[Continent heterotopic derivation of urine in a partially isolated segment of the sigmoid intestine after cystprostatectomy].

From 1992 to 2006 cystprostatectomy with continent heterotopic urine derivation in a partially isolated segment of the sigmoid intestine was made in 37 males aged 39-78 years. The patients had the following tumor stages: 2 patients with T2NXM0, 20 patients with T3NXM0, 6 patients with T3N1M0, 9 patients with T3-4N1MX. Thirty patients (81%) had no complications in an early postoperative period, 7 (19%) had complications: purulent pyelonephritis (n = 2), wound suppuration (n = 3), intestinal eventration (n = 1), interintestinal abscess (n = 1). There were two lethal outcomes early after operation: one patient died of bilateral purulent pyelonephritis and the other one--of acute cardiac failure. For 3 years 27 (77%) of 35 patients had satisfactory quality of life. Thus, urine derivation by simple methods one of which is creation of a partially isolated reservoir from a sigmoid segment with transanal urine derivation is indicated after cystprostatectomy for elderly males with a high risk of postoperative complications and lethality (stage T2-T3NXMX) and unclear distant metastases.

[Operative treatment of complications caused by intracavernous administration of "Interfal" gel]. / Operativnoe lechenie oslzhnenii, vyzvannykh intrakavernoznym vvedeniem gelia "interfal".

The authors have operated 5 men for complications after introduction of gel "interfal" into cavernous bodies of the penis. The removal of the gel was accompanied with incomplete intracavernous prosthesis of the penis by M. N. Zilberman. A satisfactory functional result was achieved in 3 patients. Postoperative purulent cavernitis required removal of the prostheses in 2 men. Individual approaches to the treatment are recommended. The use of gel "interfal" must not be permitted for treatment of erectile dysfunction.

[The indications for operations on the penile veins in venogenic erectile impotence]. / O pokazaniiakh k operatsiiam na venakh polovogo chelna pri venozno-obuslovlennoi érektil'noi impotentsii.

Unsatisfactory results of surgical management of venous erectile failure are attributed to difficult selection of relevant patients. The operation is to be performed in patients with isolated distal venous outflow. The diagnosis of occult proximal or mixed outflow may be made at dynamic cavernosography with loading test on the device for stimulation of erection. After obtaining the erection and removal of the constriction ring, distal venous outflow is blocked, thus creating the conditions for detection of occult proximal venous outflow. Surgical treatment (ligation of the dorsal vein or its insertion under tunica albuginea) is indicated only for patients free of mixed venous outflow.

[A device for stimulating erection in the combined treatment of erectile insufficiency]. / Ustroistvo dlia stimuliatsii érektsii v kompleksnom lechenii érektil'noi nedostatochnosti.

A device operating by the principle of local negative pressure has been developed and patented in Russia. Its trial in 122 patients with erectile insufficiency in combination with conservative treatment showed that positive effect may be reached in patients subjected to partial intracavernous restorative surgery of the penis with unsatisfactory outcome.