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1.
Urologiia ; (2): 97-102, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162909

RESUMO

Dysuria is the one of the most common conditions in urology. Although dysuria is not an independent disease, it accompanies a wide range of urological diseases of both infectious and non-infectious origin. Dysuria is traditionally understood as a feeling of discomfort, a burning sensation, or a sensation of pain during urination. Despite a significant reduction in the quality of life of this category of patients, pathogenetic treatment of the underlying cause is often performed in routine clinical practice, while the dysuria itself can remain without proper attention. The current possibilities of symptomatic relief of dysuria are reviewed in this article.


Assuntos
Disuria/terapia , Doenças Urológicas/complicações , Disuria/etiologia , Humanos , Qualidade de Vida , Transtornos Urinários/complicações
2.
Urologiia ; (6): 48-53, 2019 12 31.
Artigo em Russo | MEDLINE | ID: mdl-32003167

RESUMO

INTRODUCTION: Early diagnosis of renal cell carcinoma (RCC) is extremely difficult, due to the late development of clinical manifestations. The study of the aberrant expression of tumor-associated antigens and a production of autoantibodies to these proteins seems promising and novel method for RCC diagnosis. AIM: To evaluate the possibility of using arrestin-1 (Arr-1), recoverin (Rec) and autoantibodies against arrestin-1 (AAA1) and recoverin (AAR) as a kidney tumor biomarker. MATERIALS AND METHODS: Primary kidney tumors and metastases of 62 patients were investigated. For immunohistochemical studies, tissues were incubated with polyclonal antibodies against Rec and Arr1 as the main antibodies. Detection of AAR and AAA-1 in the serum of patients was performed using Western Blot analysis according to a standard protocol. RESULTS: Among 62 tumors, renal cell carcinoma (RCC) constitutes 50 cases (86.4%), and oncocytoma was diagnosed in 12 patients (19.4%). In 11 (22%) cases of RCC, distant metastases were detected. Positive expression of Rec was observed in almost 71% of all types of kidney tumors. In 61.3% of patients with RCC, Arr-1 expression was seen. In the serum, AAR was found only in 1 patient (1.6%) with RCC. However, unlike AAR, AAA-1 in the serum of patients was observed much more often (75.8%). CONCLUSION: According to our data, the presence of AAA1 in the serum, unlike AAR, can be considered as an early kidney tumor biomarker. The high expression of recoverin and arrestin-1 in kidney tumors suggests the use of these proteins in future as a marker for the diagnosis or even as a potential target for immunotherapy.


Assuntos
Arrestinas , Biomarcadores Tumorais , Carcinoma de Células Renais , Neoplasias Renais , Recoverina , Arrestinas/sangue , Biomarcadores Tumorais/análise , Carcinoma de Células Renais/sangue , Carcinoma de Células Renais/diagnóstico , Humanos , Neoplasias Renais/sangue , Neoplasias Renais/diagnóstico , Recoverina/sangue
3.
Urologiia ; (6): 150-155, 2019 12 31.
Artigo em Russo | MEDLINE | ID: mdl-32003187

RESUMO

Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual arousal and erectile function. Delayed ejaculation is one of the most studied and rare types of male sexual dysfunctions, which leads to depression, anxiety, and often is a reason of low self-esteem, reduced satisfaction of a man with his partner, and worsening of relationships between partners. In some cases, delayed ejaculation and anejaculation cause infertility. Current views on epidemiology, diagnostics and treatment strategy of delayed ejaculation are presented in the article.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Ejaculação , Humanos , Masculino , Orgasmo , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia
4.
Urologiia ; (5): 74-80, 2018 Dec.
Artigo em Russo | MEDLINE | ID: mdl-30575354

RESUMO

AIM: Experimental evaluation of the efficacy and safety of lithotripsy using a new pulsed thulium fiber laser operating at a wavelength of 1.94 microns, peak power of 500 watts (maximum average power of 50 watts) by comparing it with a holmium laser operating at a wavelength of 2.1 microns (average maximum power 100 W and 120 W). RELEVANCE: The proportion of minimally invasive surgery in the management of urolithiasis, including retrograde intrarenal surgery, is steadily growing. The most appropriate tool for stone destruction is a laser. To date, the gold standard of minimally invasive surgical treatment of nephrolithiasis is holmium laser lithotripsy, which uses a laser on yttrium-aluminum-garnet activated by holmium ions (Ho: YAG) operating at a wavelength of 2.1 m. However, in recent years, lasers on a Tm-activated fiber with a wavelength of 1.94 m have become increasingly popular since the water absorption coefficient for the Tm radiation of a fiber laser is 5.5 times higher than for a Ho: YAG laser and in 2.2 times higher than for the Tm: YAG laser. This difference may translate into greater effectiveness and speed of stone crushing, which in turn leads to shorter operating time. MATERIALS AND METHODS: This article describes physical foundations of holmium and thulium laser radiation, the mechanisms of stone fragmentation, data from a series of experiments comparing the efficiency and safety of ex-vivo lithotripsy using a holmium solid-state laser with a wavelength of 2.1 m and a thulium fiber laser with a wavelength of 1.94 m. RESULTS: The study findings suggest that the STA IRE-Polyus thulium fiber laser operating at a wavelength of 1.94 microns and a maximum power of 500 watts has several advantages over the holmium laser in the stone fragmentation in urological practice. CONCLUSION: The results of the experimental work allow us to conclude that the use of a thulium fiber laser operating at a wavelength of 1.94 m and a maximum peak power of 500 W enables highly effective and safe lithotripsy.


Assuntos
Cálculos Renais , Lasers de Estado Sólido , Litotripsia a Laser , Hólmio , Humanos , Túlio
5.
Urologiia ; (5): 94-99, 2018 Dec.
Artigo em Russo | MEDLINE | ID: mdl-30575358

RESUMO

Nowadays, various laparoscopic instruments for tissue dissection and vessel coagulation are available. However, there are ongoing studies dedicated to "ideal" type of energy suitable for this aim. Laser radiation has been used for many years in medical practice and it is established as reliable and effective method in surgical armamentarium. The ability to provide highly precision and well-controlled action on the tissues, improved hemostasis, easy adaptability to fiber-optic and minimally invasive delivery systems, as well as the possibility of facilitating complex dissection made lasers an important tool for surgeons. The mechanism and methods of laser energy using in urology have been studied since 1980s, but there is still no consensus on the optimal type of laser and its settings during urological surgeries, which determines the importance of further researches dedicated to this promising form of energy.


Assuntos
Laparoscopia , Terapia a Laser , Fotocoagulação a Laser , Procedimentos Cirúrgicos Urológicos
6.
Urologiia ; (5): 100-105, 2018 Dec.
Artigo em Russo | MEDLINE | ID: mdl-30575359

RESUMO

In the Russian Federation, a proportion of bladder cancer in the overall structure of malignant tumors is about 2.8% and among oncological diseases of genitourinary system its incidence is second only to prostate cancer. Bladder cancer ranks as ninth most prevalent in males and as eighteens in females. The most important issue is to determine a recurrence rate of non-muscle invasive bladder cancer, which can reach 80%. In this regard, currently, all over the world much more attention is paid to studying and creation of early detection, including non-invasive, which will be reliable in the early stages. It can possibly lead to a reduction the number of cystoscopy and become as "golden" standard of non-invasive diagnosis bladder cancer.


Assuntos
Neoplasias da Bexiga Urinária , Cistoscopia , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia , Federação Russa
7.
Urologiia ; (2): 54-61, 2018 May.
Artigo em Russo | MEDLINE | ID: mdl-29901295

RESUMO

RELEVANCE: Erectile dysfunction (ED) is a common condition. Pharmacological management of ED involves medications produced by chemical synthesis. Despite high efficiency, their use is often accompanied by some side effects. Considering this, herbal preparations with sufficient efficacy and greater safety have received much attention. AIM: To compare the efficacy and safety of two herbal preparations (EFFEX Tribulus and Tribestan) based on Tribulus Terrestris herb dry extract in patients with ED. MATERIALS AND METHODS: A total of 173 patients were enrolled in the study, of whom 87 (group I) and 86 (group II) received EFFEX Tribulus and Tribestan, respectively. The mean age of patients was 42.2+/-11.5 years in group I and 42.8+/-11.2 years in group II. One hundred fifty two patients completed the study. The follow-up was 13 weeks (the herbal preparation dose was titrated at week five after the treatment initiation). The effectiveness of treatment was assessed on five follow-up visits using the IIEF, AMS, MSF, GAQ questionnaires, and a complex of diagnostic and laboratory studies. RESULTS: At visit five compared to visit 1, the mean IIEF erectile function domain score increased by 5.7+/-4.6 and 5.2+/-4.3 points in group I and II, respectively. In both groups, all other IIEF domain scores demonstrated a statistically significant increase. The AMS scores decreased from 32.93+/-10.04 to 25.02+/-7.62 points in group I and 31.78+/-10.37 to 24.55+/-7.31 points in group II. The SMF scores increased from 22.36+/-4.85 to 27.16+/-4.80 points in group I and from 22.13+/-3.69 to 26.10+/-5.69 points in group II. Besides, the use of the herbal preparations was associated with a decrease in the serum cholesterol level, more pronounced with increasing patient age (correlation coefficient -0.06, p=0.41). CONCLUSION: The herbal preparations EFFEX Tribulus and Tribestan have a similar efficacy and safety profiles.


Assuntos
Disfunção Erétil/tratamento farmacológico , Fitoterapia , Extratos Vegetais/administração & dosagem , Preparações de Plantas/administração & dosagem , Saponinas/administração & dosagem , Tribulus/química , Adulto , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
8.
Urologiia ; (2): 147-153, 2018 May.
Artigo em Russo | MEDLINE | ID: mdl-29901311

RESUMO

Currently, transurethral resection of a bladder tumor (TUR) is the gold standart treatment for non-muscle invasive bladder cancer (NMIBC). Standard TUR for a bladder wall tumor has a high recurrence rate, which is caused mainly by malignant cell implantation during the surgery. Besides, specimens obtained with conventional TUR are insufficient for accurate pathological staging. The non-conformity of the standard TUR with the established oncological principle of dissecting through normal tissue prompted a search for the optimal surgical modality. En-bloc resection of the bladder wall tumor has been proposed as an alternative method for surgical management of NMIBC. This technique involves the resection of bladder tumor through the underlying muscle layer as a single piece thus providing high quality material for subsequent morphological study and reducing the risk of metastasizing by implantation of malignant cells. This paper presents an analysis of relevant research literature published in the last twenty years, describes all currently existing techniques of the bladder tumor resection using a variety of energy sources, including laser.


Assuntos
Terapia a Laser/métodos , Neoplasias da Bexiga Urinária/cirurgia , Feminino , Humanos , Masculino , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia
9.
Urologiia ; (1): 42-47, 2018 Mar.
Artigo em Russo | MEDLINE | ID: mdl-29634133

RESUMO

INTRODUCTION: With growing experience in the HoLEP, it can replace TURP as the "gold standard" for the surgical management of BPH, and therefore this technique is the most studied surgical modality. Despite the proven effectiveness of HoLEP in the treatment of patients with BPH, its widespread use has been associated with both intra- and postoperative complications. AIM: To improve the results of surgical management of patients with BPH. MATERIAL AND METHODS: The study comprised 310 patients who underwent HoLEP for BPH. HoLEP was performed using the Gillings technique. INCLUSION CRITERIA: presence of LUTS (Qmax<15 ml/s, Qav<10 ml/s, presence of residual urine, I-PSS score> 5, QoL score> 2), absence of an active inflammatory process of the urogenital organs. RESULTS: Intraoperative complications included severe hemorrhage in 16 (5.2%), the bladder wall injury in 17 (5.5%) and the ureteral orifice injury in 2 (0.6%) patients. 275 (88.7%) had no intraoperative complications. Early postoperative complications included fever in 4 (1.3%), the bladder tamponade that required cystoscopy and evacuation of blood clots in 7 (2.3%) and acute urinary retention in 36 (11.8%) patients. 263 (84.6%) patients had no postoperative complications. Long-term postoperative complications comprised urinary incontinence in 39 (12.6%) patients and urethral strictures requiring surgical treatment in 9 (2.9%) patients. There were no long-term complications in 262 (84.5%) patients. CONCLUSION: HoLEP is an effective and safe surgical modality for treating patients with BPH with minimal complications, suitable for any size of the prostate.


Assuntos
Complicações Intraoperatórias/etiologia , Terapia a Laser/efeitos adversos , Lasers de Estado Sólido/efeitos adversos , Complicações Pós-Operatórias/etiologia , Hiperplasia Prostática/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento , Urodinâmica
10.
Urologiia ; (1): 71-76, 2018 Mar.
Artigo em Russo | MEDLINE | ID: mdl-29634137

RESUMO

AIM: To evaluate the effect of Androgel on the quality of life of patients with androgen deficiency (hypogonadism) and chronic prostatitis in everyday practice. MATERIALS AND METHODS: This open multicenter observational non-interventional study comprised 401 men with testosterone deficiency and chronic prostatitis who were treated with topical applications of 1% testosterone gel of (Androgel) at a dose of 50 or 100 mg in routine clinical practice for three months. The primary endpoint was the health related quality of life. Also, the patients filled out AMS, I-PSS, NIH-CPSI questionnaires to assess the quality of life related to chronic prostatitis, lower urinary tract symptoms, and aging. Secondary endpoints included changes in the overall score of the International Index of Erectile Function (IIEF-5), changes in body weight and waist circumference, the reasons for treatment discontinuation and any adverse events that occurred during treatment. RESULTS: Mean total testosterone levels at baseline and three months were 9.5 (95% CI 9.2-9.7) nmol/L and 16.5 (95% CI 16.1-16.9) nmol/l (p<0.001), respectively. There were statistically significant (p<0.001) differences in scores on all questionnaires. Mean scores at baseline and at three months for AMS, IIEF-5, I-PSS, NIH-CPSI questionnaires were 44.6 (95% CI 43.2-45.9) and 25.8 (95% CI 24.8-26.7); 12.7 (95% CI 12.2-13.2) and 19.3 (95% CI, 18.8-19.8); 14.5 (95% CI 13.7-15.3) and 5.6 (95% CI 5.2-6.1); 27.8 (95% CI 26,5-29.1) and 10.0 (95% CI 9.1-10.9), respectively. There were positive changes in body weight and waist circumference: at baseline and three months these parameters were 95 (95% CI 93.6-96.3) and 91.4 (95% CI 90.1-92.7) kg and 102.9 (95% CI 101.8-104.1) and 98.3 (95% CI 97.3-99.3) cm, respectively. No clinically significant adverse events were observed during follow-up. CONCLUSIONS: Transdermal therapy with 1% testosterone gel (Androgel) is highly effective and safe in the management of androgen deficiency (hypogonadism). Its use in patients with chronic prostatitis and hypogonadism results in an improvement in low urinary tract symptoms, symptoms of chronic prostatitis, alleviates pelvic pain and thus leads to significant improvements in the quality of life.


Assuntos
Androgênios/uso terapêutico , Hipogonadismo/tratamento farmacológico , Prostatite/tratamento farmacológico , Qualidade de Vida , Testosterona/uso terapêutico , Administração Cutânea , Androgênios/administração & dosagem , Doença Crônica , Humanos , Hipogonadismo/complicações , Masculino , Pessoa de Meia-Idade , Prostatite/complicações , Inquéritos e Questionários , Testosterona/administração & dosagem
11.
Urologiia ; (4): 120-128, 2017 Sep.
Artigo em Russo | MEDLINE | ID: mdl-28952704

RESUMO

The article reviews clinical trials on the effectiveness of combination therapy with 5-reductase inhibitors and -blockers in men with benign prostatic hyperplasia (BPH). These trials have demonstrated a significant improvement in the symptoms and quality of life in this group of patients. The authors outline main strategies offered by the Russian clinical guidelines for BPH patients.


Assuntos
Inibidores de 5-alfa Redutase/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Dutasterida/uso terapêutico , Hiperplasia Prostática/tratamento farmacológico , Sulfonamidas/uso terapêutico , Combinação de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Hiperplasia Prostática/fisiopatologia , Hiperplasia Prostática/psicologia , Qualidade de Vida , Tansulosina
12.
Urologiia ; (1): 108-113, 2017 Apr.
Artigo em Russo | MEDLINE | ID: mdl-28394533

RESUMO

The first medical application of lasers dates back to the mid-60s of the XX century. Since then, laser systems have undergone significant changes. No longer a science fiction, lasers are used in many medical fields as an indispensable tool in the hands of the modern physician. The article outlines advances in laser techniques (from the idea of laser radiation to the modern laser systems used as effective surgical tools). We also present our experience in using laser surgical techniques in treating patients with prostatic hyperplasia.


Assuntos
Terapia a Laser/métodos , Hiperplasia Prostática/cirurgia , Endoscopia , Humanos , Terapia a Laser/instrumentação , Lasers de Estado Sólido/uso terapêutico , Masculino
13.
Urologiia ; (1): 114-122, 2017 Apr.
Artigo em Russo | MEDLINE | ID: mdl-28394534

RESUMO

The manuscript presents the analysis of scientific manuscripts written by Russian and foreign researchers devoted to chronic pelvic pain syndrome (CPPS) studies. In spite of widespread disease, there is no clear understanding on etiopathogenetic mechanisms of CPPS development and it is shown that besides infectious process cardiovascular, neuronal, locomotor, endocrine and immune systems are involved into pathological process of CPPS. Mentioned factors complicate the doctors task on effective therapy choice and stress the reasonability of complex approach to CPPS treatment. Combination drug containing affinity purified antibodies to endothelial NO-synthase and prostate-specific antigen in released-active form influences different pathogenetic mechanisms of CPPS and thereby reveals pronounced clinical efficacy.


Assuntos
Dor Pélvica/terapia , Prostatite/terapia , Antagonistas Adrenérgicos alfa/uso terapêutico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Anticorpos/uso terapêutico , Doença Crônica , Combinação de Medicamentos , Humanos , Masculino , Óxido Nítrico Sintase Tipo III/imunologia , Dor Pélvica/etiologia , Dor Pélvica/imunologia , Antígeno Prostático Específico/imunologia , Prostatite/etiologia , Prostatite/imunologia , Síndrome
14.
Urologiia ; (4): 58-62, 2016 Aug.
Artigo em Russo | MEDLINE | ID: mdl-28247727

RESUMO

Among the diseases complicating the course of calculous pyelonephritis, are among the leaders of diabetes mellitus, which is associated with reduced immune response, deterioration of renal hemodynamics, the reduced sensitivity to antibacterial drugs. The purpose of the study is to improve the results of treatment of patients with calculous pyelonephritis and diabetes mellitus type 2. The materials and methods of research. We studied 179 people. This was a retrospective pharmaco-epidemiological analysis of medical records of patients who were treated in 2009 and 2013, in hospital of Volgograd. Women in the study was greater than 99(by 55.4%), males - 80 (44,6%). All patients underwent standard clinical examination, with mandatory bacteriological urine analysis, ultrasound study of kidneys. RESULTS: During the observation period of 2009 and 2013 in patients with calculous pyelonephritis and type 2 diabetes, the major pathogens were representatives of the family Enterobacteriaceae. E.coli strains are constituted - 12 (54,5%), K. pneumoniae - 4 (18.1%) strains. In other etiologically significant microorganisms were Enterococcus spp. - 3 (13.6%) strain, P. aeruginosa - strain 2 (9%). The group of other (4.5%), we have carried pathogens isolated in the singular: Erobacter spp, S. aureus, and Klebsiella oxytoca. In patients with infection of the upper urinary tract and diabetes, there is a pronounced trend to decrease sensitivity to all groups of antibiotics. Sensitivity to unprotected penicillins and fluoroquinolones has decreased almost twice. Resistance to aminoglycosides of patients in this group increased by 23%. In patients with chronic calculous pyelonephritis and diabetes mellitus type 2 is high sensitivity of the main causative agents of infection to cephalosporins of the third and fourth generation (92%), protected beta-lactam penicillins (amoxicillin/clavulanate) - 86,4%, to carbapenemam is 89.4%. CONCLUSIONS: For the empiric treatment of infections of the upper urinary tract in patients with diabetes mellitus, can be recommended drugs: protected beta-lactam penicillins, cephalosporins of the third and fourth generation, carbapenem.


Assuntos
Infecções Bacterianas/microbiologia , Diabetes Mellitus Tipo 2/microbiologia , Cálculos Renais/microbiologia , Pielonefrite/microbiologia , Infecções Urinárias/microbiologia , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções Bacterianas/complicações , Doença Crônica , Diabetes Mellitus Tipo 2/complicações , Farmacorresistência Bacteriana , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/isolamento & purificação , Feminino , Humanos , Cálculos Renais/complicações , Masculino , Pessoa de Meia-Idade , Pielonefrite/complicações , Estudos Retrospectivos , Infecções Urinárias/complicações
15.
Urologiia ; (4): 76-81, 2016 Aug.
Artigo em Russo | MEDLINE | ID: mdl-28247730

RESUMO

PURPOSE: To evaluate the potentials of determining the telomerase activity (TA) in the cellular material of the urine for noninvasive diagnosis of bladder cancer (BC). MATERIALS AND METHODS: Evaluation of TA was performed in the urine of 48 patients with bladder cancer (study group) before and after transurethral resection of the bladder wall (n=38), an open resection of the bladder (n=4), and cystectomy (n=6). TA was also evaluated in 48 tumor tissue samples obtained from these patients during removal of the bladder tumor. Each sample of the tumor tissue was separated into two parts, one of which was subjected to histological examination, and the latter was used to determine the telomerase activity. In all cases, the diagnosis of bladder cancer was confirmed morphologically. Determination of TA in the samples was performed by the modified TRAP-method (telomerase repeat amplification protocol), RT-PCR, PCR, and electrophoresis. As a control, cell material of the urine and tissue in 12 patients with chronic cystitis was investigated. RESULTS: TA before surgery was found in 45 (93.75%) of 48 samples of cellular material of the urine from patients with suspected bladder cancer. BC was histologically verified in all patients in this group. In the postoperative period, TA was not observed in the 48 samples of cellular material of the urine from patients with BC. In the control group of patients with histologically verified cystitis, weak TA was determined only in one sample of cellular material of the urine. The analysis indicates statistically significant predominance of patients with bladder cancer in case of TA in the urine (P=0.001). TA was detected in all samples of tumor tissue. We also analyzed the dependence of TA levels in urine and tissue on the degree of BC differentiation. In patients with highly differentiated BC, mean AT in the cellular materials of the urine was 0,61% (n=15), in patients with moderately differentiated BC - 0.95% (n=23), in patients with low-grade bladder cancer - 1.33% (n=10); in other words, increase in the TA levels with decreasing the degree of differentiation was observed. This finding can be used in the prognosis of the course of disease based on determining the TA level in these patients. CONCLUSIONS: Preliminary data indicate the possibility of use of determining the TA in cellular material of the urine for the diagnosis and monitoring of bladder cancer recurrence.


Assuntos
Biomarcadores Tumorais/urina , Telomerase/metabolismo , Neoplasias da Bexiga Urinária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Neoplasias da Bexiga Urinária/enzimologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/urina , Urina/citologia
16.
Urologiia ; (4): 128-136, 2016 Aug.
Artigo em Russo | MEDLINE | ID: mdl-28247740

RESUMO

Focal therapy involving destruction of prostate specific region containing a clinically meaningful tumor is a new treatment for prostate cancer. Despite the absence of long-term results of applying this method of treatment, there are prerequisites that allow to consider focal therapy as a method with a lower risk of side effects typical of conventional treatment. Focal laser thermocoagulation is a developing technique with a number of advantages, the most important of which is the ability to perform the treatment under the real-time magnetic resonance imaging control. This review describes the principles of laser thermocoagulation, and presents the data of already published clinical studies, as well as the eligibility criteria for focal laser thermocoagulation of prostate cancer. The prospects of development of the method are discussed.


Assuntos
Terapia a Laser , Neoplasias da Próstata/cirurgia , Ensaios Clínicos como Assunto , Humanos , Masculino , Seleção de Pacientes
17.
Urologiia ; (6): 100-106, 2016 Dec.
Artigo em Russo | MEDLINE | ID: mdl-28248052

RESUMO

AIM: To assess the results of organ-sparing endoscopic treatment of patients with tumors of the upper urinary tract (UUT). MATERIALS AND METHODS: Twenty four patients underwent percutaneous and ureteropyeloscopic interventions for tumors of the upper urinary tract and were followed up at the Urology Clinic, I.M. Sechenov First MSMU. Retrograde removal of benign tumors of the renal pelvis and ureter (tumors sized from 5 to 35 mm), percutaneous removal of papillary carcinoma of renal pelvis of a solitary kidney, percutaneous removal of papillary carcinoma of renal pelvis of only one functioning kidney and percutaneous removal of papillary carcinoma of the lower calyx of the L-shaped kidney were performed in 21, 1, 1 and 1 patients, respectively. The patients had stage T1 papillary cancer of the upper urinary tract. There were 7 (29.2%) men and 17 (70.8%) women with mean age 64+/-5 years. Electroresection/vaporization was carried out in 18 patients, and 6 patients were treated using Holmium laser. RESULTS: None of the endoscopic procedures required conversion to open surgery or a more extended surgical operation. There were no recurrences or impaired UUT urinary flow in patients with benign UUT tumors at different points of follow-up. In 3 cases of malignant UUT tumors no recurrences occurred during 12-20 months follow-up. CONCLUSION: and discussion. Nephroureterectomy with resection of the urinary bladder is the standard radical treatment of patients with tumors of the UUT. Technological advances in endoscopic and percutaneous surgery for UUT have allowed for organ-sparing procedures in patients with neoplasms of pelvicalyceal system and ureter. The absolute indications for such organ-sparing operations now include solitary kidney or only one functioning kidney and chronic renal failure. Endoscopic resection of the tumor and renal pelvic wall within healthy tissue, including by holmium laser, with tumor stage not exceeding T1 and followed by trans-fistula chemotherapy can be regarded as an effective treatment for patients with tumors of pelvicalyceal system.


Assuntos
Carcinoma Papilar/cirurgia , Neoplasias Pélvicas/cirurgia , Neoplasias Ureterais/cirurgia , Idoso , Carcinoma Papilar/patologia , Endoscopia/métodos , Feminino , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Nefrectomia/métodos , Neoplasias Pélvicas/patologia , Neoplasias Ureterais/patologia
18.
Urologiia ; (6): 142-148, 2016 Dec.
Artigo em Russo | MEDLINE | ID: mdl-28248060

RESUMO

In recent years, the number of organ-sparing operations for renal tumors has been increasing steadily due to comparable oncological outcomes and the desire to preserve functioning renal parenchyma. Another technique, which is becoming increasingly popular, is so-called zero ischemia partial nephrectomy, which allows bleeding to be controlled during the operation without clamping the renal artery, thus avoiding renal ischemic injury. One of the most interesting and promising instruments for partial nephrectomy is a laser radiation. It combines good cutting and coagulating properties, thus enabling partial nephrectomy to be carried out without vascular clamping. This literature review presents the physical basis of laser technology and evidence from published clinical studies on using of various types of laser radiation for partial nephrectomy. The prospects for further development of the technique are discussed.


Assuntos
Neoplasias Renais/cirurgia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Nefrectomia/métodos , Tratamentos com Preservação do Órgão/métodos , Humanos
19.
Urologiia ; (4): 12-6, 18, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26665758

RESUMO

Remaining generally unchanged, urinary tract infection (UTI) treatment protocols require continuing monitoring due to growing antibiotic resistance and lowered immune status of the majority of patients. The article presents the results of a prospective observational program carried out the Russian Federation in to assess the effectiveness and safety of Ceforal®, Solutab® and Uro-Vaksom® in patients with recurrent uncomplicated lower urinary tract infections (FLORA). The results of the program suggest that Ceforal® Solutab® and Uro-Vaksom® administered as a part of routine clinical practice contribute to a significant reduction in the number of UTI recurrences and have a good safety profile. These findings support recommendation to use this treatment protocol in patients with recurrent UTI, taking into account individual and epidemiological features.


Assuntos
Aciclovir/administração & dosagem , Antibacterianos/administração & dosagem , Antivirais/administração & dosagem , Cefixima/administração & dosagem , Infecções Urinárias/tratamento farmacológico , Adulto , Feminino , Humanos , Pessoa de Meia-Idade
20.
Urologiia ; (4): 125-33, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26665780

RESUMO

The review presents the results of studies on combination therapy of 5α-reductase inhibitors and α-blockers in patients with benign prostatic hyperplasia (BPH). These data demonstrate a significant advantage of the combination therapy versus monotherapy in terms of quality of life and subjective symptoms as well as the safety, better results in the prevention of BPH progression and acute urinary retention, and reduced need for surgery.


Assuntos
Inibidores de 5-alfa Redutase/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/tratamento farmacológico , Ensaios Clínicos como Assunto , Quimioterapia Combinada/métodos , Humanos , Masculino , Hiperplasia Prostática/patologia , Neoplasias da Próstata/patologia
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