Experimental and Сlinical Urology最新文献

{"title":"Selective cryoablacion of penile nerves as a treatment for premature ejaculation.","authors":"Y. Mirkin, D. Cherepanov, A. Nevsky, P. Kyzlasov","doi":"10.29188/2222-8543-2022-15-4-102-106","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-4-102-106","url":null,"abstract":"Introduction. Premature ejaculation (PE) is the second most common male sexual dysfunction with a significant negative impact on quality of life. To date, there is no satisfactory treatment for PE. Surgical methods of treatment are based on reducing the sensitivity of the glans penis by various methods, the main of which is selective dorsal neurotomy (SDN). Recently, methods have been developed for temporary demyelination of the dorsal nerve of the penis using cryoablation. This article discusses the results of selective minimally invasive cryoablation for the treatment of PE. as a treatment for premature ejaculation. Materials and methods. Materials and methods. The methods of SDN by the criablation method are described. The study involved 29 patients aged 22 to 35 years (mean age 28.7 years). All patients met the Criteria for Premature Ejaculation. Patients filled out the Premature Ejaculation Profile and recorded the time of Intravaginal Ejaculation Latency Time (IELT) before and after 3 months after SDN by cryoablation. Results. After the operation average IELT increased from of 75.8 seconds to 227.6 seconds (+298%), the average Premature Ejaculation Profile score increased from 3.6 to 11.35 points (+315%). Conclusions. Selective minimally invasive cryoablation of penile nerves is a promising treatment for premature ejaculation. However, additional studies with a larger number of participants are needed.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129769490","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":"Method of expanding intestinal cystoplasty in patients with radial vesicovaginal fistulas and microcystis.","authors":"D. Eliseev, Zh.L. Kholodova, R. Abakumov, D. Ovcharenko, Y. Dobrokhotova, A. Samsonov","doi":"10.29188/2222-8543-2022-15-4-138-149","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-4-138-149","url":null,"abstract":"Introduction. Radial vesicovaginal fistulas are one of the most difficult problems of urogynecology, despite the fact that modern technologies make it possible to personalize the use of radiation therapy. Standard surgical techniques in the treatment of such patients are ineffective. The search for alternative surgical solutions can improve the results of treatment of patients with radial fistulas and microcystis. Study objective. To compare the effectiveness of augmentation ileocystoplasty and two-stage surgical treatment, represented by expanding intestinal cystoplasty in combination with the use of a Martius or Martius-Symmonds flaps. Materials and methods. The study included 8 patients. The first group included 4 patients who underwent laparotomy, augmentation ileocystoplasty. In 3 patients relapsed fistulas were closed with vaginal access using a Martius flap a few months later. The second group included 4 patients who underwent expanding intestinal cystoplasty by laparotomy, with further formation of Martius or Martius-Symmonds flaps by perineal access and moving them into the pelvic cavity for fixation from the abdominal cavity. Results. The average duration of the operation in the first group was 337.5 minutes, in the second group – 470 minutes. The patients of the first group had no complications of the III-V groups according to Clavien-Dindo. Natural urination was eventually recovered in all patients. In 2 patients of the second group, postoperative complications were recorded: in 1 patient – complication of group IIIa according to Clavien-Dindo – marginal necrosis of the skin flap after abdominoplasty, which required stage necrectomy and secondary skin sutures, in another 1 patient – complication of group IIIb according to Clavien-Dindo – dynamic intestinal obstruction, which required relaparotomy and nasointestinal intubation. There were no relapses of vesicovaginal fistulas. After urination was restored, all patients retained the urge to urinate. Conclusion. The proposed two-stage operation allows not only to eliminate the vesicovaginal fistulas, but also to increase the capacity of the bladder, restore voluntary urination.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116078953","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":"X-ray-free ureterolithotripsy for ureteral stones.","authors":"B. Guliev, A. Talyshinskii, B. Komyakov, I. Povago, O. Allakhverdiev","doi":"10.29188/2222-8543-2022-15-4-32-36","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-4-32-36","url":null,"abstract":"Introduction. The main treatment option for symptomatic ureteral stones is contact ureterolithotripsy (CULT), which is usually performed under Xray guidance. However, the risks of complications associated with radiation do not always justify the benefits obtained from its use, which justifies the study of the results of performing Х-ray-free ureterolithotripsy. Purpose. Evaluation of the efficacy and safety of non-fluoroscopic ureteroscopy in the treatment of symptomatic ureteral stones. Materials and methods. Data from 240 patients with ureterolithiasis who underwent CULT were retrospectively recruited. Clinical and demographic data of patients, stone parameters and intraoperative parameters were evaluated. A multivariate analysis of the above factors was carried out to determine their diagnostic value for predicting the results of CULT. Data collection and analysis was carried out using MS Excel and SPSS Statistics 22.0 tables, respectively. Results. The average stone size and density were 6,7±2,4 mm and 785,8±293,0 HU, respectively. The lasting of the surgery and the stone free rate were 39,5±14,6 min and 84,6%, respectively. Complications, in particular ureteral perforation, occurred in 17,0% and 6,7% of cases. According to the results of multivariate analysis, the following parameters influence the effectiveness of contact ureterolythotripsy (CULT) in symptomatic calculi: density, size and localization of the calculus, as well as the presence of ureteral stent (p <0.05). The preoperative indicators presented below significantly determined the frequency of complications: the density and localization of calculus, the presence of a ureteral stent, and the lasting of the surgery (p <0.05). Comparative analysis of CULT with and without fluoroscopy revealed identical results and the complications number. The repeated interventions were more frequent in patients without X-ray, but there were no a statistically significant differences between groups. Our data indicate that CULT without X-ray not compromising the effectiveness of the surgery. Conclusion. X-ray-free CULT for symptomatic ureteral stones eliminates possible complications from radiation without compromising the success of the operation itself","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124204152","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 bilateral retrograde intrarenal surgery with thulium fiber laser.","authors":"S. Popov, I. Orlov, T. Topuzov, D. Sytnik, I. Pazin, R. M. Radzhabov, M. Suleymanov","doi":"10.29188/2222-8543-2022-15-4-48-53","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-4-48-53","url":null,"abstract":"Introduction. Urolithiasis is a common disease and up to 15% of patients have multiple kidney stones. Retrograde intrarenal surgery (RIRS) can be used in the surgical treatment of kidney stones because this method is highly effective. Patients with multiple kidney stones often necessitate several surgeries. In this study we our own experience of bilateral RIRS to analyze its effectiveness and safety. Materials and methods. From January 2021 to February 2022 the simultaneous bilateral RIRS were performed to 11 patients (7 man and 4 woman). The maximal size of stone was 21 mm (the average size of the right kidney was 15,0 mm ± 6,0 mm and the left kidney – 11,7 mm ± 4,3 mm). Average stone density was more than 1000 HU. The mean age of the patients was 57±13 years. Bilateral retrograde intrarenal surgery was performed simultaneously by two surgeons using flexible ureteroscopes using a SuperPulsed thulium fiber laser. The following parameters were assessed: surgical intervention time; stone free rate (SFR); degree of ureteral injury according to the post-ureteroscopic lesion scale (PULS); the need for drainage of the ureter in the postoperative period, assessment of the creatinine level, glomerular filtration rate (GFR) and C-reactive protein in the postoperative period; postoperative complications according to the Clavien-Dindo classification. Results and their discussion. The average duration of the surgery was 56±11 minutes. The SFR level was 90,9 %. At the final inspection of the ureters: on the right side injury Grade 0 according to the PULS scale was recorded in 10 patients, Grade 1 – in 2 patients; on the left side Grade 0 – in 9 patients, Grade 1 – in 2 patients. The surgery was completed with the installation of ureteral catheters in 10 and 9 cases on the right and left sides, respectively. Three surgical interventions ended with the installation of ureteral stents on one side or another. The level of creatinine and C-reactive protein in the postoperative period increased on average by 10.2±5.7 μmol/l and 1.8±0.6 mg/l, respectively. The GFR decreased by 7.2 ± 2.6 ml/min. A complication was registered in 1 patient – increased body temperature on the 1st day, stopped by antibiotic therapy (Clavien-Dindo II). Conclusions. Simultaneous bilateral RIRS using single-use flexible ureteroscopes and a SuperPulsed thulium fiber laser is a safe and effective procedure for patients with bilateral nephrolithiasis.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131925371","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":"Brachytherapy for prostate cancer and immune response.","authors":"A. Sivkov, V. N. Sinyukhin, A. V. Koryakin, обзор литературы","doi":"10.29188/2222-8543-2022-15-3-36-43","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-3-36-43","url":null,"abstract":"Introduction. Information about the brachytherapy-induced immune reactions, which can be used for therapeutic purposes, is of great clinical value. Materials and methods. When preparing a review of the literature on the problem of the effect of brachytherap (BT) on immunity in prostate cancer (PCa), the following bibliographic databases were used: PubMed, Science Direct, Scientific Electronic Library of Russia (eLibrary). The search was conducted on the following keywords: «cancer», «prostate cancer», «brachytherapy», «immunity», «immunotherapy». In total, 6 sources were found that were directly related to the effect of BT on immunity in prostate cancer. Results. Clinical data shows that both low-dose and high-dose prostate cancer brachytherapy (BT) cause a systemic immune response. The authors explain the observed increase in the number of serum leukocytes by the induction of an inflammatory reaction in response to tumor irradiation, and the decrease in the number of B cells by the movement of antigen-recognizing B cells from the bloodstream to the irradiation site. In addition, after BT, an increase in the number of activated T-lymphocytes was demonstrated, while the number of myeloid suppressor cells significantly decreased. It has been suggested that a decrease in this indicator can activate T cells: the number of naive CD4+ and CD8+ T lymphocytes significantly increased after local administration of radioactive sources, with a simultaneous decrease in the number of CD4+ and CD8+ memory T cells. The latter may indicate that local radiotherapy stimulates the activation of the thymus and the release of naive T-lymphocytes into the bloodstream, during the migration of memory cells from the bloodstream to the prostate. The described effects reflect the process of «turning on» T-cell immunity after BT. Researchers believe that an increase in the number of activated T-lymphocytes contributes to the activation of antitumor immunity, long-term remission and reduces the likelihood of recurrence of prostate cancer. High-dose BT of localized prostate cancer, as well as probably low-dose BT, cause the transformation of the immunogenic properties of the tumor and lead to pronounced polyclonal infiltration of the prostate, mainly by T cells, which occurs under the control of a large number of «control points». The occurrence of immune cells infiltrates and changes in the signal transmission system between them after BT are reflected by a change in the type of «inflammatory signature of the tumor» (TIS) from «cold» to «hot». After irradiation in the tumor area the number of PD-L1 macrophages usually increases, which is regarded as a marker of the tumor response to the therapy. It is believed that if BT causes an increase in PD1+ expression, and use of checkpoint inhibitors to these patients can give a good therapeutic effect. Conclusion. The available data indicate that BT primes the systemic immune response, leads to activation of T-cell immunity and, as a","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"180 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124747144","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":"Mistakes in the diagnosis of tuberculous orchiepididymitis.","authors":"E. Kulchavenya, A. Baranchukova","doi":"10.29188/2222-8543-2022-15-3-124-129","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-3-124-129","url":null,"abstract":"Introduction. Everywhere there is a weighting of the structure of urogenital tuberculosis. Tuberculosis of the testis and its epididymis is difficult to diagnose because it does not have pathognomonic symptoms; the diagnosis cannot be verified microbiologically in the study of ejaculate or prostate secretion, however, it is possible to detect a pathogen in biopsy specimens or surgical material. Materials and methods. Search results were analyzed in the scientific databases eLibrary, PubMed, Web of Science, Embase, Cochrane Library and PEDro, Wang-fang and Cnki, Edline for the queries «urogenital tuberculosis», «tuberculosis of the male genital organs», «tuberculosis testicles», «tuberculosis of the epididymis», «tuberculous epididymitis», «tuberculous orchiepididymitis», «diagnosis». Results. An isolated lesion of the scrotum is observed with testicular neoplasms, bacterial epididymo-orchitis, genitourinary sarcoidosis, inguinal-scrotal hernia, and hydrocele. Since oncological diseases cause the greatest concern, misinterpretation of clinical and laboratory data and neglect of the epidemic history can lead to an erroneous diagnosis and unnecessary orchiectomy. At best, the patient is initially diagnosed with bacterial epididymo-orchitis and given antibiotic therapy. At the same time, the wrong choice of antibiotic can subsequently make it impossible to identify the pathogen and distort the pathomorphological picture. Description of the clinical case. The article presents a case of incorrect tactics in the treatment of a patient with tuberculous epididymitis, erroneously diagnosed as an «epididymal cyst». Neglect of microbiological data led to the formation of a fistulous form of orchiepididymitis. Conclusions. The diagnosis of tuberculous orchiepididymitis is difficult. With the help of radiation diagnostic methods, tuberculosis of the testicle and apidymis can be suspected; to confirm the diagnosis, identification of the pathogen or the presence of specific pathological signs is required. High vigilance is required for tuberculosis when examining a patient with complaints of enlargement and tenderness of the scrotum.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121628295","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":"Robot-assisted cystectomy with orthotopic vesicoplasty for bladder cancer.","authors":"V. A. Oganyan, A. Gritskevich, A. D. Simonov, Z. Polotbek, I. Miroshkina, A. Kostin","doi":"10.29188/2222-8543-2022-15-3-44-54","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-3-44-54","url":null,"abstract":"Introduction. Bladder cancer is the 10th most common cancer worldwide. Radical cystectomy remains the gold standard for muscle invasive bladder cancer. The active use of robot-assisted cystectomy for treating patients with bladder cancer allows considering it as an alternative surgical option. The review is aimed at collecting and systematizing the evidence base for intracorporeal robot-assisted cystectomy. Materials and methods. MEDLINE, Scopus, Clinicaltrials.gov, Google Scholar, and Web of Science databases were used with the PICO (Patient-InterventionComparison-Outcome) search strategy to identify research articles published between 2000 and 2022. The following keywords were used to search the medical literature: «robot-assisted cystectomy», «RARC», «orthotopic neobladder», «intracorporeal RARC», «extracorporeal RARC», «bladder cancer», «functional outcomes», and «clinical outcomes». The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Exclusion criteria: abstracts, review articles, editor's notes and comments, book chapters; experimental and laboratory studies on animals or cadavers. Results and disscussion. A total of 475 original articles were retrieved from the databases. Of them, 71 original articles were included in the analysis. The benefits and advantages of intracorporeal RARC at the intraoperative and postoperative period in comparison with RCE and extracorporeal RARC were reported. Functional and oncological outcomes following intracorporeal RARC are also comparable with RCE and extracorporeal RARC, suggesting the effectiveness and safety of the new surgical technology for treating patients with bladder cancer. Conclusions. The last decade has been marked with an active transition from traditional surgical techniques to robot-assisted surgery, enabling the precise performance, minimal trauma, and minimal intraoperative blood loss.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130786894","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":"Firsty experience with using the implantable bulking material Sphero®GEL for stress urinary incontinence in women.","authors":"A. Sivkov, V. Romikh, L.Yu. Kukushkina, V. V. Panteleev","doi":"10.29188/2222-8543-2022-15-3-130-141","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-3-130-141","url":null,"abstract":"Introduction. Among minimally invasive technologies for the treatment of stress urinary incontinence (SUI) in women, a special place is occupied by the method of paraurethral administration of bulking agents (BA). Recently, great attention has been paid to the new generation of natural biopolymers with a set of unique qualities that allow using the body's own resources to restore damaged tissues. Heterogeneous implantable gel (JSC «BIOMIR service», Russia) belongs to such BA. Objective: to evaluate the efficacy and safety of transurethral administration of BA «Sphero®GEL» LONG (SGL) in women with SUI. Materials and methods. The open prospective study included 20 women with mild or moderate SUI, aged 41-76 years, who underwent one/two transurethral implantation of SGL into the submucosal and muscular layers after clinical and urodynamic examination. Results. According to the preliminary survey, mild SUI was detected in 13 (65%) women, and moderate SUI – in 7 (35%). Initial data: visual analog scale (VAS) – 7.7 ± 2.0; quality of life (QOL) – 3.3 ± 1.2; maximum urine flow rate (Qmax) – 20.5 ± 5.3 ml/s; post-void residual urine volume (PVR) – 7.0 ± 2.1 ml; voided volume (VV) – 297.2 ± 65.6 ml; maximal cystometric capacity (MCC) – 312.1 ± 83.3 ml; maximum urethral closure pressure (MUCP) – 48.4 ±11.9 cm H2O; functional urethral length (FUL) – 20.3 ± 8.2 mm; one-hour PadTest 8.2 ± 1.9 g. Two weeks after the introduction of SGL, the satisfactory effect was detected in 17 women (85%) 6 of them (30%) were completely dry. The need for SGL additional administration occurred in 11 women (55%), which was fulfilled. There was an improvement in key parameters compared to the initial data 3 and 6 months after treatment: VAS index significant decrease by 70.1 and 63.6%; increase of MUCP by 8.9 and 7.9%; increase of FUL by 14.3 and 18.2%; statistically significant decrease of PadTest weight by 61.0 and 53.7%; improvement of QOL by 60.6 and 48.5%, respectively. There was a slight decrease in Qmax – by 11.2 – 8.3%. Changes in other indicators did not exceed normal values. When evaluating the results after 6 months in 17 patients (85%), the effect of treatment and the quality of life were assessed as satisfactory: according to PadTest results urine loss was less than 5 g. Moreover, in 11 cases (55%) urinary incontinence disappeared, so the full effect was achieved. There was no satisfactory effect in 3 women (15%), they were offered surgical treatment of SUI. Long–term results up to 12 months were followed in a group of 9 women with a good effect of SGL implantation. The dynamics of the main indicators a year after implantation was: 52.8% decrease according to VAS; 41.1% decrease according to PadTest; 48.3% of QOL improvement. SUI was also absent after a year of observation. Request for SGL re-administration was received from 3 of 8 women with unsatisfactory result, although their urine loss did not exceed 5 g per hour. No complications were observed during the SGL i","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115728180","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 role of intraoperative intrarenal pressure in the postoperative period of percutaneous nephrolithotripsy in patients with urolithiasis.","authors":"D. N. Khotko, A. I. Khotko, V. Popkov, A. I. Tarasenko, A. Efimova","doi":"10.29188/2222-8543-2022-15-3-82-87","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-3-82-87","url":null,"abstract":"Introduction. Percutaneous and endourological surgeries are the most common interventions for nephrolytiasis in urologists’ practice. During the operation, it is important to maintain the right balance between sufficient flow of irrigation fluid for adequate visualization and safe intrarenal pressure. Intraoperative increase in intrarenal pressure is associated with the development of purulent-inflammatory complications in the postoperative period. The aim of the study. To substantiate the expediency of intraoperative monitoring of intrarenal pressure, as well as to assess the risks of postoperative complications after percutaneous nephrolithotripsy. Materials and methods. The study included 250 patients with staghorn kidney stones. In the first group (n=120) percutaneous nephrolithotripsy (PCNL) was performed according to the standard procedure with a puncture canal diameter of 30-32 Сh. The second group included 130 patients who underwent percutaneous nephrolithotripsy using a mini nephroscope (mPCNL) with a working channel diameter of 16 Ch. To achieve the aim of our study, we have developed a method for determining intrapelvic pressure, implemented using a miniature pressure sensor, which is installed directly into the pelvis at the time of the calycopelvical system puncture. During the surgery, the intrapelvic pressure was constantly monitored according to the method we proposed. Results. The lowest values of intrapelvic pressure were recorded when performing PCNL with the installation of an Amplatz sheath exceeding the size of the nephroscope by 2 or more Ch. When performing mPNLT, the installation of a ureteral catheter allows minimizing the increase in intrapelvic pressure. Hyperthermia in the postoperative period significantly depends on an increased intrarenal pressure and the presence of an infectious agent in the renal system. Separately performed urine cultures from the pelvic and bladder with obstruction of even minimal severity may have significant differences. In patients of mini-PNLT group intraoperative intrapelvic pressure was significantly higher (p≤0.05). The frequency of fever and exacerbation of calculous pyelonephritis is significantly higher in group of standart PNLT (p < 0.05), which is explained by greater traumatization of the renal parenchyma when creating a working fistula. Conclusion. The proposed method allows the most accurate intrasurgery monitoring of intrarenal pressure during minimally invasive surgical treatment of kidney stones in order to minimize the frequency of infectious and inflammatory complications.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"6 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114117082","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":"Comparative analysis of various surgical methods of urolithiasis treatment.","authors":"V. B. Filimonov, R. V. Vasin, I. S. Sobennikov, E.Yu. Shirobakina","doi":"10.29188/2222-8543-2022-15-3-88-93","DOIUrl":"https://doi.org/10.29188/2222-8543-2022-15-3-88-93","url":null,"abstract":"Introduction. Urolithiasis is one of the most common urological diseases with a trend towards stable growth in different countries. Thanks to the active development of minimally invasive surgery, lithotripsy has become possible in any part of the pelvicalyceal system, practically replacing open surgery for urolithiasis. Aim: to compare the clinical efficacy and safety of various methods of surgical treatment of urolithiasis. Materials and methods. The study included patients with urolithiasis who underwent surgical treatment in the Department of Urology of the State Budgetary Institution of Regional Administration of the City Clinical Hospital No. 11 (Ryazan) in the period from January 2015 to December 2020. Statistical data processing was performed using Microsoft Excel 2003 and Statistica 10 software. Results. During this period, 4415 patients whith urolithiasis were treated in the hospital. The total number of operations performed is 5655, including the necessary repeated operations associated with the formation of residual concretions after surgical treatment. The greatest number of repeated operations was required after extracorporeal shock wave lithotripsy (ESWL) and amounted to 56.1% in the localization of stones in the PCS and 47.0% in the ureter. The average number of complications in the form of residual concretions after contact lithotripsy was 13.3%, which is significantly less than the results after ESWL. The average number of days spent in the hospital was significantly higher after open surgical interventions and amounted to 12 days, while after contact and remote lithotripsy methods 4 and 7 days, respectively. The level of postoperative pain on the VAS scale (Visual Analog Scale) varied in the range of points 6-9 after open surgical interventions and persisted for a longer time in comparison with small and non - invasive interventions, where the level of postoperative pain varied in the range of 1-4 points. Conclusion. The results obtained by us confirm the safety and effectiveness of minimally invasive methods of lithotripsy. The main disadvantage of ESWL and lithotripsy methods using Ho-YAG laser is the frequent formation of residual concretions, however, such advantages as a shorter recovery period, less need for the use of non-opioid analgesics in the early postoperative period do not raise doubts about the need for their use and a reduction in the number of more traumatic surgical interventions.","PeriodicalId":123040,"journal":{"name":"Experimental and Сlinical Urology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127632717","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}