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Urology Herald

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No 3 (2016)
View or download the full issue PDF (Russian)
https://doi.org/10.21886/2308-6424-2016-0-3

ORIGINAL ARTICLES

5-16 1992
Abstract

Abstract. From 2010 to 2016 years we obsreved 8 patients with ureteral avulsion after endoscopic surgeries. All patients were men, their age ranged from 50 to 71 years. In all patients the ureter was damaged during ureteroscopy with lithotripsy and lithoextraction. Of the 8 patients, two  had proximal ureteral avulsion between upper and middle thirds, four had ureteral avulsion 4 cm away from the pyeloureteral junction , two had had complete pyeloureteral junction avulsion. In 7 cases trauma of ureter occured at other hospitals. These patients were underwent revision of retroperitoneal space and drain for kidney by nephrostomy (6) and ureterocutaneostomy (1). One case occurred at our department and this patient was underwent laparoscopic nephrectomy with autotransplantation. The patient with ureterocutaneostomy was treated by nephrovesical bypass. In 6 patients with extended ureteral strictures we performed ileoureteroplasty. Results of reconstructive surgeries and nephrovesical bypass were successful in all patients. No intra- and postoperative complications. Mean operative time during uleoureteroplasty was 180 min, laparoscopic nephrectomy with autotransplantation – 210 min, nephrovesical bypass – 110 min. Ureteral avulsion often associated with ureterosopy in patients with large impacted proximal ureteral stones. In most cases after these injuries were diagnosed extended ureteral stricture that requires performing for autotransplantation or ileoureteroplasty. 

17-27 1436
Abstract

Abstract. This study was aimed to evaluate the role of power Doppler imaging in diagnosis of prostate cancer and prediction of its aggressiveness. This study included 118 patients with prostate cancer suspected due to elevation of prostate specific antigen (PSA) values to > 4.0 ng/ml. All patients underwent transrectal prostate biopsy with ultrasound guidance for histological verification. Prostate was scanned in power Doppler mode and one of vascularization patterns was assigned, as described by Zhao et al. Power Doppler imaging results and biopsy results were compared. Forty eight patients had normal results of power Doppler imaging. Fifty five patients had focal enhancement of blood flow, which allowed to perform a targeted biopsy of suspected lesion. Fifteen patients had diffusely enhanced blood flow. Sensitivity of power Doppler imaging was 82.4%, specificity was 70.5%, positive and negative predictive values were 66.7% and 72.3% correspondingly. Overall accuracy for prostate cancer detection was 81.1%. Association between observed vascular patterns and Gleason score, tumor dissemination and PSA level was detected. Power Doppler imaging allows efficient detection, staging and prediction of aggressiveness of prostate cancer, when compared to standard transrectal ultrasound imaging. 

REVIEWS ARTICLE

28-40 1260
Abstract

Abstract. The article contains literature review is devoted to the problem of hydrocele, comparison of different methods of treatment of patients with this pathology, and evaluation of postoperative complications. 

41-60 1326
Abstract

Abstract. The paper discusses the main etiological, phenomenological and pathogenetic mechanisms of forming the syndrome of overactive bladder (OAB) in patients with acute and chronic cerebrovascular diseases. Describes the role of melatonin, arginine vasopressin (AVP) and corticotropin-releasing factor hormone (CRFH) in maintaining the rhythms of urination, urine formation and retention of urine in norm and abnormalities in these systems in acute and chronic vascular pathology of the brain. Described phenomenology OAB syndrome in vascular diseases of the brain. Shows a differentiated approach to pharmacological correction in patients with different clinical variants of urinary disorders and urine formation in the framework of the OAB syndrome with the use of neurotransmitter therapy and hormonesensitive.

NEW MEDICAL TECHNOLOGIES

61-69 2878
Abstract

Abstract. To date, the vast majority of penis thickening techniques based on the patient's own tissue. Methods with synthetic autotransplants are often inefficient, or accompanied by a large number of complications. In the article the technique of thickening the penis using specially designed enveloped silicone implants is described. During the procedure, silicone shell implants are inserted under the Buck’s fascia in the previously prepared tunnels. This placement of implants prevents their offset. At the moment, 15 operations is made successfully. The absolute majority of the patients are satisfied with the result. The uniqueness of the presented method is ease of performance, high efficiency with minimal rehabilitation period. The technique can be recommended for plastic surgeons and urologists. 

HISTORY OF UROLOGY

70-80 1331
Abstract

Abstract. In March 2016 the urological clinic of the Moscow Regional Research and Clinical Institute named after M.F. Vladimirskiy is 85 years old. The article presents a biography of the head Clinics (1951-1975), Abramyan Aram Yakovlevich (Akopovich). 

APPLICATION

81-125 1124
Abstract

Abstract. As a result of rising life expectancy the indication for radical cystectomy is registered more and more frequently also in elderly and multimorbid patients. This work is aimed to estimate the importance of cystectomy in patients older than 70 years. The study was designed as a comparative analysis of two patients groups of 70-75 (group I) and over 75 (group II) years old with respect to following parameters: preoperative morbidity (Charlson Comorbidity-index), stat. length of hospital stay, transfusion rate, early and late complications, mortality and postoperative life expectancy. The data revealed that patients over 75 years old, who were higher cardiopulmonary preloaded, had a longer hospital stay and exhibited a higher transfusion rate. The early and late complication rates, assessed with the Clavien-Dindo classification, were identical in both groups. At the same time the internal medicine and major complications (CDC 3-5) dominated in the group of over 75 years old patients. The younger patients lived twice as long as the older patients. While having the same 30 days mortality in both groups, the 90 days mortality was higher in the older group. The 5-year survival was significantly higher in the group I. Thus, the radical cystectomy should be strived in older age expecting acceptable higher complication rates and mortality even in multi-morbid patients after more accurately risk stratification and evaluation of individual biological constellation. 



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ISSN 2308-6424 (Online)