Vol 5, No 1 (2009)

Ретенционные осложнения  со стороны верхних мочевых путей  у больных раком шейки матки IIb—III стадии

Due to the better diagnostic feasibilities of health care facilities, the proportion of patients with small renal tumors (T1a) has substantiallyincreased in recent years. In accordance with the international standards, these patients should undergo nephron-sparing surgery: neoplas-tic kidney resection. At Russian hospitals, organ-preserving treatment is not in adequate use for the technical difficulties associated withresection and for the likelihood of postoperative complications. The performed study has yielded a simple highly effective procedure ofnephrectomy in neoplasms, by using vasoselective parenchymatous sutures enhanced with polymer stripe-implants. 

The volume of an operation on the urinary bladder (UB) in case of its extensive involvement due to locally advanced colorectal can-cer varies from partial cystectomy to cystectomy. The results of a morphological examination of 18 patients after pelvic exenterationdemonstrated true invasion into the urinary bladder wall only in 7 (38.9%) cases. This created preconditions for organ-preservingtreatment. Combined operations with partial cystectomy were performed in 37 patients. Pathology showed true tumor invasion intothe urinary bladder wall in 13 (35.1%) cases. The bladder volume was 55.2±17.1 ml after surgery and 175 to 360 (230±31.2) mlfollowing autohydrotraining with pharmacological support made 3 months after surgery. No patient had recurrent urinary bladderdisease. The surgical results suggest that organ-preserving treatment does not violate the oncological radicalism principles and is aserious alternative to cystectomy: Firstly, there is no need for the technically complex stage of an operation - to create a urinaryreservoir. Secondly, urination is preserved by its natural way; there are no signs of urinary incontinence, which ensures the betterquality of life. 

According to the data obtained by Russian and foreign investigators, the major complication after radical prostatectomy (RPE) is urinaryincontinence that is recorded in 20-30% of cases.

Objective. To improve the results of surgical treatment in patients with prostate cancer, by developing and introducing a well-rounded post-operative rehabilitation program.

Subjects and methods. Seventy-four patients who were treated at the urology clinic, Bashkir State Medical University, and underwent RPEin 2005 to 2007 have been examined; 27 of them were diagnosed as having urinary incontinence (UI). After discharge from the clinic, acontrol group received rehabilitative treatment at the sanatorium “Krasnousolsk” of the Republic of Bashkortostan.

 Results and discussion. Therapeutic exercises and pelvic floor electrostimulation halve the number of day urinations and paddings used inpatients with UI, by increasing the bladder capacity from 138.2±12.7 to 196±11.2 ml and improving the trophism of the bladder neck andurethra in the sphincteral area.

Lucrin depot used to treat patients with prostate cancer has been investigated. The agent has been found to be highly effective, to causeadverse effects rarely, and to be well tolerated. The administration of leuproreline acetate yields the results comparable with those in the useof other luteining hormone-releasing hormone agonists and antagonists, bilateral orchiectomy, and estrogens. 

A major focus of this paper is on the organization of specialized urological treatment, by taking into account the Governor's program “Male urological health” in the Sverdlovsk Region. It also shows the great importance of financial support for early diagnosis, timely effective treatment, clinical examination, and better quality of life in the male population of the Sverdlovsk Region.

Отчет о III конгрессе Российского общества онкоурологов

Лечение рецидивов герминогенных опухолей у мужчин