[Recurrent urethrorectal fistulae]. / Retsidivnye uretrorektal'nye svishchi.

On the basis of 32 surgical cases of recurrent urorectal fistulas, review of relevant literature, the authors define factors determining choice of treatment and preoperative preparation policy. Such individual approach may secure success in many cases. A new surgical procedure of surgical treatment of urethrorectal fistulas involving abdominoanal resection of the rectum with implantation of the sigmoid into the anus has been tried and found satisfactory.

[The ultrasonic diagnosis of diseases of the urethra in women]. / Ul'trazvukovaia diagnostika zabolevanii mocheispuskatel'nogo kanala u zhenshchin.

Ultrasonic examinations of the urethra were carried out in 188 women suffering from dysuria, making use of transducers for transcutaneous and transvaginal scanning. The authors describe in detail the echographic picture of the urethra in health and in various diseases, e.g. urethritis, paraurethral fibrosis, cysts, diverticuli, malignant and benign tumors, etc. The diagnostic value of ultrasonography of the urethra is compared to that of urethrocystoscopy, two-balloon cystourethrography, etc. Ultrasonic scanning was found to be the most informative in paraurethral cysts, tumors, diverticuli, and inflammatory diseases of the urethra. The accuracy of ultrasonic diagnosis as against other diagnostic methods was found to be 82.2%.

[Strictures of the proximal urethra in men]. / Striktury proksimal'nogo otdela uretry u muzhchin.

Stricture of proximal male urethra remains complicated problem of urology. Surgical intervention conducted at sphincter area is fraught with the damage of potential enuresis. A total of 250 patients with proximal urethra strictures were treated. Most of them could recover normal uresis. Unlike strictures of inflammatory origin, those of traumatic and secondary genesis presented great difficulties for management in view of both sphincters impairment. To be successful, urethral operations must follow the following main principles: maximal preservation of the sphincter apparatus, radical removal of the cicatricial tissue, adequate urine elimination, reliable hemostasis. None of operations could at present meet the above requirements, the worst results being obtained after Solovov's technique surgery (25% of enuresis outcomes in 4 out of 16 treated). Endourethral surgery can produce good results, especially effective interventions being reported in short strictures and underdevelopment in paraurethral tissue. Bougienage remains a forced measure in managing urethral strictures combined with infravesicular obstruction and sphincter insufficiency. Positive long-term results were achieved in 182 patients treated. It is suggested that controlled uresis could be reestablished in absolute majority of cases.

[Postinflammatory strictures of the urethral canal in women]. / Postvospalitel'nye striktury mocheispuskatel'nogo kanala u zhenshchin.

The paper is concerned with one of the important problems of current urology--inflammation-induced strictures of the female urethra, covers questions of its etiology, pathogenesis, clinical patterns, diagnosis and treatment. It is emphasized that the strictures take the form of paraurethral fibrosis and should be managed individually. Clinicomorphological parallels are outlined. Indications to conservative and surgical treatment are specified.

[A comparative evaluation of surgical methods for treating hydrocele]. / Sravnitel'naia otsenka operativnykh metodov lecheniia vodianki obolochek iaichka.

The authors analysed the results of the surgical treatment of 167 patients with hydrocele who were operated on with the use of Winkelmann's or Bergmann's technique (group I), the same but modified by Grebenshchikov-Shevtsov's (group II), and Lord's method (group III). Sclerotherapy was employed in the group IV patients. A high percentage of complications was associated with Winkelmann and Bergmann's techniques (scrotal edema, hematoma, wound purulence) when the hydropic sac was isolated from the adjacent tissues. Postsurgical staying-in-bed time for those operated on with Winkelmann's and Bergmann's technique was mean 8.6 +/- 1.2 days and 9.4 +/- 1.3 days, respectively. When the same surgery was performed according to the Grebenshchikov-Shevtsov's modification a mean staying-in-bed time reduced to 7.2 +/- 0.9 days due to a lower incidence of postsurgical complications. Analysis of 42 surgeries performed with the Lord's method which avoided the isolation of the hydropic sac from the adjacent tissues demonstrated its efficacy and simplicity. No hematomas, suppurations or relapses were documented. The staying-in-bed time was 3.4 +/- 0.6 days. The pronounced changes in tunica propria and the multilocular character of hydrocele were the contradictions to this pattern of the treatment. In case the performance of the surgery was impossible, sclerotherapy with administration of 2-10 ml of 2.5 per cent of tetracycline solution was performed for the sclerosing and antibacterial effect. A mean staying-in-bed time was 2.1 +/- 0.9 days. Seven out of 8 patients recovered after 1-3 sessions of sclerotherapy.