Experimental and Сlinical Urology最新文献

{"title":"Urethral strictures as a complication of transurethral prostate surgery.","authors":"L. M. Sinelnikov, V. Protoshchak, P. O. Kislitsyn, T. Gasanbekov, E. I. Proskurevich, D.A. Galiuk","doi":"10.29188/2222-8543-2023-16-2-58-66","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-58-66","url":null,"abstract":"Introduction. The inclusion of antibiotic therapy into clinical practice in the second half of the 20th century radically changed the «etiological landscape» of urethral stricture disease. Against the background of a decrease in the proportion of inflammatory strictures, the introduction of new technologies, the spread of transurethral interventions in urology has led to an increase in the incidence of iatrogenic strictures. The purpose of this review is to systematize risk factors for urethral strictures after transurethral prostate surgery. Materials and methods. A search was made for the keywords «transurethral resection of the prostate», «urethral stricture», «iatrogenic urethral strictures», «urethral injuries» in the databases PubMed, eLibrary, Scopus, EMBASE, websites of professional associations. 58 publications were selected for review and analysis, 5 of which are domestic. Results. The influence of the following factors was analyzed: the method of energy supply, the type of energy, the method of removing prostatic tissue; instrument diameter and anatomical features of the patient; resection speed, operation time and volume of removed prostatic tissue; urinary tract infection; electrical damage; other risk factors for TURP. Conclusion. The proven factors include: the diameter of the instrument, operating times, urinary tract infection. Probable factors should be considered the anatomical features of the patient: «narrow urethra», a short penile suspensory ligament.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117175492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antegrade extraperitoneoscopic revascularization of the penis in the treatment of vasculogenic erectile dysfunction.","authors":"A. Mustafaev, P. Kyzlasov, G. Abuev, E. V. Volokitin","doi":"10.29188/2222-8543-2023-16-2-91-98","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-91-98","url":null,"abstract":"Introduction. Erectile dysfunction (ED) is a multifaceted and widely prevalent problem in modern medicine. The problem of erectile dysfunction has not only medical but also social significance – the presence of erectile dysfunction in men has a deleterious effect on their quality of life. One of the few pathophysiologically substantiated surgical methods of treatment for vasculogenic erectile dysfunction is penile revascularization. Objective. To evaluate the effectiveness of antegrade extraperitoneoscopic penile revascularization in patients with vasculogenic erectile dysfunction, to develop an algorithm for selecting patients with vasculogenic ED suitable for penile revascularization surgery. Materials and methods. From 2015 to 2022, 65 penile revascularizations were performed in patients with vasculogenic ED. All patients were divided into 2 groups. In the main group, antegrade extraperitoneoscopic penile revascularization was performed in 34 patients, while in the control group, penile revascularization was performed in 31 patients according to the Virag-Kovalev method. To assess the results of the treatment, we used the scales and questionnaires IIEF-5, QoL, and the evaluation of penile rigidity on the Erection Hardness Score (EHS) scale. We also compared the duration of surgery and length of hospital stay. Results. The duration of surgery in the main group was significantly shorter (p <0.01) than in the control group. Additionally, the length of postoperative hospital stay was significantly shorter (p <0.05) in the main group. When comparing patients, there was a significant statistical difference in IIEF-5, EHS, and QoL scores. Conclusions. Penile revascularization, particularly the antegrade revascularization method, is an effective method for treating ED. The proposed methodology, based on the shortcomings of previous methods, is the most effective and least invasive of all the presented options. The success of penile revascularization surgery directly depends on careful patient selection and surgeon experience.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"106 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130650212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of the use of suburethral loop plastic surgery with tension control in the treatment of urinary incontinence.","authors":"G. Kasyan, S. Sukhikh, Y. Kupriyanov, R. V. Stroganov, D. Pushkar","doi":"10.29188/2222-8543-2023-16-2-160-164","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-160-164","url":null,"abstract":"Introduction. Urinary incontinence is a disease that significantly reduces the quality of life in patients. Suburethral loop plasty is still the gold standard for the treatment of stress urinary incontinence, which is highly effective, but also has a number of possible postoperative complications. The purpose of this article is to evaluate the long-term results (after 4 years), the effectiveness and safety of the use of suburethral loop plasty with tension control. Materials and methods. Currently, there is no single way to adjust the tension of the hinge during its installation. At the Department of Urology of A.I. Yevdokimov Moscow State University of Medicine and Dentistry developed a device to control the tension of the loop, presented in the form of a self-absorbable pad (damper layer) located in the middle of a synthetic prosthesis. A prospective, comparative, randomized study that began in 2018 showed a high efficacy and safety profile for this device. When analyzing the results 1 year after the operation, the effectiveness of surgical treatment was 96%, the rate of postoperative complications in the form of infravesical obstruction was 2%, de novo urgency in the study group was 6%. In this study, we assessed long-term mid-term outcomes (over 4 years) through a telephone survey and filling in validated questionnaires (Urogenital distress inventory – UDI-6, Incontinence Impact Questionnaire – IIQ-7) among patients who underwent suburethral loop plasty with a loop tension control device. Results. The average score on the UDI-6 survey was 1.22 ±0.81, and 1.2±0.77 on the IIQ-7 survey. After a telephone survey after 48 months, there was a slight increase in scores, when compared with the results of the survey 12 months after surgical treatment, but not statistically significant (p>0.05). In the analysis of individual clinical cases after 48 months, 10 patients noted worsening of symptoms. Of these, 6 patients noted a recurrence of urinary incontinence when coughing, physical activity. Accordingly, the subjective effectiveness of surgical treatment over a 4-year follow-up period was 88%. Conclusions. Efficacy and safety data, in the medium-term follow-up of patients after suburethral loop plasty with tension control, are comparable to world data. However, further monitoring of patients in the long term is required.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134479249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of the drug pidotimod in combination with antibiotic therapy with nifuratel in the treatment of chronic recurrent cystitis in women.","authors":"П.И. Раснер, Александр Евгеньевич Шульженко, A. A. Серегин, P. Rasner, A. Shulzhenko, A. Seregin, Многоцентровое Клиническое, Исследование","doi":"10.29188/2222-8543-2023-16-2-140-150","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-140-150","url":null,"abstract":"Introduction. Cystitis is the most common clinical manifestation of lower urinary tract infection. The main reasons for the high incidence and frequent recurrences of cystitis is a decrease in the body's immunological resistance. Aim of the study. To evaluate the long-term results of treatment of patients with chronic recurrent cystitis (CRC) with a combination of a nitrofuran preparation and immunomodulatory therapy. Materials and methods. The PiNCet is a multicenter prospective observational program that was conducted from October 2021 to April 2022 in clinical centers in 19 Russian cities. 447 women aged 34 ± 8 years with a diagnosis of CRC in the acute stage received simultaneously nifuratel (Macmiror®) 400 mg 3 times a day for 7 days and pidotimod (Imunorix®) 800 mg 2 times a day for 14 days from followed by a transition to the maintenance regimen of pidotimod 800 mg once a day for another 60 days. Observation for six months included 4 visits – 14; 30±7; 90±7 and 180±7 days after the start of therapy. The primary endpoint was the frequency of exacerbations of CRC during 6 months of follow-up. The rate of resolution of the clinical picture of the disease, using Acute Cystitis Symptom Score (ACSS)), and the safety profile of therapy were also evaluated. Statistical data processing was carried out using the StatTech v. 2.8.8 Results. The percentage of patients with at least one exacerbation of CRC by the 1st, 3rd and 6th month of follow-up was 2%, 9% and 13.9%, respectively. More than 86% of patients (385/447) were free of recurrence within 6 months of follow-up. There was a significant decrease in the frequency of CRC episodes during six months against the background of the prescribed therapy in comparison with the baseline data (0.1 vs. 2.5, respectively, p <0.001). Only one patient had two relapses during 6 months of follow-up. The dynamics of total scores on the ACSS scale on the 14th, 30th, 90th and 180th days of observation showed a significant improvement in all indicators, including quality of life, while maintaining the result throughout the entire observation period. In 95% of cases, the therapy was well tolerated. Adverse events were detected in 6.7% of cases (30 out of 447). In 2 patients, temporary discontinuation of therapy was required due to exacerbation of chronic diseases of the gastrointestinal tract. Conclusion. The use of pidotimod in combination with antibiotic therapy with nifuratel allows achieving remission of chronic cystitis in 86% of patients during 6 months of follow-up. This treatment regimen is an effective and safe solution to the problem of optimizing therapy in patients with chronic recurrent cystitis.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117274195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human papillomavirus infection and possibilities of improving the effectiveness of therapy for recurrent anogenital warts.","authors":"N. Chernova, N. Frigo, A. Atabieva, E. Mayorova","doi":"10.29188/2222-8543-2023-16-2-126-132","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-126-132","url":null,"abstract":"Introduction. In recent years, there has been an increase in the number of cases of anogenital warts, with localization in the urethra, which present significant difficulties in management tactics due to the high frequency of relapses, progression of clinical manifestations and damage to underlying tissues. According to a systematic review including PubMed and EMBASE data, severe anogenital warts may be associated with a decrease in local and systemic immunity, a decrease in the level of vitamin 25(OH)D and zinc in the blood serum. The search for methods to increase the effectiveness of therapy for anogenital warts is a very urgent problem. The aim of the study was to develop a method for increasing the effectiveness of combined therapy for recurrent anogenital warts. Materials and methods. The study included 25 men aged 24 to 50 years, with the diagnosis of recurrent anogenital warts. All patients had laboratory research in human papillomavirus (HPV) in scrapings; in sexually transmitted infections; determination of the level of 25(OH)D, zinc. The complex therapy included treatment with the extract of Solanum tuberosum (Panavir) in the form: Panavir solution, Panavir-gel, Panavir-Intim spray and topical use of imichimod and surgical destruction of genital warts. Results. Monitoring patients for 6 months showed the remission of 23 men, reccurent warts in the distal section of urethra – 2 patients. Conclusions. The study obtained the high efficiency of complex therapy with the inclusion of Solanum tuberosum and surgical treatment.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123886161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of primary and recurrent buccal urethroplasty in men.","authors":"I. Abdulaev, N. Polyakov, A. Kazachenko","doi":"10.29188/2222-8543-2023-16-2-116-125","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-116-125","url":null,"abstract":"Introduction. Recently, there has been a tendency to perform reconstructive-plastic interventions for the treatment of both primary and recurrent urethral strictures. Buccal urethroplasty is currently recognized as the «gold standard» for the urethral strictures treatment. However, despite a large number of works on operative correction of urethral strictures using the cheek mucosa, the issues of prevention and correction of intra- and postoperative complications of buccal urethroplasty have not been finally resolved. The purpose. Using the world literature, to stydy complications, methods of their prevention and correction for improving the efficiency of primary and repeated recοnstructive-plastic οperations on the urethra using free autograft of mucous membranes οth cheeks. Materials and methods. The literature review was made using bibliographic databases: Pubmed, Web of Sience, Science Direct, Scopus, Cyberleninka, eLibrary.ru and others for the period from 1990–2022. The following keywords were used: urethral stricture, buccal graft, complications of buccal urethroplasty, buccal urethroplasty, diagnosis of complications of buccal urethroplasty, treatment of complications of buccal urethroplasty, anastomotic urethroplasty, urethroplasty replacement. In total, 150 original publications were identified and analyzed, and 104 articles of them were selected for a literary review. Results. The analysis of complications of primary and repeated buccal urethroplasty was carried out, possible options for diagnosis and correction of complications of reconstructive plastic surgery on the urethra of men using the cheek mucosa were studied and the quality of life of patients after surgical treatment was analyzed. Conclusion. The analysis of the scientific literature on the results of the surgical treatment of primary and recurrent urethral strictures using buccal mucosa graft shows that at present there is no single clinical position that would clearly classify the emerging complications of this method of uretroplastics and contributed to the development of measures for their prevention.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127185137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of recombinant FSH in the treatment of infertility associated with a high level of sperm DNA fragmentation.","authors":"Yu. V. Olefir, D. M. Monakov, M. A. Rodionov, A. R. Zhivulko, I. Vinogradov, D. M. Popov","doi":"10.29188/2222-8543-2023-16-2-99-105","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-99-105","url":null,"abstract":"Introduction. Male infertility, caused by a high level of sperm DNA fragmentation, remains one of the significant problems of reproductive medicine. One of the methods to overcome it may be the use of recombinant follicle-stimulating hormone (FSH), but the results of studies on this issue are ambiguous. The purpose of this literature review is to systematize publications on this issue. Materials and methods. The search, analysis and systematization of publications in the databases PubMed, eLibrary.ru, Clinicaltrials.gov were carried out using the keywords «male infertility», «sperm DNA fragmentation», «treatment», «follicle stimulating hormone», «FSH». Seventy six publications were selected and included in this review. Results and discussion. The integrity of the genetic material of the sperm is one of the prerequisites for the formation of a normal embryo. Its damage occurs in two main ways: induction of apoptosis and direct damage to DNA by reactive oxygen species. FSH stimulates spermatogenesis and also prevents the induction of spermatozoa apoptosis through the activation of protein kinase B/AKT. Also FSH regulates chromatin packing and increases the ability of spermatozoa to bind to hyaluronic acid. Its use in infertile men led to an improvement in the morphological parameters of spermogram, sperm motility, a decrease in the level of sperm DNA fragmentation, however, the data obtained are difficult to compare due to the heterogeneity of the patient groups included in the study, the lack of standardization of methods for studying the level of sperm DNA fragmentation and using its different threshold values. Conclusions. Therapy with recombinant FSH is one of the promising methods for overcoming infertility in patients with a high level of sperm DNA fragmentation. The heterogeneity of published studies does not allow to draw unambiguous conclusions regarding its effect on the integrity of the genetic material of spermatozoa. Future studies need to use strict inclusion criteria, such as thresholds for the level of sperm DNA fragmentation and the results of a pharmacogenetic study.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115129749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-throughput sequencing of the testicular microbiome in patients with non-obstructive azoospermia and varicocele.","authors":"M. Faniev, Y. Prokopiev, K.V. Faustova, Z. Kadyrov, D. Vodolazhsky, M. Markelova, D. Khusnutdinova, T. Grigoryeva, E.M. Karslyan, M.Kh. Bersanova, R. Akobova","doi":"10.29188/2222-8543-2023-16-2-38-43","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-38-43","url":null,"abstract":"Introduction. The male factor in infertile marriages accounts for about 50% of all cases, which is associated with changes in the characteristics of the ejaculate microbiota and directly correlates with changes in sperm parameters, including sperm count, motility, and morphology. Purpose of the work: to determine the presence of a correlation between the taxonomic diversity of the testicular microbiome and the urethral microbiome and its role in the development of infertility in patients with non-obstructive azoospermia against the background of existing varicose veins of the spermatic cord, using the new generation high-throughput sequencing (NGS) method. Materials and methods. From 2020 to 2022, we studied and analyzed the biological material of 11 infertile men with non-obstructive azoospermia and concomitant varicocele. The resulting material of 11 urethral swabs and 10 testicular tissue samples was prepared and taken for further study of the bacterial microbiome using the high-throughput NGS method. Results. Analysis of the studied clinical group clearly demonstrated that the testicular tissue of patients with azoospermia and concomitant varicocele has its own unique microbiome. This may indicate not only taxonomic diversity at the level of both phyla and reads, but also a high degree of significance of impaired function of the blood-testicular barrier (HTB). Сonclusions. The testicular tissue of infertile men with azoospermia and concomitant varicocele has a pronounced diversity of microbiota not only at the level of phyla, but also at the level of reads, which proves the importance of the testicular microbiota in the regulation of spermatogenesis, and also confirms the theory of the initial insufficiency of the hematotesticular barrier against the background of the existing varicose veins of the seminal cord.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123889491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothesis about the possible mechanisms of therapeutic action of Serenoa repens hexane extract on the hypertrophied bladder in accordance with the pathogenesis of its dysfunction caused by bladder outlet obstruction.","authors":"A. Sivkov, V. I. Kirpatovskiy, Научные Гипотезы","doi":"10.29188/2222-8543-2023-16-2-16-30","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-16-30","url":null,"abstract":"Introduction. Traditionally it is believed that the therapeutic effect of the hexane extract of Serenoa repens (HSRE) in patients with benign prostatic hyperplasia is realized due to its effect on prostate cells. However, in the literature there is data about the possible HSRE effect not only on the prostate, but also directly on the bladder. This paper summarizes data and analyzes the possible cellular mechanisms of HSRE action on the bladder under the development of infravesical obstruction (bladder outlet obstruction – BOO). Materials and methods. Literature data from the PubMed and eLibrary.ru databases for a 25-years period related to the study of the pathogenesis of bladder dysfunction in the development of BOO, cellular and molecular mechanisms by which pathological and adaptive processes in bladder cells are realized, as well as the influence of HSRE on these processes are analyzed. Results. The concept of the pleiotropic effect of HSRE on various links in the pathogenesis of bladder dysfunction caused by BOO has been formed. The main of which are: the antioxidant and anti-inflammatory effects of HSRE components, as well as the regulatory effect on cell growth and proliferation factors and transcription factors. All this reduces the cytotoxic effect of oxidative stress on the cells of the bladder developing in IVO, contributing to a more active proliferation of detrusor smooth muscle cells. The consequence of the complex action is to maintain the contractile function of the bladder in a state of adaptation to increased stress, due to BOO. Conclusions. The present hypothesis about the direct effect of HSRE on the hypertrophied bladder and possible mechanisms of its therapeutic action is based on an understanding of the general biological mechanisms and allows us to explain better the results of previous clinical studies and to assess the prospects for expanding the scope of further drug application.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131698984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ-preserving surgery of localized kidney cancer with preliminary superselective embolization of the tumor-feeding branch of renal artery.","authors":"Сергій Віталійович Попов, Р. Г. Гусейнов, И. Н. Орлов, С.Г. Винцковский, Е. В. Помешкин, О.Н. Скрябин, Б. А. Неймарк, В. В. Перепелица, А.Н. Архипов, М. М. Мирзабеков, А.С. Катунин, К. В. Сивак, Н. С. Буненков, А. С. Улитина, S. Popov, R. Guseynov, I. Orlov, S. G. Vintskovsky, E. Pomeshkin, O. Skryabin, B. Neymark, V. V. Perepelitsa, A. Arkhipov, M. M. Mirzabekov, A. Katunin, K. V. Sivak, N. S. Bunenkov, A. S. Ulitina, Клиническое Исследование","doi":"10.29188/2222-8543-2023-16-2-44-51","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-2-44-51","url":null,"abstract":"Introduction. Warm renal ischemia (WRI) is used during the organ-preserving surgery of localized renal cell carcinoma to reduce blood loss, improve the imaging quality, facilitate both accessing the cavitary system and suturing the parenchyma. However, WRI can lead to the ischemic reperfusion injury of the preserved nephrons. Superselective embolization (SSE) of the tumor-feeding branch of renal artery is currently being considered as the alternative method of intraoperative hemostasis. Aim. To evaluate the results of organ-preserving surgery of localized kidney cancer in the conditions of SSE. Materials and methods. Three patients who had undergone laparoscopic kidney resection (LKR) with SSE were included in the study. Parameters for assessment were as follows: surgery duration, surgery workflow, intraoperative blood loss volume, the degree of radical surgery according to the histological data, the presence of postoperative complications, and the duration of hospitalization. Results. Compared with the LKR with WRI (n=78, data from a previous own study), the features of the LRK with SSE (n=3) were as follows: 1) the same surgery duration; 2) three times less intraoperative blood loss; 3) the absence of infectious and inflammatory complications; 4) comparable duration of hospitalization. Also, additional advantages of the LKR with SSE were described: 1) the radicality of surgery; 2) the absence of the risk of renal pedicle injury; 3) the absence of the risk of ischemic reperfusion alteration of the preserved renal tissue. Conclusion. Preliminary SSE of the tumor-feeding branch of renal artery may improve functional results of the organ-preserving surgery of localized kidney cancer via reducing the intraoperative blood loss, exclusion the possibility of renal pedicle injury, and provision of the functional activity of the preserved nephrons.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114972532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}