Vol 10, No 3 (2020)

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.

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.

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.

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.

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.