Resection of the kidney for tumor

The experience of 159 organ-preserving operations (112 renal resections and 47 enucleations) enabled the authors to formulate basic aspects of nephron-saving operations. Renal resections are valid in one kidney affected by the tumor, the other being intact. A complex of the preoperative examinations must include selective renal pharmacophlebography to reject tumor thrombus of the intrarenal vein outside the tumor site. 10 patients were resected by the modified technique - frontal removal of a part of the kidney with the tumor. Frontal resection of the kidney (ventral or dorsal) is recommended in location of the tumor in the superior or inferior segment in tumor growth forward or backward, in cases when each millimeter of renal parenchyma is important for the patient. Regional and juxtaregional lymphadenectomy must be made in any surgery for renal cancer. Long-term outcomes of organ-saving operations should be assessed not only by tumor stage and malignancy but also by the state of the contralateral kidney.     

Mineral water Volzhanka from Undorovskĭ spring in combined therapy of patients with nephrolithiasis and chronic pyelonephritis

Water loading is an essential component in therapy of nephrolithiasis, especially in the presence of small ureteral concrements or fragments after extracorporeal shock-wave lithotripsy. Saluretics, furosemide in particular, cause side effects. One of these is dyselectrolytemia due to potassium loss. Mineral waters have advantages in the treatment of nephrolithiasis and pyelonephritis as their drinking does not lead to electrolyte loss. Low mineral waters are highly diuretic, e.g. after drinking 1 liter of Volzhanka day-time diuresis increases by 300-400 ml. This relieves ureteral and calyceal-pelvic tonicity stimulating elimination of the concrements or their fragments after lithotripsy. Intake of Volzhanka proved effective in combined therapy of nephrolithiasis, calculous pyelonephritis, urate nephrolithiasis.     

The role of examination of lower urinary tract function in choice of treatment policy in patients with chronic cystitis and chronic nonobstructive pyelonephritis

The latest investigations evidence for growing number of women with urination disorders in the absence of pathological changes in the urine. This fact suggests the conclusion that dysuria may be caused by neuroendocrine disorders in such women. Besides hemodynamic disorders, urodynamic ones are also involved in pyelonephritis pathogenesis. Our investigations show that chronic non-obstructive pyelonephritis and chronic cystitis can be both a cause and a result of functional disorders of the lower urinary tract related to defects in nervous regulation. Long-term dysfunction of the lower urinary tract may provoke progressive inflammation. In this case antibacterial and anti-inflammatory treatment of chronic cystitis and chronic non-obstructive pyelonephritis may be low effective without normalization of functional condition of the urinary bladder and urethra.     

Levitra in the treatment of patients with chronic prostatitis associated with sexual dysfunction

Sixty patients with chronic prostatitis and sexual dysfunction were divided into two groups. All the patients received one-month standard course of physiotherapy. In addition, group I (n = 30) was given levitra (vardenafil; 5 mg per os each other day), the control group was not given this drug. Follow-up covered 6 months to 1.5 years. General urological examination, questionnaire survey, ultrasound investigation of male genital organs were made before, 1 and 6 months after treatment. The results were processed statistically. Levitra improves circulation in male sexual organs promoting increased arterial inflow to the prostate and penis. Aftertreatment effect persisted for half a year. Regular levitra intake (2-3 times a week) is recommended to correct circulation in the sexual system, including prostatic gland, but not only for correction of erectile dysfunction as a result of psychogenic and vascular disorders in the penis accompanying chronic prostatitis.     

Urolithiasis: current aspects of diagnosis and treatment

The aim of the study was clinicodiagnostic assessment of current methods of computer visualization (spiral computed tomography, multispiral computed tomography) and their role in specification of indications, contraindications and technical characteristics of current methods of urolithiasis treatment. The results of combined examination and therapy of 759 urolithiasis patients treated in the urological clinic of I.M. Sechenov Moscow Medical Academy in 1999-2003 are presented.     

Efficiency and safety of prostamol-Uno in patients with chronic abacterial prostatitis

In this open label prospective study in patients with category III prostatitis we assessed efficacy and safety of Sabal serrulata plant extract (prostamol Uno 320 mg) (group I, n=30) as compared to watchful waiting (group II, n=24). Efficacy was evaluated by means of NIH-CPSI, IPSS-QoL questionnaires, patients' general subjective assessment of treatment outcome, uroflowmetry and transrectal Doppler mapping (colour doppler and spectral doppler) of the prostate. Patients receiving prostamol Uno in comparison with watchful waiting group had significant improvement of mean NIH-CPSI (from 17.8 to 11.4 vs 17.1 to 16.5) and IPSS (from 13.0 to 6.3 vs 13.2 to 11.6) scores, Qmax values (from 12.9 ml/s to 17.8 ml/s vs 13.3 ml/s to 14.4 ml/s) and Doppler parameters of vascular resistance in the prostate. According to the patients' subjective assessment, moderate and significant improvement was reported by 76.7% patients in prostamol Uno group vs 23.3% in the watchful waiting group. There were no severe side effects. In prostamol Uno group one patient (3.3%) had moderate dyspepsia that resolved without termination of the drug administration. Prostamol Uno showed good efficacy and safety profile in patients with category III prostatitis.