RESECTION URETHRA ANASTOMOSIS END TO END IN THE CURRENT CONDITIONS OF DEVELOPMENT UROLOGY

The article presents a review of the place in practical urology and opportunities resection urethral stricture and obliteration with various localization and extent. This opinion is based on the experience of the author, dealing with this issue for over 50 years. The author highlights the historical aspects of the development and implementation of this surgery method in clinical practice, as well as contribute to the solution of this problem, the doctors of the Rostov school of urology during the last ten years

Surgical treatment of benign prostatic hyperplasia: modern methods and potentials

Background. Benign prostatic hyperplasia (BPH) is one of the commonest diseases in male population. Surgical treatment is recommended in cases if a patient doesn't want to begin or continue his medication or lower urinary tract symptoms (LUTS) progression or complicated course of the disease. Over the past two decades there has been a significant expansion of the range of types of surgical treatment.Objectives. Conduct a comparative analysis of endovideosurgical treatment of BPH.Materials and methods. In the course of work on this issue, the following databases were analyzed: PubMed, ScienceDirect, Cohrane Library, UpToDate, eLibrary with a search range in the last 30 years, next key words were used: «benign prostatic hyperplasia», «urethral stricture», «bladder neck contracture», «TuRP», «HoLEP», «ThuLEP», «GreenLight laser». Search range: from 1989 to 2019.Results. Based on the results of numerous studies, thulium, holmium and GreenLight lasers show the best results. Laser surgery is longer than the transurethral resection of the prostate (TURP), however, the rates of hospitalization and catheterization are more significant for patients. Efficiency and safety are also two of the most important criteria, and in this respect, thulium and holmium lasers perform well. Thulium laser provides an excellent result of vaporization of the prostate tissue and reliable hemostasis without causing significant thermal injury to the surrounding tissues. Holmium laser shows the lowest rates of re-catheterization, urinary retention, inflammatory and infectious complications, stress urinary incontinence and retrograde ejaculation, but there is a chance of damaging the prostate gland capsule. GreenLight laser, due to the specificity of its wavelength, has excellent hemostasis but this entails greater thermal damage to the surrounding tissues.Conclusion. Of course, all the considered techniques are safe and effective. But due to the characteristics of each of the methods, a competent selection of the intervention method for each patient is necessary to improve the effect of surgical treatment

Surgical treatment method for nephroptosis

A new method of nephropexy with an autograft by the upper pole to the diaphragm from intercostal lumbotomy is described. The method induces little injury, is technically simple and can be employed in those patients who do not need a revision or surgery on the renal pelvis, ureter or vascular pedicle. The method was used in operations on 45 patients. Good immediate and remote results were obtained

Comparative analysis of one- and two-stage augmentation urethroplasty with dorsal INLAY buccal graft for extended stricturesof spongious urethra

INTRODUCTION: Urethral reconstructive surgery is in constant development. At present, reconstructive urethroplasty with buccal mucosa is increasingly being used. The study aimed to compare the results of a one- and two-stage augmentation urethroplasty with dorsal inlay buccal graft for strictures of the spongious urethra.MATERIALS AND METHODS: The study comprised 72 patients aged 19-64 with urethral strictures 3-18 cm long. In 34 (47.2%) patients, the stricture was localized in the penile urethra, in 30 patients (41.6%) in the penile-bulbous urethra and in 8 patients (11%) in the bulbous urethra. All patients underwent augmentation urethroplasty with dorsal inlay buccal graft. The results were evaluated separately in 55 (76.4%, group 1) and 17 (23.6%, group 2) patients who underwent one-stage and two-stage surgery, respectively.RESULTS: The incidence rate of early postoperative complications was higher after one-stage (23.6%) compared two-stage surgery (11.8%) (p\u3c0.05). Hematomas, wound dehiscence and urethrocutaneous fistulas were observed only after single-stage surgery. Primary healing of extensive strictures following augmentation urethroplasty with dorsal inlay buccal graft was achieved in 88.9% of patients; treatment effectiveness in the group 1 was 89.1%, in the group 2 - 88.2% (p\u3e0.05). The final effectiveness of the operation, achieved with the use of additional surgical interventions, is estimated at 98.6%.CONCLUSION: The results of augmentation urethroplasty with dorsal inlay buccal graft do not depend on the number of stages, but fewer complications accompany two-stage surgery