卷 11, 编号 2 (2021)

Urology reports (St. - Petersburg). 2021;11(2):97-104

97-104

精索静脉曲张对生育能力的影响研究

Zamyatnin S., Gonchar I., Schmidt A.

摘要

精索静脉曲张被认为是泌尿系统最常见的疾病之一，但其真正的患病率是一个争论的问题。在本研究中，对442名年轻男性（平均年龄为21.6岁）进行筛查，发现I级精索静脉曲张的男性占7.2%，II级占42.1%，III级占15.2%，只有35.5%的男性没有精索静脉曲张。41%的病例在左侧单独诊断精索静脉曲张，36.5%的病例在双侧发现精索静脉曲张，22.5%的病例在右侧发现精索静脉曲张。在II级精索静脉曲张患者中，有47.3%的患者出现病源性精子症，在III级精索静脉曲张患者中有61.2%出现病源性精子症。研究过程中获得的数据显示精索静脉曲张及其持续时间对精子质量，特别是精子形态有显著影响。

Urology reports (St. - Petersburg). 2021;11(2):105-112

105-112

Chronobiological approach to the treatment of patients with benign prostate hyperplasia and chronic prostatitis: results of a morphological examination

Kuzmenko A., Gyaurgiev T., Barannikov I., Leybovich B.

摘要

MATERIALS AND METHODS: 60 patients with benign prostatic hyperplasia (BPH) and category II chronic prostatitis (NIH, 1995) were examined. The average age of the patients was 60.5 ± 5.5 years. The patients were divided into two groups of 30 people each. The comparison group (GC) included patients who received standard therapy with drugs from the group of alpha-blockers and fluoroquinolones. The main group (MG) consisted of patients who received standard therapy in combination with physiotherapy sessions with the device “SMART-PROST”, which were carried out in the acrophase of the chronorhythm. After the end of the course of therapy all patients underwent transurethral resection of the prostate, after which a morphological and morphometric (immunohistochemical) study of the obtained material was carried out.

RESULTS: According to the results of the morphological and morphometric examination of the histological material in patients of the CG and MG, statistically significant differences were revealed in all the studied parameters, which testify to the persistence of signs of the inflammatory process in the CG, while in the MG, the severity of inflammation was significantly lower.

CONCLUSION: According to the results of the study, personalized complex therapy of patients with benign prostatic hyperplasia in combination with chronic prostatitis using a combined physiotherapeutic effect of the SMART-PROST device, taking into account the individual chronobiological characteristics of patients, allows to more effectively arrest the inflammatory process in the prostate tissue, which can lead to a decrease in the number of postoperative complications. However, the last statement requires further more detailed study.

Urology reports (St. - Petersburg). 2021;11(2):113-122

113-122

Assessment of copulative function and severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia after transurethral enucleation

Vydrin P., Kalinina S., Burlaka O., Aleksandrov M.

摘要

AIM: was to conduct a comparative assessment of copulative function and the severity of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) who underwent laser and bipolar transurethral enucleation of the prostate and who treated conservatively.

MATERIALS AND METHODS: 143 BPH patients aged 50 to 80 years (mean age 65 years) with complaints of copulatory and urinary disorders were under observation. All patients were divided into two groups. The 1st (main) group included 102 patients who underwent surgical treatment: transurethral laser enucleation of the prostate (n = 55) and transurethral bipolar enucleation of the prostate (n = 47). Patients of the 2nd group (n = 41) received conservative treatment. Control examinations were performed before treatment, 4, 12 and 24 weeks after it.

RESULTS: All 102 patients of group 1, regardless of the type of surgery, noted retrograde ejaculation four weeks after surgery. In the majority of patients of the 1st group during these periods weakening of orgasm was noted, in a significant number – deterioration of erection and decreased libido were noted. Upon further observation, by the 12th week after the operation, restoration of all components of the copulatory function was noted, with the exception of ejaculation. By the 24th week of observation, only in 2 patients of the 1st group the normal mechanism of ejaculation was restored. Surgical treatment of patients in group 1, regardless of the method of surgery, led to a significant decrease in the severity of LUTS, an increase in the maximum urine flow rate, a decrease in the volume of the prostate gland and the amount of residual urine. There were no significant differences in the dynamics of these indicators depending on the method of transurethral enucleation. The patients of the 2nd group also had an improvement in clinical parameters, but it was much less pronounced than in the 1st group.

CONCLUSION: Laser and bipolar transurethral enucleation of the prostate are effective surgical techniques that significantly improve the outflow of urine from the bladder, reduce the severity of LUTS and improve the sexual function of patients. Surgery is well tolerated by patients. At the same time, almost all patients operated on by these methods develop retrograde ejaculation.

Urology reports (St. - Petersburg). 2021;11(2):123-132

123-132

Formation dynamics of phase and elemental composition of the oxalate-calcium nephrolithes

Plugin P., Troitskij D., Gubanov A., Tsygankova A., Troitskaia I., Feofilov I.

摘要

BACKGROUND: Fundamental investigation of the issue how various factors influence on origin and behavior of the nephrolithiasis is very actual because of necessity of the information about of early diagnostic methods as well as a prognostication. So, the information about of formation dynamics of phase and elemental composition of oxalate-calcic nephrolithes pending of lifetime of one patient is useful.

AIM: The aim of the investigation is to obtain the information about of elemental composition as well as phase composition of the one patient nephrolithes formed pending of lifetime.

MATERIALS AND METHODS: In the paper the data of the careful investigation of the elemental and phase composition of the two nephrolithes ablated from one patient at different times are presented. First nephrolith had been ablated from the right kidney in the March of 2002 (patient was 41 years old), subsequently second that had been did from the left kidney in the December of 2019 (patient was 58 years old; the nephrolith was found in 2012). The study was carried out using mass spectrometry and atomic adsorption spectrometry with inductively coupled plasma, infrared spectroscopy, X-ray phase analysis, CHN/S analysis.

RESULTS: Both calculi were calcium oxalate, predominantly Vevellite structures. The chemical composition of the both nephrolithes is alike. They contain microimpurities of all essential as well as conditionally essential elements. Quantities of the toxic elements in the nephrolithes are identical too. Microquantities of the nitrogen and sulphur indicate a presence of amino acids and proteins in the nephrolithes structure.

CONCLUSIONS: The results indicate that the nephrolithes with invariable phase and elemental composition would be forming in the different kidneys of one patient pending of lifetime.

Urology reports (St. - Petersburg). 2021;11(2):133-140

133-140

Reviews

Pathology of the urachus. History of the issue and current state of the problem

Shchedrov D., Shormanov I., Kotov S., Morozov E.

摘要

Based on the analysis of literature sources, modern data are presented on the nosological structure of urachus diseases in adults and children, diagnostic methods, as well as treatment tactics for various anatomical variants of anomalies in the development of the urinary duct. A modern classification of urachal malformations caused by disorders of its obliteration is presented. Various modifications of the laparoscopic approach are considered for the most common types of this pathology. The reasons for the development of malignant neoplasms from the urachus tissue, including in the gender aspect, are described, and a comparative assessment of the methods of surgical treatment of urachus tumors is given.

Urology reports (St. - Petersburg). 2021;11(2):141-152

141-152

关于男性不育、代谢综合征、肥胖的研究

Korneyev I., Matsueva I.

摘要

这篇综述文章致力于当前对代谢综合征和肥胖男性生殖功能可能产生负面影响的机制的理解。本文介绍了临床研究的结果，证明代谢紊乱的严重程度、交配活动、射精参数、怀孕的可能性以及后代的健康之间存在关系。

Urology reports (St. - Petersburg). 2021;11(2):153-162

153-162

非肌层浸润性膀胱癌的光动力荧光诊断研究

Kasymov B., Shanazarov N., Muratov T., Daniyarova G., Zhumakayev A., Kyzlasov P., Mustafayev A., Slesarevskaya M., Kuzmin I., Al-Shukri S.

摘要

本文就光动力学在非肌层浸润性膀胱癌诊断中的应用作一综述。介绍了光敏剂作用机理的现代数据，荧光膀胱镜检查的方法，在实际医学中使用光动力学诊断的临床研究结果。结果表明，与标准膀胱镜检查相比，光动力诊断显著提高了膀胱癌的检测效率。这种方法在原位癌（carcinoma in situ）和多局灶尿路上皮肿瘤的病例中尤其有价值。提高诊断水平可以提高手术治疗的根治性和延长无复发期。

Urology reports (St. - Petersburg). 2021;11(2):163-174

163-174

Сlinical observations

库珀氏囊肿（尿道球部囊肿）的研究

Protoshchak V., Sivakov A., Gozalishvili S., Karandashov V., Gorbunov A.

摘要

库珀氏囊肿（来自希腊syringo—囊管，cele—扩张），或尿道球部囊肿—是球状尿道腺体（库伯腺）排泄管的囊性扩张。该病极为罕见，多见于儿童。库珀氏囊肿的临床表现是非特异性的，取决于许多因素：大小，定位，与尿道的沟通，感染过程。如果没有特殊的放射和内镜诊断方法，库珀氏囊肿的发现是不可能的。最常见的情况是，这种病理表现被掩盖为生殖器官的炎症性疾病，因为这些症状仅限于尿道外开口的分泌物、尿的一般分析变化和排尿困难的表现。目前，国内外文献中对该病理的研究还不到20篇。

Urology reports (St. - Petersburg). 2021;11(2):175-182

175-182

Clinical and laboratory features of the course of obstructive pyelonephritis in a patient with quantitative kidney abnormality

Suleymanov S., Kadyrov Z., Dilanyan O., Ramishvili V., Musohranov V., Babkin A.

摘要

The kidney duplication is the most common abnormality of the urinary system. In most cases, this condition is an accidental finding on prenatal ultrasound or can be diagnosed when the first clinical manifestations occur. Abnormalities of the upper urinary tract can be detected when examining a patient with arterial hypertension, proteinuria, or renal failure. As an example of the complicated course of the inflammatory process in a patient with quantitative kidney abnormality, a clinical observation of the course of obstructive pyelonephritis against the background of complete obliteration of the lower third of the ureter with the formation of terminal changes in the upper half of the doubled kidney, which led to renovascular hypertension and clinically significant renal failure, is presented. The article describes the clinical manifestations of the disease, laboratory and diagnostic screening, as well as the stages of surgical treatment in a multidisciplinary hospital.

Urology reports (St. - Petersburg). 2021;11(2):183-190

183-190