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Urologicheskie Vedomosti
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This is an Open Access Journal

Open Access journal
ISSN (Print) 2225-9074
Published by Eco-Vector LLC

[15 journals]

Influence of significant difference in diameters of ureters on the
possibility and effectiveness of ureteroureterostomy in the treatment of
obstructive uropathies of the duplicated kidney
- Authors: Iliya M. Kagantsov, Evgeniya A. Kondrateva, Svetlana A. Karavaeva, Anna A. Sukhotskaya, Lidiya V. Smyslova, Tatiana M. Pervunina
  Pages: 121 - 127
  Abstract: BACKGROUND: Laparoscopic ureteroureterostomy is increasingly used as a surgical correction method for obstructive uropathies of the duplicated kidney. A complicating factor for this technique may be a significant difference between the diameters of the ureters. AIM: This study aimed to analyze the effectiveness and safety of laparoscopic ureteroureterostomy in patients with obstructive uropathies of the duplicated kidney with a twofold or more difference in ureter diameters. MATERIALS AND METHODS: Among 14 children who underwent laparoscopic ureteroureterostomy for obstructive uropathies of the duplicated kidney at Almazov National Medical Research Centre between 2021 and 2023, in 10 patients (71.4%), the diameter of the “donor” ureter exceeded the diameter of the “recipient” ureter two times or more. RESULTS: In most patients, the indication for surgery was obstructive megaureter of the segment. All patients underwent laparoscopic ureteroureterostomy, proximal in 90% of cases and distal in one child. One of five patients underwent transurethral resection of the ureterocele as the first stage of operative treatment. The only complication observed in the postoperative period in the presented patients was a stent-associated urinary tract infection, which was treated conservatively. One child (10%) required ureter reimplantation with stump resection after ureteroureterostomy. CONCLUSIONS: Laparoscopic ureteroureterostomy is a safe and effective method for surgical correction of obstructive uropathies of the duplicated kidney although a significant difference is noted between the diameters of the “donor” and “recipient” ureters. This factor does not reduce the effectiveness of ureteroureterostomy and does not lead to an increased risk of postoperative complications and reoperations. Thus, laparoscopic ureteroureterostomy can be used in patients with obstructive uropathies of the duplicated kidney.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved626646
  Issue No: Vol. 14, No. 2 (2024)
Analysis of the experience of robot-assisted cystectomy with various types
of urine derivation
- Authors: Dmitry M. Monakov, Leonid T. Savin, Aleksandr G. Kochetov, Natalia A. Karelskaya, Tata A. Dmitrieva, Vardan A. Oganyan, Radzhab N. Magomedov, Aleksandr A. Gritskevich
  Pages: 129 - 138
  Abstract: BACKGROUND: Radical cystectomy is the main treatment for patients with muscle-invasive bladder cancer. Robot-assisted operations have become increasingly widespread; thus, an analysis of the results of using this technique is required. AIM: To analyze our experience with robot-assisted radical cystectomy with different types of urinary diversion and compare the results to those obtained by other centers. MATERIALS AND METHODS: The treatment results of 23 patients who underwent robot-assisted cystectomy with various types of urine derivation for bladder cancer between 2021 and 2024 were retrospectively analyzed. RESULTS: Patients who had the Studer urinary reservoir formed were slightly younger and had better functional status and a higher body mass index. Additionally, there were more patients of the very high-risk cT1 stage. In patients who underwent ureterocutaneostomy, stages sT3–4 were more common. The average duration of the operation was 418.2 minutes. The longest duration (533.5 minutes) was observed during the formation of the urinary reservoir and the shortest (294.3 minutes) during ureterocutaneostomy. The smallest (200 ml) and largest (3,500 ml) blood loss occurred in patients who underwent Bricker ileal conduit formation. Ten conversions to open surgery (5 in the group of patients who had a urinary reservoir and 5 in ileoconduit) were noted. Nine patients developed postoperative complications, with seven exhibiting Clavien–Dindo grade IIIa–IIIb complications. The median follow-up was 19.7 months. Disease progression occurred in two (9%) patients. One patient died 1.5 years after surgery due to underlying disease progression. CONCLUSIONS: Robot-assisted cystectomy is currently limited to specialized centers. The exchange of experience between them and its analysis are crucial to assess the immediate and long-term results of this technique and determine the category of patients who will benefit most from its application.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved632838
  Issue No: Vol. 14, No. 2 (2024)
Evaluation of the clinical efficacy of transurethral bipolar surgery and
laser technologies in the treatment of patients with benign prostatic
hyperplasia
- Authors: Suleiman I. Suleimanov, Alan M. Aguzarov, Zaur I. Ashurov, Aleksandr S. Babkin, Konstantin K. Bagaturiya, Vladislav V. Musokhranov, Alexander A. Tyagun, Dmitry A. Fedorov
  Pages: 139 - 146
  Abstract: BACKGROUND: Benign prostatic hyperplasia (BPH) is common middle-aged and elderly men. In modern urology, transurethral resection and its modifications are used in surgical treatment of BPH. In the last decades, an active tendency of laser technologies development in urology was noted. The search for the most appropriate techniques of transurethral removal of prostate adenoma by comparing the results of treatment of patients with the use of different technologies remains relevant. AIM: This study aimed to evaluate the clinical effectiveness of transurethral bipolar surgery and laser technologies in the treatment of BPH. MATERIALS AND METHODS: Transurethral enucleation of the prostate using various technologies was performed in 273 patients with BPH between 2021 and 2023: 94 patients underwent bipolar transurethral enucleation of the prostate, 87 underwent thulium enucleation of the prostate (ThuLEP), and 92 underwent holmium enucleation of the prostate (HoLEP). RESULTS: Clinical evaluation showed the absence of intraoperative complications. For ThuLEP, a trend toward shorter operative times compared to other techniques was observed. In the early postoperative period, significant bleeding was noted in six cases of using bipolar technology, three cases of using a thulium laser, and five cases of using a holmium laser. An examination of patients 6 months postsurgery showed pronounced positive dynamics in all three groups. No significant differences were found in clinical parameters 6 months postsurgery in patients of different groups. CONCLUSIONS: Bipolar enucleation of the prostate, ThuLEP, and HoLEP are comparable in effectiveness and the number of complications in the surgical treatment of BPH. Study results indicated that it is advisable to actively use these methods in wide clinical practice.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved624420
  Issue No: Vol. 14, No. 2 (2024)
Approbation and validation of Russian version of the interstitial cystitis
symptoms and problem index
- Authors: Natalia A. Bekker, Ekaterina S. Filippova, Aleksandr V. Zyrianov, Igor V. Bazhenov, Albert A. Makaryan
  Pages: 147 - 154
  Abstract: BACKGROUND: Improving the effectiveness of diagnosing and treating patients with primary bladder pain syndrome is crucial in current urology owing to the high prevalence of the condition, its significant impact on the quality of life, and the similarity of its clinical manifestations to other diseases. The clinical manifestations of primary bladder pain syndrome is typically evaluated using specialized questionnaires, with one of the most commonly utilized being the Interstitial Cystitis Symptoms and Problem Index. AIM: This study aimed to validate the Russian version of the Interstitial Cystitis Symptoms and Problem Index and thus assess its reliability and validity in accurately measuring the symptoms and problems associated with interstitial cystitis. MATERIALS AND METHODS: The study included 62 participants and divided them into two groups. Group A included 32 patients diagnosed with primary bladder pain syndrome, comprising 26 women and 6 men, with an average age of 55 years. Group B consisted of 30 conditionally healthy volunteers, comprising 20 men and 10 women, with an average age of 46 years. All participants were required to complete the Russian version of the Interstitial Cystitis Symptoms and Problem Index, Pelvic Pain and Urgency/Frequency (PUF) scale, and International Prostate Symptom Score (IPSS) and maintain a voiding diary. Additionally, patients with PBPS underwent cystoscopy with bladder hydrodistention. Data collected from the participants were utilized to determine the internal consistency, external validity, and test–retest reliability of the questionnaires using the interclass correlation coefficient. RESULTS: The mean of the Interstitial Cystitis Symptoms and Problem Index total in group A was 31.55 ± 7.07, which significantly (p < 0.001) exceeded the score of group B (2.90 ± 1.47). The Cronbach’s alpha of the total and “ICSI” and “ICPI” domains was 0.990, 0.834, and 0.854 respectively, confirming the high internal consistency of the Russian version of the Interstitial Cystitis Symptoms and Problem Index. External validity was verified by the relevant correlations with other questionnaires. Moreover, the total score of the questionnaire correlated with the clinical manifestations of primary bladder pain syndrome, the presence of Hunner’s lesions, and bladder capacity. CONCLUSIONS: The study findings indicate that the Russian version of the Interstitial Cystitis Symptoms and Problem Index exhibits good validity and reliability. Therefore, it can be recommended for use in clinical practice as an effective tool for assessing symptoms and problems associated with interstitial cystitis.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved630336
  Issue No: Vol. 14, No. 2 (2024)
Features of treatment of posterior urethral injuries in the acute period
of traumatic disease
- Authors: Gocha Sh. Shanava, Alexey A. Sivakov, Arutyun T. Movsisyan, Georgii G. Shanava
  Pages: 155 - 162
  Abstract: BACKGROUND: Combined pelvic trauma in men in 10%–24% of cases is accompanied by damage to the posterior urethra, and no consensus on the treatment tactics has been established for such patients. AIM: This study aimed to evaluate the results of treatment of patients with closed injury of the posterior urethra and traumatic shock. MATERIALS AND METHODS: A retrospective analysis of the results of treatment of 46 patients with closed injury of the posterior urethra caused by a fracture of the pelvic bones and traumatic shock was performed. The average age of patients was 42.1 ± 9.9 years. The severity of urethral injuries was assessed according to the American Association for the Surgery of Trauma (AAST) classification. RESULTS: The choice of treatment techniques depended on the degree of damage to the urethra and severity of traumatic shock. Upon hospital admission, 15 (32.6%) patients were diagnosed with grade I, 21 (45.6%) with grade II, and 10 (21.7%) with grade III traumatic shock. In grade I–II traumatic shock patients with incomplete urethral rupture, a urethral catheter was inserted, followed by conservative therapy. If a catheter insertion was possible, a retropubic revision of the urethra was performed. Patients with grade III–V urethral injury according to AAST and grade I–II traumatic shock underwent primary or delayed urethroplasty, such as urethral suturing and urethra-urethral anastomosis. Patients with grade III traumatic shock had a urethral catheter or cystostomy. In the long-term, 6 of 17 (36.9%) patients who underwent primary or delayed urethroplasty had short-term (up to 5 mm) urethral strictures, for which optical urethrotomy was performed. All patients with complete urethral avulsion who did not undergo early urethroplasty developed 10–20 mm strictures, requiring reconstructive surgery. CONCLUSIONS: The choice of treatment techniques for patients with concomitant damage to the posterior urethra depends on the degree of damage to the urethra and severity of traumatic shock. The scope of treatment in the acute period may include urethral or suprapubic drainage of the bladder or reconstructive surgery.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved625816
  Issue No: Vol. 14, No. 2 (2024)
Botulinum toxin therapy in urology: historical aspect
- Authors: Grigorii G. Krivoborodov, Igor V. Kuzmin, Margarita N. Slesarevskaya, Nikolay S. Efremov, Alina A. Gontar
  Pages: 163 - 174
  Abstract: The review article shows the main stages of studying botulinum toxin and its use in medicine. The possibilities of using botulinum toxin for the treatment of urological patients are similarly described. Furthermore, the most significant studies on the use of botulinum toxin in patients with neurogenic detrusor c, idiopathic overactive bladder, detrusor sphincter dyssynergia, chronic pelvic pain, benign prostatic hyperplasia, erectile dysfunction, and premature ejaculation are presented.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved633370
  Issue No: Vol. 14, No. 2 (2024)
Androgenic condition and statins: contradictions in modern literature
- Authors: Arsen V. Osipov, Tatiana I. Derevyanko, Nadezhda V. Agranovich, Roman S. Frantsev, Gayane G. Babasheva, Olga A. Aleksandrova
  Pages: 175 - 185
  Abstract: Pathological age-related involution of the male reproductive system is characterized by combined clinical manifestations, which are designated by the terms age-related androgen deficiency syndrome, andropause, and male menopause. In modern foreign literature, the term “late hypogonadism” is more often used; in domestic literature, “age-related androgen deficiency” is utilized. The problem of late hypogonadism has gone beyond the scope of endocrinology and sexopathology. Currently, it has acquired an interdisciplinary character and gained attention from gerontologists, cardiologists, diabetologists, andrologists, and other specialists. The medical and social significance of age-related androgen deficiency syndrome is determined by the fact that it worsens the quality of life and is a risk factor for death, primarily from cardiovascular diseases. The review article presents modern ideas regarding the effect of statins on the androgen status of men with cardiac pathology and hypercholesterolemia.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved623777
  Issue No: Vol. 14, No. 2 (2024)
Conservative treatment of intraperitoneal bladder perforations: a
conscious choice or forced measure
- Authors: Igor S. Shormanov, Dmitrii N. Shchedrov, Darya Yu. Garova, Natalia A. Sidorova, Ekaterina N. Babunina
  Pages: 187 - 196
  Abstract: Intraperitoneal traumatic perforations of the bladder of any origin (e.g., external trauma, iatrogenic injuries) and spontaneous ruptures are conditions that, according to the canons of surgery, require emergency surgical intervention by one or another access. However, some studies have indicated the possibility of conservative management of such patients — both adults and children. A review of publications describing the results of conservative treatment of patients with intraperitoneal bladder perforations was performed. Overall, 2,679 publications related to intraperitoneal perforations of the bladder were found in the available scientific databases, of which only 72 focused on issues of conservative treatment. In 13 of them, the possibility of such an approach is denied, but without reference to their own material. Analysis of the literature demonstrated that conservative management of intraperitoneal perforations of the may be feasible in certain circumstances, sometimes being a crucial measure. Indications for conservative treatment techniques include the absence of peritonitis, small perforation size, and short periods from the moment of perforation. However, all these indications are in the nature of opinions and assumptions and are not part of algorithmic tactics. The effectiveness of this approach remains unclear. The frequency of unsatisfactory outcomes ranges from 10% to 50%, which indicates the inappropriateness of conservative treatment. With the small number of studies and conflicting results obtained prohibits us to consider this technique as the method of choice for treating patients with intraperitoneal perforations of the bladder.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved628922
  Issue No: Vol. 14, No. 2 (2024)
Modern methods of diagnosis and treatment of vasculogenic erectile
dysfunction
- Authors: Ruslan R. Aliev, Alexandr I. Neymark, Andrei V. Davydov
  Pages: 197 - 207
  Abstract: A review of modern methods of diagnosis and treatment of vasculogenic erectile dysfunction is presented. Data regarding the diagnostic value of noninvasive and invasive diagnostic techniques are displayed: stamp test, Snap-Gauge test, use of the RigiScan and Androscan-MIT systems, intracavernous injections of vasoactive drugs, Doppler ultrasound of penile vessels, penile angiography, and magnetic resonance arteriography. The advantages and disadvantages of each of these tests are shown. The main directions of conservative and surgical treatment of vasculogenic erectile dysfunction are presented. Notably, early detection of erectile dysfunction with the prescription of appropriate treatment can improve the quality of life of patients and prevent life-threatening complications of cardiovascular conditions.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved630147
  Issue No: Vol. 14, No. 2 (2024)
Clinical aspects of the applicability of biomarkers of acute kidney injury
in ischemia-reperfusion in operative urology
- Authors: Sergey V. Popov, Ruslan G. Guseinov, Konstantin V. Sivak, Vitaliy V. Perepelitsa, Nikolai S. Bunenkov, Tatiana A. Lelyavina
  Pages: 209 - 216
  Abstract: The development of acute kidney injury during surgical renal-preserving interventions characterizes the nature of the clinical course and prognosis for the development of chronic kidney disease. The use of standard indicators of disease progression (serum creatinine and urea nitrogen) in clinical practice can lead to unfavorable outcomes of acute kidney injury due to their low sensitivity and high specificity against the background of damage to more than 50% of the renal parenchyma). Other biomarkers of acute kidney injury (cystatin C, IL-18, KIM-1, NGAL, L-FABP, NAG and others) are superior to creatinine in sensitivity and specificity, but require additional research to identify the most optimal ones for clinical practice.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved569117
  Issue No: Vol. 14, No. 2 (2024)
Embolization of prostatic arteries to stop bleeding in prostate cancer
- Authors: Sergei B. Petrov, Yulia A. Ponomareva, Sofya Yu. Glazneva, Dmitrii V. Ovcharenko, Kirill A. Smirnov, Tatiana V. Ulitko, Adel S. Al-Shukri
  Pages: 217 - 224
  Abstract: Prostatic bleeding is life-threatening, and its most common cause is locally advanced prostate cancer. In several patients, hemostatic therapy is ineffective. Surgery is not feasible in most patients owing to the high surgical risk. In such cases, prostatic artery embolization may be the method of choice to stop the bleeding. This procedure is minimally invasive; thus, it can be performed in patients with contraindications to more extensive operations. Despite limited experience with embolization of prostatic arteries, according to the literature, it is effective in 90% of treated patients. This article provides a review of the literature and clinical observations of the successful use of prostatic artery embolization to stop bleeding in patients with locally advanced prostate cancer.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved629307
  Issue No: Vol. 14, No. 2 (2024)
Boris N. Kholtsov (1861–1940): outstanding urologist, scientist, and
teacher. To the 100th anniversary of the start of employment in the
Urological Clinic of the Leningrad State Institute for Advanced Training
of Doctors
- Authors: Temuri Sh. Morgoshiia, Igor V. Kuzmin
  Pages: 225 - 231
  Abstract: This article is dedicated to outstanding clinical scientist Professor B.N. Kholtsov (1861–1940). The main stages of his scientific, clinical, and teaching activities and his scientific achievements in the development of novel methods for treating diseases of the urinary and male genital organs are presented. He was the first to propose a two-stage adenomectomy technique, an original method of urethral resection in case of stricture, and developed a surgical treatment method for contracture of the bladder neck. The role of Kholtsov in the training of urologists at the Department of Urology of the Leningrad State Institute for Advanced Training of Doctors, which he headed in 1926–1940, is shown. Kholtsov was a talented clinician, scientist, teacher, and innovator, whose main ideas remains in demand today.
  PubDate: 2024-08-08
  DOI: 10.17816/uroved625735
  Issue No: Vol. 14, No. 2 (2024)

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