Urologiia i nefrologiia最新文献

Three different approaches to treatment of non-seminomal germinogenic testicular tumors (NSGTT) of stage I after orchidofuniculectomy: preventive retroperitoneal lymphadenectomy, preventive chemotherapy, expectant treatment. Recurrences, 5-year recurrence-free and overall survivals reached 17.4, 81.8 and 95.4%; 6.3, 93.8 and 100%; 33.3, 66.4 and 83.5%, respectively. Progression occurred more frequently in patients having invasion of tumor cells in lymphatic and blood vessels in the primary tumor. The authors conclude on preferable use of preventive chemotherapy after removal of the primary tumor.

1-19-year follow-up results of plastic surgery for fused kidney hydronephrosis (FKH) in 12 children aged 3-14.5 years (a total of 15 hydronephroses, 3 cases of bilateral disease) were estimated as good. Correction of FKH is performed by resection of the affected ureteropelvic segment with bypass plastic reconstruction according to Andersen-Hynes-Kucera, compulsory total resection of the renal isthmus. Isthmotomy can be conducted only in the presence of connective tissue bridge between the renal poles. Often, renal isthmus consisting of parenchyma is to be removed together with resection of the renal pole (in joint circulation). In addition, for good outcome it is necessary to reconstruct pelvis and (or) perform nephropexy with muscular graft. The operated patients need long-term follow-up, control examinations of the kidney, updated treatment following elimination of the obstruction.

Central hemodynamics was investigated in 23 children aged 3-12 years operated on the upper urinary tracts. By anesthetic management the patients were divided into two groups: those operated under combined neuroleptanalgesia (group 1, n = 14) and under combined epidural anesthesia (group 2, n = 9). The latter anesthesia provided more reliable defense of the child's organism against surgical stress.

Transurethral laser surgery of the prostate is one of the alternative techniques able to improve therapy of patients with benign prostatic hyperplasia (BPH) associated with concomitant diseases. The operation was made in 7 patients with apparent infravesical obstruction due to BPH. They had implanted pace makers. Because of associated cardiovascular and respiratory diseases the patients were not allowed transurethral electroresection and open prostatectomy. Laser intervention produced no negative effects on the pacemaker function and hemodynamics in the course of the operation. Postoperative period was uneventful. 6-month follow-up registered natural micturition, evident subjective and objective improvement.

32 patients with chronic lymphoid leukemia (CLL) were examined to specify reasons of renal damage. Measurements were made of blood urea, creatinine, total protein, electrolytes, uric acid. Also, urinary sediment, diurnal loss of protein and creatinine with urine, glomerular filtration rate, concentration ability of the kidneys were studied. Urinary system was assessed by ultrasound. Most CLL patients studied had renal affection characteristic for chronic pyelonephritis with chronic renal insufficiency. The ultrasonic investigation stated reduced size of the kidneys, thinning of the cortex, extension of the renal pelvis and calyces, concrements. The kidneys and ureters were pressed and displaced by enlarged spleen, liver, lymph nodes. The plan of CLL patients' examination must include ultrasonic investigation of the abdominal organs for early detection of renal lesions.

Whereas 25-57% of patients diagnosed with renal cell carcinoma (RCC) present with metastatic disease, about 50% of (RCC) patients develop metastases after potentially curative radical nephrectomy. Five-year survival at following surgical removal of solitary metastases is approximately 35-50%. Our experience demonstrate that a small cohort of patients benefit from aggressive surgical therapy for consequtively arising solitary distant metastases with long-term palliation.

The paper reports the results of the study of low-intensity infrared laser radiation effects on partial kidney functions. The course of the laser radiation resulted in improved blood supply to the kidney in 57.9% of the cases. Stimulation of the secretion and urodynamics was registered in 63.1 and 79% of the cases, respectively. Positive changes were also noted in diuresis, nitrogen-excretory and concentration functions of the kidneys.

292 symptomless males aged 50-85 years were examined for blood prostate-specific antigen (PSA) for early diagnosis of prostatic cancer. Males with total PSA (TPSA) higher than age-specific standard underwent free PSA (FPSA) assay to estimate FPSA/TPSA and transperineal biopsy of the prostate. TPSA ranged from 0.3 to 112.0 ng/ml and exceeded the age standard in 102 examinees (35%). Prognostically unfavorable FPSA/TPSA (under 15%) was registered in 17(5.8%) examinees. Biopsy of the prostate has revealed cancer in 7 of them. Among those whose TPSA was above the standard, but FPSA/TPSA > 15%, morphologically verified prostatic cancer was detected in 5 males. It is thought valid to include the method of PSA fractions estimation in the program of screening for males at risk to develop prostatic cancer as it is simple, cost effective and highly informative.