[Bladder tuberculosis stage 4: how to restore urination?].

Reconstructive surgery for contracted bladder (bladder tuberculosis stage 4) was performed in 21 patients: women underwent cystectomy, and men underwent cystectomy and cystprostatectomy. The artificial bladder was formed using segment of the ileum by the Studer method with the implementation of ureteral-intestinal anastomosis by Nesbit or Wallace methods. Criteria for determining the bladder tuberculosis 4 stage, requiring the implementation of reconstructive surgery were as follows: bladder capacity of 100 ml or less (including general anesthesia); bladder volume--150 ml or less in the presence of vesicoureteral reflux. A good results were obtained in 17 (80.9%) patients. Results of 3 (14.2%) patients were regarded as satisfactory; one patient developed a stricture of ureterovaginal-reservoir anastomosis, which required re-anastomosis; 1 patient formed a stricture of membranous urethra, which recurred after optical urethrotomy and required the implementation of anastomotic urethroplasty; and 1 patient had difficulty urinating, requiring intermittent catheterization. Poor result was recorded in 1 (4.7%) patient who was diagnosed with chronic renal failure progression, despite the lack of evidence of retention of the urinary tract and vesicoureteral reflux in the presence of spontaneous urination, and satisfactory bladder capacity. This fact was attributable to the antiretroviral therapy for HIV infection.

[Urogenital tuberculosis today].

In order to analyze the structure of urogenital tuberculosis, retrospective analysis of medical records of 131 patients with newly diagnosed urogenital tuberculosis observed in the Novosibirsk Regional TB Dispensary from 2009 to 2011 was performed. The renal tuberculosis is main form in the structure is urotuberculosis, detected in 75% of patients, and widespread destructive forms of the disease were diagnosed in more than half of cases. Isolated nephrotuberculosis was more often diagnosed in women--56.8%. 15.9% of patients had asymptomatic nephrotuberculosis; one-third of patients complained of pain in the lumbar region and frequent painful urination (35.2 and 39.8%, respectively); symptoms of intoxication were present in 17% of patients, renal colic--in 9.1%, and gross hematuria--in 7.9% of patients. Mycobacteriuria in isolated nephrotuberculosis was detected in 31.8% of cases. Acute tuberculous orchiepididymitis developed in 35.7% of patients, hemospermia was observed in 7.1% of patients, dysuria was in 35.7% of patients. The pain in the perineum, frequent painful urination (both by 31.6%), hemospermia (26.3%) were main complaints in prostate tuberculosis. Mycobacteria was detected in 10.5% of cases. It was found that urogenital tuberculosis has no pathognomonic symptoms; the most alarming manifestations include long-term dysuria, hematuria, hemospermia.

[Features of the incidence of cystitis depending on the type of contraception].

For the purpose of evaluation the effect of contraceptive methods on the incidence of recurrent bacterial cystitis in women, 215 clinical records of patients with cystitis were analyzed. In addition, incidence of recurrent cystitis in three groups of sexually active women of reproductive age was compared: 26 patients (Group 1) received conventional therapy and used condom as a method of contraception; 31 patients (Group 2) received combined oral contraceptives (COC), and 32 patients (Group 3) received COC and two courses of treatment with canephrone. A negative correlation between COC use and the risk of cystitis was detected. After conventional therapy, recurrences were observed in 43.3% of patients in Group 1, in 25.8% of patients in Group 2, and only in 15.6% of women in Group 3. Thus, the choice of COCs for contraception lead to 2-fold reduction of risk of recurrence of bacterial cystitis, and additional use of canephrone--to 3-fold reduction.

[Extrathoracic tuberculosis in Siberia and the Far East].

The incidence and pattern of extrathoracic tuberculosis in the Siberian and Far Eastern areas are analyzed. The statements are illustrated by two clinical cases.

[Male genital tuberculosis in West Siberia]. / Tuberkulez polovykh organov u muzhchin v Zapadnoi Sibiri.

Clinical picture and structure of male genital tuberculosis were analyzed basing on case histories of Novosibirsk regional tuberculous hospital (outpatient department): 42 patients with tuberculous epidydymitis and 58 patients with prostatic tuberculosis. Efficiency of combined etiopathogenetic treatment was estimated in 91 patients admitted to the Urogenital clinic of Novosibirsk Research Institute of Tuberculosis. These patients received polychemotherapy alone (control group) or in combination with laser therapy (study group). Combination of polychemotherapy with laser radiation proved more effective than polychemotherapy alone.

[Extrapulmonary tuberculosis in West Siberia]. / Tuberculez vnelegochnykh lokalizatsii v Zapadnoi Sibiri.

Nine hundred and seventy-three cases of extrapulmonary tuberculosis were analyzed by using the statistical reports from 14 West Siberian areas supervised by the Novosibirsk Research Institute of Tuberculosis, Ministry of Health of the Russian Federation. In 1999, extrapulmonary tuberculosis mortality again increased in Siberia, amounting to 4.4 cases per 100,000. Its incidence was 29.95 per 100,000. In the mortality structure, urogenital tuberculosis held the lead, peripheral lymph nodal tuberculosis and osteoarticular tuberculosis occupied the second and third places, respectively. Cases of advanced and complicated tuberculosis continue to be encountered; one of them is given as an illustration.

[Possibilities of the use of immobilized proteolytic enzyme immozymase in tuberculosis]. / Vozmozhnosti primeneniia immobilizovannogo proteoliticheskogo fermenta immozimazy vo ftiziatrii.

The paper summarises the experience gained in the use of immozymase in tuberculous patients to advance the disease diagnosis and treatment. Immozymase proved valuable in obtaining sputum enriched with M. tuberculosis in patients who were previously considered noncarriers. M. tuberculosis became detectable in 28.3% of them. Immozymase instillations of the urethra before its massage for stimulation of prostatic secretion led to getting secretion in all the patients (0.35 ml, on the average). Immuzymase inhalations were used in the treatment of purulent bronchitis in patients with destructive pulmonary tuberculosis in conservative and preoperative regimens. Postoperative immozymase inhalations promoted prevention of pleuropulmonary complications. Open treatment of the caverns with immozymase after cavernotomy shortens the treatment duration. Positive results were also reached in the treatment of pleural empyema.

[A preliminary report on the therapeutic effect of laser thermal puncture with the Bozon--PIRT apparatus in urological and gynecological diseases]. / Predvaritel'noe soobshchenie o lechebnom éffekte lazeroteplopunktury apparatom "Bozon--PIRT" pri nekotorykh urologicheskikh i ginekologicheskikh zabolevaniiakh.

The operative parameters of a new unit for laser thermopuncture manufactured in Russia (Novosibirsk, Ecran) are compared to other equipment characteristics. Preheating of the zone to be exposed to laser increases sensibility to infra-red laser radiation. Laser thermopuncture techniques in cystalgia, algodysmenorrhea, enuresis are provided.

[State of nonpulmonary tuberculosis care in West Siberia]. / Sostoianie vnelegochnoi sluzhby v Zapadnoi Sibiri.

Basic epidemiologic parameters in relation to extrapulmonary tuberculosis were analysed in 6 regions of West Siberia as well as the state of the material-technical base of extrapulmonary service in these areas. Despite a general reduction of the revealed incidence and morbidity of extrapulmonary tuberculosis, the true incidence persists at a high level with predominance of advanced forms of the process. One of the causes of this situation is insufficient material-technical support of extrapulmonary tuberculosis service in West Siberia.