Urologiia i nefrologiia最新文献

Comparative clinical data are presented on efficacy of transurethral vacuum drainage of the prostate in patients with obstructive chronic prostatitis in the absence of systemic enzyme therapy and under treatment with enzyme medicine bobenzyme (Mucos Pharma, Germany) having proteolytic activity. The duration of the treatment in bobenzyme-treated patients reduced by 30% due to decreased viscosity of the aspirate and lysis of massive "plugs" of the ducts facilitating vacuum elimination of the inflammation substrate.

A new system of non-invasive diagnosis of neurogenic dysfunction of the lower urinary tracts (LUT) is proposed. It is based on the patient's complaints and uroflowmetry evidence. Each complaint and index is scored (-2-3) according to the special scale of defects. Each type of the urinary tracts dysfunction is estimated by specially designed algorithms. The diagnosis of certain dysfunction is made in the score sum > 3. The trial of the system showed that its specificity was 96.2-96.3%, sensitivity 87.5-96%, diagnostic efficiency 92.2-96.1%. The system in applicable in practical urology.

Imperative micturition occurs rather frequently. The data of different authors favour driptan (oxibutinin) in this condition. In the urological clinic of the Medical Institute oxibutinin hydrochloride was tried since 1991. A total of 354 patients were treated (328 females, 12 males and 14 adolescents). The indications to the treatment were the following: instability of the detrusor, urethra or both, isolated forms of pollakiuria, some forms of enuresis, irritation in benign prostatic hyperplasia, correction of detrusor instability in enuresis before operation. Oxibutinine hydrochloride produced positive results in various forms of imperative micturition with symptoms of urgent incontinence (urgent enuresis) or without them. The drug produced a response in many socially maladapted individuals considered incurable.

Alpha-blockers decrease sympathetic influence and thus lower pressure in bladder neck region. Pharmacoprofilometry with tamsulosin was used in diagnostic dynamic outlet obstruction in 43 patients with benign prostatic hyperplasia (BPH) and in 17 patients with urethral stricture. 12 BPH patients with positive results of the test received tamsulosin in a single daily dose 0.4 mg. After 3 months the subjective symptom score significantly improved in all the patients. Stenosis of the urethra and bladder neck was found in 17 patients who had micturation disturbance in different periods after prostatectomy. In 9 patients urethral pressure in the region of the bladder neck decreased after 3 days of tamsulosin treatment given a single daily dose 0.4 mg. Urethrotomy without bladder neck resection was performed in these patients. Three months later average Q max increased from 6 ml/s to 18 ml/s and residual urine decreased from 112 ml to 30 ml. Selective alpha-blocker profilometry allows to distinguish between organic and functional neck stenosis and choose the necessary treatment.

45 patients with chronic renal failure (CRF) were examined for blood flow in the portal vein and hepatic artery using impulse dopplerography. In the hepatic artery there was lowering of maximal systolic blood flow, end diastolic blood flow, elevated pulsative index and index of resistance. These changes appeared at early stages of CRF and progressed with its progression.

Genetic aspects are essential in genesis of urolithiasis. We have collected information on 3064 relatives of probands (1209 males, 2395 females). Genealogical analysis in the families of children with urolithiasis and in 30 control families (392 females, 211 males) was performed. Urolithiasis occurred in 15.7% of fathers, 20.4% of mothers of the probands and 3.3% of fathers of the control group. Occurrence of urolithiasis in parents of urolithiasis children was 10.7 times that of the controls and reached 36.1%. In probands' sibs urolithiasis was encountered in 28%. The number of risk factors correlated with probability of urolithiasis development.

Low-frequency magnetic field generated by the unit ProSPOK was found more efficient than that of the unit Polyus-1 in physiotherapy of chronic prostatitis. The ProSPOK magnetotherapy stimulates ganglia, improves regeneration and circulation.

Successful disintegration of the calculus in nephrolithiasis patients is impossible without normalization of the upper urinary tracts urodynamics in dyskinesia. We employ combined treatment with high-selective beta-2-adrenomimetic hexoprenalin (hinipral) to improve migration of the concrement fragments and therefore to prevent ureteral occlusion, acute pyelonephritis and renal colic. Hexoprenalin (hinipral) is taken 6 tablets a day or intravenously in drops (5 ml per 100 ml of saline) 3-5 days before and for 10-12 days after extracorporeal shock-wave lithotripsy. Adjuvant use of hexoprenalin in combined treatment of nephrolithiasis complicated by ureteropelvic dysfunction allows effective conduction of lithotripsy.