Urologiia i nefrologiia最新文献

The author believes that in diagnosis of tumors of the upper urinary tracts more information can be obtained at ureteropyeloscopy with retrograde contrasting of the urinary tracts and, if necessary, biopsy of abnormal urothelium regions. 19 patients with pelvic and 4 patients with ureteral tumor were operated on. 2(8.7%) patients with tumor in the lower third of the ureter underwent resection with Boari operation, classic nephroureterectomy with bladder resection was made in 15(65.2%) patients, transurethral resection of the wall of the bladder, ostium and distal ureter followed by nephroureterectomy was performed in 6(26.1%) patients. The latter operative procedure is radical but less traumatic. Five-year survival made up 73.9%.

Radionuclide tracing was performed to study renal function before and after hypotensive therapy in 95 patients suffering from nephrogenic hypertension with renal failure. It is shown that if hypotensive therapy in such patients brings about a blood pressure fall more than 25% of the initial blood pressure, renal function declines, the suppression being especially evident in severe renal insufficiency.

Pathogenesis of erectile dysfunction is well studied now. So another problem arises: how to choose individual methods of diagnosis and treatment as well as sequence of diagnostic and therapeutic measures. Our method of purposeful approach to diagnosis and treatment of erectile dysfunction is based on the choice of the patient who decides himself the scope and invasiveness of the diagnosis and treatment. The patient makes his choice after he is informed about all available diagnostic techniques and treatment methods.

Registration of contractility of the upper urinary tracts (UUT) at multichannel impedance ureterography was conducted in 30 patients with concrements in the kidneys and ureters before extracorporeal lithotripsy. By defects in urodynamics, the patients were divided into 4 groups. The most severe affection of urodynamics (low amplitude of the peristalsis, high tonicity of UUT wall) occurred in group 4. From group 1 to 4 contraction arrhythmia, deformity of contraction complexes, retrograde contraction waves were increasing. The index has been calculated for estimation of UUT performance in transporting urine.

Sublimate nephropathy--modelled pathology of proximal nephron--serves as illustration of a pathogenetic role in development of proximal tubular dysfunction of enhanced vasoconstrictive potential of angiotensin II in plasma, angiotensin II and thromboxane B2 in renal cortex. The multiple regression equation has been calculated. The proportional contribution of plasma angiotensin II, atrial natriuretic peptide of plasma, cortical angiotensin II, cortical thromboxane B2 to regulation of proximal nephron function was the following: 26.85, 32.72, 10.51 and 10.56%, respectively.

Central hemodynamics was studied in 53 patients divided into 3 groups who had transurethral resection of the prostate under epidural anesthesia. Patients with uneventful course of surgery (group 1) had favourable rearrangement of hemodynamic parameters in response to epidural anesthesia. In patients of group 2 hemodynamics was characterized by addition of negative effects of relative hypovolemia. A significant fall of central venous pressure was found in group 3. This low venous pressure resulted from the epidural block and contributed much to development of hyponatremia in these patients.

The authors studied morphological changes in renal tissue in terminal hydronephrosis and in exposure of freezing, regulation of arterial pressure and erythropoiesis in cryogenic effects on hydronephrotic kidney in experiment. Reparative changes in the parenchyma appear on day 30 after freezing, systemic arterial pressure and bone marrow erythropoietic activity returned to normal. Freezing is thought more physiological compared to nephrectomy in respect to prevention of nephrogenic hypertension and anemia.

Spermatic enzymes (fructose, alkaline phosphatase, gammaglutamyl transferase, alpha-glucosidase, dipeptydil aminopeptidase IV) were measured in 200 patients with secretory-toxic infertility. It is shown that in some variants of infertility changes in the levels of spermatic enzymes are compensatory. These changes may also reflect qualitative characteristics of spermatozoa.