[Treatment of patients with abscess of prostate gland by the method of percutaneous punction].

OBJECTIVES: Demonstrate the treatment of prostatic abscess with a minimally invasive method - abscess puncture with aspiration of purulent fluid and injection of an antibiotic into abscess cavity. MATERIALS AND METHODS: Diagnosis of prostatic abscess of 23 patients using ultrasonography, computed tomography and magnetic resonance imaging of the pelvic region. 19 patients with the abscess within the prostatic capsule were treated with perineal percutaneous puncture method with aspiration of the abscess fluid and injection of antibiotics into cavity. For 4 patients with prostatic abscess and purulent paraprostatitis we performed incision and drainage of purulent cavity with open transperineal access. RESULTS: Single abscess puncture was enough to normalize health status of 15 patients. In 4 cases additional puncture was required in 4-5 days after the first manipulation. All the patients recovered and were discharged from the clinic in 7-8 days. Patients after abscess incision and drainage stayed in hospital for 10-14 days. In 1-3 months after the surgery, imaging methods revealed a high-density lesion in prostate whatever the method was used. DISCUSSION: Treatment response was controlled by imaging methods. 2 days after puncture 4 patients had a lesion with liquid content larger than 50% of the initial purulent lesion size. Repeated puncture was performed in this patients. CONCLUSION: Abscess puncture with aspiration of fluid is an effective method of treatment when prostatic abscess is within the capsule. In cases of purulent paraprostetitis incision and drainage of an abscess cavity is needed.

[Uroflowmetry in examination of the female with stress urinary incontinence].

AIM: Show the ability of uroflowmetry to record episodes of involuntary loss of urine at an altitude cough bursts. MATERIAL AND METHODS: A total of 49 women with a genital prolapse and stress urinary incontinence. The study was conducted during bladder filling 150-300 ml of urine. A patient chair being Uroflowmeter three times at intervals of 3-5 coughs seconds. Episodes of involuntary discharge of urine at an altitude cough shocks on uroflowgramme recorded as separate trapezoidal or triangular peaks. The same procedure was carried out and after surgery. RESULTS: All women graphically documented episodes of involuntary discharge of urine at an altitude cough shocks before operation. Uroflowmetry after surgery confirmed the fact of continence. DISCUSSION: The study is simple, not cumbersome for the patient. The opportunity to document the diagnosis stress urinary incontinence. CONCLUSIONS: The proposed method of uroflowmetry in examining women with stress urinary incontinence allows not only to estimate the total evacuation function of the bladder and urethra, but also graphically record the episodes of involuntary loss of urine during coughing.

[Erosions of the vaginal, bladder and urethral mucosa after transvaginal correction of genital prolapse and stress urinary incontinence using synthetic materials].

The article presents the results of treatment of 13 women with erosion of the vaginal mucosa with an exposure of the part of prosthesis and 4 women with the migration of fragments of the prosthesis into the lumen of the bladder or urethra after surgical correction of genital prolapse and stress urinary incontinence with the use of synthetic materials (Prolift, TVT operations). Interventions included the removal of part or all prosthesis from zone of erosion of the vaginal mucosa and removal of prosthesis migrated into the lumen of the bladder or urethra. Good results of operations were achieved in all cases. 8-12 months after surgery, recurrence of erosion and migration of prosthesis into the lumen of urinary organs were not observed.

[Condition of the urinary tract and the kidneys in females with prolapse and descent of the internal genitalia].

Excretory urography (EU), retrograde cystography (RC), static and dynamic pelvic MRT, renoradiography (RRG) were performed in 82 females with descent and prolapse of the internal genitalia. The above examination identified four degrees of the urinary bladder descent. The latter descent of the third and fourth degree caused ureteral obstruction in 48.1 and 87.1% cases, respectively, renal dysfunction in 81.5 and 100% cases, respectively. Static and dynamic pelvic MRT proved to be the most informative methods of examination of the urinary bladder and urethra in females with prolapse and descent of the internal genitalia.

[Synthetic prosthesis in surgical treatment of females with stress urinary incontinence combined with genital prolapse].

Simultaneous surgical treatment of females with genital prolapse and stress urinary incontinence using Gynecare Prolift, TVT techniques with use of mesh, colpo-urethrosuspension with threads corrected static disorders of the genital organs in 96.7 +/- 3.3% cases, resulted in adequate continence in 93.3 +/- 4.6% operated patients. A 1.5 to 8 month postoperative follow-up registered adequate urination (no residual urine, complete continence) in 93.3 +/- 4.6% patients.

[Simultaneous operations for combined surgical diseases in urological practice].

The study covered 653 patients with a combination of two surgical urological diseases or one urinary disease with one abdominal disease. Simultaneous operations were made in 409 patients, staged surgical treatment was performed in 154 patients who rejected one stage treatment. Simultaneous surgery was contraindicated because of severe associated diseases in 90 patients. Short-term results showed that simultaneous elective operations are characterized neither by increased frequency of postoperative complications nor longer stay of the patients in hospitals. Medical, psychological and cost-effective benefits of simultaneous operations in the treatment of combined surgical pathology make simultaneous operations promising for wide clinical practice.

[The late results of organ-saving operations in T1,2 N0M0 kidney cancer]. / Otdalennye rezul'taty organosokhraniaiushchikh operatsii pri rake pochki T1,2 N0M0.

The analysis of organ-saving operations for renal cancer T1,2 N0M0 demonstrates that in cancer of the kidney up to 5 cm in size organ-saving operations are not inferior to routine nephrectomy by 5-year survival (95.4 +/- 4.5% versus 84.0 +/- 8.1%, respectively). The operated kidney functions well in 89.2 +/- 5.1% of cases.

[Results of organ preserving treatment of T1,2 kidney tumors]. / Rezul'taty organosokhraniaiushchego lecheniia bol'nykh rakom pochki T1,2.

The results of organ-saving surgery performed for kidney tumor T1.2N0M0 in 21 patients are presented. The renal pole or a tumor-bearing sector of the parenchyma of the kidney was resected in all cases. Metastases developed in the retroperitoneal lymph nodes 6-9 months after pole resection in 2 cases of pT2N0M0 tumor in whom no lymphadenoctomy had been carried out. The remaining 19 patients have survived 6-48 months without any signs of recurrence or metastasis. Organ-saving surgery for kidney tumor T1N0M0 should be considered justified provided lymphadenectomy is performed.