Neurogenic Bladder Dysfunction in Cancer Patients after Operations on the Pelvic Organs

The review is devoted to the generalization and analysis of domestic and foreign works describing the mechanism of development of neurogenic dysfunction of the bladder after surgery on the pelvic organs in cancer patients. All modern authors agree that the cause of these disorders is trauma of the pelvic nerves and interruption of the reflex arc. Unfortunately, when removing malignant tumors of the pelvic organs, urological complications are difficult and often impossible to avoid. This is due to the complex neuroanatomy of the bladder, its proximity to the rectum, the uterus, as well as the volume and radicality of cancer operations. The article shows that if the parasympathetic ganglia are damaged, there is a violation of the evacuation function of the bladder and a weakening or absence of the urge to urinate. If the sympathetic nervous system is damaged in isolation, on the contrary, an increase in the detrusor tone, intravesical pressure and a decrease in the capacity of the bladder is observed, which is in conditions of low bladder sphincter tone causes imperative urges, frequent urination and incontinence. Prior radiation therapy also affects the development of urological complications. Postradiated soft tissue changes, ischemia, fibrosis lead to great technical difficulties during surgery. In addition, factors that are important in the development of pelvic disorders in this category of patients include urinary system diseases and metabolic – endocrine disorders in case history

МЕТОДЫ ИДЕНТИФИКАЦИИ ЭЛЕМЕНТОВ СОСУДИСТО-НЕРВНОГО ПУЧКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ (ОБЗОР ЛИТЕРАТУРЫ)

With regard to a considerable number of erective dysfunction after radical prostatectomy and a rise in the number of patients concerned with postoperative potency preservation, the identification of neurovascular bundles (NVB) remains an urgent problem. Different NVB imaging procedures exist today; however, there is now no method that is optimal and able to prevent cavernous nerve injury with high probability and reduce the number of complications. The advantages and disadvantages of these procedures should be determined by the long-term functional results of their use, which were assessed in randomized studies.С учетом значительного числа больных с эректильной дисфункцией после радикальной простатэктомии и роста числа пациентов, заинтересованных в сохранении потенции после операции, остается актуальной проблема идентификации сосудисто-нервных пучков (СНП). В настоящее время существуют различные методики визуализации СНП, однако оптимальной, позволяющей с высокой вероятностью избежать травмирования кавернозных нервов и снизить количество осложнений, на данный момент нет. Достоинства и недостатки этих методик должны определяться отдаленными функциональными результатами их применения, оцененными в рандомизированных исследованиях

НЕИНВАЗИВНАЯ ДИАГНОСТИКА РАКА МОЧЕВОГО ПУЗЫРЯ МЕТОДОМ КРОСС-ПОЛЯРИЗАЦИОННОЙ ОПТИЧЕСКОЙ КОГЕРЕНТНОЙ ТОМОГРАФИИ (СЛЕПОЕ СТАТИСТИЧЕСКОЕ ИССЛЕДОВАНИЕ)

Whether cross-polarization (CP) optical coherence tomography (OCT) could be used to detect early bladder cancer was ascertained; it was compared with traditional OCT within the framework of blind (closed) clinical statistical studies. One hundred and sixteen patients with local nonexophytic (flat) pathological processes of the bladder were examined; 360 CP OCT images were obtained and analyzed. The study used an OCT 1300-U CP optical coherence tomographer. CP OCT showed a high (94%) sensitivity and a high (84%) specificity in the identification of suspected nonexophytic areas in the urinary bladder.Оценена возможность кросс-поляризационной (КП) оптической когерентной томографии (ОКТ) в выявлении раннего рака мочевого пузыря (РМП), выполнено сравнение ее с традиционной ОКТ в рамках клинических слепых (закрытых) статистических исследований. Исследованы данные 116 пациентов с локальными неэкзофитными («плоскими») патологическими процессами мочевого пузыря, получено и проанализировано 360 КП ОКТ-изображений. В работе использован КП оптический когерентный томограф «ОКТ 1300-У». КП ОКТ показала высокую чувствительность (94 %) и специфичность (84 %) в идентификации неэкзофитных подозрительных зон в мочевом пузыре

Современные технологии инкапсуляции островков Лангерганса поджелудочной железы для коррекции сахарного диабета 1-го типа

The review includes the results of analytical research on the problem of application of pancreatic islet encapsulation technologies for compensation of type 1 diabetes. We present a review of modern encapsulation technologies, approaches to encapsulation strategies, insulin replacement technologies: auto-, allo- and xenotransplantation; prospects for cell therapy for insulin-dependent conditions; modern approaches to β-cell encapsulation, possibilities of optimization of encapsulation biomaterials to increase survival of transplanted cells and reduce adverse consequences for the recipient. The main problems that need to be solved for effective transplantation of encapsulated islets of Langerhans are identified and the main strategies for translating the islet encapsulation technology into medical reality are outlined.В обзор включены результаты аналитических исследований по проблеме применения трансплантационных технологий инкапсулированных островков Лангерганса поджелудочной железы для компенсации сахарного диабета первого типа. Представлен обзор современных технологий получения капсул, подходов к стратегиям инкапсуляции, трансплантационных технологий инсулинозамещения: ауто-, алло-, ксенотрансплантаций; перспектив клеточной терапии при инсулинзависимых состояниях; современных подходов к инкапсуляции β-клеток, возможностей оптимизации используемых биоматериалов при инкапсуляции для повышения выживаемости трансплантируемых клеток и снижения негативных последствий для реципиента. Выявлены основные проблемы, которые необходимо решить для эффективной трансплантации инкапсулированных островков Лангерганса, и обозначены основные стратегии для перевода технологии инкапсуляции островков в медицинскую реальность

METHODS FOR IDENTIFICATION OF THE ELEMENTS OF THE PROSTATE NEUROVASCULAR BUNDLE (A REVIEW OF LITERATURE)

<p><em>With regard to a considerable number of erective dysfunction after radical prostatectomy and a rise in the number of patients concerned with postoperative potency preservation, the identification of neurovascular bundles (NVB) remains an urgent problem. Different NVB imaging procedures exist today; however, there is now no method that is optimal and able to prevent cavernous nerve injury with high probability and reduce the number of complications. The advantages and disadvantages of these procedures should be determined by the long-term functional results of their use, which were assessed in randomized studies.</em></p

NONINVASIVE DIAGNOSIS OF BLADDER CANCER BY CROSS-POLARIZATION OPTICAL COHERENCE TOMOGRAPHY: A BLIND STATISTICAL STUDY

Whether cross-polarization (CP) optical coherence tomography (OCT) could be used to detect early bladder cancer was ascertained; it was compared with traditional OCT within the framework of blind (closed) clinical statistical studies. One hundred and sixteen patients with local nonexophytic (flat) pathological processes of the bladder were examined; 360 CP OCT images were obtained and analyzed. The study used an OCT 1300-U CP optical coherence tomographer. CP OCT showed a high (94%) sensitivity and a high (84%) specificity in the identification of suspected nonexophytic areas in the urinary bladder.</p

NONINVASIVE DIAGNOSIS OF URINARY BLADDER CANCER BY CROSS-POLARIZATION OPTICAL COHERENCE TOMOGRAPHY: CLINICAL RESULTS

<span>The investigation examined the feasibility of cross-polarization optical cohe-rence tomography (CP OCT) to detect early urinary bladder cancer (UBC). Studies were performed in 376 patients; 5290 images were obtained using an OCT 133-U optical coherence tomograph. To acquire and compare intrared-light scattering images in baseline and orthogonal polarizations is the basis of CP OCT; their analysis makes it possible to judge from the state of the epithelium/connective tissue system and to obtain information on changes in tissue depolarizing components, collagen in particular. The authors elaborated criteria as determinants of the nature of CP OCT changes in direct and orthogonal polarizations in health, inflammatory changes, and UBC at its early stage - urothelial dysplasia and carcinoma in situ in flat suspected areas.</span