Urologiya

Application of augmented anastomotic urethroplasty with buccal graft in treatment of decompensated posttraumatic urethral stricture of bulbar urethra (case report)

2023-11-21T15:03:44+02:00

Introduction: treatment of decompensated urethral stricture is a challengeable issue of modern operative urology. Presented case of successful operative treatment of complex stricture of bulbous urethra with combination of anastomotic technique and augmentation by buccal graft. Case presentation: 54-years old male admitted to urology clinic of National Military Medical Clinical Center for the decompensated bulbous urethra stricture, previously repeatedly treated by internal optical urethrotomies and dilatations. During examination, almost complete obliteration of 4 cm segment of urethra was detected. Augmented anastomotic urethroplasty with application of buccal graft as substitution material was performed. After excision of obliterated and adjacent fibrous parts of urethra, end to end anastomosis on the ventral semicircle of urethra was performed with subsequent augmentation of defect on the dorsal wall by oral mucosa patch fixed to cavernous bodies. No recurrence observed after 5 months of observation. Augmented anastomotic urethroplasty is useful for treatment of complex posttraumatic strictures of bulbous urethra. Practicing urologists should know indications to all reconstructive treatment options and avoid repeated ineffective attempts of dilatations.

Significant and jubilee dates in the history of urology and related areas in 2023

2023-12-15T11:08:47+02:00

Significant and jubilee dates in the history of urology and related areas in 2023

Pathophysiology of the excretory system in case of general unintentional overheating of the body (scientific and literary review)

2023-11-21T14:47:58+02:00

Due to the global warming of the climate, unintentional general overheating of the body is a certain problem among the military, workers of "hot enterprises", agricultural workers, etc. With heat stress, acute kidney damage is caused in 25-35% of cases, and with heat stroke it exceeds 50% and requires renal replacement therapy and is accompanied by significant mortality. Chronic or repeated episodes of heat stress with dehydration ultimately lead to abnormal repair mechanisms, renal fibrosis, urolithiasis, vascular refinement, and glomerulosclerosis. The authors hope that the collected material will be useful for medical workers to help victims of accidental general overheating.

External beam radiation therapy proves to be radical treatment for very high risk localized prostate cancer in active elderly patient

2023-11-21T14:09:00+02:00

We present the case report of radical treatment of localized very high risk prostate cancer (рТ2сN0M0 Gleason score 5+5=10, GG5/5, initial total PSA=5 ng/ml) in active elderly patient by IMRT radiotherapy on linear accelerator Novalis Tx with definitive treatment dose 66 Gy without concomitant hormonal therapy. Efficiency of radiotherapy was demonstrated by PSA nadir <0.003 ng/ml, complete pathological response and absence of vital malignant tissue on histological study. The pathology study of the eradiated prostate gland was performed two years after radiotherapy on the specimen obtained after radical cystprostatectomy due to recurrent high-grade muscle-invasive bladder cancer. This way we could confirm that IMRP radiotherapy with dose of 66 Gy is a radical treatment of very high risk localized prostate cancer.

Levels of quality of life in patients with muscle invasive bladder cancer after organ-preserving treatment

2023-11-21T14:32:55+02:00

The aim of the study was to analyze the quality of life of MIBC patients’ life after RC with orthotopic ileal neobladder, after partial cystectomy (PC) with adjuvant radiotherapy (RT) and after PC with adjuvant chemotherapy (CT). A retrospective analysis of 120 MIBC patients who were treated at the Kyiv city clinical oncological center which is the base of SI “Institute of urology named after academic O.F. Vozianov” NAMS of Ukraine during the period from 2008 to 2019 was performed. The patients were divided into 3 groups depending on the intervention extent. The 1^st one included patients after RC (42), group 2 consisted the patients after PC and adjuvant RT , group 3 consisted the patients after PC and adjuvant CT . The patients' quality of life has been assessed by three questionnaires – EORTC QLQ-C30, EORTC SHQ-C22, ICIQ-UI. The results of the study confirm better quality of life after PC with adjuvant CT, especially with regard to physical condition, patients' adaptation in society (social scale), financial toxicity, gastrointestinal tract functioning (according to symptoms of vomiting, nausea and diarrhea). Our study has confirmed that PC can provide adequate control of MIBC in the individual cases and showed that it offers patients a good chance of long-term bladder preservation providing satisfactory overall postoperative health and quality of life. A critical approach should be taken into consideration when choosing the most appropriate regimen for treatment of MIBC and considering between radical cystectomy or partial cystectomy. However, it is important to inform patients that organ-preserving treatment allows them to achieve a better quality of life, the treatment process may be longer than that after radical cystectomy.

Evaluation of the activity of energy and biosynthetic processes as a screening for the course of acute experimental pyelonephritis under the influence of pharmacological monitoring

2023-11-21T11:45:41+02:00

In the aspect of studying the prerequisites for the development of diabetic nephropathy, it seems appropriate to study in depth individual enzyme systems that are directly related to the respiratory chain of mitochondria, the implementation of endothelial functions, and biosynthetic processes. Nicotinamide adenine dinucleotide (NAD) has key functions: it is an important coenzyme in the electron transfer reaction and a coenzyme for NAD-dependent enzymes. The role of NAD in electron transfer reactions is significant, since more than 400 enzymes require NAD and nicotine amide adenine dinucleotide phosphate (NADP), mainly to accept or donate electrons for redox reactions, that is, energy reactions in mitochondria and biosynthetic processes. The aim of the study was to study the role of pyridine nucleotides in the pathogenesis of acute pyelonephritis (AP) and concomitant diabetes mellitus in an experiment with the use of drug exposure. It has been established that the use of etiotropic-pathogenetic drug effect (EPDE) in comparison with etiotropic drug effect (EDE) creates a pronounced normalizing effect on the level and ratio of the forms of the coenzyme system NAD / NADH and NADP / NADPH, contributing to a decrease in the level of the reduced form of NAD increased in AP and type I diabetes and an increase in the content of NADPH in the kidneys, as well as decrease in the level of NADP and NADPH in AP and type II diabetes by 17.9% and 36.3%, The results of experimental biochemical studies obtained by us convincingly prove the expediency of the clinical use of EPDE in order to increase the effectiveness of the corrective effect on pathological changes and prevent the complicated course of diabetic nephropathy.

Frequency and prevention of stent-related pathological symptoms after uretero- and pyelolithotripsy

2023-11-21T12:13:50+02:00

The frequency of stent-related pathological symptoms was studied in 38 patients who had internal JJ stents installed after ureterolithotripsy (10 patients) and pyelolithotripsy (28 patients), and the effectiveness of their drug correction was studied. We found out that internal stents cause the development of pathological symptoms in patients are dysuria, nocturia, pain and such formidable complication the acute reflux - pyelonephritis. Drug pathogenetic therapy with silodosin and oxybutynin hydrochloride prevents the development of stent-related pathological symptoms.