Vol 9, No 3 (2019)

Original articles
The level of nerve growth factor and its relationship with the content of leukocytes and mast cells in experimental interstitial cystitis/painful bladder syndrome
Sholan R.
Abstract

Relevance. Interstitial cystitis/painful bladder syndrome (IC/PBS) is a debilitating condition of pain and discomfort in the bladder. Due to the limited number of published studies in this area, there is a need for further research.

Objective: to evaluate the level of nerve growth factor and its relationship with various types of leukocytes and mast cells of the bladder tissue in animals with experimental models of interstitial cystitis/painful bladder syndrome.

Material and methods. IC/PBS modeling was performed on 38 female rabbits. The IC/PBS modeling was created by introducing HCl into the bladder (group 1), urine into the wall of the bladder (group 2), and physiological saline (group 3). Nerve growth factor (NGF) was determined by the ELISA method, and white blood cells along with mast cells in tissues were determined by histological processing.

Results. A statistically significant high level of NGF in blood and urine was observed on the 1st day after IC/PBS initiation in groups 1–3 and in group 2 respectively. Two weeks after the initiation of IC/PBS in animals of group 1 a decrease in the level of FRN in the blood by 29.3% and its increase in urine by 14.3% was observed; in group 2 – an increase by 65.5% (p < 0.01) in blood and by 52.7% (p < 0.01) in urine was observed and in group 3 – a decrease by 30.8% (p < 0.05) in blood and by 30.5% (p < 0.05) in urine was observed. The greatest number of leukocytes was determined in the tissue of the bladder in animals of the 1st group. Mast cell infiltration was observed in groups 1 and 2. Correlation between the NGF in blood and urine and between NGF and the number of leukocytes and mast cells was revealed.

Findings. In IC/PBS, the level of NGF in the blood and urine is increased. Indicators of nerve growth factor in blood and urine are correlated with multidirectional connections. High mast cell infiltration occurs when damage to the integrity of the bladder by urinary toxicity. Nerve growth factor correlates with leukocyte and mast cell infiltration in the bladder tissue.

Conclusion. During IC/PBS, the level of NGF in the blood and urine is increased. Levels of nerve growth factor in blood and urine are correlated with multidirectional connections. High mast cell infiltration occurs as a response to the damage of the bladder wall integrity caused by urinary toxicity. The level of nerve growth factor correlates with the bladder tissue intensity of infiltration with leukocytes and mast cells.

Urology reports (St - Petersburg). 2019;9(3):5-11
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Stimulation of kidneys’ adaptive capabilities in patients with urolithiasis
Streltsova O.S., Pochtin D.P., Gorbunova T.A., Lazukin V.F., Sidnev I.L.
Abstract

Inflammatory changes in the kidney that occurred in the early postoperative period due to surgical trauma, deterioration of microcirculation, hypoxia, are significant risk factors for the development of renal function violation. The aim of this work is to study the effect of the combined drug “Uriclar” (Asfarma-Ros) on the kidneys’ adaptive capability in the early postoperative period as a response to operative trauma of patients with complicated urolithiasis. The effect of surgical intervention – percutaneous puncture nephrolithotripsy on the blood content of proteins of the acute phase of inflammation and cystatin C was studied. The results of examination of 35 patients (20 – the main group and 15 – the control group) were analyzed. The median age was 51 ± 8.4 years. 20 patients of the main group began receiving Uriclar 2 capsules (430 mg) twice a day for 5 days before surgery and continued it for 1 month after surgery. Patients from the control group in the pre- and postoperative periods didn’t receive Uriclar. The median age was 51 ± 8.4 years. There was a statistically significant increase in the level of cystatin C and changes in biochemical markers in the patients of the main group only that indicates the presence of adaptogenic effect of Uriclar. Thus, the inclusion of a combined drug Uriclar in a complex treatment of patients with urolithiasis allows disturbed biological and adaptive functions of the kidneys to be corrected in the early postoperative period.

Urology reports (St - Petersburg). 2019;9(3):13-20
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Experience of treating patients with urolithiasis in the urological clinic of the Aleksandrovskaya hospital
Kalinina S.N., Burlaka O.O., Korenkov D.G., Nikolskii A.V., Lebedev D.G., Krivenko A.E., Ostrikov V.P., Borychev M.V., Pavlov A.L., Vydryn P.S., Karapuzov E.G.
Abstract

The article presents the experience of treating patients with urolithiasis in the urological clinic of the Aleksandrovskaya hospital. Due to the improvement of technologies, the number of minimally invasive surgeries such as contact ureterolithotripsy, percutaneous nephrolithotripsy and percutaneous nephrolitholapaxy has increased significantly. Performing open surgical interventions is indicated only in complicated cases such as the presence of purulent calculous pyelonephritis. The indication for contact ureterolithotripsy is the localization of concretions in the pelvic ureter, as well as long-term (more than 4 weeks) presence of concretions in any part of the ureter. Percutaneous nephrolitolapaxy is the method of choice in the treatment of urolithiasis in case of uninfected kidney stones smaller and larger than 20 mm in diameter, especially in elderly patients. Emergency contact lithotripsy is indicated for treatment of acute serous obstructive pyelonephritis caused by concretion of any localization. When stones locate in lower calices of kidney effective method is percutaneous nephrolitholapaxy.

Urology reports (St - Petersburg). 2019;9(3):21-28
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Capability of doppler ultrasonography in prevention of hemorrhagic complications of prostate biopsy
Popov S.V., Orlov I.N., Demidov D.A., Suleimanov M.M., Gulko A.M.
Abstract

The article presents the results of a comparative study of the frequency and severity of bleeding after prostate biopsy performed under the control of Doppler mode of vascular scanning and without its use. Compared with the usual mode of ultrasound scanning of the prostate, the use of Doppler imaging mode of intraprostatic vessels reduces the number of hemorrhagic complications of prostate biopsy, which confirms the feasibility of using the Doppler mode when taking biopsy material.

Urology reports (St - Petersburg). 2019;9(3):29-32
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Efficacy of Tadalafil-SZ in the treatment of erectile dysfunction in patients with type 2 diabetes mellitus and with prediabetes
Korenkov D.G., Tumanov D.V., Toropov V.A.
Abstract

The aim of the study was to evaluate the effectiveness of Tadalafil-SZ in treatment of erectile dysfunction in men suffering from type 2 diabetes mellitus or prediabetes. Two patient groups of thirty people with type 2 diabetes mellitus and prediabetes were identified. Patients’ mean age was 52.2 ± 3.4 years and 48.5 ± 2.8 years in groups with type 2 diabetes mellitus and prediabetes respectively. All patients suffered from erectile dysfunction, which significantly reduced their quality of life. To assess the erectile function, the ICEF (International Index of Erectile Function) and QoL (Quality of Life) questionnaires were used. Patients with prediabetes took Tadalafil-SZ 5 mg once a day for 3 months and patients with type 2 diabetes mellitus took Tadalafil-SZ 20 mg 2 times a week (Monday and Thursday) for 3 months as a treatment for erectile dysfunction. Results of this study showed that the administration of Tadalafil-SZ not only led to a significant improvement in the quality of life, a significant reduction in weight, body mass index, waist size in patients of both groups, but also led to a glycated hemoglobin level normalization without increasing the dose of glucose-lowering therapy in patients with uncomplicated type 2 diabetes mellitus and a pronounced decrease in morning insulin levels measured in the blood in patients with prediabetes. Almost half of patients in both groups increased testosterone blood level. According to the ICEF questionnaire, erectile function was significantly improved: in the group of patients with prediabetes: the ICEF-5 index prior to taking Tadalafil-SZ averaged 18.68 points (mild ED) whereas after taking the drug, a statistically significant increase in the ICEF index to an average of 23.02 points (p < 0.05) was observed, which indicates the absence of erectile dysfunction in this group of patients during intake of Tadalafil-SZ. In the 2nd group of patients (with type 2 diabetes mellitus), the ICEF-5 index before treatment averaged 12.18 points, which reflects the average degree of erectile dysfunction, and at the end of the study there was a statistically significant increase in the ICEF-5 index to 18.44 points on average, which indicates a decrease in the severity of erectile dysfunction from moderate to mild (p < 0.05). Overall Tadalafil-SZ is an effective treatment for erectile dysfunction in both patients with prediabetes and patients with type 2 diabetes mellitus.

Urology reports (St - Petersburg). 2019;9(3):33-38
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Reviews
Approaches to kidney anti-ischemic protection in organ-preserving surgical treatment of patients with renal cell cancer
Shormanov I.S., Los M.S.
Abstract

The advantages of organ-preserving kidney operations are the improvement of functional results, the reduction in the number of patients with end-stage chronic renal failure in long-term follow up and related cardiovascular complications along with overall patients’ quality of life improvement. On the one hand, a dry surgical field is necessary for visualizing the resection margin and on the other hand, its creation starts the process of acute ischemic damage to the tissue of the operated kidney. Each minute of kidney ischemia proportionally increases the risk of developing renal failure in the long-term postoperative period. It is especially important to consider the duration of ischemia during operations on a single kidney, with bilateral tumor lesions of the kidneys, as well as in the presence of chronic renal failure. After resection of the kidney, its residual function depends on the preoperative level of glomerular filtration, the amount of parenchyma retained during surgery, and the duration of renal ischemia. The predicted functional insufficiency of the “healthy” contralateral kidney in the postoperative period is 18%. The possibility of the chronic renal failure onset or worsening of the existing one due to the progression of nephrosclerosis reaches almost 80%. The development of chronic renal failure stage III and above in the long term after renal resection is more than 30%. Thus, there is a need for the development of precision surgery, as well as the search for anti-ischemic kidney protection, aimed at maintaining the maximum volume of functioning renal parenchyma.

Urology reports (St - Petersburg). 2019;9(3):39-47
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Vascular conflicts in andrology. Part 2. Lower level arteryovenous conflicts
Kapto A.А., Smyslova Z.V.
Abstract

This paper presents a review of the literature on the prevalence, classification, symptoms, diagnosis and treatment of lower level arteriovenous conflicts. New approaches in the treatment of both arteriovenous conflicts and comorbid diseases such as varicocele, varicose veins of the pelvic organs, venogenic erectile dysfunction, chronic pelvic pain syndrome are presented. The data of the literature review can form the basis for the revision of approaches to the management of patients with varicocele, erectile dysfunction and chronic recurrent prostatitis. It is shown that x-ray surgical embolization of prostatic plexus veins alone or in combination with testicular vein embolization, angioplasty and iliac vein stenting is possible only at the junction of urology, andrology and x-ray surgery.

Urology reports (St - Petersburg). 2019;9(3):49-56
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Case reports
Experience of combined pudendal and sacral electrostimulation in a patient with chronic pelvic pain
Polushkin A.A., Isagulyan E.D., Tomskiy A.A., Salyukov R.V.
Abstract

Treatment of patients with chronic pelvic pain is one of the most difficult tasks of modern medicine. Recently, surgical neuromodulation has been increasingly used to treat chronic pain syndrome. The positive experience of chronic sacral stimulation usage in patients with pelvic organ dysfunction accompanied by pain syndrome determines the appropriateness of further search for effective methods of chronic pelvic pain treatment, for example, its combination with stimulation of peripheral nerves. The article presents a clinical observation of a patient suffering from chronic pelvic pain for a long time, who underwent chronic electrical stimulation of the sacral roots in combination with sacral nerve stimulation. After the first year of treatment, a decrease in pain intensity on the visual analog scale from 8 to 3 points, depression on the Zips from 14 to 10 points and a decrease in the indicator on the anxiety scale from 14 to 11 points was observed. The patient’s quality of life was improved, pain attacks were decreased, daily motor activity was increased, self-service along with social communication indicators were improved and the need for medicines was decreased.

Urology reports (St - Petersburg). 2019;9(3):57-64
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History of medicine
Professor A.Ya. Damsky – an urologist-innovator and a teacher (the 150th anniversary of his birth)
Morgoshiia T.S., Kuzmin I.V., Sasova V.D., Inkin A.V.
Abstract

The article is devoted to the 150th anniversary of the birth of Professor Albert Yakovlevich Damsky who was an urologist-innovator and a teacher. The main stages of scientific and pedagogical activity and practical activity of the scientist are presented. A.Ya. Damsky published about 60 scientific papers, also he was the author of the first two Soviet urology textbooks and a creator of an operating cystoscope of his own design. Moreover he was the first to perform transvesical adenomectomy.

Urology reports (St - Petersburg). 2019;9(3):65-68
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