Urologiia i nefrologiia最新文献

A case of a 2-year-old boy with a rare form of hypospadia is reported. The anomaly consisted of the absence of a part of the urethral stem along 1.6 cm. The defect was filled with urethral mucosa instead of the testicular skin. The penis was not deformed. The foreskin was hooded. The defect was identified as segmentary urethral hypoplasia. This is a rare variant of hypospadia in which the urethral defect is repaired not with the skin but the mucosa.

The analysis of organ-saving operations for renal cancer T1,2 N0M0 demonstrates that in cancer of the kidney up to 5 cm in size organ-saving operations are not inferior to routine nephrectomy by 5-year survival (95.4 +/- 4.5% versus 84.0 +/- 8.1%, respectively). The operated kidney functions well in 89.2 +/- 5.1% of cases.

Ureteral motility changes were followed up in 10 patients with hydronephrosis and urolithiasis which were recorded by multichannel impedance ureterography prior to internal drainage and during stent manipulations. The establishment of the ureteral stents reduces peristaltic amplitude and frequency as well as ureteral tonicity. After the stent removal 20% of the examinees showed peristaltic hyperfunction of the ureter. Urodynamic positive effects of the stents consist in better regulation of the motility, elimination of its local disturbance foci, improved coordination of movements of different parts of the upper urinary tracts. For positive results it is important to practice an individual approach to choice of drainage time and stent size. Urodynamic impedance studies can be used in control of endoscopic treatment adequacy.

Specialists of the Research Institute of Urology have practiced combination of transurethral resection (TUR) with electrovaporization in endoscopic treatment of bladder cancer (BC) since 1995. A total of 46 patients with transient cell BC (29 males and 17 females aged 49-87) stage Ta-T1 (32 patients) and T2-T3b (14 patients) underwent TUR or electrovaporization (if morphologically verified) of the exophytic part of the tumor. In addition, electrovaporization of the base of the tumor was made. Main indications for such treatment were standard indications for TUR in contraindications for more radical treatment. 6-24-month follow-up was possible in 23(71.9%) patients with superficial BC (group 1) and in 9(64.2%) patients with invasive BC (group 2). Endoscopically, the recurrence was detected in 3(13%) and 5(55.5%) patients of group 1 and 2, respectively. They were reoperated on with electrovaporization. It is inferred that TUR-vaporization of the bladder is an effective endoscopic treatment of superficial BC. Electrovaporization is a good palliative treatment in patients with invasive BC when radical surgery is impossible. It inhibits the progression of the disease, prevents hemorrhages due to the tumor destruction, reduces intraoperative blood loss, improves endoscopic visualization. It may also increase the operation ablasticity.

We report the results of examination, treatment and follow-up of 30 patients aged 25-40 years with chronic bacterial prostatitis. We used the method of local transurethral hyperthermia of the prostate ("Thermex" unit). This method proved effective as the period of remission in comparison with standard conservative therapy increased 2-3-fold. This treatment is indicated in patients with longstanding inflammatory process and in patients suffering from prostatitis with secondary disorders of potency.

Recently, drug polyuria has found wide application in diagnosis and treatment: to detect latent urinary insufficiency, to assess functional performance of the contralateral (unaffected) kidney in nephrolithiasis and calculous pyelonephritis, to stimulate elimination of fragments of the disintegrated concrement, to check up suture impermeability after surgical repair of the urinary tracts, to outline afunctional zone in hydronephrosis. Clinical experience gives grounds for use of saluretics at certain stages of pyelolithotomy for mobilization of intrarenal pelvis and its dissection, removal of the calculus and subsequent suturing of the intrarenal pelvis. Therapeutic polyuria can also facilitate ureterolithotomy.

Central hemodynamics was studied in 29 children aged 7 to 14 years operated on the upper urinary tracts. Anesthetic management consisted of either combined neuroleptanesthesia (15 patients) or combined epidural anesthesia (14 patients). The results of the study demonstrate that combined epidural anesthesia is a method of choice in patients undergoing long-lasting and traumatic operations. It provides better protection of the body from surgical stress through more complete blockade at several levels. It also contributes to optimization of the hemodynamics and to favorable course of anesthesia and operation.

A scale of total quantitation of male copulative function (MCF) is offered to facilitate the diagnosis and monitoring of MCF abnormalities, control of MCF correction. The scale is based on normal values provided by statistical data on sexual activity of males and its age-related changes. The patient is asked to answer 13 questions of the questionnaire listed under the numbers I-XIII. Each question has 6 variants of answer having the score 0 to 5. The patient is to choose one variant and write down his choice. Such MCF scale is able to identify both sexual disorder and defects in components of the copulative cycle. The scale was applied 89 times to study sexual function of 68 males aged 24-77 years. The scale findings and those of a comprehensive clinical examination coincided. The scale was found useful in evaluation of male copulative function as a whole and by components, for analysis of the detected disorders, differentiation between psychogenic factor and primarily organic one, for ascertaining attitude of the patient to his sexual dysfunction.

Dynamic nephroscintigraphy (DSG) was performed in 112 patients aged 14 to 76 years who had undergone 1 to 6 sessions of EL for unilateral or bilateral nephrolithiasis. A total of 254 EL sessions on 119 kidneys were performed. DSG was conducted before EL and at least 12 months after elimination of the stone fragments. The improvement of secretory renal function occurred in 68(57%) patients, aggravation was registered in 17(14.3%), unchanged renal function was in 34(28.6%) patients. Out of 17 cases of aggravation EL was responsible for only 3 of them. The others were due to other factors (progressive chronic pyelonephritis, acute pyelonephritis, hematoma, etc.). The conclusion is made that EL is a low-traumatic treatment of urolithiasis which is a method of choice in making decision on therapeutic policy in urolithiasis.