Urologiia i nefrologiia最新文献

Reproductive function and treatment results have been analysed for 59 patients aged 17 to 32 years after herniotomy. 28 and 31 of them underwent standard and endosurgical interventions, respectively. The control group consisted of 30 healthy males matched for age. As shown by 6-month follow-up, the endosurgical herniotomy was not associated with such complications as hydroscheocele, hydrocele, testicular atrophy, diminution of blood flow along the testicular arteries. Ejaculate, levels of sex hormones in the blood, cremasteric reflex remained intact. After routine herniotomy there appeared defects in scrotal and testicular microcirculation with partial testicular atrophy in 25% of cases, testicular circulation fell 2.2-2.5-fold, deterioration of spermogram and cremasteric reflex parameters, reduction of serum testosterone were observed.

Citrate therapy was tried in 483 patients with urate nephrolithiasis. A good response was obtained both in monotherapy or in combination of urates with invasive or remote treatment. The authors advocate the drug blemaren (ESPARMA, Germany) as most beneficial among citrate drugs.

The authors report a case of a male patient with urate nephrolithiasis aggravated with postrenal anuria due to total obturation of the single kidney's ureter with multiple calculi located as a path. The outcome was satisfactory.

The authors report a case of massive hemorrhage from the vessels of the renal peduncle in a 68-year-old male patient with nephroureterolithiasis after one session of ESWL. Urgent nephrectomy was made. Histologically, there were sclerotic-distrophic changes of the vascular peduncle of the left kidney induced by long-term obstruction of the ureter with the calculus and extravasation of the urine into the renal sinus. This ESWL complication may take place in elderly patients with long-term ureteral obstruction with the stone. In such cases ESWL should be carried out only in hospital.

The trends in male urinary and genital cancer morbidity and mortality are specified. Statistics on separate malignant urological diseases are provided. In 1996 the number of patients with cancer of male urinary and sex organs reached 31.700. A growth in morbidity was due rather to a higher risk to develop the disease than because of changes in the population age. Urological cancer reduces mean life span of Russian population by 2 months, and the patients' life terminates 10-19 years earlier. Financial losses due to deaths of urological cancer stand as high as 197 million roubles as estimated in 1990 prices.

Laparoscopic dissection of common renal cysts was made in 27 patients who complained of low back pains and hypertension. The diagnosis and indications for operation rested on ultrasonic investigation and dynamic nephroscintigraphy. All the surgical interventions were performed under endotracheal anesthesia after creation of pneumoperitoneum with the use of three trochars. The procedure comprised maximal dissection of the free cystic wall, electrocoagulation of the residual part's margins and retroperitoneal drainage. Postoperative period was uneventful in 92.6% of the cases. Control examination 3 and 6 months after the operation indicated good results: pain relief, stabilization of arterial pressure and improvement of renal function.

Tumors arising in human embryo from embryonic laying of an organ can be considered anomalies. Such tumors are renal adenomyosarcoma (Wilms' tumor), mesenchymoma and sarcoma botryoides of the prostatic gland, embryonal cancer of the testis, leydigocellular tumors of the testis and teratomas. Such anomaly as testicular teratoma occurs not rarely. However, testicular teratoma containing brain tissue is a rare finding. A case of teratoma of the left testis is reported in an 11-month-old infant. The tumor contained skin, appendages of the skin, cartilage, bone tissue, brain tissue, hair, fat.

Of late, there has been a strong tendency to growing occurrence of intrahospital infections (IHI) caused by opportunistic pathogens. IHI of the urinary system is leading among them. IHI diagnosis is made basing on both clinical and microbiological data. Usage of the computer program "Journal of Microbiologist" adapted to urological hospital provides information on etiological structure of urinary infection, association of IHI with some therapeutic and diagnostic manipulations, antibiotic sensitivity of clinically active microorganisms among which Pseudomonas aeruginosa becomes the most frequent finding. This infection demonstrates resistance to a great number of previously effective antibacterial drugs.

Replacement of the gall bladder with an isolated ileal segment was made to evaluate function of the urinary tracts depending on configuration of the created urine reservoir early and late after the operation in dogs. Intestinoplasty of the gall bladder changes parameters of ureteral function. Upper urinary tract urodynamics after ileocystoplasty is characterized by lowering of intraureteral pressure, decreased amplitude of the contractions, high tonicity and motility. The intestinal bladder has the same mean basal pressure at rest but less when full than the control animals. Reflex urination after the bladder reconstruction in subtotal resection was intact. Detubulized urinary reservoir had low intravesical pressure and no spontaneous contraction activity.