[A modified method of nephropexy (an experimental study)].

The aim of the study was design of an experimental model for more reliable nephropexy. The experiments were performed on 35 mongrel dogs divided into three groups. In group 1 the right kidney was separated under general anesthesia, in its subcapsular tunnels the tension-free vaginal tape made of polypropylene (PPT) was inserted and knotted to the 12th rib. The excretory function and micromorphological state of the kidneys were examined during six months. In group 2 (control) only subcapsular tunnels were created followed by micromorphological examination of the kidneys. In group 3 after fixing the kidney, as described above, the duration of fixation was evaluated by means of dynamometry. The PPT inserted subcapsularly and knotted to the 12th rib caused a light aseptic inflammation which resulted in firm adhesion of the tape to the fibrous capsule and external surface of the kidney and their safe fixation able to stand an effort up to 6.6 +/- 0.4 kg. The above method of nephropexy can be recommended for clinical use by means of open, laparoscopic or retroperitoneoscopic approaches.

[Investigation of general toxic influence of preparation Buta in experiment on rats].

At the department of urology preparation Buta was created, which contain two active components. It is intended for the injection into the prostate. As a result of influence of electroresectoscope the mentioned preparation is underwent a deep polymerization, causes the embolism of blood vessels and this way can ensure the bloodless operating field and prevention of TUR-syndrome. Up today it was not investigated the general toxicity of this preparation. In order to solve this problem there were performed experiments on twenty white rats divided into two groups. In the I group (10 animals) 20 ml of preparation Buta was injected intramuscularly. In the II (control) group (10 animals) 20 ml of Saline (NaCl 0,9%) solution was injected intramuscularly. The rats were under observation during 2 weeks. General physiological state of animals was estimated according to the Irvin's scheme. After 2 weeks the animals were decapitated. Samples of blood, liver, kidneys suprarenal glands and spleen have been obtained. Their morphological structure were examined under the light microscope "Option". The obtained data testify that even in 100 times more doses then injected into prostate the preparation Buta caused only local necroses, but didn't show any general toxic influence on the organism. The mentioned preparation can be recommended for clinical trial.

[Influence of antioxidants on the development of benign prostatic hyperplasia].

The main objectives of the study was the evaluation of concentration of endogenous antioxidants (Vitamins E, A, C and Beta-carotene) in the blood plasma of elderly men and to determine their roles in the development of benign prostatic hyperplasia. There were carried out investigations in 110 men during 2003-2006 in the Urological Clinic of the Tbilisi State Medical Academy. 71 patient entered into the main group (65-81 years old), who were diagnosed for benign prostate hyperplasia. The control group included 30 men (60-80 years old) who did not suffer from the typical signs of benign prostatic hyperplasia. Besides, to evaluate normal levels of endogenous antioxidants (Vitamins E, A, C and Beta-carotene) concentration in the blood plasma additionally were studied young practically healthy 10 persons (20-35 years old), they compiled the second control group. Our study showed that endogenous antioxidants concentration reduces in the blood plasma with the age, this reduction becomes more obvious with the clinical detection of prostate benign hyperplasia. It is recommended for elderly patients to control periodically the endogenous antioxidants level (Vitamins A, C, E and Beta-carotene) in the blood plasma and in the case of changes to get food enriched with vitamins or combined vitamins preparations. This will be accomplice factor for the prophylactic of benign prostatic hyperplasia. This will be prophylactic activity during the conservative treatment process (by alpha-adrenoceptor blocking drugs, phytotherapy medicines, 5 alpha-reductase inhibitors and others). Inclusion of vitamins complexes which contains antioxidants is necessary. Prescription of antioxidants complex after the operative treatment will accelerate the healing process and reduce the rehabilitation period.

[Efficiency of assessment of retinol, alpha-tocopherol and beta-carotene by the liquid chromatography method].

Benign prostatic hyperplasia is very frequent disease of the primogenital system of elderly men. As the investigations show the antioxidant vitamins have various influence on the men's organism. They participate in the pathogenesis of many diseases. Taking into account all these circumstances, the prophylactic problem must be solved according to the foreseen provision of organism with the vitamins. It is very important to have the appropriate methods for determination of vitamins and their provitamins. Nowadays, to determine vitamin A, its form b-carotene and vitamin E, a High Pressure Liquid chromatography is used. We have developed an original, highly sensitive method of determining retinol, alpha-tocopherol and b-carotene, which is characterised by simplicity and high accuracy. Applying this method to the determination of vitamins concentration in 10 healthy donor's blood gave the following results: for the Vitamin A 567.99+/-57.49345 mkg/l , Vit. E-16.133+/-0.33941 mkg/l and b-carotene- 0.8621+/-0.810 mkg/l. This corresponds to the reference data. It is suggested that it is possible to use above-mentioned method for routine epidemiological investigations.

[Chemical destruction of the prostate by Prostalyser-1 and Prostalyser-2 solutions: an experimental study in dogs].

The aim of the study was elaboration of a new minimally invasive but effective alternative method of BPH treatment. The experiments were carried out on 46 male dogs divided into two equal groups. 10 ml of Prostalyser-1 solution (natrii chloridi 9.5 g, dimethylsulfoxidi 0.5 g, aquae destill. Ad 1000.0 g) was given in a single injection into the prostates of the first group of animals. The same volume of Prostalyser-2 solution (spiritus ethilicus 96% - 76.5 g, DMSO 0.5 g, aq.destill ad 100.0 g)--into the prostates of the other group, respectively. The temperature of the solutions was +80 degrees C. Within the first 2 months, essential disorders were observed in the cellular Na-pump, membrane permeability system, there were lobular and diffusive necroses in prostatic alveolar epithelium and a decrease of the prostate weight by 68-66%. This condition of the prostate persisted for 4-6 months. Prostalyser-1 and Prostalyser-2 solutions can be recommended as very prospective substances for chemical destruction of the prostate in case of BPH.

[Comparative evaluation of a current method of treating varicocele]. / Sravnitel'naia otsenka sovremennykh metodov lecheniia varikotsele.

To compare two methods of varicocele treatment--ligation and reconstruction--two groups of patients with left-sided varicocele of three different grades were compared. In group 1 (n = 108) a ligation of all visible veins of the seminal cord was performed. In group 2 (n = 310) a microsurgical reconstruction was made by an original technique developed in experiment: connection of the distal end of the lower epigastric vein and then joining the remaining open ends of the same veins. In group 1 signs of varicocele disappeared in 68%, in group 2--in 99.4% patients. Impregnation of wives was achieved in 31.6 and 74% of the couples, respectively. The results of both methods are discussed.

Surgical reinnervation of the transplanted kidney: is it needed?

The influence of surgical reinnervation on the organ was experimentally investigated on 175 dogs using the model of in situ denervation and kidney autotransplantation. It was found to ensure: anatomic and physiological conditions for the directed intergrowth of nerve fibres up to the principal structural elements of kidney; normal levels of nervous mediators, and complete kidney efficiency over a long period of time. The expediency of surgical reinnervation in the case of auto- and allotransplantation of the kidney is discussed.

A case of successful replantation of testis after autohemicastration.

A case of autohemicastration in a 19-year-old patient with schizophrenia is reported. Orthotopic replantation of the testis under local hypothermia was performed. One pair of arterial, two pairs of venous vessels and vas deferens ends were anastomosed micro-surgically end-to-end. Surgical reinnervation of the testis was carried out. Peculiarities the operation technique, expediency of local hypothermia and surgical reinnervation of the testis in replantation are discussed.

Bilateral abdominal cryptorchidism in males: autotransplantation of the testis.

5 patients with bilateral abdominal cryptorchidism are reported. Orthotopic autotransplantation of the right testis was performed in 4 cases and both testes in 1 case. Testicular vessels were anastomosed end-to-end with the inferior epigastric vessels. The ischemic testes were cooled to 20 degrees C. The vas was mobilized intact. We discuss the expediency of this organ-preserving operation, the type of vascular anastomosis and the use of local hypothermia.

[Effect of reinnervation on the state of transplanted kidneys in dogs]. / Vliianie reinnervatsii na sostoianie transplantirovannoi pochki u sobak.

In the experiments lasted for 2 years, the effect of surgical reinnervation on the morphofunctional state of autotransplanted and denervated kidney was studied in 175 dogs. General morphological, impregnational, special neurohistological investigations and kidney scanning demonstrated that 2 months after surgical reinnervation of the autotransplantated and denervated kidneys, active sprouting of nerve fibers, adrenergic and cholinergic including, was started along the degenerated nerve trunks, and by the 4th month the nerve fibers reached the renal glomeruli, tubules and pelves. A rather complete restoration of the organic innervation resembling that of the intact organ provided stability of the general morphological structure in the reinnervated kidney, its functional ability and prevented atrophy, sclerosis and stable functional depression observed in cases of renal transplantation and denervation without surgical reinnervation. From this point of view, the problem of necessary active surgical reinnervation of the renal transplantation is discussed.

Results of the clinical use of a 'dry' kidney's hypothermia.

This report describes the operative treatment of staghorn renal stones under ischaemia and hypothermia. The renal artery is blocked by digital pressure and the vascular pedicule is clamped. The kidney is cooled to an optimal level as established by the author (between 20 and 25 degrees C) by means of his own device for local hypothermia. Late results observed over a period of 0.5--5 years in 30 out of 40 patients showed no renal stone relapse and 3 (10%) 'false' relapses. In 25 cases (83.3%) the function of the kidney improved and in 8 out of 10 cases (80%) the arterial blood pressure returned to normal.