67 stereotypes of structural modification of the urothelium in various diseases of the urinary bladder and prostate

Structural modification of the urothelium was studied in various diseases of the urinary bladder and prostate, including urinary bladder cancer, vibration cystopathy, chronic prostatitis, benign prostate hyperplasia, and chronic cystitis. The general phenomena of changes in urinary bladder epithelium were atrophy, squamous metaplasia, and instability of the urothelium (focal atrophy, dysplasia, hyperplasia, and metaplasia). This phenomenon can be interpreted as a morphological marker for cancer risk.

[Administration of afala preparation in urological practice]

Our studies of afala in patients with prostatic adenoma demonstrate that afala reduces irritative disorders of urination. Effect of this drug is seen in 98.3% patients during 4 weeks of its use. In longer intake the effect becomes stronger. The dose of 6 tablets a day significantly improves life quality. Three times a day dose is more effective in elimination of nicturia, enhances urine flow rate. Thus, choice of afala dose depends on the symptoms. Afala is indicated for prophylaxis in patients with initial stage of prostatic adenoma and as an alternative to expectation policy.

[A new method of hemostasis with porous nikelide-titan cryoapplicator in percutaneous approach to the kidney]

The aim of the study was improvement of percutaneous interventions outcomes by introduction of innovation--cryohemostasis of the wound for arrest and prevention of hemorrhage. A total of 242 percutaneous roentgenoendoscopic operations were made in 2004-2006. Intensive intra- and postoperative hemorrhage arose in 17 (7.02%) patients. An original technique of wound hemostasis and prevention of postoperative hemorrhage with cryoapplicator made of porous nikelide-titan alloy was tried in 122 patients. None of these patients developed hemorrhage. High efficacy of the method was confirmed by a fall oferythrocyte count and hemoglobin in irrigation liquid: after cryohemostasis their level decreased 13 and 150 fold, respectively. The catalase method corrects hematuria in patients after cryohemostasis much earlier than in patients after conventional hemostasis. The proposed technique of hemostasis and prevention of hemorrhage from percutaneous wound canal proved highly effective even at early stages of its investigation, is simple in application, cost-effective.

Structural and functional modification of hollow organs (urinary bladder and stomach) in vibration syndrome

Exposure to total and local vibration leads to the formation of specific forms of hollow organ diseases: vibration cystopathy and gastropathy. Their characteristic signs are organ dysfunction, thinned wall, atrophy of the mucosa, reduction of the capillary bed, and degenerative atrophic changes in the epithelium, associated with reduction of the protein-producing function and focal metaplasia. Vibration cysto- and gastropathies are systemic manifestations of microangio- and visceropathies of vibration origin.

[Temporary and permanent NiTi stents in percutaneous surgery for ureteropelvic segment stricture]

A total of 18 roentgenoendoscopic percutaneous interventions for strictures of the ureteropelvic segment (UPS) have been made by the authors from the beginning of 2004: in 15 (83.3%) females and 3 (16.7%) males aged 16-48 years. Recurrent strictures developed in 11 (61.1%) patients after operations by Kuchere, Pristlay, Andersen-Hines, in 7 (38.9%) patients the strictures were primary. UPS bougieurage and endotomy were made in 3 and 15 patients, respectively. UPS intubation with a PVC tube was made in 2 cases, with a permanent NiTi stent-crown--in 5 cases, temporary stent--in 9 cases, in 2 cases intubation was not made. Complete recovery of UPS passability and significant reduction of hydronephrosis were seen in 15 (83.3%) patients, insignificant effect was registered in 3 patients (one case of PVC tube intubation, one case of NiTi temporary stent, one case of no intubation). Efficacy in patients with permanent stent was 100%, in patients with temporary stent--88.9%, in patients with a PVC tube and without intubation--in 50%. Novel techniques of intubation with permanent and temporary stents with shape memory after percutaneous correction of UPS stricture are promising in the treatment of patients with this pathology of the upper urinary tract and may become an operation of choice.