Saratov JOURNAL of Medical and Scientific Research

Urology

Clinical significance of cystatin С and TGF-01 in the assessment of renal function in the surgical treatment of renal cell carcinoma

Year: 2020, volume 16 Issue: №3 Pages: 786-792
Heading: Urology Article type: Original article
Authors: Tarasenko A.I., Rossolovsky A.N., Berezinets O.L., Durnov D.A., Chekhonatskaya M.L., Loiko V.S., Bobylev D.A., Maslyakova G.N.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Objective: to evaluate the possibility of using cystatin С and TGF-p as prognostic markers of renal impairment and unfavorable oncological results of surgical treatment of renal cell carcinoma (RCC). Material and Methods. We examined 60 patients with RCC. Patients were divided into 3 groups: with RCC after nephrectomy (group 1); after laparo-scopic nephrectomy (group 2); after laparoscopic resection of the tumor (group 3). All patients before the operation on the 7th-10th day, after 1-3 years of postoperative follow-up, the concentrations of cystatin С and TGF-p in the blood serum were studied by solid-phase ELISA. Results. The majority of patients in the groups showed a significant decrease in glomerular filtration rate (GFR) compared to the control, and 3 years after nephrectomy, most patients had stage C3A chronic kidney disease (CKD). The Cystatin С content in all groups of patients with RCC had a statistically significant increase compared to the control (2664, 3103, and 2709 ng/ml in groups 1.2 and 3 versus 143 ng/ml, respectively) (p<0.05). Conclusion. In the majority of patients with RCC, postoperative initiation and progression of "surgical" CKD occurs, which persists 3 years after surgical treatment. Cystatin С can be considered as a predictor of high antitumor activity in patients with RCC, and requires monitoring in the long-term postoperative period.

AttachmentSize
2020_03_786-792.pdf942.21 KB

Morphological changes of the bladder wall of fetuses with antenatally detected syndrome "megacystis"

Year: 2020, volume 16 Issue: №3 Pages: 779-785
Heading: Urology Article type: Original article
Authors: Deryugina L.A., Napsheva A.M., Medvedeva A.V., Rozhkova D.V., Maslyakova G.N.
Organization: Saratov State Medical University
Summary:

Objective: To determine the morphological features of the structure of the wall of the urinary bladder of the fetus with antenatally identified syndrome "megacystis". Material and Methods: Morphological investigations of the bladder wall of 11 fetuses of 12-21 weeks of gestation with diagnosed "megacystis" syndrome, obtained as a result of the termination of pregnancies, were carried out. The study was carried out using survey method, histochemical and immunohisto-chemical staining methods. Results: In all cases, the structure of the bladder wall with diagnosed syndrome "megacystis" sharply differed from the norm. The changes affected all layers, but the most pronounced pathological processes developed in the muscle layer, which did not differentiate into layers, the process was accompanied by a violation of the course of muscle fibers. Detrusor hypotrophy was observed in fetuses up to 18 weeks of gestation, the thickness of which decreased on average by 1,8 times. In fetuses with a gestational age of 21 weeks, the hypertrophic variant of the detrusor prevailed with an increase in its thickness by 2,6 times. In all cases, there was a significant depletion of the muscle wall with blood vessels up to 6% of the norm and a decrease in the number of nerve fibers to 24%. Conclusion. The study allowed to distinguish two variants of changes in the bladder at the syndrome "megacystis": "hypertrophic variant", characterized by an increase in the thickness of the muscle layer, and "hypotrophic variant", characterized by a decrease in the thickness of the muscle layer, which fits into the diagnostic concept of "detrusor dysplasia".

AttachmentSize
2020_03_779-785.pdf1.29 MB

Urolithiasis: modern concepts of etiology of disease (review)

Summary:

Urolithiasis is a polyetiological disease that occupies an important place in the practice of urologist. In the treatment of urolithiasis, the main approach is a search for the cause of disease and competent correction of existing disorders. It is especially important to know the etiology and risk factors of urolithiasis, which is the subject of this literature review. In this article, we look at inhibitors of stone formation, genetic aspects of the disease, risk factors in detail (bariatric surgery, inflammatory bowel disease, colonization of the intestine by Oxalobacter formigenes, renal SLC26A6 expression), relationship between urolithiasis and vitamin D. To review the literature, a search was performed in electronic databases, such as eLIBRARY, Embase, MEDLINE, Scopus, Web of Science, from January 1, 2000 to April 1, 2020, which considered the etiology and risk factors of urolithiasis. For the search, we used keywords and their combinations: "urolithiasis", "risk factors", "etiology". A total of 49 literature sources were analyzed.

AttachmentSize
2020_03_773-779.pdf366.49 KB

Efficiency of the installation of suburetral loop by different methods in women with stress urinary incontinence

Year: 2020, volume 16 Issue: №1 Pages: 73-76
Heading: Urology Article type: Original article
Authors: Eizenakh I.A., Rakitin F.A., Mozes V.G., Mozes K.B., Zakharov I.S.
Organization: Novokuznetsk City Clinical Hospital №1, Kemerovo State Medical University, Institute of Cytology, Russian Academy of Sciences
Summary:

The aim: to assess the effectiveness of the installation of a suburethral loop with fixation in the obturator membrane in various ways in case of stress urinary incontinence in women. Material and Methods. 191 women aged from 35 to 65 years old were selected with stress urinary incontinence, which were installed with a suburethral loop with fixation in the obturator membrane in various ways: using an in-out trocar method (group A, n=65); trocar out-in method (group B, n=67); without trocar method in-out (group C, n=59). Randomization of patients into groups was carried out by random numbers. As the primary outcome of the installation of a suburethral loop with fixation in the obturator membrane, the frequency and severity of stress urinary incontinence recurrence was studied using a cough test and a Valsalva test after 12, 36 and 60 months. The timing of surgery, the structure and frequency of the immediate postoperative complications were evaluated as secondary outcomes. Results. The time of the operation in group Awas 31 (30; 33) minutes, in group В 53 (52; 54) minutes, in group С 29 (28; 30) minutes, respectively, F12=1908; p=0,001. Stress incontinence recurrence within 12 months after surgery developed in 3.1 % in group A, 0% in group В and 5.1 % in group С (p =0,14; pAC=0,57; p =0,061); within 36 months after surgery in 7.6; 0; 10.1%, respectively (p =0,02; pAC=0,628; pBC=0,007); for 60 months after the operation in 24.6; 11.9; 28.8%, respectively (pAB=0,017; p =0,421; pBC=0,018). Conclusion. Despite the longer time to perform surgery and greater technical complexity, the installation of a suburethral loop with fixation in the obturator membrane by the out-in trocar method is accompanied by a lower incidence of early postoperative complications and recurrence of the disease.

AttachmentSize
2020_01_073-076.pdf356.29 KB

Evaluation of the development time and characteristics of the clinical manifestations of chronic prostatitis/chronic pelvic pain syndrome in men, taking into account the age and body weight according to UPOINT classification

Year: 2020, volume 16 Issue: №1 Pages: 69-72
Heading: Urology Article type: Original article
Authors: Popkov V.M., Loyko V.S., Mikhaylov I.V.
Organization: Kuban State Medical University, Saratov State Medical University
Summary:

Objective: to study the terms and clinical features of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) development using UPOINT classification in men from 32 to 60 age depending on body weight. Material and Methods. A total of 121 men with CP/CPPS with various body weight aged by 32-60 years were observed. Body Mass Index (BMI) was used to prove absence or presence of overweight and obesity. The diagnosis of CP/CPPS in patients was based on the information of anamnesis, analysis of health cards and case histories. Differential diagnosis of CP/CPPS forms was organized by the cytological and bacteriological studies of prostatic secretion. Results. Only 26.4% of patients with CP/CPPS showed normal body weight. It was observed that in men with excess body weight and obesity the CP/CPPS developed at more earlier periods of their life. The differences of phenotype and clinical manifestations in patients with obesity and normal body index were determined according to the UPOINT classification. Conclusion. The risk of chronic pelvic pain syndrome development in men with obesity (BMI>30) under the 45 years increases in 2.3 times compared to men with normal body weight. The results of men phenotyping with chronic pelvic pain syndrome and obesity snowed the prevalence for P, О and N domains from UPOINT classification thus represent the predominance of disuric symptoms with expressed psychogenic features on the background of pain feelings outside the pelvis.

AttachmentSize
2020_01_069-072.pdf294.04 KB

Basic principles of prenatal counseling by a pediatric urologist: challenges and opportunities

Year: 2019, volume 15 Issue: №4 Pages: 884-887
Heading: Urology Article type: Author's opinion
Authors: Deryugina L.A.
Organization: Saratov State Medical University
Summary:

This publication is based on the results of the accumulated experience of a practicing pediatric urologist during prenatal counseling in the framework of the regional prenatal consultation and is the result of long-term research work in the field of pediatric urology, fetal urology, prenatal ultrasound diagnosis of urinary system defects. The system of prenatal diagnosis of urinary system pathology proposed in the article will significantly increase the reliability of antenatal diagnosis and prognosis, plan the timing, scope and tactics of treatment activities carried out as early as possible after birth at the stage of preclinical manifestations. To do this, it is assumed, firstly, the creation of a group of perinatal observation of patients; secondly, the use of evaluation and interpretation of ultrasound data that determine the level and nature of urodynamic lesions of the fetal urinary system, the severity of urinary tract dilatation, the preservation of renal parenchyma, which is the basis for prenatal diagnosis, evaluation of prospective kidney function. The signs of prognostically unfavorable malformations of the urinary system, in which the question of termination of pregnancy is discussed, are highlighted.

AttachmentSize
2019_04_884-887.pdf280.51 KB

Possibilities of radiological methods in the diagnosis of bilateral uroepithelial cancer (clinical case)

Year: 2019, volume 15 Issue: №3 Pages: 666-668
Heading: Urology Article type: Case report
Authors: Chekhonatskaya M.L., Rossolovsky A.N., Kryuchkov I.A., Kondratyeva O.A., Bobylev D.A., Klimashin D.F., Kondratyeva D.A., Zuev V.V., Gladkov V.A.
Organization: Saratov State Medical University
Summary:

The article presents data on the development of urothelial cancer and methods of its diagnosis. A clinical case of diagnosis of bilateral uroepithelial cancer in a patient by magnetic resonance imaging is described.

AttachmentSize
2019_03_666-668.pdf275.62 KB

Magnetic resonance imaging in the diagnosis of bladder cancer (review)

Year: 2019, volume 15 Issue: №3 Pages: 662-666
Heading: Urology Article type: Review
Authors: Bobylev D.A., Chekhonatskaya M.L., Rossolovsky A.N., Ponukalin A.N., Kryuchkov I.A., Kondratieva O.A., Zakharova N.B., Abramova A.P., Popkov V.M.
Organization: Saratov State Medical University
Summary:

The current review represents possibilities of magnetic-resonance imaging in bladder cancer diagnostics. The most important indicator that determines the bladder cancer prognosis and surgical treatment tactics is the muscle wall invasion. Dynamic-contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging can determine the depth of invasion, although although both are susceptible to over-staging. Magnetic resonance imaging and computed tomography have approximately the same accuracy in determining perivesical invasion as well as in relation to metastatic lymph nodes less than 8 mm in diameter. A promising new technique is the ultra-small paramagnetic iron oxide particles-enhanced magnetic resonance imaging.

AttachmentSize
2019_03_662-666.pdf313.28 KB

Principles of the program of enhanced recovery of patients after radical prostatectomy

Year: 2019, volume 15 Issue: №2 Pages: 324-327
Heading: Urology Article type: Review
Authors: Pavlov V.N., Tarasenko A.I., Korelov Yu.A., Maksimova S.Yu., Khotko D.N., Khotko A.I.
Organization: Bashkir State Medical University of the Russian Health Care, I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Analysis of statistical data on cancer incidence shows a high prevalence of such diseases as prostate cancer. The existing methods of treatment of this pathology are efective, but the question of reducing the surgical stress of patients who underwent surgery, reducing the number of complications, early mobilization and early recovery remains relevant. The presented literary review reveals the provisions proposed in the XX century, multimodal strategy «Fast track sur-gery», revealing the tactics of surgical patients throughout the perioperative period. The application of this protocol shows its efectiveness in reducing the duration of hospitalization and early rehabilitation of the considered group of patients.

AttachmentSize
2019_02_324-327.pdf274.46 KB

Principles of the program of enhanced recovery of patients after radical prostatectomy

Year: 2019, volume 15 Issue: №2 Pages: 324-327
Heading: Urology Article type: Review
Authors: Pavlov V.N., Tarasenko A.I., Korelov Yu.A., Maksimova S.Yu., Khotko D.N., Khotko A.I.
Organization: Bashkir State Medical University of the Russian Health Care, I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Analysis of statistical data on cancer incidence shows a high prevalence of such diseases as prostate cancer. The existing methods of treatment of this pathology are efective, but the question of reducing the surgical stress of patients who underwent surgery, reducing the number of complications, early mobilization and early recovery remains relevant. The presented literary review reveals the provisions proposed in the XX century, multimodal strategy «Fast track sur-gery», revealing the tactics of surgical patients throughout the perioperative period. The application of this protocol shows its efectiveness in reducing the duration of hospitalization and early rehabilitation of the considered group of patients.

AttachmentSize
2019_02_324-327.pdf274.46 KB