostate. Despite a significant number of studies on the use of ultrasound of the prostate in patients with BPH, many aspects of its clinical use remain unclear. One of these issues is the features of changes in blood flow in the prostate after transurethral surgical interventions.

AIM: to assess the state of blood flow in the prostate gland in patients with BPH before and after transurethral enucleation by laser and bipolar methods.

MATERIALS AND METHODS: The study included 88 patients with BPH aged 50 to 79 years who complained of urinary disorders. All patients underwent transurethral enucleation of BPH: 41 patients with the laser method (HoLEP) (1st group) and 47 patients with the bipolar method (TUEB) (2nd group). Before surgical treatment, 4, 12 and 24 weeks after surgery, patients underwent transrectal Doppler ultrasound of the prostate.

RESULTS: The results of the study indicate a significant impact of surgery on the state of blood flow in the prostate gland. Examination 12 weeks after the operation showed a significant decrease in the peak blood flow velocity and values of the resistance index in patients of the 1st and 2nd groups compared with the corresponding values before the surgery and 4 weeks after the surgery. By 24 weeks after surgery, all patients showed normalization of blood flow parameters, while in patients of the 1st group (HoLEP) this process occurred faster than in patients of the 2nd group (TUEB).

CONCLUSIONS: The high diagnostic efficiency and informativeness of transrectal Doppler ultrasound in the assessment of blood circulation in the prostate in patients with BPH has been confirmed. The blood flow velocity in the subcapsular and especially paraurethral arteries, as well as the values of the resistance index, were higher in patients with large prostates, which must be taken into account when planning surgical interventions.

Urology reports (St. - Petersburg). 2022;12(1):63-70
pages 63-70 views

Reviews

Long-term botulinum therapy for overactive bladder: myths and reality
Kuzmin I.V., Slesarevskaya M.N., Amdiy R.E., Ulitko T.V., Al-Shukri S.K.
Abstract

The review article presents data on the efficacy and tolerability of intravesical injections of botulinum toxin in patients with overactive bladder. The pharmacological bases of the use of botulinum therapy in this category of patients are described in detail. Data on the history of the use of botulinum toxin for medical purposes are presented. Experience to date shows that intravesical botulinum toxin injections are highly effective and well tolerated in patients with refractory overactive bladder. Botulinum therapy is included in domestic and foreign clinical guidelines as a 3rd line treatment for idiopathic and neurogenic overactive bladder. Indications for its implementation are the inefficiency and/or poor tolerability of oral pharmacotherapy. It is noted that the only botulinum toxin recommended for use in clinical practice for the treatment of overactive bladder is onabotulinumtoxin A (Botox®). The results of clinical studies are presented, showing that the effectiveness and safety of botulinum therapy do not decrease over time.

Urology reports (St. - Petersburg). 2022;12(1):71-84
pages 71-84 views

Case reports

Benign prostatic hyperplasia with high PSA values: a clinical case
Protoshchak V.V., Paronnikov M.V., Karpushchenko E.G., Ignateva V.V., Ovchinnikov D.V., Erohina A.A.
Abstract

The article presents a clinical case of treatment of a patient with benign prostatic hyperplasia and high serum prostate-specific antigen values. Prostate-specific antigen (total) blood level – 160.1 ng/ml. The volume of the prostate gland is 230 cm3, the average proportion is 53 mm. The patient underwent a full range of diagnostic tests. A retropubic transvesical adenomectomy was performed. During a histological examination of the preparation, no data was obtained for the presence of an oncological process.

Urology reports (St. - Petersburg). 2022;12(1):85-90
pages 85-90 views
Malacoplakia of the urinary bladder. Clinical case report
Barysheva O.Y., Simanov R.N., Bukalev A.V.
Abstract

A clinical case of bladder malacoplakia in a 33-year-old woman, clinically manifested by dysuria and gross hematuria, is presented. Malacoplakia is a rare tumor-like granulomatous-inflammatory disease with a predominant lesion of the bladder mucosa. The literature describes extravesical forms of malacoplakia with involvement of the ureters, renal pelvis and calyces, prostate, testicles and their appendages, intestines and other organs. In women, the disease occurs 4 times more often than in men. The reasons for the development of malacoplakia are not fully understood. The main importance in its pathogenesis is attached to the infectious factor and immunosuppression. Diagnosis is based on histological examination of bladder biopsy specimens and the detection of Hansemann cells and Michaelis – Gutman bodies. Treatment of patients with malacoplakia consists of resection of the affected areas of the bladder and antibiotic therapy.

Urology reports (St. - Petersburg). 2022;12(1):91-98
pages 91-98 views

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