SURGERY FOR BLADDER CANCER: CURRENT STATE PROBLEMS, DEVELOPMENT TRENDS

The aim. of the review was to demonstrate an arsenal of surgical interventions that can be utilized at treatment of patients with bladder cancer. Based on the scientific literature analysis the authors highlight the etiology and the existing classifications of bladder cancer, the historical stages of surgical treatment of this disease. The advantages and shortcomings of current methods and. ways of treatment, possible complications are described

Current concepts of Peyronie’s disease (clinical lecture)

The article is presented in the format of a lecture. Peyronie’s disease (induratio penis plastica) is a progressive fibrotic disorder of the penile tunica albuginea that results in fibrotic penile plaques and  can cause penile deformity. The issues of  etiology, pathogenesis, clinical picture and diagnosis of Peyronie’s disease (PD) are reviewed in the lecture from the modern points of view. PD is frequently associated with penile pain, erectile dysfunction, and a secondary anxiety-depressive state. Despite the existence of this problem for several centuries, no unified concept of the Peyronie’s disease pathogenesis can be found in literature. A growing amount of research has shown that PD is a chronical disorder of local wound healing process within the tunica albuginea and the Smith’s space. Over the past 40 years, multiple lines of evidence have pointed to a genetic factor that predisposes some men to the development of Peyronie’s disease. Treating men with PD remains a challenging problem for clinicians working in urology. Given the high prevalence of PD and its significant impact on affected men, its better understanding is essential. Treatment methods for PD are varied and include oral, local, intralesional and traction therapy, and surgical treatment. Current clinical care standards for PD are aimed at the symptom suppression, as there are currently no treatment for PD that can eliminate its causes or progression. Clostridium histolyticum collagenase has shown its effectiveness in  treating PD, but its efficacy and safety remain controversial. Surgery remains the most effective method for PD treatment and is considered to be “gold standard”. The choice of the  surgical technique depends on the length of the penis, degree of deformity, erectile function, patients’ expectations and surgeon’s preferences. Various surgical techniques and grafting materials (autologous and non-autologous) can  be used for  the coverage of  the tunica albuginea defect after partial plaque excision or incision

Chronic scrotal pain: Pathogenesis, clinical phenotypes and modern treatment concept (clinical lecture)

Chronic scrotal pain (CSP) is a general term, which defines variety of problems causing discomfort or pain in the scrotum, which can be caused by the problems with testicles and other structures of the scrotum: epididymis, vas deferens, paratesticular structures. For a practicing urologist, the diagnosis and treatment of chronic scrotal pain is always a difficult task due to the many reasons for its appearance and the variety of clinical symptoms. CSP is a widespread but poorly understood condition, the etiology of which often can not be identified. Pain localized in the scrotum makes up 38.8 % of all cases of chronic men’s pelvic pain. From 2.5 to 4.8 % of all visits to the urologist relate to CSP syndrome. Primary scrotal pain syndrome is not associated with infection or other local pathological processes that could cause pain. The treatment of chronic scrotal pain is challenging because the pain often does not react to the traditional treatments.The purpose of this lecture is to draw the attention of urologists, general practitioners, and everyone who is interested in the problem of treating chronic scrotal pain to the possibilities of modern medicine in solving this multidisciplinary problem

Muscle non-invasive bladder cancer: clinical and morphological features, treatment outcomes, survival analysis

The article presents the analysis of the results of surgical treatment of 896 patients with muscle non-invasive bladder cancer who were operated in the period from 2000 to 2011: 662 (73,9 %) men and 234 (26,1 %) women of 31-84 years (average age - 61,6 years). The authors describe experience of using bipolar transurethral resection (TURis) and vaporization (vap) for a urinary bladder tumor. The article represents the study of frequency and nature of the recurrence and survival rate (common, oncology-specific, disease-free) after transurethral surgery of patients with non-muscle invasive bladder cancer (BC) of Ta, T1 and Tis stages. The obvious advantage of the technique bipolar transurethral resection (TURis) and vaporization (vap) over others suggests that in the nearest future the TURis-vap will serve as the "golden standard" in non-muscle invasive bladder tumors surgery

Testicular diffuse large B-cell lymphoma. Clinical lecture and case report

Lymphoma is a heterogeneous group of lymphocyte malignancies that may involve lymphatic tissue, bone marrow, or extranodal sites. The lecture provides a  brief overview of the current state of the problem of diagnosis and treatment of primary testicular lymphoma. Primary testicular lymphoma (PTL) is a rare lymphoid malignancy. Though it is rare, PTL is the most common type of testicular tumor in men over 60 years of age. The most common histological type is diffuse large B-cell lymphoma. To date, there are no well-documented etiological or risk factors for PTL. In contrast to other common testicular neoplasms, there was no statistically significant association of PTL with cryptorchidism, trauma, chronic orchitis, or infertility. Ultrasound is generally the first-line imaging method used to characterize testicular lesions. PTL manifests itself in the form of a hypoechoic formation, which can take the form of either a single large formation or multiple small formations that occupy most of the testicular parenchyma or completely replace it. Systemic treatment, including orchiectomy, chemotherapy, radiation therapy, and intrathecal prophylaxis, is necessary for all patients with PTL. In addition to achieving complete remission, the goal of PTL treatment is to prevent recurrences in the contralateral testis and central nervous system. The presented information is supplemented by our own observation and images. Personal medical data is published with the written consent of the patient. In our case, the patient’s age was 38 years, which does not fall into the specified age group for primary testicular lymphoma. In our opinion, the publication of this clinical case and analysis of scientific literature on this topic are relevant