[Regnerative technologies in reconstructive operations on the urethra: a review. Part 2].

Recent advances in the treatment of urethral strictures are associated with regenerative medicine and tissue engineering. Urethral reconstruction in some cases is a difficult task for urologists due to the insufficient amount of autologous tissue and relapses, which encourages clinicians to search for alternatives. The purpose of this work is to review the latest achievements in the use of regenerative technologies, biomaterials and cell therapy in urethroplasty. The second part of the literature review presents the prospects of using the stromal vascular fraction (SVF) of autologous adipose tissue during reconstructive operations on the urethra, especially considering the availability of these cells through lipoaspiration. Tissue engineering technologies are reflected, which offer their own solutions to problems and limitations of their use. The article also provides examples of experimental studies in which cell-free and cellular biomaterials were used for urethral reconstruction. We believe that the approach of using SVF and biomatrix can become a potentially safe and effective method of therapy associated with the acceleration of regeneration processes, and can be of great benefit to patients with urethral diseases in the future.

[The use of prostate extract preparations in patients after transurethral resection of prostate for its benign hyperplasia].

The purpose of the study is to study the efficacy and safety of the prostate extract (GEROFARM LLC, Russia) in the postoperative period in patients after transurethral bipolar resection of the prostate. MATERIALS AND METHODS: The clinical study included 127 men aged 50 to 78 years with grade II benign prostatic hyperplasia (adenoma) who underwent a typical bipolar transurethral resection of the prostate. Patients of the main (n=60) group received tamsulosin 0.4 mg/day for 30 days in the postoperative period in combination with prostate extract 10 mg rectally for 21 days. In the control group (n=67) - tamsulosin 0.4 mg/day for 30 days as monotherapy. To assess the results of treatment, the questionnaire of the international system of total assessment of symptoms in prostate diseases (IPSS) with the definition of quality of life (QoL), the international index of erectile function (IIEF-5) and uroflowmetry were used. The control was carried out in terms of 1 and 3 months after the operation. RESULTS: In the main group, in the observation period of 1 and 3 months after the operation, a decrease in the average IPSS score by 40.2% and 52.9% was revealed, and an improvement in the quality of life by 45% and 64.7%, respectively, was noted. In the control group, at the same time of observation, a decrease in the average IPSS score by 34% and 44.7%, respectively, was revealed, and the quality of life improved by 25.5% and 37.3%, respectively. The increase in the average rate of urination in the main group by the end of 1 and 3 months of treatment was 59.2% and 85.7%, respectively, and in the control group, these figures were 40.5% and 50%. The positive effect of the proposed combination therapy on erectile function in the main group by the end of 1 and 3 months of treatment was 5.2% and 9.2%, respectively, and in the control group, these figures were 2.9% and 5.2%. DISCUSSION: There is a significant decrease in the symptoms of the lower urinary tract in the group of patients who received the drug Prostateks (GEROFARM LLC, Russia). CONCLUSIONS: The efficacy results of Prostatex (GEROFARM LLC, Russia) (reduced symptom severity on IPSS (11.7 1.2 ) and QoL (2.3 0.3)) scales are comparable to those of Vitprost Plus which allows you to evaluate the effectiveness of two drugs equally.

[Open and laparoscopic Boari distal ureteroplasty technique: a comparative analysis of efficiency and safety].

INTRODUCTION: Distal ureter strictures are complications of surgical interventions for obstetric, gynecological, urological, vascular and oncological diseases. Reconstructive plastic correction of these strictures is a complex urological procedure. The choice of a technique is associated with the localization and extent of the stricture. Boari flap ureteroneocystostomy is one of the main operations to choose from. Its implementation in open and laparoscopic versions in recent history required special analysis. OBJECTIVE: to analyze the experience of ureteral reimplantation according to the Boari technique with a detailed description of its open and laparoscopic approaches. MATERIALS AND METHODS: In 2010-2019, 30 patients underwent surgery using the Boari technique. 17 patients underwent open surgery (group 1) and 13 patients underwent surgery using laparoscopic techniques (group 2). A comparative analysis of the two groups was carried out considering clinical and intraoperative data. Complications were studied, as well as immediate and long-term results with a follow-up period of 6-120 months. RESULTS: Patients of the two groups showed similar clinical characteristics. Patients had an equal extent of lesion in the groups (p>0.05). However, the lesions were located more proximally from the bladder in group 1, which required the use of longer flaps (p=0.024). Blood loss volume was identical, and the duration of laparoscopic operations was significantly shorter (p=0.019). Postoperative complications occurred in 26.7% of cases in the next 3 months, which required a temporary percutaneous puncture nephrostomy (IIIa degree according to Clavien-Dindo) in 2 cases and conservative therapy (II degree according to Clavien-Dindo) in 6 cases. Clinical vesicoureteral reflux was determined in only one case during a one-year follow-up period. CONCLUSION: Open and laparoscopic Boari techniques have an equally high ureteral recovery efficiency without the need for a re-operation in all cases. Refluxing flap ureteral anastomosis is extremely rarely accompanied by a clinic of vesicoureteral reflux. The ureter can be restored using a laparoscopic Boari technique in all cases.

Clinical study of the efficiency and safety of afala in patients with benign prostatic hyperplasia.

The use of afala in patients with benign prostatic hyperplasia and moderate urination disturbances reduced the symptoms of the disease, improved urodynamic parameters, and increased quality of life. Clinical efficiency of afala was comparable with the efficiency of Serenoa repens extract (reference preparation).

[Effects of indol-3-carbinol and epigallocatexin-3-gallate on alteration and reparation in affected urethra of experimental animals].

The effects of indol-3-carbinol and epigallocatexin-3-gallate on alteration and reparation in the urethra were studied in 30 male Shinshilla rabbits. From the observation day 2 the rabbits were fed with indol-3-carbinol and epigallocatexin-3-gallate in addition to standard diet. Microcirculation was assessed with a laser analyzer of capillary circulation LAKK-01 which detected earlier recovery of microcirculation in the group of the animals fed with indol-3-carbinol and epigallocatexin-3-gallate. Thus, antioxidant and antiproliferative properties of indol-3-carbinol and epigallocatexin-3-gallate improve alteration and reparation in affected urethra due to development of soft elastic connective tissue with better capillary circulation.

[The role of laser Doppler flowmetry as a diagnostic criterion of impaired microcirculation of vesico-urethral segment and prostatic gland].

To study changes in microcirculation of the lower urinary tract in different diseases we used laser analyzer of capillary circulation LAKK-01. The control group consisted of 25 volunteers, the study group--of 65 patients with different vesico-urethral diseases. Normal values of microcirculation in the wall of the urinary bladder, prostatic gland and urethra were determined. These values were significantly reduced in patients with vesico-urethral disorders. Thus, alterations in microcirculation in different pathological conditions of the vesicourethral segment confirm the hypothesis of a direct involvement of microcirculation disorders in pathogenesis of many urological diseases.