Experimental and Сlinical Urology最新文献

{"title":"Male preconceptional training: the role of nutrition and nutrient complexes. Part 1.","authors":"V. Bozhedomov, I. Kononenko","doi":"10.29188/2222-8543-2023-16-1-128-136","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-128-136","url":null,"abstract":"Introduction. One of the reasons for the decline in the reproductive function of men is an unbalanced diet. This review is devoted to the assessment of the role of such nutrients as vitamin E, L-carnitine, coenzyme Q10, zinc, selenium and arginine in the occurrence of male infertility: their role in spermatogenesis and the possibility of clinical application are shown. Materials and methods. Publications from domestic and international databases (Russian State Library, MEDLINE, PubMed, Cochrane Database of Systematic Reviews) were analyzed: original studies, relevant chapters in collective monographs available to the authors, reviews, incl. Cochrane, meta-analyses over the last 20 years. When searching in electronic databases, the following keywords were used: male infertility, food products, oxidative stress, male infertility therapy, nutrients, incl. the name of individual substances: carnitines, ubiquinone/coenzyme Q10, selenium, zinc, vitamin E, arginine in various combinations. Results. From the standpoint of fundamental sciences (physiology and biochemistry) and, at the same time, data from clinical medicine, the role of various nutrients in the implementation of male reproductive function, as well as their use for preconception preparation of men, is considered. A quantitative assessment of the effectiveness of isolated and complex use of these nutrients to increase the concentration and mobility, improve morphology, reduce oxidative stress and DNA damage in spermatozoa is given. Conclusion. Nutrients play an important role in metabolic processes during the formation and maturation of spermatozoa. Their deficiency leads to impaired reproductive function, and additional intake in the form of dietary supplements can lead to an increase in the likelihood of pregnancy and live births due to improved motility, concentration and fragmentation of sperm DNA. At the same time, today it is difficult to give any clear recommendations for their use as a therapy in infertile men. A significant number of studies lack randomized and placebo-controlled groups. Randomized controlled trials of sufficient power, taking into account the deficiency of individual nutrients, should be planned to clarify the indications for the use of specific dietary supplements in the concept training of men.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126179274","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":"Predictors of success performing ureterolitotripsy.","authors":"S. Darenkov, E. Pronkin, G.A. Monastyrnyy, V. A. Novikov","doi":"10.29188/2222-8543-2023-16-1-68-72","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-68-72","url":null,"abstract":"Urolithiasis is one of the most common diseases seen by urologists. In 28% of patients with kidney stones, the disease is symptomatic. The benefits of ureteral stone extraction include minimal invasiveness, a shorter postoperative recovery time, and a favourable safety profile. Aim: to compare and evaluate the relationship between the density of the ureter, the density of the calculus, its localization and the value of the creatinine level and predicting the success of ureterolithoextraction. Materials and methods. In total, 125 ureteral lithotripsy procedures were performed (42 in women and 83 in men). Initially, the patients were divided into two groups. In the first group, ureteral stone extraction was performed in 97 patients. The second group included 28 patients with ureteral stent placement, without ureteral lithotripsy. In percentage terms, the increase in mean calculus size in the groups (10%) was less significant than the increase in ureter density under the calculus (65%). Results. There was no relationship between the ureter density under the calculus and the residence time of the calculus in the ureter. However, there is a relationship between the residence time of the calculus and the anatomical narrowing of the ureter, which may affect the success of the procedure. Elevated creatinine levels in the group with initial ureteral stent placement may indicate impaired urine passage from the kidney. Conclusions. Routine measurement of the ureter density under the calculus during MSCT may be an additional parameter in determining the surgical treatment method.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128930882","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":"Modified robot-assisted YV plastic surgery for recurrent bladder neck stenosis. Тhe first results.","authors":"S. Popov, I. Orlov, A. V. Tsoy, T. Topuzov, V.V. Malik, A. Neymark, B. A. Neymark","doi":"10.29188/2222-8543-2023-16-1-148-153","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-148-153","url":null,"abstract":"ntroduction. Bladder neck stenosis (BNS) is one of the most formidable and difficult to correct complications of transurethral surgical interventions on the prostate. Despite the significant progress in endourology and the abundance of new technological solutions used in transurethral surgery, the results of endoscopic correction of BNS are still unsatisfactory. One of the methods of correction of recurrent BNS is robot-assisted YV-plastic surgery of the BNS. Materials and methods. From 2021 to 2022, 30 robot-assisted modified YV-plastic bladder necks in patients with recurrent bladder neck stenosis were performed in St. Petersburg State Medical Institution «St. Luke's Clinical Hospital». Conclusion. The robot-assisted YV plastic in the presented modification has a high degree of efficiency and safety in recurrent bladder neck stenosis.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127780470","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":"Urolithiasis and renal tubular acidosis.","authors":"N. V. Anokhin, M. Prosyannikov, Sergey Golovanov, O. Konstantinova, D. Voytko, A. Sivkov","doi":"10.29188/2222-8543-2023-16-1-73-79","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-73-79","url":null,"abstract":"Introduction. Distal renal tubular acidosis (dRTA) is a rare cause of stone formation in urolithiasis patients according to the conventional wisdom in the urological community. At the same time prevalence of the incomplete dRTA in patients with idiopathic calcium stones is 16.8% (13.6% in men and 25.5% in women) according to the recent studies. Previously, we published a review article, which describes the features of the dRTA etiology and pathogenesis, and presents diagnostic and treatment algorithms. We consider it interesting to present a clinical case in continuation of the previous publication. Clinical case. There are anamnesis data, results of laboratory and instrumental analysis of the patient Zh. with a urolithiasis and renal tubular acidosis are presented. The patient was prescribed a long course of conservative citrate and thiazide diuretics therapy. The patient managed to achieve normalization of the main parameters of blood and urine, stable remission of the disease against the background of ongoing therapy. Conclusions, patients with distal renal tubular acidosis and urolithiasis are quite common in the clinical practice of urologist. Timely diagnosis of the disease and the appointment of adequate therapy can improve the quality of patient's life and reduce the number of stone relapses.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"394 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116020130","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":"Results of a multicentre observational program to study the efficacy and safety of multidose menotropin in patients with male infertility.","authors":"O. Apolikhin, S. Bogolyubov, E. A. Efremov, G. Mskhalaya, S. Krasnyak","doi":"10.29188/2222-8543-2023-16-1-100-107","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-100-107","url":null,"abstract":"Introduction. Currently, menotropins are widely used to treat male infertility, both to stimulate spermatogenesis and to compensate for hormonal imbalance. But the actual practice of using menotropins may differ from the recommendations given by the manufacturer. Therefore, observational programs are particularly important, which allow assessing the effectiveness of a drug in routine practice. Purpose. To establish prognostic criteria for response to short and stadard course of multidose menotropin therapy in men with pathospermia. Materials and methods. The study was designed as a multicentre, prospective, observational cohort study. The study included 1120 men with infertility enrolled between January 2020 and April 2021. The study included men with the absence of pregnancy during 12 months of regular unprotected sexual activity. The average duration of infertility was 20.6 months. As a treatment, men received multidose menotropin at a dosage of 75 IU, 112.5 IU or 150 IU every other day with hCG 2000 IU 2-3 times a week. Sperm parameters and hormones (total testosterone, Sex hormone-binding globulin - SHBG, luteinizing hormone - LH, follicle stimulating 12 months - FSH, Inhibin B, estradiol) were evaluated before treatment and for 12 months. Results. When comparing the parameters of the spermogram, it was noted that without differentiation according to the prescribed dose, after 3 months of administration, the concentration of spermatozoa increased by 32.6%, the total number of spermatozoa in the ejaculate increased by 32.3%, progressive mobility increased by 20.7%, the proportion of morphologically normal forms increased increased by 34.8%. The level of total testosterone after 3 months of use of multidose menotropin increased by 33.6%. The levels of inhibin B and estradiol did not change significantly. When using multi-dose menotropin for 12 months, sperm concentration increased by 88.5%, the total number of spermatozoa in the ejaculate increased by 55.3%, progressive mobility increased by 42%, the proportion of morphologically normal forms increased by 64.3%. Conclusions. We found the increase of the effectiveness of menotropins with an increase in the duration of their use and an increase in dosage.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123455774","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":"Conservative treatment of urinary incontinence after transurethral resection of the prostate.","authors":"V. Kruglov, F. Asfandiyarov, K. Seidov, K.G. Oflidi, R. Aliev, A. Murzagalieva, M. F. Hiji, E. Valitova","doi":"10.29188/2222-8543-2023-16-1-90-98","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-90-98","url":null,"abstract":"Introduction. Among the existing methods of surgical treatment of patients with benign prostatic hyperplasia (BPH) transurethral resection (TUR) of the prostate is the most widely used. Due to the long-term improvement of the technique, non-lethal complications are now more characteristic of this operation. These include postoperative urinary incontinence, which dramatically reduces the quality of life of patients and casts doubt on the effectiveness of the operation performed. Stress urinary incontinence, the most common type of disorder, basically has sphincter insufficiency associated with iatrogenic damage to the external closure apparatus of the bladder when it goes beyond the distal border of resection in TUR BPH. However, an equally important role in the genesis of sphincter insufficiency belongs to the inflammatory process, which always accompanies trauma to muscle structures during surgery. The aim of this prospective study was to improve outcomes in patients with urinary incontinence after TUR BPH. Materials and methods. The study involved 86 patients who underwent TUR BPH, with the leading complaint of urinary incontinence. Patients were divided into 2 groups, initially comparable in terms of the main evaluated criteria. Patients of the first (control) group (n=30) received complex antibacterial and anti-inflammatory therapy, according to indications - alpha-blockers, prostatotropic regulatory biopeptides and enzyme preparations, in the presence of a hyperactivity component – M-anticholinergics and / or a selective agonist of β3 adrenoreceptors. Patients of the second (main) group (n=56) for the purpose of long-term anti-inflammatory effects and reduce the pharmacological load additionally received the phytocomplex «Profilaprost» 1 capsule per day for 2 months. Result. In the main group of patients who received the «Profilaprost» complex, after 2.5 months from the start of therapy, we recorded an improvement in the reservoir function of the bladder. In 65% of patients, complete continence was achieved, in 20% – stabilization of incontinence at a mild degree, requiring no more than one safety pad per day, in another 10% the result can be described as not quite satisfactory – the frequency and degree of incontinence decreased, but persisted the level of symptoms was considered unacceptable by the patients and insisted on continuing treatment. And only in 5% of patients, complex therapy had no effect. A decrease in IPSS and QoL indices, an improvement in continence significantly correlated with a decrease in the degree of leukocyturia. Conclusion. The herbal-mineral complex «Profilaprost» showed good efficacy with no side effects and adverse events in the treatment of urinary incontinence after TURP.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124362428","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":"Urinary disorders and quality of life in patients with BPH after transurethral resection of the prostate.","authors":"R. N. Simanov, R. Amdiy, S. Al-Shukri, T. Alekseeva","doi":"10.29188/2222-8543-2023-16-1-116-121","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-116-121","url":null,"abstract":"Introduction. Transurethral resection (TUR) of the prostate remains the gold standard for surgical treatment of patients with benign prostatic hyperplasia (BPH). A proportion of patients who have undergone a prostatic TUR for BPH continue to have urinary dysfunction. Aim. The aim of the study was to determine the incidence of urinary disorders and quality of life in the long-term postoperative period in patients after prostatic TUR. Materials and methods. We interviewed and surveyed 176 patients who underwent prostate TUR between 2018 and 2021. To determine the prevalence of lower urinary tract symptoms (LUTs) after prostate TUR, we surveyed 176 patients between 12 and 36 months after surgical treatment. The age of the patients surveyed ranged from 47 to 89 years. Results. 53.4% of the patients were completely satisfied with the surgical treatment and 46.6% reported various urinary disorders. According to the questionnaire about the IPSS scale 47.7% patients moderate to severe symptoms persisted after prostate TUR. In 21.6% of the patients quality of life due to urinary disorders was unsatisfactory, poor and very poor. However, moderate and severe symptoms as well as worsening quality of life were more often observed in the older age groups. Conclusions. After prostate TUR, 10.2% of patients have severe and 37.5% have moderate urinary dysfunction in the long-term postoperative period. These urinary disorders worsen quality of life and are more frequent in older patients.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130461833","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":"Cystic glands metaplasia of the urinary bladder.","authors":"S. A. Zamyatnin, I. S. Gonchar","doi":"10.29188/2222-8543-2023-16-1-170-173","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-170-173","url":null,"abstract":"Introduction. Cystic-glandular cystitis is one of the varieties of metaplasia of the bladder wall, which, in rare cases, can manifest itself in the form of voluminous polypoid growths. Clinical study. This article presents a case of polypoid changes in the bladder wall due to cystic glandular cystitis in a 74-year-old man against the background of a chronic inflammatory process and achalasia of the upper urinary tract. This observation confirms the theory of the etiological significance for the development of urothelial metaplasia of a long-term persistent urinary tract infection. The only reliable method for diagnosing cystic glandular cystitis and differential diagnosis of pseudotumor changes from urothelial carcinoma is morphological, after transurethral resection. Conclusion. The observation presented in this article showed that the clinical manifestations of cystic glandular cystitis can be variable and require an integrated approach to diagnosis and treatment.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122955283","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":"Transperineal fusion prostate biopsy. Diagnostic value in comparison with a standard biopsy.","authors":"R. A. Romanov, A. V. Koryakin, I.S. Tolstov, V. I. Kirpatovskiy, B. Alekseev","doi":"10.29188/2222-8543-2023-16-1-48-54","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-48-54","url":null,"abstract":"Introduction. A significant improvement in the quality of prostate imaging by magnetic resonance (MRI), as well as the possibility of combining MRI and ultrasound images (fusion technology) for biopsy, open up new possibilities for the diagnosis of prostate cancer. The arsenal of methods of treating prostate cancer includes active surveillance and focal therapy for patients with low risk disease. That raises the question of improving the accuracy of diagnosis of tumor volume, stage and differentiation, which will largely determine the tactics of patient management. The aim of our work was to determine the diagnostic effectiveness of targeted MRI-assisted fusion biopsy of the prostate in comparison with standard biopsy. Materials and methods. We analyzed data of 356 patients who underwent tranperineal fusion biopsy. The age of the patients ranged from 48 to 72 years with an average value of 68.2 ± 2.1 years. The selection criteria for the study were an increase in the level of PSA (345 patients) – the range from 4 to 44.5 ng/ml (on average 6.02±0.21) or the detection of tumor-suspicious areas during finger rectal examination or transrectal ultrasound examination (TRUS) of the prostate gland (41 patients). Further methods of examination included multiparametric magnetic resonance imaging (MRI) and subsequent transperineal fusion biopsy in combination with standart biopsy. Results. In our study, the detection rate of prostate cancer was (82.6%) – the diagnosis was confirmed in 294 out of 356 examined patients. At the same time, with an increase in the PI-RADS gradation, the frequency of histological confirmation of cancer increased: 62.4% for PI-RADS 3 lesions, 89.6% for 4 and 96.7% for PI-RADS 5. Targeted biopsies confirmed the presence of prostate cancer in 246 cases out of 356 patients (69.1%). In relation to all cases of cancer detection, the proportion of positive targeted biopsies was 83.7%. Conclusion. Targeted MRI-assisted fusion biopsy allows detecting prostate cancer in 69.1%, but when supplemented with a polyfocal biopsy at standard points, the diagnostic accuracy increases to 82.6%. Thus, the data obtained allow us to conclude that based on the examination of patients with suspected prostate cancer using mpMRI with targeted fusion biopsy, supplemented by polyfocal biopsies at standard points, it is possible to determine the localization, extent and degree of malignancy of the tumor with a high degree of certainty.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114991348","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":"Simultaneous surgical correction of stress urinary intention and erectile dysfunction after surgical treatment of prostate cancer.","authors":"P. Kyzlasov, V. B. Filimonov, R. V. Vasin, I. S. Sobennikov, A. Petryaev","doi":"10.29188/2222-8543-2023-16-1-55-59","DOIUrl":"https://doi.org/10.29188/2222-8543-2023-16-1-55-59","url":null,"abstract":"Introduction. Urinary incontinence and erectile dysfunction are common consequences of radical prostatectomy, which may require surgical correction. The article presents the results of simultaneous implantation of a suburethral sling and a penile prosthesis from one access in a patient after radical prostatectomy. Clinical case. A 63-year-old patient, 13 months after radical prostatectomy (without preservation of neurovascular bundles) for prostate cancer pT2cN0M0 underwent simultaneous installation of a male sling and a semi-rigid phaloprosthesis from the perineal access. Results and discussion. The duration of the surgery was 1 h 5 min. There were no complications during the surgery. The postoperative course was uneventful. The patient was discharged on the 6th day after the surgery. During the control examination 2 months after the operation, good cosmetic and functional results were noted. Conclusions. Simultaneous implantation of a suburethral sling and a phaloprosthesis may be an effective way to eliminate the functional consequences of urinary incontinence and erectile dysfunction after radical prostatectomy, not accompanied by an increase in the risk of complications.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130904407","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}