The functional assessment of the renal parenchyma and perirenal fatty tissue during electropiezolithotripsy by x-ray computed tomography]

Computed tomography was performed before and after telelithotripsy to evaluate changes in renal parenchyma induced by the procedure in 34 patients with nephroliths. Piezolith-2300 lithotriptor ("Wolf", FRG) was employed. The images showed no serious parenchymal injuries or paranephric hematomas, on the one hand, but density changes in the parenchyma, on the other hand. These were of 3 types: focal reduction in 3, diffuse reduction in 4 and diffuse increase of the density in 2 patients. As shown by comparison with literature data, telelithotripsy on "Piezolith-2300" causes minimal changes in renal parenchyma and perirenal fat. In view of this, the procedure is recommended for wide clinical and outpatient practice.     

Comparative assessment of the WHO and Gilson histological classifications of prostatic neoplasms (taking into account data of ploidy studies)

We estimated ploidometric nuclear parameters of predominating cell population in various prostatic adenocarcinomas in using WHO vs Glison classification to define advantages of the above classifications. Ploidometry provides information on cell composition and proliferative activity of cells. We observed greater ploidity in different grades of cell atypia. WHO histological classification by differentiation grade corresponds to ploidometric characterization of tumor cell populations but fails to reflect the presence of different histological types of the tumor. Currently introduced classification by Glison is more effective both diagnostically and prognostically as it reveals a dominant histological type of the tumor and shows other variants of tumor growth progression.     

Shockwave destruction of stones in the kidneys and ureters

Experience gained in the use of the first Soviet unit and western lithotriptors is based on the treatment of over 2500 patients of different age groups. Comparative characteristics of lithotriptors are provided to mark substantial advantages of the Soviet unit. Distant lithotripsy (DL) is much more effective and atraumatic as compared with conventional surgical interventions. The use of DL provides positive effect in 97-99% of cases. The rate of complications is extremely low, amounting to 5-10%. Indications and contraindications as to the use of DL are given. Contraindications include cases requiring reconstructive surgical interventions and the presence of coral-like calculi and acute inflammation. The Soviet unit appeared especially effective in the treatment of children with urolithiasis. The cure was attained in 97.2% of the patients, no serious complications occurred. Functional studies of the kidneys did not reveal any changes both in the short- and long-term periods after DL.     

Combined laser recanalization in the prostatic region of the urethra

A case is reported of an effective use of laser endoscopic intervention in benign prostatic hyperplasia when urethral anatomic size was small. The combined laser recanalization helped recovery of adequate non-assisted urination. Long-term outcome was favorable.     

The treatment of stress urinary incontinence in women]

Fifty-six females with enuresis were observed in 1986-1990. Their x-ray examinations included urodynamic techniques: uroflowmetry, cystomanometry, test of the profile of the intraurethral pressure. Basing on the findings, 11 patients were excluded from the group to be operated on. Two kinds of surgery were employed: urethrovesicofixation according to Marshall-Marketti-Kranz, endoscopic submucous administration of teflon paste. The former method corrected the position of the bladder but is less effective in correction of the intraurethral pressure. The experience obtained by the authors permitted them to propose Marshall-Marketti-Kranz operation for apparent vesicoptosis whereas the teflon paste injection in enuresis without pronounced vesicoptosis. The methods can be used in combination: if, in spite of good anatomical results of the operation, enuresis persists, the paste administration is advocated to achieve better functional outcome.