Urologiia最新文献

{"title":"[Current approaches to diagnosis and treatment of urinary tract infections during pregnancy].","authors":"I Shperling M, V Shperling N, I Neimark A, S Kovaleva Yu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are one of the leading causes of extragenital pathology in pregnant women, occurring in to 5-7% of women. Despite the asymptomatic course in many cases, even uncomplicated UTIs carry the risk of complications for both the woman and the fetus due to the high risk of ascending infection. Therefore, timely diagnosis and rational therapy are key to preventing adverse outcomes. The diagnosis is based on characteristic clinical and laboratory signs. The basis for the treatment of UTIs is timely antibacterial therapy (ABT). At the same time, approaches to the empirical selection of a specific drug are identical between different types of infections, due to their etiological similarity. Rational ABT varies depending on the severity of the UTIs. In case of complicated course requiring hospitalization, preference is given to parenteral forms, while in those with uncomplicated UTIs, oral drugs are chosen in order to achieve high compliance. Oral ABT for uncomplicated UTI in pregnant women include nitrofurans, fosfomycin trometamol, and third-generation cephalosporins. Among the latter, cefixime seems to be most rational due to high sensitivity of the main uropathogens (E. coli), high efficiency, safety and compliance with treatment in pregnant women.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 4","pages":"116-122"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677027","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":"[Horizontal pyeloureteral anastomosis in patients with UPJ obstruction has anatomical and functional advantages over vertical anastomosis].","authors":"I Kogan M, V Sizonov V, L Medvedev V, A Palaguta G","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The standard approach to the treatment of short ureteropelvic junction (UPJ) obstruction is the Anderson-Hynes procedure. Despite its high efficiency and low complication rate, there are ongoing studies which study the modification of the procedure using open, laparoscopic, and robotic approaches.</p><p><strong>Aim: </strong>To describe a modified pyeloplasty technique with an assessment of the anatomical and functional results in comparison with the Anderson-Hynes procedure.</p><p><strong>Materials and methods: </strong>The results of 1,768 procedures for short UPJ obstruction and hydronephrosis performed using open (804), laparoscopic (888), and robotic (76) approaches in children and adults from 2000 to 2023 are presented in the article. A technique for horizontal ureteropyeloanastomosis after UPJ resection was developed by V.V. Sizonov and M.I. Kogan. A comparative analysis of the anatomical and functional results of vertical (standard) and horizontal anastomoses of the ureteral pelvis was performed using mathematical methods of the theory of hydrodynamics, and imaging studies after 12 months of follow-up.</p><p><strong>Results: </strong>Horizontal anastomosis of the renal pelvis and ureter increases the passage of urine by 19.75% compared to vertical anastomosis. Horizontal anastomosis is less tense after resection of the ureteral pelvis. Postoperative dynamics of the anteroposterior size of the renal pelvis after horizontal anastomosis reliably demonstrates accelerated reduction compared to standard technique. Horizontal anastomosis is associated with a significantly higher increase in GFR compared to vertical anastomosis.</p><p><strong>Conclusion: </strong>The author's technique of horizontal anastomosis between the ureter and pelvis has reliable anatomical and functional advantages over the Anderson-Hynes technique when performing open, laparoscopic and robotic pyeloplasty.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 4","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677035","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":"[Mini PCNL versus RIRS for renal stones: a prospective randomised controlled study].","authors":"N Akopyan G, Kh Davronbekov Kh, I Tursunova F, V Shpot E, A Gazimiev M, M Rapoport L, V Glybochko P","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Today it is urgent to introduce into clinical practice more advanced methods of kidney stone treatment with high indicators of their effectiveness and safety while minimizing the risk of repeated interventions. The goal of effective treatment of kidney stones is to completely rid the patient of stones and complaints, to eliminate organ dysfunction, using minimally invasive treatment methods that reduce the patients hospital stay and the risk of complications. However, there are only few studies comparing the clinical efficacy and safety of modern methods of surgical treatment of kidney stones 2 to 3 cm in size. Remote shockwave lithotripsy or retrograde intrarenal surgery is the treatment of choice for kidney stones up to 2 cm, and percutaneous nephrolithotomy is the treatment of choice for stones larger than 2 cm. Flexible ureterorenoscopy is not recommended as first-line treatment in patients with kidney stones &gt;2 cm due to the high risk of reintervention, according to the RTC clinical guidelines. However, it can be performed successfully in centers with extensive experience with this technique. The advantages of retrograde intrarenal surgery are low trauma, low risk of complications such as bleeding and damage to adjacent organs, and shorter hospital stay. The efficacy of flexible ureterorenoscopy is significantly lower for stones larger than 3 cm, and for stones between 2 and 3 cm there are only a few studies, which do not allow a reliable judgment on the efficacy and safety of this technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;To evaluate the efficacy and safety of flexible ureterorenoscopy in comparison with mini-percutaneous nephrolithotomy for kidney stones from 2 to 3 cm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A prospective randomized study to determine the efficacy of methods of surgical treatment of kidney stones from 2 to 3 cm in size using flexible ureterorenoscopy and mini-PCNL was conducted at the Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University (Sechenov University) in Moscow. The study analyzed the results of the performed surgical interventions in patients with urolithiasis using flexible URS and mini-PCNL as an example from the point of view of their effectiveness and safety for kidney stones from 2 to 3 cm. The study utilized the results of 133 patients (including 64 patients after flexible URS and 69 patients after mini-PCNL). The mean size and mean density and location of the nodule between the groups were comparable and had no statistically significant differences. The effectiveness of the intervention in the form of complete absence of concretions, length of stay in the clinic, operative time, development of postoperative complications (bleeding, urinary tract infection) and Claviens surgical complication score were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;of the study. The duration of surgery was longer in the","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 4","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677038","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":"[Prevalence of urinary incontinence in people aged 65 years and older: results from the study EUCALYPTUS].","authors":"N Tkacheva O, G Krivoborodov G, M Vorobieva N, V Kotovskaya Yu, S Efremov N, A Gontar A, A Shirin D","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary incontinence (UI) is any involuntary leakage of urine. It is a common and distressing problem, which may have a large impact of quality of life.</p><p><strong>Aim: </strong>To assess the prevalence of UI in people over the age of 65.</p><p><strong>Materials and methods: </strong>Participants were 4308 elderly individuals (1292 men and 3016 women) with an average age of 78+/-8 years.</p><p><strong>Results: </strong>UI was detected in 1953 patients (45,3%), including urgent UI in 25,8%, stress UI in 12,3% and mixed UI in 8,3% cases. There was a clear tendency to higher incidence of all types of UI with age. Our data show the need for mandatory consultation with a urologist for all person over the age of 65.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 4","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676991","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":"[Endoscopic treatment of obliteration of the ureteral orifice after transurethral resection of bladder tumor. Rendez-vous technique].","authors":"A Aboyan I, A Grigoriev N, M Pacus S, A Shiranov K","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Transurethral resection is the main method for diagnosing and staging bladder cancer, which allows to determine treatment tactics. Tumors located in the area of the ureteric orifice is an important clinical problem.</p><p><strong>Aim: </strong>To describe our experience in the treatment of ureteral obliterations after transurethral resection of the bladder tumors.</p><p><strong>Materials and methods: </strong>From 2021 to 2023 in the CDC \"Zdorovie\" in Rostov-on-Don, a total of 6 patients underwent endoscopic recanalization of the obliteration of the ureteral orifice after transurethral resection of bladder cancer.</p><p><strong>Results: </strong>The average follow-up period for patients was 6 months. The average duration of the operation was 42 minutes, bladder catheterization 2 days. One of the main criteria for the efficiency of treatment was the absence of upper urinary tract obstruction 3 months after stent removal. In 3 patients, ureteral stents were removed. In two cases, the absence of stricture recurrence was confirmed; in one patient with a stricture of 1 cm in length, a relapse was detected.</p><p><strong>Discussion: </strong>In this article, we describe a technique for endoscopic treatment of iatrogenic obliteration of the ureteral orifice and intramural part of the ureter, in which a combination of antegrade and retrograde access (Rendez-vous) or \"cut-to-the-light\" technique allows to restore ureteral patency.</p><p><strong>Conclusions: </strong>The endoscopic approach in patients with obliteration of the ureteral orifice after transurethral resection of a bladder tumor is an alternative to open or laparoscopic ureteral reimplantation and provides high efficiency with a low percentage of complications.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 3","pages":"10-13"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676847","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":"[Postcoital cystitis in menopause].","authors":"V Kulchavenya E, S Treivish L, V Telina E, P Kholtobin D, V Brizhatyuk E, Yu Shevchenko S","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Symptoms of dysuria due to bladder inflammation associated with sexual intercourse (postcoital cystitis) negatively affect the psycho-emotional state of patients, reduce the quality of life and lead to the development of sexual dysfunction. With the advent of the possibility of antibacterial prophylaxis and improved sanitary and hygienic conditions, interest in surgical treatment of postcoital cystitis has decreased.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;An open, prospective, non-comparative study included 56 patients with postcoital cystitis in different periods of menopause (perimenopause, menopause and postmenopause). At the time of inclusion, all women had symptoms of cystitis associated with recent (no more than 24 hours ago) sexual intercourse. Patients filled out a specially developed questionnaire and the Acute Cystitis Symptom Score (ACSS). They underwent urinalysis and urine culture with antibiogram. All patients were prescribed Superlymph suppositories in a dose of 10 units as monotherapy according to the scheme: 1 suppository rectally in the evening, 1 suppository vaginally in the morning. Patients with leukocyturia and bacteriuria were initially given antibacterial therapy, after which they were prescribed Superlymph according to the scheme described above as monotherapy. The targeted cytokine therapy was prescribed for 1 month. During treatment, the patients continued to have sexual activity as usual. The efficiency of treatment was assessed immediately after completion of the course and 3 months after its completion. The efficiency was evaluated according to the incidence of postcoital cystitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In patients included in the study, the first episode of cystitis occurred on average at the age of 33.1+/-2.4 years. In almost half of women (n=24 (42.9%)), the onset of cystitis was associated with sexual activity. During reproductive age, 42 (75%) women had postcoital cystitis, and 10 (23.8%) of them had only one episode. At the same time, every fourth woman (n=14 (25%)) suffered from first episode of postcoital cystitis during menopause. The average age of patients at which the first episode of postcoital cystitis occurred was 38.6 +/- 7.7 years. After a month of monotherapy with Superlymph, 31 patients (55.4%) did not report a single episode of postcoital cystitis, while after three months, 42 women (75.0%) achieved recurrence-free status. Of the 26 patients (46.4%) who were initially diagnosed with bacterial vaginosis, the vaginal normocenosis was found in 18 (69.2%) cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Postcoital cystitis can occur in women of any age, including those with a normal anatomy of the genitourinary system. Combined rectal and vaginal use of Superlymph suppositories at a dose of 10 U for a month helps to avoid relapse of postcoital cystitis in 55.4% of patients. Targeted cytokine therapy has a prolonged effect within three months after completion ","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 3","pages":"21-27"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677016","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":"[Studers operation is a fight for the quality of life of the patient].","authors":"S Los M, S Makov P, V Ukharsky A","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article presents a clinical observation demonstrating the functional results of orthotopic bladder plastic surgery according to Studer after radical cystectomy, which demonstrates the progression of chronic kidney disease (CKD) 2.5 years after surgery. According to the literature, patients who survived the early postoperative period with muscle-invasive bladder cancer and no lymph node involvement have a high probability of relapse-free and cancer-specific life expectancy of more than 15 years, but the probability of developing severe renal failure reaches 20%, which reduces the quality and duration of life of such patients. Progression of CKD in patients after orthotopic bladder plastic surgery according to Studer is possible against the background of high intravesical pressure in the emptying phase. According to clinical guidelines, intermittent autocatheterization is indicated for patients with neurogenic bladder dysfunction such as detrusor hypotension and high intravesical pressure during the voiding phase, minimizing the risk of upper urinary tract damage. Standards for managing patients with an orthotopic bladder do not provide such recommendations. Additional studies are needed to determine the advisability of persistent catheterization of an artificial bladder in the absence of residual urine but high intravesical pressure during urination.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 3","pages":"93-97"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677019","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 the combined drug Urolife-Next for recurrent lower urinary tract infections: clinical and microbiological aspects].","authors":"N Slesarevskaya M, V Kuzmin I, A Kraeva L, V Smirnova E, A Lisitsa D","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Improving the efficiency of treatment and prevention of recurrent lower urinary tract infection (LUTI) is an important problem in modern urology. A significant role is given to the non-antibiotic measures.</p><p><strong>Aim: </strong>To evaluate the clinical and microbiological efficiency of the drug Urolife-Next in patients with recurrent UTI.</p><p><strong>Materials and methods: </strong>A total of 70 women with recurrent UTI aged 18 to 55 years (mean 35.1+/-10.1) and symptoms of cystitis were included in the study. After antibacterial therapy, all patients were divided into 3 groups. In the group 1 (n=24), patients took Urolife-Next 1 capsule 3 times a day for 90 days, in the group 2 (n=23) Urolife-Next in the same dose, but for a period of 30 days, while patients of group 3 (n=23) did not receive any treatment. The total follow-up period was 90 days. Frequency and severity of symptoms of recurrent UTI were assessed. The microbiological part of the study included evaluation of the presence and severity of anti-adhesive, anti-biofilm and direct antibacterial effects of the Urolife-Next against uropathogens isolated from urine of patients with exacerbation of UTI.</p><p><strong>Results: </strong>In group 1, in which patients took Urolife-Next throughout the study, the lowest frequency of relapses was seen. During the 90-day follow-up, recurrences of UTI occurred in only 3 (12.5%) patients in group 1, compared to 18 (78.3%) in group 3. In addition, in the group 1 there was a significantly lower severity of symptoms during exacerbation of cystitis compared to the initial episode, as well as to 3. Urolife-Next showed antibacterial activity against 29 (41.4%) of 70 strains of uropathogens. The minimum inhibitory concentration of Urolife-Next against gram-negative microorganisms was on average 2 times higher than for gram-positive pathogens. A pronounced anti-adhesive activity of Urolife-Next in vitro was also revealed. The maximum anti-adhesive effect was observed 2 hours after the start of the study. By this time, the adhesion index for cultures in the presence of Urolife-Next was 2.3 times lower than the control values for E. coli, 2.5 times for Kl. pneumoniae, and 2.9 times for E. faecalis. Significant antibiofilm activity of Urolife-Next was also noted. The severity of biofilm formation, which was assessed by changes in the optical density of cultures, decreased by 1.3-2.2 times, depending on the type of uropathogens.</p><p><strong>Conclusions: </strong>The results of the study prove the efficiency of the dietary supplement Urolife-Next for the prevention of recurrences in patients with UTI. Its components (D-mannose, cranberry extract, vitamins D and C, hyaluronic acid, probiotics) influence the main pathogenetic factors.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 3","pages":"39-49"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677021","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":"[Antioxidants as part of preconception preparation in men over 45 years of age].","authors":"A Nashivochnikova N, N Krupin V, V Krupin A, E Leanovich V, O Getigezhev I","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The reproductive potential of older men is influenced by the androgen deficiency and an increased risk of sperm DNA damage. In addition, with aging, a number of other diseases may have a detrimental effect on spermatogenesis. For this reason, the search for methods for correcting impaired spermatogenesis in men of the older age group is of relevance. The use of dietary supplements with antioxidant effects seems promising.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To increase the efficiency of preconception preparation for men aged 45 years and older using an antioxidant complex.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A total of 102 patients aged 45 years and older with pathospermia and metabolic syndrome (MS) of varying severity were included in the study. The main group consisted of 52 patients aged 45 to 55 years, while in the control group there were 50 patients (45-54 years). In addition to standard therapy for MS, patients of the main group received the dietary supplement \"Speroton\", 1 sachet 2 times a day with meals for 3 months. In the control group, men received only standard therapy for MS. The results were assessed after 3 and 6 months from the start of treatment. A sperm analysis was used as the main criterion for assessing treatment efficiency. Sperm DNA damage was characterized by DNA fragmentation. In addition, the concentration of zinc in seminal plasma, as well as the total antioxidant activity (TAA), was determined for all patients. Laboratory analysis of sex hormones, carbohydrate metabolism parameters, and lipid profile was also performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As a result of the adding the antioxidant complex \"Speroton\", the indicators of oxidative stress in the main group decreased almost two-fold. By the 6th month, the level of immunoreactive insulin (IRI) decreased by 22%, which was accompanied by a decrease in the level of glycosylated hemoglobin (HbA1c) by 6.6%, indicating stabilization of carbohydrate metabolism. Positive dynamics in reducing body mass index (BMI) by almost 12% in the main group were seen, as well as normalization of the lipid profile. In addition, there was a significant increase in sperm concentration from 10.5+/-5.5 million/ml to 21.5+/-4.8 after 3 months of taking the antioxidant complex \"Speroton\", positive dynamics were also noted in terms of DNA fragmentation, TAA level and zinc level in seminal plasma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The use of the antioxidant complex \"Speroton\" in an increased dose of 2 sachets per day for 3 months in men older than 45 years with pathospermia and MS of varying severity improves the qualitative and quantitative sperm indicators and the morphological state of the male reproductive system. A determination of the level of zinc in seminal plasma, TAA, as well as the sperm DNA fragmentation, especially in patients aged 45 years and older suffering from MS, is justified. The use of the \"Speroton\" results in a decrease in the per","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 3","pages":"72-78"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676590","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":"[Recurrent varicocele: causes and treatment].","authors":"V Kotov S, D Korochkin N, V Vasilyiev, M Iritsyan M","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Among the different options for varicocele surgery, microsurgical varicocelectomy demonstrates the best results, but a relapse is subsequently detected in 1-3% of cases. It was previously believed that the cause of recurrence lies in the presence of various sources of venous outflow from the testicle, but recent studies show that the collaterals of the gonadal vein are the main reason of recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;to determine the leading cause of recurrence, to evaluate the effectiveness and optimal surgical tactics depending on the method of primary treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Surgical treatment of 74 patients with recurrent varicocele was performed for 5 years. Depending on the method of primary treatment, two groups were formed: 1 - relapse after non-microsurgical varicocelectomy (n=37), 2 - relapse after microsurgical varicocelectomy (n=37). Patients of the first group underwent microsurgical subinguinal varicocelectomy. Patients of the second group underwent endovascular surgery or redo microsurgical varicocelectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;1 group. Scrotal pain syndrome was relieved in 90% of cases (n=18). Among patients with complaints of infertility (n=8), natural pregnancy occurred in 57,1% (n=4). An improvement in sperm parameters was found among 18 (75%) patients with pathospermia. The US-recurrence rate was 5.4% (n=2), clinical manifestation revealed in 1 case (2,7%). Intraoperatively, preserved branches of the gonadal vein were detected in all cases. 2 group. Scrotal pain syndrome was relieved in 95,8% of cases (n=23). Among patients with complaints of infertility (n=11), natural pregnancy occurred in 27,3% (n=3). An improvement in sperm parameters was found among 14 (73,7%) patients with pathospermia. The US recurrence rate after repeated microsurgery was 13% (n=3), after endovascular intervention - 38.5% (n=5). Clinical manifestation and indications for reoperation were identified in one patient who underwent endovascular embolization. Other cases of the second recurrence were subclinical, no indications for surgical treatment were identified. Renospermatic reflux was determined in all cases of phlebographic recurrence confirmation. No patients with ileospermatic reflux, as well as May-Turner syndrome, were identified. In 8 cases of phlebography, there was no technical possibility to perform embolization; in 3 patients, recurrence was not confirmed. Always the intact gonadal vein branches were identified mainly in the immediate vicinity of the testicular artery, in case of repeated microsurgical operation. There were no cases of testicular atrophy or postoperative hydrocele in any of the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Missing collaterals from the gonadal vein basin play a key role in the genesis of varicocele recurrence. When choosing a surgical treatment option for patients with recurrent varicocele, it is necessary to","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 3","pages":"14-20"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682408","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}