Saratov JOURNAL of Medical and Scientific Research

ultrasound surgery

Endoscopic correction of obstructive complications after HIFU-ablation of the prostate with holmium laser

Year: 2018, volume 14 Issue: №2 Pages: 272-277
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Shatylko T.V.
Organization: Saratov State Medical University
Summary:

Purpose: to improve the results of treatment of the obstructive complications (an urethra stenosis, a bladder neck sclerosis) caused by application of the high-intensity focused ultrasonic ablation (HIFU) concerning treatment of the localized prostate cancer. Material and Methods. An object of the research included 41 patients, with the infravesical obstruction (IVO) which has arisen in the postoperative period to which elimination the holmium laser is used. Results. The bladder neck was the most frequent place of obstruction. Average time before emergence of the first episode of IVO: 8.2±1.3 months. Distinctions on time before development of an episode of IVO depending on the fact of carrying out TURP before HIFU not confirmed (p=0.440). More advanced age for a moment HIFU-ablation has been associated with much higher frequency of IVO (p=0.021). Considerably smaller frequency repeated was observed by IVO at a larger ratio transurethral resection to the initial volume of a prostate (p=0.031). Duration of a laser endoscopic ure-throtomy was 27 [10-70] minutes, serious perioperative or postoperative complications were not determined. Average term before removal of a catheter of Foley: 3 [1-5] days, hospitalization duration included 4 [3-6] days. After treatment considerable improvement on indicators of the maximum speed of a stream of urine (Qmax) and volume of residual urine was observed. The total score according to the questionnaires of IPSS and QoL has considerably improved, significant changes on symptoms of accumulation are noted. After the first holmium laser urethrotomy of 80.4% of patients have noted satisfactory results without recurrence of IVO; 19.6% of patients were required a repeated laser endoscopic urethrotomy. Recurrence term after the first laser urethrotomy is on average equal to 2.5 months. Conclusion. The endoscopic urethrotomy by means of the holmium laser is safe, effective and minimum invasive type of treatment of a stenosis of a neck of the bladder / urethra after ablative cancer therapy of prostate. The advantages are the minimum of traumas of surrounding tissues and preservation of the mechanism of deduction of urine.

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Возможности прогнозирования рецидива рака простаты после HIFU-аблации с помощью математического моделирования

Year: 2013, volume 9 Issue: №2 Pages: 314-320
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blumberg B.I.
Organization: Saratov State Medical University
Summary:

Research objective: Creation of mathematical prognosis of model of local relapsing tumors in patients with prostate cancer after treatment by high-intensive focused ultrasound (HIFU). Objects and Research Methods: Results of treatment are estimated at 102 patients with morphologically localized prostate cancer proved at biopsy. For the purpose to analyze interrelation of prognostic factors and postoperative morphological research of prostate control biopsies after HIFU ablation with frequent development of relapses comparative statistical research of received data has been conducted. For construction of mathematical models of relapse prognosis after HIFU of prostates two methods of mul-tifactorial analysis of the data have been used: the discriminant analysis and logistical regress. Results: While planning treatment of patients after HIFU ablation of prostates it has been necessary to estimate morphological risk factors of local relapse of a neoplasm such as preoperative level of serum PSA, the sum of Gleason, severity of disease, presence of lymphovascular and perineural invasion. The offered formulas are worth while using in revealing of probability of development of relapses. The comparative analysis of mathematical models has showed that accuracy of prognosis of results of HIFU of prostates is high enough.

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Prognostic factors in the estimation of HIFU treatment efficiency in patients with localized prostate cancer

Year: 2013, volume 9 Issue: №1 Pages: 116-121
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blyumberg B.I.
Organization: Saratov State Medical University
Summary:

Research objective: To study the role of prognostic factors in the estimation of risk development of recurrent prostate cancer after treatment by high-intensive focused ultrasound (HIUF). Objects and Research Methods: The research has included 102 patients with morphologically revealed localized prostate cancer by biopsy. They have been on treatment in Clinic of Urology of the Saratov Clinical Hospital n.a. S. R. Mirotvortsev. 102 sessions of initial operative treatment of prostate cancer by the method of HIFU have been performed. The general group of patients (n=102) has been subdivided by the method of casual distribution into two samples: group of patients with absent recurrent tumor and group of patients with the revealed recurrent tumor, by morphological research of biopsy material of residual prostate tissue after HIFU. The computer program has been used to study the signs of outcome of patients with prostate cancer. Results: Risk of development of recurrent prostate cancer has grown with the PSA level raise and its density. The index of positive biopsy columns

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