Saratov JOURNAL of Medical and Scientific Research

Urology

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.

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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.

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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.

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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.

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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.

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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.

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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.

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Prognostic significance of the assessment of the expression of immunohistochemical markers and the degree of pathomorphism before and after treatment of patients with prostate cancer at high risk of progression

Year: 2019, volume 15 Issue: №2 Pages: 318-324
Heading: Urology Article type: Original article
Authors: Voronina E.S. , Fomkin R.N. , Bucharskaya A.B. , Palatova T.V. , Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University
Summary:

Purpose: to analyze the expression of immunohistochemical markers in patients with prostate adenocarcinoma at high risk of progression before and after combined and combined treatment of patients with prostate specific antigen (PSA) level of blood below discriminatory. Material and methods. Examined patients (n = 80) with a diagnosis of “High-risk progression prostate cancer,” with clinical stage T3a, total score for Gleason scale from 8 to 10, the level of total PSA more than 20 ng / ml. Patients of the 1st group (n = 42) only combined surgical treatment in the scope of TUR and HIFU ablation the prostate; The 2nd group of patients (n = 38) additionally applied androgen deprivation in adjuvant mode. Results. Blood PSA, determined in patients after various methods of treatment is not always an objective indicator of its effectiveness. Immunohistochemical studies of tumor tissue for proliferative activity tumor cells, the activation of apoptosis in them, as well as the assessment of specific tumor markers and tumor suppressor genes showed that a decrease in the expression of these markers in patients with PSA values ​​of blood lower than discriminatory observed in all patients independently on the type of treatment. However, after treatment in the 1st group of patients, despite the achievement PSA level of nadir, there is a decrease in the expression of an intercellular adhesion marker E-cadherin, which indicates an increased risk of tumor metastasis, as well as increased expression of markers of the apoptosis inhibitor Bcl-2 and androgens, which indicates about the possibility of progression of tumor growth. Conclusion For a more accurate assessment therapeutic pathomorphism in patients with prostate cancer at high risk of progression, which HIFU ablation monotherapy was carried out, along with the determination of blood PSA level, it is necessary during the control biopsy of the prostate immunohistochemical studies of tumor tissue to determine the prognosis and risk of relapse.

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The value of tumor markers in prognos-ing the outcomes of treatment of patients with bladder cancer

Year: 2018, volume 14 Issue: №4 Pages: 661-666
Heading: Urology Article type: Review
Authors: Ponukalin A.N., Zakharova N.B., Skriptsova S.A., Fomkin R.N., Chekhonatskaya M.L.
Organization: Saratov State Medical University n.a. V I. Razumovsky, Scientific Research Institute of Fundamental and Clinical Uronephrology, Saratov State Medical University
Summary:

The review analyzes the recent publications of the results of the use of molecular genetic markers of bladder cancer (RMP) in clinical practice. The prospects of application of a series of molecules determined in tumor tissue, serum, urine in the diagnosis of RMP are presented. One ofthe most promising areas of finding a marker forthe diagnosis and control of treatment of RMP in recent years are the study ofthe proteomic composition of urine.

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Biomarkers of renal damage and immunohistochemical detection of oncogenesis in the surgical treatment of renal cell carcinoma

Year: 2018, volume 14 Issue: №3 Pages: 420-426
Heading: Urology Article type: Original article
Authors: Tarasenko A.l., Rossolovsky A.N., Berezinets O.L., Ponukalin A.N., Medvedeva A.M., Zakharova N.B., Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University, I.M. Sechenov First Moscow State Medical University
Summary:

Objective: to assess the possibility of using markers of renal injury and carcinogenesis as additional criteria for the choice of the method of surgical treatment of RCC and to minimize the risk of development and progression of kidney injury. Material and Methods. 60 patients with morphologically confirmed RCC T1-3M0N0 operated on in the volume of open nephrectomy or laparoscopic nephrectomy or laparoscopic resection and the kidney were examined. Patients were divided into 3 groups: group 1: patients after nephrectomy performed for kidney cancer using traditional surgical technique, group 2: patients after laparoscopic nephrectomy and group 3: after laparoscopic resection of kidney tumor. Before surgical operation, on the 5-7 day and after 1 month, all patients were examined by concentrations of urinary excreted lipocalin 2 (NGAL), and serum concentrations of IL-18, MMP-9 and IGF-1. Renal function was estimated using the calculated GFR equation (CKD-EPI 2009) based on serum creatinine level. Immunohistochemical study of histological preparations of distant tumors on proliferation antibodies (Ki-67, PCNA), apoptosis (BAX, Bcl-2) was performed. Differences in clinical data and clinical variables were compared using Spearman rank correlations and t-test. Results. The studied indices of renal damage of IL-18, NGAL, MMP-9 and IGF-1 both in the early (5-7 days) and later (1 month) postoperative period showed a correlation between the surgical intervention method and the degree of tumor cell differentiation. Conclusion. The levels of biomolecular markers of renal damage (IL-18, NGAL, MMP-9 and IGF-1) correlate with the degree of differentiation in thetumoral cells and functional activity of the remaining renal parenchyma in the postoperative period, but also depend on the individual characteristics of the patient's body. A certain level of expression of MMP-9 and IL-18 with a small tumor size can be a guide to determine the indications for the choice of organ-preserving surgery in patients.

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