Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-131-140
N. R. Akramov, A. A. Isroilov, A. A. Rakhmatullaev, V. Sizonov, M. S. Pospelov, A. I. Gallyamova, V. Orlov
Cross or transverse testicular ectopia is a rare congenital condition of the reproductive system that involves the migration of a testicle into the opposite inguinal canal, along with the presence of an inguinal hernia on the same side as the ectopic testicle. In the modern literature, there are discussions about diagnostic issues, particularly the use of ultrasound scanning and magnetic resonance imaging to diagnose this condition. However, it is the results of laparoscopic examination that determine the most accurate criteria for surgical treatment. Many publications discuss the choice of surgical tactics, including separate transabdominal orchiopexy, with or without laparoscopic assistance; transeptal orchiopexy on both sides of the scrotum; and rare cases of orchiopexy for both testicles on one side of the scrotum. Ultimately, the choice of surgery depends on the individual characteristics and needs of the patient, and the surgeon should make the decision based on these factors. The article describes, for the first time, a case of familial testicular ectopia with bilateral inguinal hernia in siblings who underwent surgery using laparoscopic assistance. The method used was single-trocar laparoscopic access with transscrotal transeptal orchiopexy and simultaneous bilateral puncture of the inguinal ring and suture. During the long-term follow-up period (50 and 20 months after surgery) in both siblings, there were no signs of malformation or atrophy of the gonads.
{"title":"Familial cross-testicular ectopia: a clinical case report","authors":"N. R. Akramov, A. A. Isroilov, A. A. Rakhmatullaev, V. Sizonov, M. S. Pospelov, A. I. Gallyamova, V. Orlov","doi":"10.21886/2308-6424-2024-12-3-131-140","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-131-140","url":null,"abstract":"Cross or transverse testicular ectopia is a rare congenital condition of the reproductive system that involves the migration of a testicle into the opposite inguinal canal, along with the presence of an inguinal hernia on the same side as the ectopic testicle. In the modern literature, there are discussions about diagnostic issues, particularly the use of ultrasound scanning and magnetic resonance imaging to diagnose this condition. However, it is the results of laparoscopic examination that determine the most accurate criteria for surgical treatment. Many publications discuss the choice of surgical tactics, including separate transabdominal orchiopexy, with or without laparoscopic assistance; transeptal orchiopexy on both sides of the scrotum; and rare cases of orchiopexy for both testicles on one side of the scrotum. Ultimately, the choice of surgery depends on the individual characteristics and needs of the patient, and the surgeon should make the decision based on these factors. The article describes, for the first time, a case of familial testicular ectopia with bilateral inguinal hernia in siblings who underwent surgery using laparoscopic assistance. The method used was single-trocar laparoscopic access with transscrotal transeptal orchiopexy and simultaneous bilateral puncture of the inguinal ring and suture. During the long-term follow-up period (50 and 20 months after surgery) in both siblings, there were no signs of malformation or atrophy of the gonads.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"111 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-46-52
G. Y. Gvozdev, E. P. Bryanskykh, N. A. Sazonova, E. K. Lazareva, A. L. Sarukhanian
Introduction. Post-coital cystitis is not a separate nosologic unit, but belongs to recurrent urinary tract infection. Surgical interventions are only recommended in cases where conservative treatment fails to provide relief.Objective. To evaluate the results of post-coital cystitis prophylaxis in urethral transposition.Materials & methods. A retrospective study of 46 patients who underwent surgical treatment in the volume of transposition of the distal urethra from 2011 to 2013 was conducted in the clinic of Urology of MSUMD based on the Spasokukotsky Moscow Clinical Hospital.Results. Based on subjective reports from patients, urethral transposition was found to be effective in 71.7% of cases. Half of the participants reported no recurrence of cystitis within the past year, and over half (67%) reported no inflammatory episodes after undergoing surgery.Conclusion. The findings suggest that urethral transposition is an effective and relatively safe treatment option for patients with post-coital cystitis who have failed to respond to conservative treatments.
{"title":"Transposition of the distal urethra: 10-year treatment results","authors":"G. Y. Gvozdev, E. P. Bryanskykh, N. A. Sazonova, E. K. Lazareva, A. L. Sarukhanian","doi":"10.21886/2308-6424-2024-12-3-46-52","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-46-52","url":null,"abstract":"Introduction. Post-coital cystitis is not a separate nosologic unit, but belongs to recurrent urinary tract infection. Surgical interventions are only recommended in cases where conservative treatment fails to provide relief.Objective. To evaluate the results of post-coital cystitis prophylaxis in urethral transposition.Materials & methods. A retrospective study of 46 patients who underwent surgical treatment in the volume of transposition of the distal urethra from 2011 to 2013 was conducted in the clinic of Urology of MSUMD based on the Spasokukotsky Moscow Clinical Hospital.Results. Based on subjective reports from patients, urethral transposition was found to be effective in 71.7% of cases. Half of the participants reported no recurrence of cystitis within the past year, and over half (67%) reported no inflammatory episodes after undergoing surgery.Conclusion. The findings suggest that urethral transposition is an effective and relatively safe treatment option for patients with post-coital cystitis who have failed to respond to conservative treatments.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"5 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-70-78
S. Popov, R. Huseynov, E. Pomeshkin, O. N. Scriabin, K. Sivak, V. V. Perepelitsa, T. A. Lelyavina, E. A. Malyshev
Introduction. The gold standard of treatment for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) is transurethral resection of the bladder (TURB) in combination with intravesical therapy. However, this procedure may cause serious complications. At the same time, studies of various lasers for the treatment of NMIBC have demonstrated their safety and efficacy. Despite this, the topic has not yet been fully explored and is not widely practiced in clinical oncology, making further research necessary.Objective. To compare thulium and holmium lasers with conventional TURB for management of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. In our study, depending on the treatment approach, 84 NMIBC-patients were divided into three groups. Group 1 included 27 patients (34.14%), who underwent laser thulium bladder resection; group 2 included 25 patients (29.76%), who underwent laser holmium bladder resection, and group 3 included 32 patients (38.1%), who underwent standard TURB. Prior to surgery, all patients received a standard set of preoperative general clinical and instrumental examinations for bladder cancer, and the choice of surgical approach was based on informed patient consent, taking into account the benefits and risks of the three treatment options. All surgeries were performed in accordance with established protocols.Results. In the TURB group, the surgery time was the longest and totalled in 20.5 ± 7.4 min. Laser technologies reduce the surgery time to 16.3 ± 5.3 min for a holmium laser and to 14.7 ± 5.2 min for a thulium laser. Also, in groups 1 and 2, a shorter duration of postoperative bladder irrigation was noted (4.4 ± 1.8 and 4.7 ± 1.6 hours) and shorter periods of postoperative bladder catheterisation (1.5 ± 0.08 and 1.6 ± 0.08 days) compared to group 3, where these indicators were 16.4 ± 2.5 hours and 2.5 ± 0.13 days, respectively. Among patients undergoing either holmium or thulium surgery, a higher rate of disease-free survival has been noted. Independent prognostic factors that influence the prognosis of NMIBC in all groups include the type of surgery, history of bladder tumors, and pathological stage.Conclusion. The use of laser technology, such as thulium and holmium laser, in bladder wall resection for NMIBC shows promising results and provides a good clinical outcome that is comparable to (and in some cases, superior to) standard TURB.
{"title":"Comparison of thulium and holmium lasers with conventional transurethral bladder resection for non-muscle invasive bladder cancer","authors":"S. Popov, R. Huseynov, E. Pomeshkin, O. N. Scriabin, K. Sivak, V. V. Perepelitsa, T. A. Lelyavina, E. A. Malyshev","doi":"10.21886/2308-6424-2024-12-3-70-78","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-70-78","url":null,"abstract":"Introduction. The gold standard of treatment for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) is transurethral resection of the bladder (TURB) in combination with intravesical therapy. However, this procedure may cause serious complications. At the same time, studies of various lasers for the treatment of NMIBC have demonstrated their safety and efficacy. Despite this, the topic has not yet been fully explored and is not widely practiced in clinical oncology, making further research necessary.Objective. To compare thulium and holmium lasers with conventional TURB for management of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. In our study, depending on the treatment approach, 84 NMIBC-patients were divided into three groups. Group 1 included 27 patients (34.14%), who underwent laser thulium bladder resection; group 2 included 25 patients (29.76%), who underwent laser holmium bladder resection, and group 3 included 32 patients (38.1%), who underwent standard TURB. Prior to surgery, all patients received a standard set of preoperative general clinical and instrumental examinations for bladder cancer, and the choice of surgical approach was based on informed patient consent, taking into account the benefits and risks of the three treatment options. All surgeries were performed in accordance with established protocols.Results. In the TURB group, the surgery time was the longest and totalled in 20.5 ± 7.4 min. Laser technologies reduce the surgery time to 16.3 ± 5.3 min for a holmium laser and to 14.7 ± 5.2 min for a thulium laser. Also, in groups 1 and 2, a shorter duration of postoperative bladder irrigation was noted (4.4 ± 1.8 and 4.7 ± 1.6 hours) and shorter periods of postoperative bladder catheterisation (1.5 ± 0.08 and 1.6 ± 0.08 days) compared to group 3, where these indicators were 16.4 ± 2.5 hours and 2.5 ± 0.13 days, respectively. Among patients undergoing either holmium or thulium surgery, a higher rate of disease-free survival has been noted. Independent prognostic factors that influence the prognosis of NMIBC in all groups include the type of surgery, history of bladder tumors, and pathological stage.Conclusion. The use of laser technology, such as thulium and holmium laser, in bladder wall resection for NMIBC shows promising results and provides a good clinical outcome that is comparable to (and in some cases, superior to) standard TURB.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"113 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-53-61
M. I. Kogan, Y. L. Naboka, A. V. Ryzhkin, I. Gudima, A. G. Ivanov, S. Ivanov, O. N. Vasiliev, V. P. Glukhov, A. V. Ilyash, D. V. Sizyakin
Introduction. There is evidence of a connection between infectious and inflammatory lesions of the lower urinary tract and bladder cancer (BCa). However, there is virtually no data on the urine microbiota of middle-aged and elderly men with suspected BCa. This knowledge is extremely important from the point of view of studying the role of the infectious-inflammatory hypothesis in the genesis of BCa.Objective. To conduct a comparative assessment of the microbiota of bladder urine obtained during natural urination and bladder catheterization through standard and extended cultural studies in men with a presumptive diagnosis of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. The prospective comparative study with consecutive patient recruitment included 23 men older than 45 years with suspected NMIBC based on clinical, laboratory and sonographic data, as well as with no history of infectious and inflammatory diseases of the kidneys and urinary tract, including sexually transmitted infections and recurrent infections of other organs and systems. A midstream urine samples and catheter-drained urine immediately before urethrocystoscopy were subjected to bacteriological analysis. Urine culture study was carried out using a standard set of nutrient media under aerobic cultivation conditions and an expanded set of nutrient media under aerobic and anaerobic cultivation conditions.Results. An anaerobic spectrum of microorganisms was predominantly detected in the urine of patients with suspected NMIBC. Moreover, Peptococcus spp. was more often found among anaerobic taxa. (70%), Eubacterium spp., Propionibacterium spp. (45% each, respectively), among representatives of the aerobes — Corynebacterium spp. (60%), S. lentus (up to 45%), S. haemolyticus (35%) and E. faecalis (30%). Data from a comparative analysis of the detection frequencies of microorganisms depending on the method of collecting material and the set of media for cultivation showed that more isolates are isolated in the midstream urine samples than in the study of catheter urine (2.9- and 1.9-fold with the standard and extended sets of media, respectively). In addition, when performing an extended bacteriological study compared to the standard method, the detection of microorganisms is 3.5-fold higher when examining an average portion of urine and 5.1-fold higher when examining catheter urine. The average number of microorganisms per one patient is also higher when using the extended method (midstream portion — 4.7 ± 1.9; catheterised urine — 2.3 ± 1.0) in comparison with the standard one (midstream portion — 1.3 ± 0.9; catheterised urine — 0.3 ± 0.5).Conclusion. Middle-aged and older men with NMIBC are characterized by asymptomatic bacteriuria in the form of a wide range of aerobic and anaerobic microorganisms. The urine pattern obtained with a urethral catheter contains a significantly narrower range of bacteria compared to the sample obtained through natural urination. It is adv
{"title":"Urine microbiota in non-muscle-invasive bladder cancer and approaches to its detection","authors":"M. I. Kogan, Y. L. Naboka, A. V. Ryzhkin, I. Gudima, A. G. Ivanov, S. Ivanov, O. N. Vasiliev, V. P. Glukhov, A. V. Ilyash, D. V. Sizyakin","doi":"10.21886/2308-6424-2024-12-3-53-61","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-53-61","url":null,"abstract":"Introduction. There is evidence of a connection between infectious and inflammatory lesions of the lower urinary tract and bladder cancer (BCa). However, there is virtually no data on the urine microbiota of middle-aged and elderly men with suspected BCa. This knowledge is extremely important from the point of view of studying the role of the infectious-inflammatory hypothesis in the genesis of BCa.Objective. To conduct a comparative assessment of the microbiota of bladder urine obtained during natural urination and bladder catheterization through standard and extended cultural studies in men with a presumptive diagnosis of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. The prospective comparative study with consecutive patient recruitment included 23 men older than 45 years with suspected NMIBC based on clinical, laboratory and sonographic data, as well as with no history of infectious and inflammatory diseases of the kidneys and urinary tract, including sexually transmitted infections and recurrent infections of other organs and systems. A midstream urine samples and catheter-drained urine immediately before urethrocystoscopy were subjected to bacteriological analysis. Urine culture study was carried out using a standard set of nutrient media under aerobic cultivation conditions and an expanded set of nutrient media under aerobic and anaerobic cultivation conditions.Results. An anaerobic spectrum of microorganisms was predominantly detected in the urine of patients with suspected NMIBC. Moreover, Peptococcus spp. was more often found among anaerobic taxa. (70%), Eubacterium spp., Propionibacterium spp. (45% each, respectively), among representatives of the aerobes — Corynebacterium spp. (60%), S. lentus (up to 45%), S. haemolyticus (35%) and E. faecalis (30%). Data from a comparative analysis of the detection frequencies of microorganisms depending on the method of collecting material and the set of media for cultivation showed that more isolates are isolated in the midstream urine samples than in the study of catheter urine (2.9- and 1.9-fold with the standard and extended sets of media, respectively). In addition, when performing an extended bacteriological study compared to the standard method, the detection of microorganisms is 3.5-fold higher when examining an average portion of urine and 5.1-fold higher when examining catheter urine. The average number of microorganisms per one patient is also higher when using the extended method (midstream portion — 4.7 ± 1.9; catheterised urine — 2.3 ± 1.0) in comparison with the standard one (midstream portion — 1.3 ± 0.9; catheterised urine — 0.3 ± 0.5).Conclusion. Middle-aged and older men with NMIBC are characterized by asymptomatic bacteriuria in the form of a wide range of aerobic and anaerobic microorganisms. The urine pattern obtained with a urethral catheter contains a significantly narrower range of bacteria compared to the sample obtained through natural urination. It is adv","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"122 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-125-130
M. AlTawil
Introduction. Partial nephrectomy is the treatment of choice for small renal tumors. There are other indications include tumors in a solitary kidney, multiple and bilateral tumors.Сase presentation. A 67-year-old male presented with left flank pain and lower urinary tract symptoms. Computed tomography for abdominal and pelvis showed bilateral renal masses. After doing the essential laboratory tests and investigations, he underwent bilateral open simultaneous partial nephrectomies. After two days, he was discharged with no complains. Follow-up after three months showed no recurrence and acceptable renal function.Discussion. Partial nephrectomy is increasingly used for the management of renal masses. The preservation of renal function with reduced morbidity and equivalent oncologic outcomes led to a paradigm shift away from radical nephrectomy.Conclusion. Bilateral partial nephrectomy is feasible with both clinical and oncological good results.
{"title":"Bilateral simultaneous partial nephrectomy","authors":"M. AlTawil","doi":"10.21886/2308-6424-2024-12-3-125-130","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-125-130","url":null,"abstract":"Introduction. Partial nephrectomy is the treatment of choice for small renal tumors. There are other indications include tumors in a solitary kidney, multiple and bilateral tumors.Сase presentation. A 67-year-old male presented with left flank pain and lower urinary tract symptoms. Computed tomography for abdominal and pelvis showed bilateral renal masses. After doing the essential laboratory tests and investigations, he underwent bilateral open simultaneous partial nephrectomies. After two days, he was discharged with no complains. Follow-up after three months showed no recurrence and acceptable renal function.Discussion. Partial nephrectomy is increasingly used for the management of renal masses. The preservation of renal function with reduced morbidity and equivalent oncologic outcomes led to a paradigm shift away from radical nephrectomy.Conclusion. Bilateral partial nephrectomy is feasible with both clinical and oncological good results.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"118 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-114-124
M. Chibichyan, M. I. Kogan, I. I. Belousov, D. V. Sizyakin, A. V. Avetyan, P. V. Trusov, S. Shkodkin, A. S. Pchelkin
Introduction. Urinary incontinence is a common complication of radical prostatectomy. The development of surgical techniques when performing radical prostatectomy that improve the function of urinary continence after surgery is actual.Objective. To compare urinary continence functions in long-term follow-up after open and laparoscopic radical prostatectomy when only posterior or combined (anterior + posterior) reconstruction of the pelvic fascial spaces is performed.Materials & methods. The study included 130 patients aged 63.0 [59.0; 68.0] years with local prostate cancer (сT1a-2сN0-xM0; 1 – 4 ISUP groups), subjected to non-nerve-sparing retropubic radical prostatectomy with posterior reconstruction and non-nerve-sparing extraperitoneal laparoscopic radical prostatectomy with isolated posterior or combined (anterior + posterior) fascial reconstruction of the pelvic fascial spaces. Postoperative continence function was studied at 1, 3, 6, and 12 months following surgery using a standard pad test.Results. The incidence of urinary continence was higher at all follow-up periods during laparoscopic surgery. From the 6-months follow-up, these patients did not have severe urinary incontinence. At the same time, the rate of growth of some patients who began to retain urine did not depend on the method of reconstruction of the pelvic fascial spaces. The use of combined reconstruction of the pelvic fascial spaces at 12-months follow-up showed an advantage in urinary continence over performing only posterior reconstruction. Such patients achieved urinary continence in 90% of cases compared to 80.0% of cases. At the same time, the restoration of urinary continence at all periods of observation had a relatively uniform linear rate of increase in the indicator.Conclusion. Reconstruction of the pelvic fascial spaces during open and laparoscopic radical prostatectomy allows one to achieve satisfactory continuation in the postoperative period. However, higher efficiency is achieved when using a combined reconstruction technique.
{"title":"Urinary continence following extraperitoneal radical prostatectomy: impact of surgical technique and pelvic fascial spaces reconstruction","authors":"M. Chibichyan, M. I. Kogan, I. I. Belousov, D. V. Sizyakin, A. V. Avetyan, P. V. Trusov, S. Shkodkin, A. S. Pchelkin","doi":"10.21886/2308-6424-2024-12-3-114-124","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-114-124","url":null,"abstract":"Introduction. Urinary incontinence is a common complication of radical prostatectomy. The development of surgical techniques when performing radical prostatectomy that improve the function of urinary continence after surgery is actual.Objective. To compare urinary continence functions in long-term follow-up after open and laparoscopic radical prostatectomy when only posterior or combined (anterior + posterior) reconstruction of the pelvic fascial spaces is performed.Materials & methods. The study included 130 patients aged 63.0 [59.0; 68.0] years with local prostate cancer (сT1a-2сN0-xM0; 1 – 4 ISUP groups), subjected to non-nerve-sparing retropubic radical prostatectomy with posterior reconstruction and non-nerve-sparing extraperitoneal laparoscopic radical prostatectomy with isolated posterior or combined (anterior + posterior) fascial reconstruction of the pelvic fascial spaces. Postoperative continence function was studied at 1, 3, 6, and 12 months following surgery using a standard pad test.Results. The incidence of urinary continence was higher at all follow-up periods during laparoscopic surgery. From the 6-months follow-up, these patients did not have severe urinary incontinence. At the same time, the rate of growth of some patients who began to retain urine did not depend on the method of reconstruction of the pelvic fascial spaces. The use of combined reconstruction of the pelvic fascial spaces at 12-months follow-up showed an advantage in urinary continence over performing only posterior reconstruction. Such patients achieved urinary continence in 90% of cases compared to 80.0% of cases. At the same time, the restoration of urinary continence at all periods of observation had a relatively uniform linear rate of increase in the indicator.Conclusion. Reconstruction of the pelvic fascial spaces during open and laparoscopic radical prostatectomy allows one to achieve satisfactory continuation in the postoperative period. However, higher efficiency is achieved when using a combined reconstruction technique.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-88-96
K. S. Skrupskiy, K. Kolontarev, A. V. Govorov, V. Dyakov, A. L. Sarukhanian, I. O. Gritskov, D. Y. Pushkar
Introduction. Radical prostatectomy (RP) stands the gold standard method of treatment for localised prostate cancer. Pelvic lymph node dissection (PLND) is a common surgical procedure that can be used for both diagnostic and therapeutic purposes. Lymphocele is the most common complication after robot-assisted radical prostatectomy (RARP) and PLND.Objective. To develop a surgical technique aimed at reducing the incidence of lymphocele in patients who underwent RARP with TL and to evaluate its efficacy and safety.Materials & methods. The study included 49 patients who underwent RARP and PLND. The patients were divided into 2 groups: group 1 — patients with free peritoneal flap fixed to the pubic bone after RARP and PLND (n = 25) and group 2 — control group «without peritoneal flap fixation» (n = 24). The average follow-up period was 3 months.Results. No significant differences in clinical parameters were observed between the groups in perioperative period. In postoperative period lymphocele was diagnosed in 5 (10.2%) patients: group 1 — 1 (4%) patients, group 2 — 4 (16.7%). There were no significant differences in lymphocele volume between the groups. In group 1 lymphocele had no clinical manifestation. Symptomatic lymphocele was diagnosed in 1 patient (4.2%) from the control group.Conclusion. The surgical technique of a free peritoneal flap fixation to the pubic bone combined with PLND after RARP may reduce the incidence of lymphocele if compared to the standard technique.
{"title":"Surgical technique for preventing lymphatic complications during robot-assisted radical prostatectomy","authors":"K. S. Skrupskiy, K. Kolontarev, A. V. Govorov, V. Dyakov, A. L. Sarukhanian, I. O. Gritskov, D. Y. Pushkar","doi":"10.21886/2308-6424-2024-12-3-88-96","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-88-96","url":null,"abstract":"Introduction. Radical prostatectomy (RP) stands the gold standard method of treatment for localised prostate cancer. Pelvic lymph node dissection (PLND) is a common surgical procedure that can be used for both diagnostic and therapeutic purposes. Lymphocele is the most common complication after robot-assisted radical prostatectomy (RARP) and PLND.Objective. To develop a surgical technique aimed at reducing the incidence of lymphocele in patients who underwent RARP with TL and to evaluate its efficacy and safety.Materials & methods. The study included 49 patients who underwent RARP and PLND. The patients were divided into 2 groups: group 1 — patients with free peritoneal flap fixed to the pubic bone after RARP and PLND (n = 25) and group 2 — control group «without peritoneal flap fixation» (n = 24). The average follow-up period was 3 months.Results. No significant differences in clinical parameters were observed between the groups in perioperative period. In postoperative period lymphocele was diagnosed in 5 (10.2%) patients: group 1 — 1 (4%) patients, group 2 — 4 (16.7%). There were no significant differences in lymphocele volume between the groups. In group 1 lymphocele had no clinical manifestation. Symptomatic lymphocele was diagnosed in 1 patient (4.2%) from the control group.Conclusion. The surgical technique of a free peritoneal flap fixation to the pubic bone combined with PLND after RARP may reduce the incidence of lymphocele if compared to the standard technique.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-106-113
I. V. Feofilov, V. Chernega, I. A. Arbuzov
Introduction. Currently, single- and multifactorial criteria are employed to evaluate the quality of urolithiasis treatment utilizing lithotripsy. Among the most utilized single factors that influence the efficacy of urolithiasis therapy are the stone-free rate (SFR), the duration of lithotripsy, the level of intra- and post-operative complications, and hospital stay following lithotripsy. A more promising approach is the integrated indicator of the efficacy of urolithiasis management using the lithotripter, which considers all the aforementioned factors. It is an urgent task to determine the extent to which alterations in individual variables impact the value of an integrated assessment of the efficacy of laser lithotripsy-based urolithiasis intervention.Objective. To study the dependence of the integral efficiency indicator on the magnitude of influencing factors in the treatment of urolithiasis using transurethral thulium lithotripsy.Materials & methods. We used the method of mathematical modeling of the integral criterion for urolithiasis treatment efficacy using the Scilab v.6.02 software package to determine the extent to which individual factors influence the overall effectiveness of laser thulium lithotripsy.Results. Graphical dependences of the index of urolithiasis treatment efficacy for lithotripsy on the complication rate (at different values of surgery time and dependence of urolithiasis treatment efficacy on SFR at different values of complication rate, surgery time and hospital stay) were obtained. A software system for determining the integral index of urolithiasis treatment efficiency for lithotripsy was developed.Conclusion. The resulting dependencies of the index of urolithiasis treatment efficacy for lithotripsy can be used to evaluate the impact of the complication grade and the SFR on the value of the efficacy index and to devise measures to enhance it. The software developed for the calculation of this index allows to obtain the required value at different input influencing parameters.
{"title":"The effects of various factors on the efficacy of lithotripsy treatment of urolithiasis","authors":"I. V. Feofilov, V. Chernega, I. A. Arbuzov","doi":"10.21886/2308-6424-2024-12-3-106-113","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-106-113","url":null,"abstract":"Introduction. Currently, single- and multifactorial criteria are employed to evaluate the quality of urolithiasis treatment utilizing lithotripsy. Among the most utilized single factors that influence the efficacy of urolithiasis therapy are the stone-free rate (SFR), the duration of lithotripsy, the level of intra- and post-operative complications, and hospital stay following lithotripsy. A more promising approach is the integrated indicator of the efficacy of urolithiasis management using the lithotripter, which considers all the aforementioned factors. It is an urgent task to determine the extent to which alterations in individual variables impact the value of an integrated assessment of the efficacy of laser lithotripsy-based urolithiasis intervention.Objective. To study the dependence of the integral efficiency indicator on the magnitude of influencing factors in the treatment of urolithiasis using transurethral thulium lithotripsy.Materials & methods. We used the method of mathematical modeling of the integral criterion for urolithiasis treatment efficacy using the Scilab v.6.02 software package to determine the extent to which individual factors influence the overall effectiveness of laser thulium lithotripsy.Results. Graphical dependences of the index of urolithiasis treatment efficacy for lithotripsy on the complication rate (at different values of surgery time and dependence of urolithiasis treatment efficacy on SFR at different values of complication rate, surgery time and hospital stay) were obtained. A software system for determining the integral index of urolithiasis treatment efficiency for lithotripsy was developed.Conclusion. The resulting dependencies of the index of urolithiasis treatment efficacy for lithotripsy can be used to evaluate the impact of the complication grade and the SFR on the value of the efficacy index and to devise measures to enhance it. The software developed for the calculation of this index allows to obtain the required value at different input influencing parameters.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141669867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-62-69
I. E. Mamaev, Y.V. Sushkova, S. Kotov
Introduction. In patients with suprapubic tube (SPT) surgical restoration of voiding is not 100% successful. Sometimes urination is inadequate or not recovered at all.Objective. To determine factors influencing the outcomes of benign prostatic hyperplasia / benign prostate obstruction (BPH/BPO) surgery in patients with cystostomy drainage.Materials & methods. The study included 52 men with suprapubic tube initially placed for urinary retention caused by prostate hyperplasia. Afterwards, all patients underwent transurethral resection of the prostate. The age of the patients ranged from 48 to 85 years old. Clinical and urodynamic data of the patients were analysed, restoration of adequate urination after surgery was evaluated as well. We took into account patients age, IPSS scores, bacterial growth in the urine culture test, number of episodes of urinary retention, volume of urinary retention prior to cystostomy, prostate volume, intravesical prostate growth, detrusor overactivity and ability to void in the presence of SPT.Results. We were unable to achieve adequate bladder emptying after transurethral resection of the prostate in 4 (7.6%) patients. These patients required continued bladder drainage after surgery. In 48 (92.4%), adequate urination was restored after surgery and cystostomy drains were removed. Patients with one or more of the following characteristics were more likely to experience a failure of surgical treatment: age over 80, residual urine volume over 1500 mL, and absence of overactive bladder.Conclusion. The study indicates that use of cystometry prior to BPH/BPO surgery is reasonable in such patients. Feasibility of BPH/BPO surgery for this group of patients should be considered individually.
{"title":"Prognostic factors for the success of BPH/BPO surgery in patients with suprapubic tube","authors":"I. E. Mamaev, Y.V. Sushkova, S. Kotov","doi":"10.21886/2308-6424-2024-12-3-62-69","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-62-69","url":null,"abstract":"Introduction. In patients with suprapubic tube (SPT) surgical restoration of voiding is not 100% successful. Sometimes urination is inadequate or not recovered at all.Objective. To determine factors influencing the outcomes of benign prostatic hyperplasia / benign prostate obstruction (BPH/BPO) surgery in patients with cystostomy drainage.Materials & methods. The study included 52 men with suprapubic tube initially placed for urinary retention caused by prostate hyperplasia. Afterwards, all patients underwent transurethral resection of the prostate. The age of the patients ranged from 48 to 85 years old. Clinical and urodynamic data of the patients were analysed, restoration of adequate urination after surgery was evaluated as well. We took into account patients age, IPSS scores, bacterial growth in the urine culture test, number of episodes of urinary retention, volume of urinary retention prior to cystostomy, prostate volume, intravesical prostate growth, detrusor overactivity and ability to void in the presence of SPT.Results. We were unable to achieve adequate bladder emptying after transurethral resection of the prostate in 4 (7.6%) patients. These patients required continued bladder drainage after surgery. In 48 (92.4%), adequate urination was restored after surgery and cystostomy drains were removed. Patients with one or more of the following characteristics were more likely to experience a failure of surgical treatment: age over 80, residual urine volume over 1500 mL, and absence of overactive bladder.Conclusion. The study indicates that use of cystometry prior to BPH/BPO surgery is reasonable in such patients. Feasibility of BPH/BPO surgery for this group of patients should be considered individually.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21886/2308-6424-2024-12-3-79-87
S. V. Poroyskiy, D. V. Perlin, O. G. Srussovskaya, N. A. Goncharov, A. A. Kuznetsov, E. A. Morozov
Introduction. For the treatment of overactive bladder syndrome (OAB), injection of botulinum toxin A (BoNT-A) has been shown to be effective. However, there is a need for a less invasive method for administering BoNT-A, which could significantly expand the treatment options for OAB.Objective. To assess the impact of tizol on the absorption of BoNT-A by the bladder mucosa and compare it to the individual absorption of BoNT-A.Materials & Methods. Dialysis through the mucous membrane of the сalf bladder was used as an experimental model to study changes in bioavailability of BoNT-A complexed with tisol (BoNT-A + T) and pure BoNT-A solution during in vitro experiment. After dialysis, the BoNT-A concentration in both samples was determined using a spectrophotometer. Dialysis curves were plotted according to the data obtained. Kruvchinsky equilibrium dialysis method was used to determine botulinum toxin A bioavailability. The UV spectrophotometry method was used to determine the concentration of BoNT-A in the acceptor medium by reaction of BoNT-A with Benedict's reagent.Results. It was established that the maximum concentration of BoNT-A diffused into the acceptor medium from the blend of the test substance with tizol after nine hours. The area under the curve for dialysis of BoNT-A + T exceeds the area under the curve of pure BoNT-A by almost 20%, suggesting an improvement in the drug's bioavailability when blended with tizol.Conclusion. Based on our experiment, it was found out that the BoNT-A + T has greater bioavailability than a solution of pure BoNT-A. However, the diffusion rate of the component mixture is sufficiently low.
{"title":"Comparative evaluation of bioavailability of Botulinum toxin A complexed with Tizol (titanium glycerosolvate aquacomplex) versus pure Botulinum toxin A solution for bladder mucosa: an experimental study","authors":"S. V. Poroyskiy, D. V. Perlin, O. G. Srussovskaya, N. A. Goncharov, A. A. Kuznetsov, E. A. Morozov","doi":"10.21886/2308-6424-2024-12-3-79-87","DOIUrl":"https://doi.org/10.21886/2308-6424-2024-12-3-79-87","url":null,"abstract":"Introduction. For the treatment of overactive bladder syndrome (OAB), injection of botulinum toxin A (BoNT-A) has been shown to be effective. However, there is a need for a less invasive method for administering BoNT-A, which could significantly expand the treatment options for OAB.Objective. To assess the impact of tizol on the absorption of BoNT-A by the bladder mucosa and compare it to the individual absorption of BoNT-A.Materials & Methods. Dialysis through the mucous membrane of the сalf bladder was used as an experimental model to study changes in bioavailability of BoNT-A complexed with tisol (BoNT-A + T) and pure BoNT-A solution during in vitro experiment. After dialysis, the BoNT-A concentration in both samples was determined using a spectrophotometer. Dialysis curves were plotted according to the data obtained. Kruvchinsky equilibrium dialysis method was used to determine botulinum toxin A bioavailability. The UV spectrophotometry method was used to determine the concentration of BoNT-A in the acceptor medium by reaction of BoNT-A with Benedict's reagent.Results. It was established that the maximum concentration of BoNT-A diffused into the acceptor medium from the blend of the test substance with tizol after nine hours. The area under the curve for dialysis of BoNT-A + T exceeds the area under the curve of pure BoNT-A by almost 20%, suggesting an improvement in the drug's bioavailability when blended with tizol.Conclusion. Based on our experiment, it was found out that the BoNT-A + T has greater bioavailability than a solution of pure BoNT-A. However, the diffusion rate of the component mixture is sufficiently low.","PeriodicalId":316238,"journal":{"name":"Urology Herald","volume":"103 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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