[Comparison of rotoresection and transurethral resection in the treatment of benign prostatic hyperplasia]. / Sravnitel'naia otsenka rotorezektsii i transuretral'noi rezktsii v lechenii dobrokachestvennoi giperplazii predstatel'noi zhelezy.

Comparison of duration, blood loss and efficacy of TUR and rotoresection in the treatment of benign prostatic hyperplasia has demonstrated that rotoresection allows almost bloodless and effective transurethral removal of prostatic hyperplastic tissue and, therefore, is a promising alternative to routine TUR of the prostate.

[Combination surgery in radical nephrectomy]. / Sochetannye operatsii pri vypolnenii radikal'noi nefréktomii.

In 18 of 487 patients (11 males, 7 females) operated for renal cancer, radical nephrectomy was made simultaneously with cholecystectomy (n = 14) and prosthetic repair of the abdominal aorta (n = 4). A transabdominal approach was used in all the cases. Duration of radical nephrectomies from the transabdominal approach varies from 95 to 180 min while simultaneous operations lasted from 130 to 228 min. Cholecystectomy increased duration of the operations by 25-55, aortic repair--by 60-90 min. Conduction of concomitant operations had no negative effect on the course of postoperative period or on the number of complications. 18 cases of simultaneous operations (radical nephrectomy and cholecystectomy or aortic repair) showed that there was neither increased number of complications nor duration of hospital stay. Cholecystectomy can be made from the same incision as radical nephrectomy whereas aortic repair demands the middle approach which is not convenient for performance of radical nephrectomy.

[Benign neoplasms of the urethra in men]. / Dobrokachestvennye novoobrazovaniia mocheispuskatel'nogo kanala u muzhchin.

A 20-year follow-up (1975-1994) in urological clinic of 107 males with benign tumors of the urethra (BTU) has determined that most commonly encountered BTU comprise viral papillomas (67.3%), polyps (22.4%), angiomas (10.3%). Viral papillomas and angiomas locate as a rule in the hanging urethra, while polyps arise both in the anterior and posterior portions. Urethral polyps and angiomas manifest most frequently with hemospermia, urethrorrhagia and terminal macrohematuria after coitus or exertion. Chronic nonspecific urethritis is thought to be a factor predisposing to urethral condylomas and polyps. Viral papillomas originate from the external orifice and Morgagni fossa spreading proximally. BTU are diagnosed primarily at urethroscopy and managed with transurethral resection, electrocoagulation, partial urethral resection which proved curative in many cases.

[A trial of the use of finasteride and terazosin in patients with benign prostatic hyperplasia]. / Opyt primeneniia finasterida i terazosina u bol'nykh s dobrokachestvennoi giperplaziei prostaty.

94 patients with obstructive urination due to benign prostatic hyperplasia received finasteride (proscar), inhibitor of 5 alpha-reductase, in a single dose 5 mg and terazosine, alpha 1 adrenoblocker, in a daily dose of 9.7 mg/day. The follow-up averaged 16.1 months. As shown by overall score of the symptoms and quality of life, rectal and ultrasonic examinations, uroflowmetry, the prostate decreased by 17%, on the average in 72% of the patients. Subjectively, urination has also improved. Maximal flow rate elevated by 55% in the majority of patients. Combination of finasterine with terazosine is well tolerated and proved optimal as a conservative therapy in patients with obstructive urination as a result of benign prostatic hyperplasia.

[Obstructive anuria in patients with tumors of the pelvic organs]. / Obstruktivnaia anuriia u bol'nykh s opukholiami tazovykh organov.

The paper discusses the data on 57 cases of pelvic tumor--induced obstructive anuria. As a rule, obstructive anuria is easy to diagnose ultrasonography being most instrumental. Duration of anuria was found to be the main factor determining outcome in the early postoperative period. Early detection of ureteral obstruction and timely treatment prevented excretory anuria in some cases.

[Ureteral obstruction after radiotherapy in patients with cancer]. / Obstruktsiia mochetochnikov posle luchevoi terapii u onkologicheskikh bol'nykh.

Diagnosis and treatment of postradiation ureteral obstruction is a problem of utmost importance, whose resolution will make it possible to prolong survival of many postcancer patients. A review of 58 cases of ureteral compression as a result of radiation and combined treatment for cervical, uterine and vesical cancer is presented. Upper urinary tract changes were shown to range from moderately dilated calycopelvic system to bilateral ureterohydronephrosis and a nonfunctional kidney. The fact that postradiation urethral compression remains asymptomatic for a long period of time makes the diagnosis still more difficult. Mean interval between radiotherapy and the detection of ureteral obstruction was 5.6 years. Ureteral affection was either isolated or combined with vesicovaginal fistulas and radiation cystitis. Short ureteral strictures were detected in 37 (68.9%) patients, and long strictures, in 16 (31.1%), mostly in cases of combined treatment. Urinary infection and pelvic inflammation are major contributing factors to postradiation ureteral obstruction. Surgical treatment was performed in 34 (64.2%) patients with postradiation ureteral stenosis; the operation was limited to nephrectomy of urine collection because of the patient's grave condition in 25 (73.5%) of those.

[Treatment of acute radiation cystitis with preparations of immobilized trypsin]. / Lechenie ostrykh luchevykh tsistitov preparatami immobilizovannogo tripsina.

At present the problem of bladder injuries and methods of their therapy are very urgent in view of a wide use of radiation therapy of cancer of the uterine body, bladder and rectum. None of the existing methods of therapy of local radiation cystitis is sufficiently effective. To obtain better therapeutic results and immobilized trypsin preparation on a powder-like cellulose matrix was used. Therapy was provided to 34 patients with symptoms of acute radiation cystitis. The therapy in all the cases proved to be effective. It was confirmed by the disappearance of clinical symptoms and cystoscopic findings.

[Prevention and treatment of early radiation reactions of the urinary bladder in patients with cancer of the cervix and corpus uteri]. / Profilaktika i lechenie rannykh luchevykh reaktsii mochevogo puzyria u bol'nykh rakom sheiki i tela matki.

The report discusses early-onset radiation injuries in the urinary bladder of more than 1000 patients with cancer of the cervix and corpus uteri. Clinical symptoms of such injuries were observed in 487 patients (44.3%). In 47 (10%), the lesions were pronounced. The degree of radiation-induced cystitis was evaluated on a 6-point scale used by WHO classification (1982). Said lesions mainly occurred at stage III of tumor and predominantly in cases of cancer of the corpus uteri. Complications development was stimulated by vascular lesions, diabetes mellitus and inflammatory processes in pelvic organs. Radiation injuries were treated by standard procedures as well as with immobilised trypsin administered in a cellulose powder vehicle. This method proved the most effective. Since patients suffering early-onset radiation-induced destructive injuries are at high risk of further exacerbation at later stages, they should be followed-up closely.