Saratov JOURNAL of Medical and Scientific Research

Mozes K.B.

Kemerovo State Medical University, Assistant of Department of Poly clinic Therapy and Nursing

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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Comparative analysis of efficiency of two techniques of endoscopic organ sparing surgery at ectopic tubal pregnancy

Year: 2019, volume 15 Issue: №1 Pages: 14-18
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Fetisheva L.E., Mozes V.G., Mozes K.B.
Organization: Kemerovo State Medical University
Summary:

Aim: to compare the effectiveness of salpingostomy with the subsequent evacuation of the ovum and the resection of a part of the ampulla of the fallopian tube with the ovum and the subsequent neostomatoplasty in the treatment of tubal pregnancy. Material and Methods. A retrospective randomized study of the effectiveness of two techniques of endoscopic organ-sparing surgical treatment of ectopic tubal pregnancy was conducted. Results. The time for performing salpingostomy and resection was 11.8±1.5 minutes and 21±2 minutes, respectively (U[12458]=0, p=0.001). Compared with salpingostomy, the thread did not lead to the appearance of a trophoblast, which was accompanied by a decrease in the degree of adhesions in the pelvis in the third month of observation (PAI showed 2 (2; 2) and 0 (0; 1) points, respectively U =759, p=0.001; R-AFS corresponded to the minimum degree of severity: 2(0; 2) and 0 (0; 0) points, respectively (U4 =1076, p=0.001); according to the modified classification of the degree of adhesions in the pelvis after cesarean section corresponded to the minimum degree of severity: 4 (0;4) and 0 (0;4) points, respectively (U[12458]=2617, p=0.006)and more frequent the operated fallopian tube (30.6% and 58,6%, respectively, p=0.001)was accompanied by a more frequent onset of spontaneous uterine pregnancy by the 12th month of observation (12.9% and 29,3%, respectively, p=0.007) and delivery to 18 months of observation (3.2% and 15.5%, respectively, p=0.001). Conclusion. Despite the higher technical complexity, resection of a part of the ampulla of the fallopian tube with a fetal egg and subsequent neostomatoplasty is an effective alternative to salpingostomy andmay be used in women with an ectopic pregnancy wishing to preserve reproductive function.

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Comparative analysis of efficiency of two techniques of endoscopic organ sparing surgery at ectopic tubal pregnancy

Year: 2019, volume 15 Issue: №1 Pages: 14-18
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Fetisheva L.E., Mozes V.G., Mozes K.B.
Organization: Kemerovo State Medical University
Summary:

Aim: to compare the effectiveness of salpingostomy with the subsequent evacuation of the ovum and the resection of a part of the ampulla of the fallopian tube with the ovum and the subsequent neostomatoplasty in the treatment of tubal pregnancy. Material and Methods. A retrospective randomized study of the effectiveness of two techniques of endoscopic organ-sparing surgical treatment of ectopic tubal pregnancy was conducted. Results. The time for performing salpingostomy and resection was 11.8±1.5 minutes and 21±2 minutes, respectively (U[12458]=0, p=0.001). Compared with salpingostomy, the thread did not lead to the appearance of a trophoblast, which was accompanied by a decrease in the degree of adhesions in the pelvis in the third month of observation (PAI showed 2 (2; 2) and 0 (0; 1) points, respectively U =759, p=0.001; R-AFS corresponded to the minimum degree of severity: 2(0; 2) and 0 (0; 0) points, respectively (U4 =1076, p=0.001); according to the modified classification of the degree of adhesions in the pelvis after cesarean section corresponded to the minimum degree of severity: 4 (0;4) and 0 (0;4) points, respectively (U[12458]=2617, p=0.006)and more frequent the operated fallopian tube (30.6% and 58,6%, respectively, p=0.001)was accompanied by a more frequent onset of spontaneous uterine pregnancy by the 12th month of observation (12.9% and 29,3%, respectively, p=0.007) and delivery to 18 months of observation (3.2% and 15.5%, respectively, p=0.001). Conclusion. Despite the higher technical complexity, resection of a part of the ampulla of the fallopian tube with a fetal egg and subsequent neostomatoplasty is an effective alternative to salpingostomy andmay be used in women with an ectopic pregnancy wishing to preserve reproductive function.

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2019_1_014-018.pdf386.96 KB