Stereomorphology of the peripheral zone of the human prostate.

OBJECTIVE: Introduction: The human prostate gland is a complex organ that consists of two main components - glandular and non-glandular. The first of them represents a compound of components of different origin, structure, location, and complexity of spatial organization. Their stereomorphology and microanatomical interrelations remain understudied for a number of reasons. The aim: The objective of the research was to study the stereomorphological features of the glandular component of the peripheral zone of the prostate in view of its zonal structure concept. PATIENTS AND METHODS: Materials and methods: The material for the study was the glandular zone of the human prostate, which corresponds to the peripheral zone of the prostate according to the classification (Mc.Neal J.E., 1988). The following methods were used in the study: histological (4 mkm thick paraffin sections), microscopic (light microscopy using the Olympus BX-41 microscope), stereomorphological (obtaining waxed model reconstructions based on graphic ones). The study was conducted on 10 isolated prostate preparations (10 series of 50 preparations in each) taken from the deceased men without changes in the organ under investigation. The prostate gland was fixed in a 10% solution of buffered formalin, followed by obtaining serial plane-parallel sections and staining with hematoxylin and eosin according to the conventional technique. RESULTS: Results and conclusions: The ducts of the glands of the peripheral zone of the human prostate normally have recurrent luminal dilatations, which, like the multi-cavity terminal portions, can serve as a place for depositing a secret. The ducts of the peripheral zone glands, with the exception of the main duct, visually differ little in diameter. Their walls and walls of intra-acinar cavities are lined with homologous epithelial cells. Therefore, there is no clear morphological boundary between the transfer of the terminal portion to the duct and from one excretory duct to the other.

Management of the patients with blunt renal trauma: 20 years of clinical experience.

OBJECTIVE: Introduction: Blunt renal trauma (BRT) is a dangerous medical condition. The aim: Analysis of effectiveness of conservative and expectant treatment tactics under ultrasound and CT monitoring in patients with blunt renal trauma (BRT). PATIENTS AND METHODS: Materials and methods: The results of treatment of 81 patients with BRT during 20 years (1998-2017) were analyzed. Amount of men was 58 (71.6%), women - 23 (28.4%). Grade I trauma was seen in 37.0% of cases, grade II - in 25.9%, grade III - in 11.1%, grade IV - in 16.1% and grade V - in 9.9% of observations. RESULTS: Review: Conservative tactics was effective in 67.9% of observations. In 11.1% of cases treatment was accompanied with percutaneous drainage of liquid perirenal hematoma and urohematomas (in 2 cases with formation of perirenal abscess). Indications for surgical treatment (in 21.0% of observations) were progressing perirenal hematoma, unstable hemodynamics, inefficiency of hemorrhage stop with conservative treatment. In 9 cases, the kidney was sutured. Eight patients with multiple ruptures of the kidney, damage of the kidney vessels, massive bleeding underwent nephrectomy. CONCLUSION: Conclusions: Achievements in visualization and therapeutic technologies can avoid and, at severe trauma, reduce the surgical treatment rates in BRT. In the presence of urohematomas with the formation of perinephral abscess and development of sepsis, the method of choice is percutaneous drainage. Indications for surgical treatment are multiple parenchymal lacerations with damage of the segmental vessels and vessels of the renal hilum when the hemorrhage stop is ineffective by conservative or noninvasive methods.