Urologiia i nefrologiia最新文献

Spermoplasm of 21 fertile and 96 subfertile males was examined for Fe, transferrin and scaferrin the concentrations of which were compared to 14 morphofunctional and physicochemical parameters of ejaculate fertility. Fe and non-hemic spermoplasm ferroproteins are involved in male reproduction: participate in ejaculate thinning, in formation of viscosity and sperm pH, are important for normal spermatogenesis and intercellular interactions. The findings can be applied in diagnosis of male subfertility and control of ongoing treatment, hold promise for improvement of fertilizing ability of the sperm used for artificial insemination and extracorporeal fertilization.

828 patients were operated on the retroperitoneal organs since 1985 using a retroperitoneoscope. A total of 836 surgical interventions were performed. A cut of 3.0-3.5 cm long was made to revise the kidney and ureter, retroperitoneal part of the colon, tail of the pancreas, retroperitoneal vessels and lymph nodes via lumbocostal and inguinal approaches. A new intercostal (ribs X-XI) approach is proposed. Most of the patients had urolithiasis, pyoinflammatory lesions, renal cysts, varicocele, obstructive uropathies. Complications developed in 1.7% of cases. Retroperitoneoscopy is a method of choice in diagnosis and treatment of retroperitoneal diseases.

The clinical sign "anemia" is found in a majority of patients after solid organ transplantation. A variety of etiological factors cause reduced red blood counts--in different situations hemolysis is the culprit. Thrombotic microangiopathy (hemolytic uremic syndrome, transplant rejection or induced by immunosuppressive therapy), infections (bacterial, viral, fungal), and autoalloimmune reactions (differences in blood-group or Rhesus-antigens, drug induced RBC lysis) are most important pathologies to be considered in differential diagnostic steps. Methods applied in diagnostics, underlying pathologies and therapeutic consequences are described based on the clinical history of three transplant patients from a single university department. Therefore, hemolysis as a possible and important situation following organ transplantation should be considered, immediately traced back to the underlying disorder and effectively treated.

The study of intrarenal and upper urinary tracts urodynamics in the presence of the ureteropelvic obstruction and of the function of the lower urinary tract shows that congenital hydronephrosis was in 42.8% of cases associated with bladder dysfunction presenting with hyperreflex-type dysfunction. Maladapted hyperreflex bladder was diagnosed in 29.4%, adapted--in 13.5% of cases. The hyporeflex dysfunction occurred in 15.9% of cases. The urinary bladder dysfunction in children with congenital hydronephrosis accounts for 58.7%. These aggravate the same defects of the upper urinary tracts and deteriorate the course of chronic obstructive pyelonephritis.

Patients with benign prostatic hyperplasia (BPH) received proscar (finasteride) in daily dose 5 mg for: at least 6 months (n = 206, 20.4%), 12 months (n = 513, 50.9%), 24 months (n = 164, 16.3%), 3-4 years (n = 125, 12.4%). Because the size of the prostatic gland reduced significantly (by 22%) only after one year of proscar treatment, the duration of this treatment should be continued for at least 12 months, in some patients as long as the whole life. The duration of the treatment should be decided for each individual patient. The improvement after the proscar treatment was observed in 95% of the patients treated for benign prostatic hyperplasia.

Upper urinary tract drainage in patients with chronic calculous pyelonephritis (CCP) results in not only successful anti-inflammatory and antibacterial treatment but also in more effective and safe ESWL. In 21 CCP patients with upper urinary tract drainage by means of catheter-stent, ESWL was performed using Lithostar-Plus (Siemens). Active inflammation with marked pyuria, bacteriuria and even moderate upper urinary tract dilation were indications for the upper urinary tract drainage with catheter-stent before and during ESWL in CCP patients. Upper urinary tract drainage with catheter-stent contributed to effective treatment of chronic pyelonephritis and allowed to perform ESWL. There were neither attacks of acute pyelonephritis nor upper urinary tract obstruction after catheter-stent removal. The catheter-stent allows to create closed drainage system with active evacuation function as it functions in physiological conditions. ESWL in patients with upper urinary tract drainage using catheter-stent is more effective and has lower risk of complications.