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Vol 10, No 3 (2020)

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Original articles

Substitutional urethroplasty with tissue-engineered structures in an experiment

Gorelova A.A., Murav’ev A.N., Vinogradova T.I., Gorelov A.I., Yudintseva N.M., Nashchekina Y.A., Samusenko I.A., Yablonsky P.K.


Introduction. In order to exclude the difficulties arising in the course of traditional surgical interventions in the scope of substitutional urethroplasty, in recent years, alternative materials have been developed using tissue engineering. This study is devoted to the development of new tissue-engineered constructions for urethroplasty using cells of different tissue origins and biopolymers, which is an urgent problem of modern medicine.

Aim. Experimental provision of a rationale for the possibility of using tissue-engineered constructions to replace urethral defects.

Methods and materials. Two-staged, experimental, controlled study. Dedicated to the development of tissue-engineered constructions (TEC) based on biopolymers seeded with mesenchymal stem cells or buccal epithelial cells. The prepared TECs were implanted into the rabbit’s urethra wall in a acute trauma model. Comparison of the results of the TECs usage with the “gold standard” – buccal urethraplasty was carried out.

Results. Urethrography showed similar results in all groups of animals, regardless the type of implanted material. No urethral patency was found, and confocal microscopy of urethral cryosections revealed the presence of nanoparticle-labeled mesenchymal stem cells / buccal epithelium cells with signs of their differentiation in the urothelial direction in the mucous layer.

Conclusion. The possibility of using tissue-engineered constructions based on biopolymers containing autologous mesenchymal stem cells or buccal epithelium cells for experimental substitutional urethroplasty was shown. The developed TECs can be used as an alternative to buccal urethroplasty in an experiment.

Urology reports (St. - Petersburg). 2020;10(3):201-208
pages 201-208 views

Our experience of application of low-level laser therapy in red spectrum in male idiopathic secretory infertility

Potapova M.K., Borovets S.Y., Slesarevskaya M.N., Al-Shukri S.K.


Introduction. Due to insufficient efficacy of medical therapy of idiopathic secretory male infertility there is a need to develop and apply more resultative methods of treatment.

The aim of our study was to assess the efficacy of low-level laser therapy (LLLT) in red spectrum on sperm parameters, sperm DNA fragmentation (SDNAF) and MAR-test rate in men with idiopathic infertility.

Patients and methods. 85 men with idiopathic infertility were examined, 50 of them (first group) were treated with LLLT and 35 (second group) didn’t have course of LLLT. Average age of patients of the first and second groups was 31.4 ± 1.3 and 32.3 ± 1.4 years. LLLT was performed in red spectrum on a Rubin-C device (Russia). 10 laser therapy procedures were carried out every two days with active luminescence for 10 minutes of both testicles. Male hormone panel, semen analysis, MAR-test, SDNAF were assessed before and after the treatment.

Results. LLLT in patients of the first group resulted in significant increase in ejaculate volume, sperm viability, number of morphologically normal sperm forms (by an average of 11, 9 and 23% respectively), and active mobile sperm forms by an average of 14 and 19% one and two months after the therapy respectively. In 12 patients of the first group with initially increased SDNAF its level became normal after the treatment. Significant decrease of MAR-test we searched out in patients of the first group with its initial level less than 30%. As a result of the treatment, pregnancies developed in 10 (20%) out of 50 couples in the first group.

Conclusions. LLLT in red spectrum leads to significant improvement of sperm quality in patients with idiopathic infertility, normalizes sperm DNA-fragmentation level and decreases MAR-test level.

Urology reports (St. - Petersburg). 2020;10(3):209-216
pages 209-216 views

Possibilities of proteolytic enzymes in the treatment of some forms of male infertility

Neymark A.I., Neymark B.A., Nozdrachev N.A., Davydov A.V., Kablova I.V., Yakovets Y.V., Levin V.P., Plotnikova A.Y.


In the study 46 men with impaired fertility and the presence of viscosipathy were included. The patients’ age ranged from 22 to 45 years, the average duration of infertility in marriage was 3.5 ± 2.4 years. All patients with Longidaza drugs according to the following scheme were treated. First, ten intramuscular injections of Longidaza® lyophilisate were performed to prepare a solution of 3000 IU once every five days, then Longidaza® suppositories 3000 IU rectally once every three days were prescribed, for a total of 15 suppositories. The total duration of the course of treatment is 90 days. A decrease in sperm viscosity from 2.1 ± 0.05 cm to 0.6 ± 0.07 cm (p < 0.05), an increase in total sperm motility (from 32.6 ± 2.9 to 61 ± 3.1%, p < 0.05) and the number of sperm with progressive movement (from 22 ± 1.1 to 36.7 ± 2.9 %, p < 0.05) after the treatment were revealed. Also, in the course of treatment, the restoration of the antioxidant protection of the ejaculate was noted, as evidenced by an increase in the activity of glutathione peroxidase and superoxide dismutase and a decrease in the content of malon dialdehyde. During the first year after the end of treatment, conception in marriage was registered in 21 (45.7%) patients. The results of the study indicate that a violation of the lipid peroxidation system can lead to both an increase in sperm viscosity and a disruption in the activity of acrosomal enzymes, as a result of which it becomes difficult for spermatozoa to penetrate the ovum. Longidaza is able to increase the hyaluronidase activity of the sperm acrosome, thereby improving the fertilizing ability of the ejaculate.

Urology reports (St. - Petersburg). 2020;10(3):217-221
pages 217-221 views

Effectiveness of melatonin use in treatment of premature ejaculation combined with erectile dysfunction

Kuzmenko A.V., Gyaurgiev T.A., Vishnyakov A.A., Tizyo D.V.


The article presents the results of the treatment of 60 patients with premature ejaculation in combination with erectile dysfunction. Patients were divided into three groups, in which patients were prescribed non-drug treatment, or sildenafil 50 mg on demand, or sildenafil 50 mg on demand in combination with melatonin 3 mg at night. Duration of treatment was 6 months. The psychoemotional status, quality of life, quality and duration of intercourse, erectile function and chrono-rhythms of patients were assessed. The results of the study showed that treatment with sildenafil in combination with melatonin was the most clinically effective, which manifested in prolongation of sexual intercourse, improvement of the quality of erection and normalization of the chronobiological status of patients.

Urology reports (St. - Petersburg). 2020;10(3):223-228
pages 223-228 views

Hypertensive nephropathy as an outcome of unilateral nephrectomy in kidney cancer

Titjaev I.I., Andreev S.S., Andreeva S.V., Udalov K.V., Kas’janov D.S.


Aim. To study the adaptive mechanisms of structural and functional changes in a single kidney after nephrectomy for kidney cancer.

Materials and Methods. A total of 179 operations of two types were performed: nephrectomy and kidney resection in patients with cancerous lesions. Postoperative ultrasound was performed – size control and dopplerography of the vessels of the contralateral single kidney, monitoring-control of blood pressure.

Results. In case of kidney resection, the adaptive mechanisms controlling the volume of functioning tissue are preserved. The load on the organ remains minimal and physiological, and is not redistributed, blood pressure remains close to baseline. Nephrectomy does not lead to functional changes in a single kidney, but to adaptive and pathophysiological structural damage as a result of increased plasma pressure, organ “reboot”, its vicarious hypertrophy, which is accompanied by venous edema of interstitium as a pressure factor on the tissue, increased tone of arterioles, the development of secondary organ ischemia, circulatory hypoxia and increased blood pressure. All this fits into the clinical picture of hypertensive nephropathy.

Conclusions. The potential risk of hypertension and hypertensive nephropathy in patients undergoing nephrectomy, compared with patients after organ-saving surgery, is significantly higher. One of the most important manifestations of hypertension in the elderly is a violation of the structure and function of “target organs”, which include: the brain, heart, blood vessels, kidney. Nephrectomy forms a pathological vicious circle, contributing to the development and further progression of renal and cardiovascular failure.

Urology reports (St. - Petersburg). 2020;10(3):229-234
pages 229-234 views

Results of extracorporeal shock wave lithotripsy in patients with high density kidney calculi

Ensebaev E.Z., Bajgaskinov Z.K.


A study of the efficacy of extracorporeal shock wave lithotripsy (ESWL) in patients with urolithiasis with renal calculi of high-density (>1000 HU) and size less than 20 mm was carried out. A total of 18 patients underwent 54 ESWL sessions. The tolerability of the treatment was satisfactory. The best results were obtained in patients with structural heterogeneity of calculi with a difference in the density of different sections of the calculus according to multi-slice computer tomography data of more than 500 HU. Such calculi disintegrated more easily during ESWL.

Urology reports (St. - Petersburg). 2020;10(3):235-241
pages 235-241 views


Prostatic bioregulatory polypeptide prostatilen: pharmacological properties and 30-year experience of clinical application in urology

Kuzmin I.V., Borovets S.Y., Gorbachev A.G., Al-Shukri S.K.


The review summarizes the results of 30-year clinical application of the prostatic bioregulatory peptide Prostatilen. The data from experimental studies, testifying for the high biological activity of the drug is shown, the mechanisms of its therapeutic action are described. The review presents the results of clinical studies demonstrating the effectiveness and pathogenetic justification of the prescription of Prostatilen in the treatment of chronic prostatitis, benign prostatic hyperplasia, infectious and inflammatory diseases of the kidneys and urinary bladder, as well as of several other diseases. The experience of Prostatilen application in the urological clinic of First Pavlov Saint Petersburg State Medical University is shown.

Urology reports (St. - Petersburg). 2020;10(3):243-258
pages 243-258 views

Case reports

Intramural urinary bladder leiomyoma

Protoshchak V.V., Sivakov A.A., Karandashov V.K., Skryabin M.M., Kushnirenko N.P., Chirsky V.S.


Benign neoplasms of the bladder are a rare pathology. Non-epithelial benign tumors of the bladder (fibromas, fibromyxomas, fibromyomas, hemangiomas, rhabdomyomas, leiomyomas, etc.) account for less than 0.5% of all that affect this organ. The analyzed literature describes about 250 cases of bladder leiomyoma. This article describes the clinical case of surgical treatment of bladder leiomyoma.

Urology reports (St. - Petersburg). 2020;10(3):259-263
pages 259-263 views

Fibroma of epididymis

Protoshchak V.V., Sivakov A.A., Karandashov V.K., Gozalishvili S.M., Chirsky V.S., Erohina A.A., Lazutkin M.V., Alent’ev S.A.


Benign or malignant tumors of the epididymis are extremely rare. Fibroids of the epididymis and scrotal tissues are rare benign neoplasms. Over the past 10 years, there have been isolated cases in the medical literature describing fibroids of the epididymis and testicular membranes. This article describes a clinical case of surgical treatment of a tumor of the epididymis.

Urology reports (St. - Petersburg). 2020;10(3):265-268
pages 265-268 views

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