Pub Date : 2022-06-23DOI: 10.21886/2308-6424-2022-10-2-00-00
S. Eremenko, A. Eremenko, V. Mykhaylichenko, V. Dolgopolov, V. Chernega, A. S. Khalilova
Introduction. Existing methods of surgical treatment of benign prostatic hyperplasia are accompanied by the frequent development of postoperative complications, such as urinary incontinence, retrograde ejaculation, and urethral strictures. The method of preserving the prostatic urethra has been developed for a long time. At present, it is possible to use the operation technique and perform laparoscopic urethral-sparing adenomectomy.Objective. To assess the possibility of performing extraurethral adenomectomy with prostatic urethral preservation using the laparoscopic approach, its advantages and disadvantages.Materials and methods. Based on St. Luke’s Simferopol сlinical Multidisciplinary Medical Center, 35 successful laparoscopic operations were performed to remove benign prostate hyperplasia with the prostatic urethra preservation. The features of the operation are laparoscopic access, a transverse section of the capsule, alternate isolation of adenomatous nodes while preserving the prostatic urethra on the catheter without replacing it during the operation, suturing the capsule with a decrease in space from the removed adenomatous nodes. Urethral preservation provided accelerated epithelialization of the defect, in the absence of the formation of a “prevesical” space.Results. After the operation, it is possible to turn off the urinary bladder irrigation system earlier (up to 4 – 6 hours after the operation) and early removal of the catheter after surgery (2 – 3 days). The hospital stay averaged 5.7 days. Urination was restored immediately after catheter removal in 92% of the patients. There were no elements of dysuria, particularly urinary incontinence. Prostate volume measured throughout transrectal ultrasound after operation was 20 – 24 cm³.Conclusion. The technique of retropubic extraurethral adenomectomy with prostatic urethral preservation can be performed in laparoscopic technique. The advantages are early activation of the patient and discharge from the hospital, early removal of the catheter with restoration of independent urination, absence of dysuria, urinary incontinence, and postoperative complications. The results of our study demonstrate the effectiveness of the laparoscopic extraurethral adenomectomy technique, the further development of this technique, and the possibility of its application in practice.
{"title":"Laparoscopic retropubic extraurethral adenomectomy","authors":"S. Eremenko, A. Eremenko, V. Mykhaylichenko, V. Dolgopolov, V. Chernega, A. S. Khalilova","doi":"10.21886/2308-6424-2022-10-2-00-00","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-2-00-00","url":null,"abstract":"Introduction. Existing methods of surgical treatment of benign prostatic hyperplasia are accompanied by the frequent development of postoperative complications, such as urinary incontinence, retrograde ejaculation, and urethral strictures. The method of preserving the prostatic urethra has been developed for a long time. At present, it is possible to use the operation technique and perform laparoscopic urethral-sparing adenomectomy.Objective. To assess the possibility of performing extraurethral adenomectomy with prostatic urethral preservation using the laparoscopic approach, its advantages and disadvantages.Materials and methods. Based on St. Luke’s Simferopol сlinical Multidisciplinary Medical Center, 35 successful laparoscopic operations were performed to remove benign prostate hyperplasia with the prostatic urethra preservation. The features of the operation are laparoscopic access, a transverse section of the capsule, alternate isolation of adenomatous nodes while preserving the prostatic urethra on the catheter without replacing it during the operation, suturing the capsule with a decrease in space from the removed adenomatous nodes. Urethral preservation provided accelerated epithelialization of the defect, in the absence of the formation of a “prevesical” space.Results. After the operation, it is possible to turn off the urinary bladder irrigation system earlier (up to 4 – 6 hours after the operation) and early removal of the catheter after surgery (2 – 3 days). The hospital stay averaged 5.7 days. Urination was restored immediately after catheter removal in 92% of the patients. There were no elements of dysuria, particularly urinary incontinence. Prostate volume measured throughout transrectal ultrasound after operation was 20 – 24 cm³.Conclusion. The technique of retropubic extraurethral adenomectomy with prostatic urethral preservation can be performed in laparoscopic technique. The advantages are early activation of the patient and discharge from the hospital, early removal of the catheter with restoration of independent urination, absence of dysuria, urinary incontinence, and postoperative complications. The results of our study demonstrate the effectiveness of the laparoscopic extraurethral adenomectomy technique, the further development of this technique, and the possibility of its application in practice.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127366125","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 : 2022-04-01DOI: 10.21886/2308-6424-2022-10-1-5-14
B. Guliev, A. Talyshinskiy, E. O. Stetsik, M. Agagyulov
Introduction. The non-biological simulators presented in the literature are far from the real human anatomy and are primarily aimed at developing the skill of the pyelocalyceal system (PCS) puncture without the possibility of imitating various intraoperative scenarios.Purpose of the study. To describe the manufacturing and initial testing of the ultrasound-guided PCS puncture simulator with arbitrary placement of bone landmarks and a kidney model, along with the use of a retrograde view during PCS puncture.Materials and methods. This study included training for 5 resident and 2 urologists. Each participant performed the puncture 5 times using an 18-gauge ultrasound-guided needle. A comparison was made between the number of attempts to form access, the duration of the puncture and its correctness (puncture into the small calyx through the papilla), as well as the correctness of determining the target calyx. The trajectory of the needle was retrogradely assessed using a semi-rigid ureteroscope, and the anatomical identification of the selected calyx was assessed using our mobile application.Results. The total number of attempts was 49 and 14 among residents and urologists, respectively. The average duration of the puncture step was 25.2 and 12.0 seconds. In 9/25 cases, residents were able to correctly analyze visual ultrasound information to determine the target calyx. When a contrast agent was injected into the PCS after 63 punctures, no contrast leakage was found.Conclusion. The proposed PCS puncture simulator allows to develop to develop all the necessary skills for cost-effective training of young urologists in the technique of percutaneous access.
{"title":"The non-biological simulator with the ability to regulate the position of the kidney and bone landmarks: use for training puncture access in percutaneous nephrolithotripsy","authors":"B. Guliev, A. Talyshinskiy, E. O. Stetsik, M. Agagyulov","doi":"10.21886/2308-6424-2022-10-1-5-14","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-5-14","url":null,"abstract":"Introduction. The non-biological simulators presented in the literature are far from the real human anatomy and are primarily aimed at developing the skill of the pyelocalyceal system (PCS) puncture without the possibility of imitating various intraoperative scenarios.Purpose of the study. To describe the manufacturing and initial testing of the ultrasound-guided PCS puncture simulator with arbitrary placement of bone landmarks and a kidney model, along with the use of a retrograde view during PCS puncture.Materials and methods. This study included training for 5 resident and 2 urologists. Each participant performed the puncture 5 times using an 18-gauge ultrasound-guided needle. A comparison was made between the number of attempts to form access, the duration of the puncture and its correctness (puncture into the small calyx through the papilla), as well as the correctness of determining the target calyx. The trajectory of the needle was retrogradely assessed using a semi-rigid ureteroscope, and the anatomical identification of the selected calyx was assessed using our mobile application.Results. The total number of attempts was 49 and 14 among residents and urologists, respectively. The average duration of the puncture step was 25.2 and 12.0 seconds. In 9/25 cases, residents were able to correctly analyze visual ultrasound information to determine the target calyx. When a contrast agent was injected into the PCS after 63 punctures, no contrast leakage was found.Conclusion. The proposed PCS puncture simulator allows to develop to develop all the necessary skills for cost-effective training of young urologists in the technique of percutaneous access.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"4 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123656462","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-42-51
K. Pozdnyakov, V. Bazaev, V. Dutov
Introduction. One of the most researched alternative treatments for localized prostate cancer (PCa) is ultrasound ablation (HIFU ¾ High-intensity Focused Ultrasound). Although the world history of the application of this method of PCa treatment is more than 15 years old, the scope of the application of the method has not finally been determined.Purpose of the study. To study the results of the application of ultrasound ablation in the treatment of patients with localized and locally advanced PCa.Materials and methods. The study included 147 patients with PCa who underwent HIFU treatment using the AblathermÒ device («EDAP TMS», Vaulx-en-Velin, Lyon, France). Group 1 included patients with localized and locally advanced PCa treated at the stage of gaining experience and evaluating the results of treatment (n = 82). Group 2 consisted of patients with localized PCa of low and moderate oncological risk (n = 65). The number of sessions in group 1 varied from 1 (65) to 2 (17). The need to perform a second session was associated with the ineffectiveness of the first. HIFU was also performed after the failure of external beam radiation (2), and photodynamic (1) therapy. In group 2, 61 patients received one treatment session, 4 patients received 2 sessions each. The mean follow-up time for the patients in group 1 was 17.4 ± 5.2 (3 – 29) months, for group 2 was 18.2 ± 7.3 (3 – 29) months.Results. In group 1 of patients with a low degree of oncological risk, a decrease in blood prostate-specific antigen (PSA) below the threshold value and the absence of its significant increase during the observation period was noted in 87.5% of cases (28 patients), with an average degree of oncological risk in 65.6% of cases (21 patients), with a high degree in 27.7% of cases (5 patients). In 34.1% (28 patients), the treatment was ineffective, 21 of them underwent repeated ultrasound ablation of the prostate, and 7 patients received subsequent external beam radiation therapy. These results led us to abandon the use of HIFU in patients with baseline blood PSA levels greater than 20 ng/ml and locally advanced disease. In group 2, biochemical recurrence was noted in 9 patients. A control biopsy in 6 patients confirmed local recurrence, which became the basis for a second HIFU session (4). Five patients received adjuvant hormonal therapy. The total effectiveness of the treatment in group 2 was 86.2%.Conclusion. The results support the notion that HIFU is a treatment option for localized PCa only. The evaluation of the initial results led us to abandon treatment with this method in patients with locally advanced and high-risk localized PCa.
{"title":"Optimization of HIFU monotherapy for prostate cancer","authors":"K. Pozdnyakov, V. Bazaev, V. Dutov","doi":"10.21886/2308-6424-2022-10-1-42-51","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-42-51","url":null,"abstract":"Introduction. One of the most researched alternative treatments for localized prostate cancer (PCa) is ultrasound ablation (HIFU ¾ High-intensity Focused Ultrasound). Although the world history of the application of this method of PCa treatment is more than 15 years old, the scope of the application of the method has not finally been determined.Purpose of the study. To study the results of the application of ultrasound ablation in the treatment of patients with localized and locally advanced PCa.Materials and methods. The study included 147 patients with PCa who underwent HIFU treatment using the AblathermÒ device («EDAP TMS», Vaulx-en-Velin, Lyon, France). Group 1 included patients with localized and locally advanced PCa treated at the stage of gaining experience and evaluating the results of treatment (n = 82). Group 2 consisted of patients with localized PCa of low and moderate oncological risk (n = 65). The number of sessions in group 1 varied from 1 (65) to 2 (17). The need to perform a second session was associated with the ineffectiveness of the first. HIFU was also performed after the failure of external beam radiation (2), and photodynamic (1) therapy. In group 2, 61 patients received one treatment session, 4 patients received 2 sessions each. The mean follow-up time for the patients in group 1 was 17.4 ± 5.2 (3 – 29) months, for group 2 was 18.2 ± 7.3 (3 – 29) months.Results. In group 1 of patients with a low degree of oncological risk, a decrease in blood prostate-specific antigen (PSA) below the threshold value and the absence of its significant increase during the observation period was noted in 87.5% of cases (28 patients), with an average degree of oncological risk in 65.6% of cases (21 patients), with a high degree in 27.7% of cases (5 patients). In 34.1% (28 patients), the treatment was ineffective, 21 of them underwent repeated ultrasound ablation of the prostate, and 7 patients received subsequent external beam radiation therapy. These results led us to abandon the use of HIFU in patients with baseline blood PSA levels greater than 20 ng/ml and locally advanced disease. In group 2, biochemical recurrence was noted in 9 patients. A control biopsy in 6 patients confirmed local recurrence, which became the basis for a second HIFU session (4). Five patients received adjuvant hormonal therapy. The total effectiveness of the treatment in group 2 was 86.2%.Conclusion. The results support the notion that HIFU is a treatment option for localized PCa only. The evaluation of the initial results led us to abandon treatment with this method in patients with locally advanced and high-risk localized PCa.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131756750","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-84-95
S. Shkodkin, M. Pokrovskiy, S. Krasnyak, A. Polishchuk, S. V. Chirkov, O. Churikova, N. Kravtsova
Introduction. Non-neurogenic lower urinary tract symptoms (LUTS) are a serious polyetiologic problem in the male population. The side effects of the medication agents used to treat LUTS significantly reduce treatment compliance. According to the literature data, the frequency of refusal for the proposed treatment during the year varies from 20 to 80%. Several studies have shown the benefits of herbal medicine for LUTS concerning the fewer side effects and increased adherence to treatment. However, to obtain a high-level recommendation base, clinical trials are required.Purpose of the study. To evaluate the effectiveness of Gardaprost® in LUTS combination therapy.Materials and methods. The study included 57 men aged 60 – 70 years with diagnosed medium- or large-volume benign prostatic hyperplasia (BPH) and moderate-to-severe LUTS according to I-PSS, morphologically excluded prostate cancer, without urinary infection signs. The patients were randomized into two follow-up groups. Tamsulosin 0.4 mg q.d. was prescribed to patients in the control group. Patients of the main group received Gardaprost® 0.4 mg q.d. in addition to Tamsulosin. The follow-up period in both groups was one-year. The statistical analysis includes data from 56 men. To evaluate therapy at the screening visit and on days 180 and 360, I-PSS, urination diary, IIEF-5, urinalysis, prostate-specific antigen, uroflowmetry, ultrasound were analyzed. Paired t-test and one-way ANOVA test were used to determine intergroup differences in normally distributed variables. For variables with a distribution other than normal, Friedman's two-way ANOVA for related samples was used. Events with a probability greater than 95% were considered statistically significant.Results. At the time of inclusion in the study, the groups were comparable concerning the control parameters. In the main group, there was a more pronounced positive dynamics in the I-PSS score, maximum urine flow rate, and post-void residual urine volume, which corresponded to 7.9 ± 2.1 points, 18.0 ± 7.3 ml/sec, 23.6 ± 13.6 ml vs 19.7 ± 7.2 points, 10 ± 3.5 ml/sec, 65.9 ± 33.2 ml in the main and control groups, respectively (p < 0.001). Additionally, in the main observation group, a decrease in prostate volume was recorded by 18.8% (p < 0.001) was recorded.Conclusion. We have obtained encouraging long-term results from the use of Gardaprost® in combination therapy of moderate-to-severe LUTS caused by medium- and large-volume BPH.
{"title":"Combination therapy for benign prostate hyperplasia-related urinary symptoms","authors":"S. Shkodkin, M. Pokrovskiy, S. Krasnyak, A. Polishchuk, S. V. Chirkov, O. Churikova, N. Kravtsova","doi":"10.21886/2308-6424-2022-10-1-84-95","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-84-95","url":null,"abstract":"Introduction. Non-neurogenic lower urinary tract symptoms (LUTS) are a serious polyetiologic problem in the male population. The side effects of the medication agents used to treat LUTS significantly reduce treatment compliance. According to the literature data, the frequency of refusal for the proposed treatment during the year varies from 20 to 80%. Several studies have shown the benefits of herbal medicine for LUTS concerning the fewer side effects and increased adherence to treatment. However, to obtain a high-level recommendation base, clinical trials are required.Purpose of the study. To evaluate the effectiveness of Gardaprost® in LUTS combination therapy.Materials and methods. The study included 57 men aged 60 – 70 years with diagnosed medium- or large-volume benign prostatic hyperplasia (BPH) and moderate-to-severe LUTS according to I-PSS, morphologically excluded prostate cancer, without urinary infection signs. The patients were randomized into two follow-up groups. Tamsulosin 0.4 mg q.d. was prescribed to patients in the control group. Patients of the main group received Gardaprost® 0.4 mg q.d. in addition to Tamsulosin. The follow-up period in both groups was one-year. The statistical analysis includes data from 56 men. To evaluate therapy at the screening visit and on days 180 and 360, I-PSS, urination diary, IIEF-5, urinalysis, prostate-specific antigen, uroflowmetry, ultrasound were analyzed. Paired t-test and one-way ANOVA test were used to determine intergroup differences in normally distributed variables. For variables with a distribution other than normal, Friedman's two-way ANOVA for related samples was used. Events with a probability greater than 95% were considered statistically significant.Results. At the time of inclusion in the study, the groups were comparable concerning the control parameters. In the main group, there was a more pronounced positive dynamics in the I-PSS score, maximum urine flow rate, and post-void residual urine volume, which corresponded to 7.9 ± 2.1 points, 18.0 ± 7.3 ml/sec, 23.6 ± 13.6 ml vs 19.7 ± 7.2 points, 10 ± 3.5 ml/sec, 65.9 ± 33.2 ml in the main and control groups, respectively (p < 0.001). Additionally, in the main observation group, a decrease in prostate volume was recorded by 18.8% (p < 0.001) was recorded.Conclusion. We have obtained encouraging long-term results from the use of Gardaprost® in combination therapy of moderate-to-severe LUTS caused by medium- and large-volume BPH.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134251056","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-135-146
D. Rogozin
The article presents an overview of the most significant publications on the topic of male infertility. The main selection criteria were the practical significance of the article, as well as the impact factor of the journal in which it was published, according to the SCImago Journal Rank. As a result, a list of 10 articles published in the IV quarter (October — December) of 2021 was compiled. The review includes articles on the following topics: genetic causes of male infertility, the effectiveness of antioxidants, the use of testicular spermatozoa in Intra Cytoplasmic Sperm Injection, the impact of DNA fragmentation of spermatozoa on the results of assisted reproductive technology, the relationship of male fertility with physical activity, the consumption of sweetened beverages and vitamin D intake, as well as the prognostic value of blood anti-Mullerian hormone levels before testicular biopsy.
{"title":"Male fertility: summary overview of the publications October – December 2021","authors":"D. Rogozin","doi":"10.21886/2308-6424-2022-10-1-135-146","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-135-146","url":null,"abstract":"The article presents an overview of the most significant publications on the topic of male infertility. The main selection criteria were the practical significance of the article, as well as the impact factor of the journal in which it was published, according to the SCImago Journal Rank. As a result, a list of 10 articles published in the IV quarter (October — December) of 2021 was compiled. The review includes articles on the following topics: genetic causes of male infertility, the effectiveness of antioxidants, the use of testicular spermatozoa in Intra Cytoplasmic Sperm Injection, the impact of DNA fragmentation of spermatozoa on the results of assisted reproductive technology, the relationship of male fertility with physical activity, the consumption of sweetened beverages and vitamin D intake, as well as the prognostic value of blood anti-Mullerian hormone levels before testicular biopsy.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"288 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133678011","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-104-109
A. Keln, D. G. Alifov, S. A. Zvezda, M. A. Zasorina
Prostate cancer is one of the most common malignancies among men, accounting for 19% of malignant neoplasms and the third leading cause of cancer-related death. The suicide rate among men around the world has increased over the past decade. Additionally, suicide rates are higher among cancer patients, including those with prostate cancer, compared to the general population. The article aimed to make review the current literature and determine the correlation between prostate cancer, depression, and suicidal thoughts.
{"title":"Prostate cancer: relationship with depression and suicidal thoughts","authors":"A. Keln, D. G. Alifov, S. A. Zvezda, M. A. Zasorina","doi":"10.21886/2308-6424-2022-10-1-104-109","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-104-109","url":null,"abstract":"Prostate cancer is one of the most common malignancies among men, accounting for 19% of malignant neoplasms and the third leading cause of cancer-related death. The suicide rate among men around the world has increased over the past decade. Additionally, suicide rates are higher among cancer patients, including those with prostate cancer, compared to the general population. The article aimed to make review the current literature and determine the correlation between prostate cancer, depression, and suicidal thoughts.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122444631","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-15-31
A. Kamalov, S. Matskeplishvili, M. Chaliy, A. Strigunov, D. Okhobotov, N. Sorokin, O. Nesterova, A. Kadrev, L. Dyachuk, R. Bogachev
Introduction. The American Heart Association identifies 7 major factors that affect the condition of the vascular wall: smoking, blood pressure, total cholesterol, glucose, body mass index, physical activity, and diet. The vascular wall lesions most often manifest clinically as vasculogenic erectile dysfunction (ED). Consequently, evaluating patients for the presence of the above risk factors can not only help in the treatment of ED, but can also significantly increase the chances of early detection of cardiac pathology.Purpose of the study. To assess cardiovascular disorder markers’ role in prognosing of the presence or absence of ED and its severity.Materials and methods. The study included 40 patients aged 33 – 60 years. Erectile function was assessed using the device «Androscan – MIT» ("Minimally invasive technologies" LLC, Moscow, Russian Federation) and the IIEF-15 questionnaire. Statistical data processing was carried out using Statistica 12 («StatSoft Inc.», Tusla, CA, USA) и IBMÒ SPSS Statistics 26 («SPSS: An IBM Company», IBM SPSS Corp., Armonk, NY, USA).Results. For patients with more severe ED, a greater deviation of the parameters studied from normal is typical. The most significant impact on the detection of different ED degrees using the device «Androscan – MIT» had TC, HDL, LDL, RP, BMI, triglycerides и HbA1c levels. Based on the androscanning data, a classification tree with two branches (branching conditions — the level of TC and LDL) and four terminal vertices (depending on the degree of ED) was obtained. There were no classification errors predicting ED degrees, which in this case indicates the good significance of the mathematical prediction. Only IIEF-15 scores had the greatest impact on ED detection using IIEF-15. The only condition for branching when constructing classification trees was the number of IIEF-15 points (two branches with three terminal vertices were obtained).Conclusion. Cardiovascular risk factors are predictors of vascular ED, detected by androscanning, while the widespread IIEF-15 questionnaire remains completely dependent on subjective feelings of patients without relying on laboratory and instrumental research methods.
介绍。美国心脏协会确定了影响血管壁状况的7个主要因素:吸烟、血压、总胆固醇、葡萄糖、体重指数、体育活动和饮食。血管壁病变在临床上最常表现为血管源性勃起功能障碍(ED)。因此，评估患者是否存在上述危险因素不仅有助于ED的治疗，而且可以显著增加早期发现心脏病理的机会。研究目的:评估心血管疾病标志物在ED存在与否及其严重程度的预后中的作用。材料和方法。该研究包括40名年龄在33 - 60岁之间的患者。使用«Androscan - MIT»设备(“微创技术”有限责任公司，莫斯科，俄罗斯联邦)和IIEF-15问卷评估勃起功能。统计数据处理使用Statistica 12(«StatSoft Inc.»，Tusla, CA, USA)， IBMÒ SPSS Statistics 26(«SPSS: An IBM Company»，IBM SPSS Corp.， Armonk, NY, USA)。对于更严重的ED患者，研究参数与正常的偏差更大是典型的。使用“Androscan - MIT”设备检测不同ED程度的最显著影响是TC、HDL、LDL、RP、BMI、甘油三酯和HbA1c水平。基于androscan数据，得到了一个具有两个分支(分支条件为TC和LDL水平)和四个终端顶点(取决于ED程度)的分类树。ED度预测没有出现分类错误，说明数学预测具有良好的意义。只有IIEF-15分数对使用IIEF-15检测ED有最大的影响。在构建分类树时，分支的唯一条件是IIEF-15点的个数(得到两个分支，三个终端顶点)。心血管危险因素是血管性ED的预测因素，通过男性扫描检测，而广泛使用的IIEF-15问卷仍然完全依赖于患者的主观感受，而不依赖于实验室和仪器研究方法。
{"title":"Assessing the influence of cardiovascular risk factors on the severity of erectile dysfunction: a multivariate statistical analysis","authors":"A. Kamalov, S. Matskeplishvili, M. Chaliy, A. Strigunov, D. Okhobotov, N. Sorokin, O. Nesterova, A. Kadrev, L. Dyachuk, R. Bogachev","doi":"10.21886/2308-6424-2022-10-1-15-31","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-15-31","url":null,"abstract":"Introduction. The American Heart Association identifies 7 major factors that affect the condition of the vascular wall: smoking, blood pressure, total cholesterol, glucose, body mass index, physical activity, and diet. The vascular wall lesions most often manifest clinically as vasculogenic erectile dysfunction (ED). Consequently, evaluating patients for the presence of the above risk factors can not only help in the treatment of ED, but can also significantly increase the chances of early detection of cardiac pathology.Purpose of the study. To assess cardiovascular disorder markers’ role in prognosing of the presence or absence of ED and its severity.Materials and methods. The study included 40 patients aged 33 – 60 years. Erectile function was assessed using the device «Androscan – MIT» (\"Minimally invasive technologies\" LLC, Moscow, Russian Federation) and the IIEF-15 questionnaire. Statistical data processing was carried out using Statistica 12 («StatSoft Inc.», Tusla, CA, USA) и IBMÒ SPSS Statistics 26 («SPSS: An IBM Company», IBM SPSS Corp., Armonk, NY, USA).Results. For patients with more severe ED, a greater deviation of the parameters studied from normal is typical. The most significant impact on the detection of different ED degrees using the device «Androscan – MIT» had TC, HDL, LDL, RP, BMI, triglycerides и HbA1c levels. Based on the androscanning data, a classification tree with two branches (branching conditions — the level of TC and LDL) and four terminal vertices (depending on the degree of ED) was obtained. There were no classification errors predicting ED degrees, which in this case indicates the good significance of the mathematical prediction. Only IIEF-15 scores had the greatest impact on ED detection using IIEF-15. The only condition for branching when constructing classification trees was the number of IIEF-15 points (two branches with three terminal vertices were obtained).Conclusion. Cardiovascular risk factors are predictors of vascular ED, detected by androscanning, while the widespread IIEF-15 questionnaire remains completely dependent on subjective feelings of patients without relying on laboratory and instrumental research methods.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134402943","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-32-41
Y. Malinin
Introduction. An actual issue of modern endoscopic surgery for urolithiasis is the development of techniques for optimal access to the stone. Percutaneous access during contact nephrolithotripsy (PCNL) is believed to reach the pyelocalyceal system (PCS) along the shortest trajectory and pass through the small calyces. It assumes multi-accessibility, as well as interventional cascading. Anatomically, the kidney is divided into five relatively independent segments in terms of blood supply. The thickness of the posterior one is only a quarter of the thickness of the kidney, which allows us to assume a significantly smaller number of vessels in this segment even outside the Zondek (Brödel) bloodless line.Purpose of the study.To prove the possibility of using an optimized transparenchymal approach in PCNL based on the renal vascular structure.Material and methods. A prospective analysis of the treatment of 41 patients with urolithiasis who hadPCNL. Before surgery, patients were randomized by gender, age, average stone size, and urolithiasis forms. Subjects were divided into two groups. Group 1 (study) —20 (48.8%) patients underwent PCNL through trans-parenchymal access to the inferior-lateral parts of the pelvis or the large lower renal calyx due to the ventral orientation of the lower small calyces. Group 2 (control) — 21 (51.2%) patients underwent standard PCNL. The creation of access to PCS was provided simultaneously with Doppler ultrasound of the renal vessels to prevent damage to the segmental and interlobular vessels of the kidney.Results. In 73.2% of patients, the blood supply in the region of standard access to the PCS goes through the posterior segmental artery, which does not supply blood to the lower half of the kidney (type 1 blood supply). In 26.8% of patients, branches of the posterior segmental artery cross the projection of the inferior calyces (type 2 blood supply). In cases where it is impossible to perform a standard puncture of the PCL (patients of the first group), type 1 blood supply allows you to safely make an alternative trans-parenchymal access directly to the lower calyx or pelvis through the inferior-lateral dorsal wall. The optimization of the access decreasesthe average operation time by 1.4 times and the average number of accesses by 1.3 times.Conclusion. Doppler ultrasound scanning allows to visualize of arterial vessels, which helps to provide safe trans-cutaneous puncture access to PCS. In 73.2% of patients, the region of the posterior surface of the pelvis and the lower calyx was identified with the possibility of an anatomically justified low-traumatic trans-parenchymal access. It significantly expands the area of the parts of the PCS accessible for direct intervention. The creation of a trans-parenchymal access to the lower lateral parts of the renal pelvis allows reducing the total number of accesses to the PCS, which reduces the operation time and the number of complications.
{"title":"Alternative trans-parenchymal access for percutaneous contact nephrolithotripsy","authors":"Y. Malinin","doi":"10.21886/2308-6424-2022-10-1-32-41","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-32-41","url":null,"abstract":"Introduction. An actual issue of modern endoscopic surgery for urolithiasis is the development of techniques for optimal access to the stone. Percutaneous access during contact nephrolithotripsy (PCNL) is believed to reach the pyelocalyceal system (PCS) along the shortest trajectory and pass through the small calyces. It assumes multi-accessibility, as well as interventional cascading. Anatomically, the kidney is divided into five relatively independent segments in terms of blood supply. The thickness of the posterior one is only a quarter of the thickness of the kidney, which allows us to assume a significantly smaller number of vessels in this segment even outside the Zondek (Brödel) bloodless line.Purpose of the study.To prove the possibility of using an optimized transparenchymal approach in PCNL based on the renal vascular structure.Material and methods. A prospective analysis of the treatment of 41 patients with urolithiasis who hadPCNL. Before surgery, patients were randomized by gender, age, average stone size, and urolithiasis forms. Subjects were divided into two groups. Group 1 (study) —20 (48.8%) patients underwent PCNL through trans-parenchymal access to the inferior-lateral parts of the pelvis or the large lower renal calyx due to the ventral orientation of the lower small calyces. Group 2 (control) — 21 (51.2%) patients underwent standard PCNL. The creation of access to PCS was provided simultaneously with Doppler ultrasound of the renal vessels to prevent damage to the segmental and interlobular vessels of the kidney.Results. In 73.2% of patients, the blood supply in the region of standard access to the PCS goes through the posterior segmental artery, which does not supply blood to the lower half of the kidney (type 1 blood supply). In 26.8% of patients, branches of the posterior segmental artery cross the projection of the inferior calyces (type 2 blood supply). In cases where it is impossible to perform a standard puncture of the PCL (patients of the first group), type 1 blood supply allows you to safely make an alternative trans-parenchymal access directly to the lower calyx or pelvis through the inferior-lateral dorsal wall. The optimization of the access decreasesthe average operation time by 1.4 times and the average number of accesses by 1.3 times.Conclusion. Doppler ultrasound scanning allows to visualize of arterial vessels, which helps to provide safe trans-cutaneous puncture access to PCS. In 73.2% of patients, the region of the posterior surface of the pelvis and the lower calyx was identified with the possibility of an anatomically justified low-traumatic trans-parenchymal access. It significantly expands the area of the parts of the PCS accessible for direct intervention. The creation of a trans-parenchymal access to the lower lateral parts of the renal pelvis allows reducing the total number of accesses to the PCS, which reduces the operation time and the number of complications.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134167479","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-128-134
K. Ibishev, J. Prokop
The male reproductive health depends on several factors that can be divided into two main groups: the first group, genetic or hereditary (in particular, Klinefelter syndrome, etc.), the second acquired factors that depend on the person's lifestyle (bad habits, diet), stress, infectious diseases of the genitourinary system, etc. The presence of infectious and inflammatory diseases of the male reproductive system leads to impaired reproductive and endocrine function, significantly reducing the reproductive potential. In the last three years of our time around the world, including Russia, the number of people who have become ill with a new viral infection (COVID-19) caused by the new coronavirus (SARS-CoV-2), which causes dysfunction and has a negative effect on many organs and organs, body systems.The overview of recent publications is devoted to the study of the effect of SARS-CoV-2 on the reproductive health of men. The search was performed using the Medline, PubMed, and EMBASE databases.
{"title":"New coronavirus disease 2019 (COVID-19): Is there an impact on male reproductive health","authors":"K. Ibishev, J. Prokop","doi":"10.21886/2308-6424-2022-10-1-128-134","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-128-134","url":null,"abstract":"The male reproductive health depends on several factors that can be divided into two main groups: the first group, genetic or hereditary (in particular, Klinefelter syndrome, etc.), the second acquired factors that depend on the person's lifestyle (bad habits, diet), stress, infectious diseases of the genitourinary system, etc. The presence of infectious and inflammatory diseases of the male reproductive system leads to impaired reproductive and endocrine function, significantly reducing the reproductive potential. In the last three years of our time around the world, including Russia, the number of people who have become ill with a new viral infection (COVID-19) caused by the new coronavirus (SARS-CoV-2), which causes dysfunction and has a negative effect on many organs and organs, body systems.The overview of recent publications is devoted to the study of the effect of SARS-CoV-2 on the reproductive health of men. The search was performed using the Medline, PubMed, and EMBASE databases.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116102361","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 : 2022-03-30DOI: 10.21886/2308-6424-2022-10-1-96-103
D. Babaevskaya, Andrey K. Bazarkin, M. Taratkin, Dmitry V. Enikeev
Transurethral resection of the bladder tumor (TURBT) is a standard procedure in bladder cancer management. TURBT has two main goals: to resect completely all the tumor lesions in healthy tissues and to provide high-quality specimen to facilitate accurate diagnosis. To achieve these goals, urologists make use of several options to maximize the efficiency of the procedure. To make tumor detection as effective as possible, the European Association of Urology guidelines recommend using enhanced visualization methods such as photodynamic diagnostics (PDD) and narrow-band imaging (NBI). Novel en bloc technique enables one to provide specimens of a higher quality and to increase recurrence-free survival. Also, the use of new energy sources such as lasers helps to decrease bleeding and prevent several complications after TURBT, e.g., obturator nerve reflex and bladder perforation. This article summarizes the options available to enhance the TURBT procedure and reports on the latest data on their feasibility for clinical practice.
{"title":"Recent advances in transurethral resection of bladder tumors","authors":"D. Babaevskaya, Andrey K. Bazarkin, M. Taratkin, Dmitry V. Enikeev","doi":"10.21886/2308-6424-2022-10-1-96-103","DOIUrl":"https://doi.org/10.21886/2308-6424-2022-10-1-96-103","url":null,"abstract":"Transurethral resection of the bladder tumor (TURBT) is a standard procedure in bladder cancer management. TURBT has two main goals: to resect completely all the tumor lesions in healthy tissues and to provide high-quality specimen to facilitate accurate diagnosis. To achieve these goals, urologists make use of several options to maximize the efficiency of the procedure. To make tumor detection as effective as possible, the European Association of Urology guidelines recommend using enhanced visualization methods such as photodynamic diagnostics (PDD) and narrow-band imaging (NBI). Novel en bloc technique enables one to provide specimens of a higher quality and to increase recurrence-free survival. Also, the use of new energy sources such as lasers helps to decrease bleeding and prevent several complications after TURBT, e.g., obturator nerve reflex and bladder perforation. This article summarizes the options available to enhance the TURBT procedure and reports on the latest data on their feasibility for clinical practice.","PeriodicalId":345779,"journal":{"name":"Vestnik Urologii","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121975098","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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