[The use of low-molecular heparins in prevention and treatment of thrombotic complications after radical prostatectomy]. / Primenenie nizkomolekuliarnykh geparinov v profilaktike i lechenii tromboticheskikh oslozhnenii posle radikal'noy prostatéktomii.

Effects of low-molecular heparin flaxiparin on prevention of thrombotic complications after radical prostatectomy were studied in two groups of patients with localized forms of prostatic cancer at stages T1c, T2a, T2b and T3a. Group 1 received non-fractionated standard heparin in a dose 5000 units 4 times a day for 10 days. Group 2 was treated with flaxiparin in a dose 0.3 ml (7500 U anti-Xa) twice a day s.c. for 10 days. After therapy no thromboembolic complications were observed. In group 2 removal of the urethral catheter was conducted 4-5 days earlier than in group 1. This reduced hospital stay from 29 to 20 days. Flaxiparin accelerated growing vessels in the zone of urethrourethral or urethrovesical anastomosis resulting in improvement of microcirculation and preventing strictures in the anastomotic zone. Thus, low-molecular heparin prevents thromboembolic complications, reduces hospital stay and duration of rehabilitation after radical prostatectomy.

[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.

[Hyperbaric oxygenation in the treatment of patients with chronic congestive prostatitis and lower fertility]. / Giperbaricheskaia oksigenatsiia v lechenii bo'nykh khronicheskim kongestivnym prostatitom i snizheniem fertil'nosti.

Due to deteriorated demographic indices in the country, male infertility is a highly pressing problem. Chronic prostatitis is one of its causes. Hyperbaric oxygenation was used to affect male genital microcirculation, thus improving the spermatic morphological and functional characteristics. Positive effects of the method are ascribed not only to better microcirculation, but also to improved redox processes in spermatogenesis.

[Optimization of hydrodynamic conditions in transurethral resection of benign prostatic hyperplasia]. / Oprimizatsiia gidrodinamicheskikh uslovii pri transuretral'noi rezektsii dobrokachestvennoi giperplazii prostaty.

Water intoxication remains a serious complication of transurethral resection (TUR) occurring more frequently in patients with large-size benign prostatic hyperplasia (BPH) and in those who was operated for more than 1 hour. An advanced irrigation system employing mechanical valve "Floval" and active aspiration provides controlled irrigation of the bladder preventing spontaneous rise of intravesical pressure in conducting TUR in BPH patients.

[The detection of latent circulatory and respiratory failure in urologic patients at the prehospital stage]. / Vyiavlenie skrytoi nedostatochnosti krovoobrashcheniia i dykhaniia u urologicheskikh bol'nykh na dogospital'nom étape.

Elderly patients admitted to urological hospitals and departments with increasing frequency have the disease complicated with age-specific and associated circulatory and respiratory affections. Occasionally, these complications are not clinically evident, but may acquire unwanted decompensated course. Subclinical forms of circulatory and respiratory insufficiency can be managed using relatively simple methods of functional assessment applicable in outpatient setting. Recommendations are provided on operative preparations which can be made at home or in outpatient department thus reducing the cost of hospital stay.

[The central hemodynamics and hormonal status before, during and after urologic operations in children]. / Tsentral'naia gemodinamika i gormonal'nyi status do, vo vremia i posle urologicheskikh operatsii u detei.

Urological operations in children are made as a rule to correct congenital malformations. The prevention of operative injury to the child' body is secured only in conditions of adequate anesthesiological defense. This is possible only in availability of rapid information on cardiovascular, oxygen metabolic and hormonal statuses. Central hemodynamics, oxygen metabolism and hormonal findings have been summarized for 89 children. The above parameters were measured before and during plastic reconstruction of the upper urinary tract. Initially hyperkinetic hemodynamics because of inadequate premedication to control psychoemotional lability, changed for stable and hypokinetic circulation to the end of the operative intervention as a result of neuroleptanalgesia. Eukinetic trends were induced by balanced promedol analgesia throughout the operation. Concentrations of hydrocortisone, aldosterone and STH were on the increase, while T3 and T4 levels lowered. Hyperkinetic and eukinetic hemodynamics were observed postoperatively after neuroleptanalgesia and balanced promedol-including analgesia, respectively.

[The diagnosis of vasorenal arterial hypertension]. / Diagnostika vazorenal'noi arterial'noi gipertenzii.

Clinical and specific examination of 525 patients with special emphasis on ultrasonic, radionuclide and angiographic procedures, a captopril pharmaco-radiological test, radioimmunoassay of renin in the renal vein and vena cava inferior provided the diagnosis of vasorenal hypertension (VRH) in 65 of them (30 males, 35 females at the age of 18-60). Among etiological factors atherosclerosis, fibromuscular dysplasia, nephroptosis, renal artery aneurysm, aortic arteritis were involved in 40%, 24.6%, 16.9%, 12.3%, 6.2% of the cases, respectively. Chronic renal failure developed in 17% of VRH patients with the disease duration more than 3 years. Also, aspects of evaluation of cardiovascular function with invasive and noninvasive techniques in pre-, intra- and postoperative periods, indications to VRH, basic operative procedures are reviewed. According to WHO criteria, a complete response was obtained in 21 (35.6%), a partial response in 34 (57.6%) patients, no response was registered in 1 (1.7%) case.

[The anesthesiological support for children in extracorporeal lithotripsy on the Urat-P apparatus]. / Anesteziologicheskoe obespechenie distantsionnoi litotripsii u detei na apparate Urat-P.

The Urat-P lithotriptor made in this country was employed for remote lithotripsy (RLT) in 94 children with urolithiasis. Altogether 132 sessions were conducted. In 120 cases the concrement disintegration progressed in a sparing regimen (impulse duration 0.3-0.4 ms, shock wave energy 5-8 J). In the rest 12 cases there were additional hard impulses (0.5-0.6 ms, the energy 10-12 J). Anesthesiological and transfusiological problems are considered. It is shown that choice of anesthesiological defense is based on the clinical form of the disease, the concrement size, the child's age. Intubation anesthesia with artificial pulmonary ventilation is indicated for young children (under 5). Intravenous balanced anesthesia under normal respiration accompanies RLT in large coral calculi treated in senior children (6-14 years of age). Single stones (up to 1.5 sm) in them are managed under local infiltration anesthesia. It is stated that a valid choice of anesthesia and transfusion therapy warrants favourable conditions for RLT sessions, adverse effects of the impulses on the renal parenchyma and adjacent tissues lessen facilitating the fragments elimination and reducing the number of complications in the postoperative period.