Pub Date : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-33-41
I. A. Tyuzikov, E. A. Grekov, A. V. Smirnov
Since the discovery of prolactin, scientific and practical interest in it has been focused exclusively from the standpoint of female endocrinology and reproductology. At the same time, the physiology and pathophysiology of prolactin in men, due to the historically established interpretation of the functions of this hormone only as an endocrine regulator of the female reproductive system, have remained insufficiently studied for a long time. However, in recent decades, convincing scientific evidence has begun to accumulate that prolactin is just as important for men as for women. It has been shown that in both sexes prolactin not only exhibits important classical (reproductive) effects, but has a wide range of non-productive physiological functions in many organs and cells. In particular, to date, not only reproductive, but various hormonal-metabolic, psychosomatic, immune-inflammatory, sexual disorders caused by disorders of prolactin secretion (hypo- and hyperprolactinemia) have been described. The review article, based on the available modern literature, examines the general issues of endocrinology and physiology of prolactin in men, as well as the main andrological manifestations of disorders of its secretion by male reproduction, male sexual function and prostate gland.
{"title":"Andrological aspects of prolactin secretion disorders","authors":"I. A. Tyuzikov, E. A. Grekov, A. V. Smirnov","doi":"10.17650/2070-9781-2023-24-3-33-41","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-33-41","url":null,"abstract":"Since the discovery of prolactin, scientific and practical interest in it has been focused exclusively from the standpoint of female endocrinology and reproductology. At the same time, the physiology and pathophysiology of prolactin in men, due to the historically established interpretation of the functions of this hormone only as an endocrine regulator of the female reproductive system, have remained insufficiently studied for a long time. However, in recent decades, convincing scientific evidence has begun to accumulate that prolactin is just as important for men as for women. It has been shown that in both sexes prolactin not only exhibits important classical (reproductive) effects, but has a wide range of non-productive physiological functions in many organs and cells. In particular, to date, not only reproductive, but various hormonal-metabolic, psychosomatic, immune-inflammatory, sexual disorders caused by disorders of prolactin secretion (hypo- and hyperprolactinemia) have been described. The review article, based on the available modern literature, examines the general issues of endocrinology and physiology of prolactin in men, as well as the main andrological manifestations of disorders of its secretion by male reproduction, male sexual function and prostate gland.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825646","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-50-55
N. P. Naumov, P. A. Shcheplev, V. V. Ipatenkov, Ya. A. Stoletov, A. V. Konyshev, D. S. Bazunov
The purpose of this literature review is to assess the role of phosphodiesterase 5 inhibitors not only in the treatment of erectile dysfunction, but also in the treatment of male infertility. Phosphodiesterase 5 inhibitors has a positive effect on the secretory function of Leydig and Sertoli cells, the biochemical environment in the vas deferens, the contractility of the testicular protein membrane and the secretory function of the prostate gland. In several studies, the effect of taking sildenafil positively affected the quantitative and qualitative motility of spermatozoa. In addition, some studies show that phosphodiesterase 5 inhibitors has a positive effect on the ability of spermatozoa to undergo capacitation. The “Vildegra” is the only sildenafil in a prolonged release form, with equal effectiveness, it has better tolerability compared to the original.
{"title":"The relationship of phosphodiesterase 5 inhibitors and male fertility: literature review","authors":"N. P. Naumov, P. A. Shcheplev, V. V. Ipatenkov, Ya. A. Stoletov, A. V. Konyshev, D. S. Bazunov","doi":"10.17650/2070-9781-2023-24-3-50-55","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-50-55","url":null,"abstract":"The purpose of this literature review is to assess the role of phosphodiesterase 5 inhibitors not only in the treatment of erectile dysfunction, but also in the treatment of male infertility. Phosphodiesterase 5 inhibitors has a positive effect on the secretory function of Leydig and Sertoli cells, the biochemical environment in the vas deferens, the contractility of the testicular protein membrane and the secretory function of the prostate gland. In several studies, the effect of taking sildenafil positively affected the quantitative and qualitative motility of spermatozoa. In addition, some studies show that phosphodiesterase 5 inhibitors has a positive effect on the ability of spermatozoa to undergo capacitation. The “Vildegra” is the only sildenafil in a prolonged release form, with equal effectiveness, it has better tolerability compared to the original.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135826887","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-101-106
S. I. Suleymanov, Z. A. Kadyrov, D. A. Fedorov, A. S. Babkin, A. M. Aguzarov, A. V. Babkina
This article describes the clinical manifestations of testicular vein thrombosis, methods for diagnosing this disease, as well as possible complications and methods for their elimination. The presented nosology is a rare pathology with a clinical picture of an acute scrotum that can develop at any age. In most cases, the symptom group of acute scrotum syndrome is caused by orchiepididymitis, testicular torsion. In a small percentage of cases, according to the results of the examination, testicular vein thrombosis is detected. As an example, clearly illustrating the treatment options for a complicated course of testicular vein thrombosis, a clinical case of a patient admitted to the emergency department of a city hospital with edematous and pain reaction in the scrotum, hypertheremia is presented. The article describes in detail the clinical manifestations of the disease, options and treatment in a multidisciplinary hospital.
{"title":"Thrombosis of the testicular vein with outcome in testicular infarction. Clinical case","authors":"S. I. Suleymanov, Z. A. Kadyrov, D. A. Fedorov, A. S. Babkin, A. M. Aguzarov, A. V. Babkina","doi":"10.17650/2070-9781-2023-24-3-101-106","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-101-106","url":null,"abstract":"This article describes the clinical manifestations of testicular vein thrombosis, methods for diagnosing this disease, as well as possible complications and methods for their elimination. The presented nosology is a rare pathology with a clinical picture of an acute scrotum that can develop at any age. In most cases, the symptom group of acute scrotum syndrome is caused by orchiepididymitis, testicular torsion. In a small percentage of cases, according to the results of the examination, testicular vein thrombosis is detected. As an example, clearly illustrating the treatment options for a complicated course of testicular vein thrombosis, a clinical case of a patient admitted to the emergency department of a city hospital with edematous and pain reaction in the scrotum, hypertheremia is presented. The article describes in detail the clinical manifestations of the disease, options and treatment in a multidisciplinary hospital.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135826883","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-42-49
L. E. Belyi
The most frequent causative agent of chronic bacterial prostatitis is Escherichia coli , however, in recent years, the proportion of other gram-negative and gram-positive microorganisms in the structure of pathogens has been increasing. There is not only an increase in the proportion of extended-spectrum β-lactamases producing Escherichia coli , which ensures the resistance of bacteria to penicillins, cephalosporins and aztreonam, but also carbapenemases producing strains. The tendency of increasing resistance of uropathogens to fluoroquinolones is noted. An alternative for the treatment of bacterial prostatitis may be fosfomycin, which is due to its high bioavailability when taken orally and the ability to reach high concentrations in the prostate. This review examines the mechanisms of action of fosfomycin, the features of its pharmacokinetics in the prostate gland, the antimicrobial spectrum and the mechanisms of resistance to fosfomycin of uropathogens. The results of oral fosfomycin for the treatment of chronic bacterial prostatitis are discussed.
{"title":"Prospects of oral fosfomycin for the treatment of chronic bacterial prostatitis","authors":"L. E. Belyi","doi":"10.17650/2070-9781-2023-24-3-42-49","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-42-49","url":null,"abstract":"The most frequent causative agent of chronic bacterial prostatitis is Escherichia coli , however, in recent years, the proportion of other gram-negative and gram-positive microorganisms in the structure of pathogens has been increasing. There is not only an increase in the proportion of extended-spectrum β-lactamases producing Escherichia coli , which ensures the resistance of bacteria to penicillins, cephalosporins and aztreonam, but also carbapenemases producing strains. The tendency of increasing resistance of uropathogens to fluoroquinolones is noted. An alternative for the treatment of bacterial prostatitis may be fosfomycin, which is due to its high bioavailability when taken orally and the ability to reach high concentrations in the prostate. This review examines the mechanisms of action of fosfomycin, the features of its pharmacokinetics in the prostate gland, the antimicrobial spectrum and the mechanisms of resistance to fosfomycin of uropathogens. The results of oral fosfomycin for the treatment of chronic bacterial prostatitis are discussed.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825640","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-23-32
M. V. Epifanova, A. A. Kostin, E. V. Gameeva, K. R. Ikonova, S. A. Artemenko, A. A. Epifanov, V. B. Chernykh
Peyronie’s disease (PD) is a benign fibrous lesion in the albuginea of the penis that can occur in men of various ages. Despite the fact that epidemiological and pathophysiological data on PD are contradictory, there are a number of comorbidities that suggest a genetic predisposition to this pathology. Genetic and molecular studies of PD are insufficient and their results are often contradictory. This literature review will consider the most studied and potential genetic predictors of PD, namely: transforming growth factor β1, myostatin, matrix metalloproteinases, Wnt signaling pathway, microRNAs (MiR-29b), major histocompatibility complex proteins (human leukocyte antigen). Expanding the possibilities of early diagnosis of the disease will increase the effectiveness of the treatment.
{"title":"Genetic predictors of Peyronie’s disease: review","authors":"M. V. Epifanova, A. A. Kostin, E. V. Gameeva, K. R. Ikonova, S. A. Artemenko, A. A. Epifanov, V. B. Chernykh","doi":"10.17650/2070-9781-2023-24-3-23-32","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-23-32","url":null,"abstract":"Peyronie’s disease (PD) is a benign fibrous lesion in the albuginea of the penis that can occur in men of various ages. Despite the fact that epidemiological and pathophysiological data on PD are contradictory, there are a number of comorbidities that suggest a genetic predisposition to this pathology. Genetic and molecular studies of PD are insufficient and their results are often contradictory. This literature review will consider the most studied and potential genetic predictors of PD, namely: transforming growth factor β1, myostatin, matrix metalloproteinases, Wnt signaling pathway, microRNAs (MiR-29b), major histocompatibility complex proteins (human leukocyte antigen). Expanding the possibilities of early diagnosis of the disease will increase the effectiveness of the treatment.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135884513","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-95-100
A. A. Kapto, A. S. Pankov
In the available scientific medical literature, we did not find evidence that vertebral osteophytes can form as a complication of stenting of the left common iliac vein. This paper presents the first such observation.
{"title":"Vertebral osteophyte formation after stenting of the left common iliac vein. Clinical case","authors":"A. A. Kapto, A. S. Pankov","doi":"10.17650/2070-9781-2023-24-3-95-100","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-95-100","url":null,"abstract":"In the available scientific medical literature, we did not find evidence that vertebral osteophytes can form as a complication of stenting of the left common iliac vein. This paper presents the first such observation.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135826433","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-107-111
M. Y. Gvozdev, A. O. Arefyeva, E. A. Prilepskaya, E. K. Lazareva, M. I. Dianov, A. K. Akhmedov
Fibroadenoma of the vulva is a benign fibroepithelial tumor that is extremely rare. We present a rare clinical case of a 49-year-old woman with a large slow-growing paraurethral fibroadenoma of the vulva, confirmed by histological examination. This observation describes a rare pathology that contributed to urination disorders, which required surgical treatment and confirmation of the benign process by immunohistochemical examination.
{"title":"Paraurethral fibroadenoma of the vulva: a clinical case","authors":"M. Y. Gvozdev, A. O. Arefyeva, E. A. Prilepskaya, E. K. Lazareva, M. I. Dianov, A. K. Akhmedov","doi":"10.17650/2070-9781-2023-24-3-107-111","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-107-111","url":null,"abstract":"Fibroadenoma of the vulva is a benign fibroepithelial tumor that is extremely rare. We present a rare clinical case of a 49-year-old woman with a large slow-growing paraurethral fibroadenoma of the vulva, confirmed by histological examination. This observation describes a rare pathology that contributed to urination disorders, which required surgical treatment and confirmation of the benign process by immunohistochemical examination.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135826886","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 : 2023-09-12DOI: 10.17650/2070-9781-2023-24-3-56-65
A. I. Ryzhkov, S. Yu. Sokolova, I. S. Shormanov
Background . Anti-Müllerian hormone (AMH) is secreted in men by Sertoli cells and plays an important role in the development of the male reproductive organs. High expression of AMH during embryonic development contributes to the regression of the Müllerian (paramesonephric) ducts; in the absence of AMH, the Müllerian ducts develop into the female internal genital organs. In adulthood, the clinical value of measuring AMH in serum and seminal plasma remains controversial. It is assumed that AMH, as a marker of the functional state of Sertoli cells, can be useful in the diagnosis of male infertility. Aim . To determine the clinical value of measuring serum and seminal plasma AMH levels in the diagnosis of male infertility by examining the current evidence base in the world literature. Materials and methods . A search was made for publications devoted to the study of the role of AMH in the diagnosis of male infertility in the international database PubMed, in the scientific electronic library eLIBRARY.RU and in the Google Scholar search engine. There were no restrictions regarding the status and period of publication. Results and conclusion . The results of the analysis indicate the absence of a significant relationship between the parameters of the ejaculate and the serum concentration of AMH, which does not allow using this indicator to assess male fertility. Serum AMH is of no value in the differential diagnosis of obstructive and non-obstructive azoospermia, the prediction of assisted reproductive technologies outcomes, and the prediction of testicular biopsy outcomes in the general non-obstructive azoospermia patient population. It is likely that serum AMH may be useful in predicting testicular biopsy results in patients with Klinefelter’s syndrome and idiopathic non-obstructive azoospermia. The clinical application of measuring the level of AMH in seminal plasma is limited by the high variability of this indicator, probably due to the dependence on the volume of the ejaculate and exposure to semen proteolytic enzymes. This indicator may be useful for the differential diagnosis of obstructive and non-obstructive azoospermia. In obstructive azoospermia, AMH is not detected in seminal plasma, but undetectable AMH concentrations can also be observed in patients with non-obstructive azoospermia, which reduces the differential value of this indicator. A promising direction is the use of AMH concentration in seminal plasma to predict the recovery of sperm motility after cryopreservation.
{"title":"Can evaluation of seminal plasma and serum anti-Müllerian hormone be useful in the diagnosis of male infertility? (Literature review)","authors":"A. I. Ryzhkov, S. Yu. Sokolova, I. S. Shormanov","doi":"10.17650/2070-9781-2023-24-3-56-65","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-56-65","url":null,"abstract":"Background . Anti-Müllerian hormone (AMH) is secreted in men by Sertoli cells and plays an important role in the development of the male reproductive organs. High expression of AMH during embryonic development contributes to the regression of the Müllerian (paramesonephric) ducts; in the absence of AMH, the Müllerian ducts develop into the female internal genital organs. In adulthood, the clinical value of measuring AMH in serum and seminal plasma remains controversial. It is assumed that AMH, as a marker of the functional state of Sertoli cells, can be useful in the diagnosis of male infertility. Aim . To determine the clinical value of measuring serum and seminal plasma AMH levels in the diagnosis of male infertility by examining the current evidence base in the world literature. Materials and methods . A search was made for publications devoted to the study of the role of AMH in the diagnosis of male infertility in the international database PubMed, in the scientific electronic library eLIBRARY.RU and in the Google Scholar search engine. There were no restrictions regarding the status and period of publication. Results and conclusion . The results of the analysis indicate the absence of a significant relationship between the parameters of the ejaculate and the serum concentration of AMH, which does not allow using this indicator to assess male fertility. Serum AMH is of no value in the differential diagnosis of obstructive and non-obstructive azoospermia, the prediction of assisted reproductive technologies outcomes, and the prediction of testicular biopsy outcomes in the general non-obstructive azoospermia patient population. It is likely that serum AMH may be useful in predicting testicular biopsy results in patients with Klinefelter’s syndrome and idiopathic non-obstructive azoospermia. The clinical application of measuring the level of AMH in seminal plasma is limited by the high variability of this indicator, probably due to the dependence on the volume of the ejaculate and exposure to semen proteolytic enzymes. This indicator may be useful for the differential diagnosis of obstructive and non-obstructive azoospermia. In obstructive azoospermia, AMH is not detected in seminal plasma, but undetectable AMH concentrations can also be observed in patients with non-obstructive azoospermia, which reduces the differential value of this indicator. A promising direction is the use of AMH concentration in seminal plasma to predict the recovery of sperm motility after cryopreservation.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878546","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 : 2023-09-11DOI: 10.17650/2070-9781-2023-24-3-82-88
L. M. Sinelnikov, V. V. Protoshchak, P. A. Babkin, N. P. Kushnirenko, P. O. Kislitsyn, E. I. Proskurevich, T. N. Gasanbekov, D. A. Galyuk
Background . For over a century retrograde urethrography (RUG) has offered the key method to diagnose urethral stricture (US). The disadvantage of the technique, however, is a potential high risk to underestimate the stricture length due to distorted visualization and eventual flawed surgical planning. Aim . To consider retrograde sagittal urethrography (RSU) and how it contributes to enhancing US preoperative diagnostics and treatment efficacy in clinical practice. Materials and methods . We compared the protocols of pre-op urethrograms performed by a radiologist and a urologist to surgery protocols for both patient groups. Group 1 included 154 patients who underwent US surgical treatment from 2017 to 2021 after using RSU as a diagnostic method (positioning 90°). Group 2 comprised 142 patients presented with identical disease who received surgery between 2012 to 2016 in our hospital after RUG using traditional technique (positioning 45°). Discrepancies of 5 mm and over in stricture length measurements between radiography protocols and intraoperative data were considered a diagnostic flaw (i.e. inconsistency). Treatment efficacy was compared across both groups. Results . In 87.6 % of cases in Group 1 (RSU) protocols provided by a radiologist matched intraoperative data versus 45.7 % of cases receiving accurate protocol data in Group 2 (RUG) (χ 2 = 59.15, p <0.001). Urethrogram protocols prepared by a urologist pre-operatively were accurate in 95.4 % of cases in Group 1 versus 62.0 % in Group 2 (χ 2 = 49.11, p <0.001). The overall efficiency of surgery was higher in Group 1 (91.6 %), than in Group 2 (82.4 %) (χ 2 = 5.54, p <0.01). Conclusion . RSU is an innovative technique that allows to significantly improve the accuracy of urethral stricture length measurement, resulting in greater treatment efficiency in Group 1 of patients. The proposed urethrographic technique can be recommended as a basic diagnostic procedure for anterior US in men.
背景。一个多世纪以来，逆行尿道造影(RUG)一直是诊断尿道狭窄的关键方法。然而，该技术的缺点是由于视觉扭曲和最终的手术计划缺陷而低估狭窄长度的潜在高风险。的目标。考虑逆行矢状尿道造影(RSU)及其如何在临床实践中提高US术前诊断和治疗效果。材料和方法。我们比较了两组患者术前由放射科医生和泌尿科医生进行的尿道造影方案和手术方案。组1包括154例2017 - 2021年使用RSU作为诊断方法(定位90°)后接受美国手术治疗的患者。第二组为2012 - 2016年在我院采用传统手法(45°体位)行手术治疗的同病患者142例。x线摄影方案和术中数据之间5毫米及以上的狭窄长度测量差异被认为是诊断缺陷(即不一致)。比较两组患者的治疗效果。结果。由放射科医生提供的第一组(RSU)方案中有87.6%的病例符合术中数据，而第二组(RUG)中有45.7%的病例获得准确的方案数据(χ 2 = 59.15, p <0.001)。1组术前泌尿科医师制定的尿道造影方案准确率为95.4%，2组为62.0% (χ 2 = 49.11, p <0.001)。手术总有效率1组(91.6%)高于2组(82.4%)(χ 2 = 5.54, p <0.01)。结论。RSU是一项创新技术，可以显著提高尿道狭窄长度测量的准确性，使1组患者的治疗效率更高。建议的尿道造影技术可作为男性前路尿道结石的基本诊断方法。
{"title":"Retrograde sagittal urethrography in diagnostics of urethral stricture disease: shifting the focus","authors":"L. M. Sinelnikov, V. V. Protoshchak, P. A. Babkin, N. P. Kushnirenko, P. O. Kislitsyn, E. I. Proskurevich, T. N. Gasanbekov, D. A. Galyuk","doi":"10.17650/2070-9781-2023-24-3-82-88","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-82-88","url":null,"abstract":"Background . For over a century retrograde urethrography (RUG) has offered the key method to diagnose urethral stricture (US). The disadvantage of the technique, however, is a potential high risk to underestimate the stricture length due to distorted visualization and eventual flawed surgical planning. Aim . To consider retrograde sagittal urethrography (RSU) and how it contributes to enhancing US preoperative diagnostics and treatment efficacy in clinical practice. Materials and methods . We compared the protocols of pre-op urethrograms performed by a radiologist and a urologist to surgery protocols for both patient groups. Group 1 included 154 patients who underwent US surgical treatment from 2017 to 2021 after using RSU as a diagnostic method (positioning 90°). Group 2 comprised 142 patients presented with identical disease who received surgery between 2012 to 2016 in our hospital after RUG using traditional technique (positioning 45°). Discrepancies of 5 mm and over in stricture length measurements between radiography protocols and intraoperative data were considered a diagnostic flaw (i.e. inconsistency). Treatment efficacy was compared across both groups. Results . In 87.6 % of cases in Group 1 (RSU) protocols provided by a radiologist matched intraoperative data versus 45.7 % of cases receiving accurate protocol data in Group 2 (RUG) (χ 2 = 59.15, p <0.001). Urethrogram protocols prepared by a urologist pre-operatively were accurate in 95.4 % of cases in Group 1 versus 62.0 % in Group 2 (χ 2 = 49.11, p <0.001). The overall efficiency of surgery was higher in Group 1 (91.6 %), than in Group 2 (82.4 %) (χ 2 = 5.54, p <0.01). Conclusion . RSU is an innovative technique that allows to significantly improve the accuracy of urethral stricture length measurement, resulting in greater treatment efficiency in Group 1 of patients. The proposed urethrographic technique can be recommended as a basic diagnostic procedure for anterior US in men.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136023260","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 : 2023-09-11DOI: 10.17650/2070-9781-2023-24-3-89-94
B. K. Komyakov, M. V. Shevnin, V. A. Tarasov, T. Kh. Nazarov, E. S. Shpilenya, I. V. Rychkov
Aim . To improve the results of surgical treatment of patients with recurrent postcoital cystitis. Material and methods . From 2005 to 2023, extravaginal transposition of the urethra according to the method developed by us (patent No. RU2408296C1 from 10.01.2011) and its modification (patent No. RU2686948C1 from 18.06.2018) was performed in 502 women aged from 18 to 61 years (average age 29.6 ± 7.2 year) at the Urology Department of the I.I. Mechnikov Northern State Medical University. The main part of patients was operated at the Center of Urology of the City Multidisciplinary Hospital No. 2 (St. Petersburg). Results . Out of 502 women we operated on, 370 (73.7 %) were examined in the distant postoperative period. A satisfactory result was observed in 338 (91.4 %) of them. The operation proved to be ineffective in 32 (8.6 %) women. Repeated transposition of the urethra was performed in 17 patients (3.4 %). С onclusion . The indication for extravaginal urethral transposition is the association of sexual intercourse with episodes of cystitis exacerbations. The high efficacy of this operation for the prevention and treatment of postcoital cystitis is achieved through the correct selection of women as well as compliance with all technical features of the proposed surgical intervention.
{"title":"Surgical correction of vestibulo-vaginal frictional dislocation of urethra in postcoital cystitis","authors":"B. K. Komyakov, M. V. Shevnin, V. A. Tarasov, T. Kh. Nazarov, E. S. Shpilenya, I. V. Rychkov","doi":"10.17650/2070-9781-2023-24-3-89-94","DOIUrl":"https://doi.org/10.17650/2070-9781-2023-24-3-89-94","url":null,"abstract":"Aim . To improve the results of surgical treatment of patients with recurrent postcoital cystitis. Material and methods . From 2005 to 2023, extravaginal transposition of the urethra according to the method developed by us (patent No. RU2408296C1 from 10.01.2011) and its modification (patent No. RU2686948C1 from 18.06.2018) was performed in 502 women aged from 18 to 61 years (average age 29.6 ± 7.2 year) at the Urology Department of the I.I. Mechnikov Northern State Medical University. The main part of patients was operated at the Center of Urology of the City Multidisciplinary Hospital No. 2 (St. Petersburg). Results . Out of 502 women we operated on, 370 (73.7 %) were examined in the distant postoperative period. A satisfactory result was observed in 338 (91.4 %) of them. The operation proved to be ineffective in 32 (8.6 %) women. Repeated transposition of the urethra was performed in 17 patients (3.4 %). С onclusion . The indication for extravaginal urethral transposition is the association of sexual intercourse with episodes of cystitis exacerbations. The high efficacy of this operation for the prevention and treatment of postcoital cystitis is achieved through the correct selection of women as well as compliance with all technical features of the proposed surgical intervention.","PeriodicalId":36603,"journal":{"name":"Andrologia i Genital''naa Hirurgia","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136024038","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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