Vol 8, No 1 (2018)

Articles
Assesment of the efficiency of conservative treatment of Peyronie’s disease
Kalinina S.N., Fesenko V.N., Nikolskii A.V., Burlaka O.O., Marchenko N.V.

Abstract

There were 27 men under observation who got conservative treatment for Peyronie's disease. The criteria for inclusion in the study were the maximum size of the plaque of the penis up to 1.5 cm and the angle of curvature of the penis is less than 45 degrees. Before treatment, after 6 and 12 months, patients underwent ultrasonic dopplerography of the penis, the velocity of blood flow in the cavernous and dorsal arteries and the size of the plaque were determined. All observed patients were prescribed combined therapy, such as symptomatic, immunological and physiotherapeutic treatment. In this case, the patients of the 1st group (n = 15) additionally got longidase treatment (intramuscularly for 3000 IU every 3 days, for a course of 10 injections with concurrent administration of rectal suppositories with longidase at the same dose for a course of 10 suppositories). Locally, these patients were assigned phonophoresis with lengidase on the plaque area (10 sessions). The remaining 12 patients (2nd group) didn’t got longidase treament. Six months after the start of treatment the absence of plaques was recorded in 8 (53.3%) patients in the 1st group and 4 (33.3%) in the 2nd group of patients and in 12 months in 11 (73.3%) and 6 (41.6%) patients. Thus, conservative therapy in Peyronie's disease is effective in patients in the early stages of the disease with moderate deviation of the penis and plaques up to 1.5 cm. The inclusion of longidase in the complex therapy increases the effectiveness of the treatment.

Urology reports (St. - Petersburg). 2018;8(1):5-10
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Endovascular surgery of the iliac veins with bilateral varicocele and varicose veins of the pelvic organs in men
Kapto A.A.

Abstract

In this study an analysis of the examination and treatment of 66 patients with bilateral varicocele, varicose veins of the pelvic organs due to ileal venous compression was performed. The obtained data testify to the need to review existing approaches to the surgical treatment of bilateral and recurrent varicocele. Carrying out balloon angioplasty and stenting in varicose veins of the pelvic veins in men due to the syndrome of ileal venous compression is currently an innovative and promising direction in urological practice at the interface of specialties.

Urology reports (St. - Petersburg). 2018;8(1):11-17
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Combined (citrate and herbal) drug uriklar in extracorporeal shock wave lithotripsy and metaphylaxis of urolithiasis
Shestaev A.Y., Protoshchak V.V., Paronnikov M.V., Kiselev A.O.

Abstract

The aim of the study was to study the clinical efficiency and safety of the drug uriklar in extracorporeal shock wave lithotripsy (ESWL) and early metaphylaxis of urolithiasis.

Materials and methods. 45 patients were included in the prospective study. The patients were divided into two groups. The main group consisted of 25 patients, they received uriklar 1 capsule three times a day for one month before and three after ESWL. The control group included 20 patients who underwent ESWL only. Uriklar is combined drug with citrate and herbal components.

Results. The total efficiency of ESWL was 92% in I group versus 75% in control group. Among the patients of the main group, the frequency of renal colic after ESWL was 24% (6 patients), while in the control group colic occurred in 9 patients (45%). The severity of pain syndrome was of 5.12 ± 2.1 in I group and of 7.48 ± 2.2 and in II group (p < 0.05). Uriklar in the first group of patients increased the pH of urine and the excretion of citrate significantly and decreased excretion of uric acid. After 3 months, the vast majority of patients (n = 24, 96%) of the main group underwent curing of the urinary tract, and daily diuresis remained at 2.3 ± 0.3 l/day.

Conclusions. The uriklar taking increases the fragmentation of urinary stones and the elimination of the resulting fragments from the urinary tract, promotes the normalization of metabolic disorders, and effectively eliminates infectious-inflammatory complications of urolithiasis. It is also well-tolerated and has no side effects.

Urology reports (St. - Petersburg). 2018;8(1):19-25
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Diagnosis and treatment of lower urinary tract symptoms and erectile dysfunction in patients with benign prostate hyperplasia
Kalinina S.N., Burlaka O.O., Aleksandrov M.S., Vydryn P.S.

Abstract

The efficacy and safety of alpha-1-adrenergic blocker alfuprost MP (alfuzosin) at a dose of 10 mg once a day and a fifth-type phosphodiesterase inhibitor viatile (sildenafil) 50 mg once a day in the combined treatment of 75 patients with benign prostate hyperplasia (BPH) with low urinary tract symptoms and erectile dysfunction (ED). Patients were divided into 3 groups, depending on the severity of ED and urination disorders. The 1st (main) group included 34 (45.3%) patients with moderate-stage ED (IIEF 11-15 points, IPSS 10-12 points) who got a combination therapy that included the intake of viatile (sildenafil) 50 mg in day daily and alfuprost MP (alfuzosin) 10 mg once a day for 12 weeks. The second group included 21 (28%) patients with a mild degree of ED (IIEF 16-20 points, IPSS-10-12 points), who received only viatile (sildenafil) 50 mg daily once a day with the same duration. The third group included 20 (26.6%) patients with mild ED (IIEF 16-20, IPSS 7-8), who received only alfuprost MP (alfuzosin) 10 mg once a day for 12 weeks. After the end of treatment 29 (85.3%) patients of the 1st group, 16 (76.2%) patients of the 2nd group and 11 (55%) patients of the 3rd group noted high efficiency. The patients of the 1st group had the greatest clinical effect of treatment – an increase in the quality of erection by an average of 7.0 according to IIEF, an increase in blood flow in the vessels of the penis by 3.5 times, decrease in the IPSS index by 5 points, and an increase in the rate of urination. The results of the study indicate the advisability of prescribing patients with BPH with low unitary tract symptoms and erectile dysfunction of combined therapy with alpha-blockers and phosphodiesterase type 5 inhibitors.

Urology reports (St. - Petersburg). 2018;8(1):26-33
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Closed manual detorsion in case of a testicular torsion in children
Shormanov I.S., Shchedrov D.N.

Abstract

Aim of study. To evaluate the effectiveness of closed manual detorsion in case of testicular torsion in children of different age groups.

Materials and methods. Manual detorsion was carried out according to the classical technique (Yudin Ya.B. et al., 1987) by 79 patients with a testicular torsion at the age from the neonatal period to 18 years. A comparative analysis of the effectiveness of detorsion depending on various factors (the age of the patient, the duration of ischemia, the presence of a secondary hydrocele) was performed.

Results. The effectiveness of the detorsion depended on the duration of the ischemia period before manipulation in patients of all ages. The effectiveness of the detorsion is more pronounced in adolescents, which is due to the more advanced structures of the spermatic cord and the larger testicle mass. A hydrocele of a secondary nature is a factor complicating detorsion, but its puncture emptying increases the efficiency of manipulation.

Conclusions. The effectiveness of manual detorsion is directly proportional to the age of the patient and inversely proportional to the duration of ischemia before the manipulation is performed. The frequency of residual torsion does not allow us to consider the method as independent in the treatment of testicular torsion, and ultrasound and ultrasound dopplerography are completely reliable evaluation criteria. The effectiveness of the method allows you to recommend it in the first day of the disease in patients of all age groups, except for newborns, but emergency surgery should be performed as soon as possible after the detorsion. Carrying out a discharge puncture in patients with a secondary hydrocele against a background of testicular vesicle significantly improves the effectiveness of manual detorsion.

Urology reports (St. - Petersburg). 2018;8(1):34-39
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Radiation diagnostics of arteriovenous erectile dysfunction: history and development
Kyzlasov P.S., Kasymov B.G., Al-Shukri S.K., Iskakov E.A., Nugumanov R.M., Kuzmin I.V., Muratov T.M., Turgumbaev T.N.

Abstract

The review article is devoted to the history and current state of radiation methods for diagnosis of arteriovenous erectile dysfunction. The indications, advantages and disadvantages of the diagnostic methods are presented. It is indicated that magnetic resonance imaging (MRI) and computed tomography scan (CT scan) with intracavernous contrasting, which have the greatest sensitivity and specificity, are currently the optimal methods for radiation diagnosis of arteriovenous erectile dysfunction.

Urology reports (St. - Petersburg). 2018;8(1):40-46
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Сlinical justification of laser therapy efficiency of men’s infertility
Moskvin S.V., Borovets S.J., Toropov V.A.

Abstract

The article presents clinical studies of low-intensity laser irradiation (LILI). The effect of laser therapy in male infertility is shown. Russian and foreign sources of literature on this topic have been analyzed.

Urology reports (St. - Petersburg). 2018;8(1):47-55
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