[Tamsulosin in combind treatment of patients with urolithiasis].

In administration of tamsulosine (focusin, Zentiva, Czech Republic) in combined treatment of urolithiasis concrement evacuation after extracorporeal lithotripsy occurred in 83% cases in patients with the concrement stay in the ureter for less than one month. The size of the concrement after successful lithotripsy had no significant effect on subsequent stone-eliminating therapy but long-term stay of the concrement in one place promoted inflammatory and urodynamic disturbances in the ureter treated surgically. The comparative analysis of the contractile function of the distal ureteral comparment in patients given tamsulosin showed a less active (amplitude of the contractions) and passive (tonicity) resistance to urine flow than in patients given a standard therapy. These changes were accompanied with lower pressure in the renal pelvis and suppression of enzymuria. Thus, tamsulosin addition to combined treatment of urolithiasis has a positive effect on ureteral urodynamics, concrement evacuation and functional structures of the kidney by indirectly lowering intrapelvic pressure.

[Role of the level of obstruction and urodynamics of the upper urinary tract in infectious-toxic complications in urolithiasis. (Clinical and experimental study). ]. / Rol' urovnia obstuktsii v narushenii urodinamiki verkhnikh mochevykh putei pri oslozhneniiakh mochekamennoi bolezni (Kliniko-éksperimenal'noe issledovanie)

Clinical studies have revealed that location of the occlusion in the kidney and upper third of the ureter raises the risk of severe infectious-toxic complications of urolithiasis. It is shown experimentally that mechanisms of compensation of impaired urinary transport along the upper urinary tracts differ in obstruction of the upper and lower third of the ureter.

[Diagnosis and treatment of bladder cancer]. / Diagnoz i lechenie raka mochevogo puzyria.

The authors present a retrospective analysis of the results of transurethral conservative and radical operations in 125 patients with invasive cancer of the urinary bladder (UB) treated in the Research Institute of Urology throughout 1992-2002. Transurethral resection (TUR) of the UB was made in 72 patients. Stages pT2a, pT2b, T3 and T4 were diagnosed in 23 (31.9%), 18 (25%), 14 (19.5%) and 17 (23.6%) cases, respectively. 53 patients with advanced invasive UB cancer have undergone radical cystectomy varying by the method of urine derivation. Stages pT2N0M0, pT3aN0M0, pT3bN0M0, pT4aN0M0 and N1-2 were registered in 4 (7.5%), 13 (25%), 21 (40%), 7 (12.5%) and 8 (15%) patients, respectively. UB cancer recurrences after TUR occurred in 12 (16.7%) patients with stage pT2a, in 8 (11.1%) patients with stage pT2b. Three-year overall and recurrence-free survival after TUR at stage T2 reached 97.5 +/- 3.2 and 47.4 +/- 2.8, respectively, at stage T3 and T4--57.1 +/- 4.3 and 26.6 +/- 3.4%, respectively. Postcystectomy distant metastases to the lungs, bones and iliac lymph nodes after treatment were detected in 3, 2 and 3 patients, respectively. One patient had a local pelvic recurrence. For all 53 patients a 2-year corrected survival made up 68 +/- 12.0%. Thus, transurethral electrosurgery is an effective treatment of invasive UB cancer; the only radical surgical treatment for invasive UB cancer is cystectomy.

[Urinary tract occlusion: a principal cause of some complications of urolithiasis]. / Okkliuziia mochevyvodiashchikh putei -- osnovnaia prichina razvitiia riada oslozhnenii mochekamennoi bolezni.

Urinary tract occlusion in urolithiasis is a serious complication which provokes an attack of acute obstructive pyelonephritis. The infected urine aggravates this infectious-inflammatory process and endangers bacterial shock. Etiopathogenesis of this shock is outlined and modern approaches to its management are described.

[Gastrointestinal hemorrhage in urological diseases]. / Zheludochno-kishechnye krovotecheniia pri urologicheskikh zabolevaniiakh.

The authors analyse 28 cases of gastrointestinal hemorrhage (GIH) in urological diseases and after uronephrological operations, emphasize factors of uremic intoxication and relevant complications provoking DIC syndrome. Various factors leading to stress (acute blood loss, shock, sepsis) and development of immunodeficiency disturbed morphostructure of gastric and duodenal mucosa and provoked hemorrhage which was stopped most efficiently by fibrogastroduodenoscopy with coagulation of the bleeding vessel. If this operation failed, open surgery was performed. Conservative measures consisted in DIC syndrome management policy.