ТРИАМЦИНОЛОН В ЛЕЧЕНИИ НЕОСЛОЖНЕННОГО БАКТЕРИАЛЬНОГО ЦИСТИТА (ЭКСПЕРИМЕНТАЛЬНОЕ ИССЛЕДОВАНИЕ)

The problem of the bacterial cystitis treatment continues to be relevant among the urologists all over the world due to its prevalence rate and the complexity in its treatment. The goal of research: to study experimentally the influence of synthetic glucocorticoidtriamcinоlon on the inflammatory mucosa of the urinary bladder.Material. The experimental study was conducted on the outbred white reproductive rats-females. The main group of the animals (40 rats) was exposed to simulation of the inflammatory mucosa of the urinary bladder. Triamcinоlon instillations (0.3 ml) were performed on 20 rats. In the other group of rats the triamcinоlon instillation was added with intramuscular injection of antibiotics. There were two compari-son groups of rats with the simulated inflammatory mucosa of the urinary bladder. The first (20 rats) re-ceived only intramuscular antibiotics injections and the second (20 rats) received no treatment. The con-trol group of animals (10 rats) received instillations of intact 0.9% NaCl.Methods. The bladder wall ultrastructure was analyzed by the method of transmission electronic microscopy.Rresults. According to the research data, decongestion of the swelling enchasing mass was observed after 5 days of triamcinоlon instillations both with antibiotics and without it in comparison with the inflammatory process without any treatment and with the antibiotics injections only. After 10 days this result in the main group was the same as in the control group. Infiltrating cells density in the main group after 7 days was obviously lower than in the comparison groups. The triamcinоlon injections induce neovasculogenesis and fibrogenesis, improve hemorheology in the vascular plexus of the urinary bladder mucosa. The results come up to a high level of statistical significance.Summary. The experimental data prove the safety of intravesical triamcialon instillation and its therapeutic effectiveness. В работе изучалось влияние синтетического глюкокортикоида триамцинолона на слизистую оболочку мочевого пузыря при моделировании неосложненного бактериального цистита. Экспериментальное исследование проведено на 90 беспородных белых половозрелых крысах, которые были разделены на следующие группы. Первой группе животных (20 крыс) после развития воспаления в слизистой оболочке мочевого пузыря вводили триамцинолон, второй группе (20 крыс) инстилляции глюкокортикоида сочетали с внутримышечным введением антибиотика. Третьей группе (20 крыс) внутримышечно вводили антибиотик. В четвертой группе (20 крыс) не производилось лечение острого бактериального цистита. Контрольной группе животных осуществляли инстилляции физиологического раствора.Морфологическое и морфометрическое исследование слизистой оболочки мочевого пузыря при моделировании бактериального цистита показало, что введение триамциналона уменьшает выраженность воспаления, улучшает кровоснабжение стенки мочевого пузыря и стимулирует регенерацию эпителия слизистой оболочки мочевого пузыря

Integrated retrograde and antegrade contact electro-impulse lithotripsy in the treatment of kidneys and ureteropelvic junction stones

Introduction. Nowadays, the tactics of removing stones from the kidneys and the ureteropelvic junction are widely covered and described in detail in modern guidelines. Determination of one or another treatment way depends on stone specific features and patient`s constitutional peculiarities. However, usage of percutaneous or retrograde access only does not always allow achieving a good result. In sophisticated cases, such as a large-size branchy renal stone, a “penetrated” stone in the ureter’s upper third, or some patient`s anatomic peculiarities, search for new ways to remove such stones with integrating accesses.Purpose of the study. To evaluate the removal efficiency of kidney stones and ureteropelvic junction by a combination of retrograde and percutaneous lithotripsy using electrical impulse energy. Materials and methods. In 2014-2019 in Siberian State Medical University Clinics (Tomsk, Russia), the integrated retrograde and percutaneous lithotripsy was applied in 26 cases to patients that had differently positioned kidneys’ and ureteropelvic junction stones. The treatment was based on the usage of the electro-impulse lithotriptor Urolith-105M (Lithotech Medical, Israel, MedLine LLP, Russia). In some cases, the laser lithotriptor Calculase II (Karl Storz, Germany) was also engaged. Result. The patients were aged from 25 to 76 (women - 69.2%). The calculus average size was 19.5 mm (varying from 5 to 51 mm). The calculus average density was 1229 HU (from 510 to 1720 HU). The operation average duration was 131 minutes (from 40 to 280 minutes). The incidence of complications was 3.84%. The complete calculus destruction occurred in 92.3% of cases. The overall response rate in re-operations reached up 100%.Conclusion. Integration of antegrade and retrograde accesses with use of the electro-impulse energy in removing complex stones from ureteropelvic junctions and kidneys proved to be an efficient method of treatment and demonstrated great results. Furthermore, this option of the single-step access to the stones is the only one possible in some cases when the extracorporeal lithotripsy is contraindicated, application of upfront surgery is quite risky, or endoscopic methods as an antegrade/retrograde mono-access are not effective

TRIAMCINОLON IN THE TREATMENT OF THE SIMPLE BACTERIAL CYSTITIS (EXPERIMENTAL STUDY)

The problem of the bacterial cystitis treatment continues to be relevant among the urologists all over the world due to its prevalence rate and the complexity in its treatment. The goal of research: to study experimentally the influence of synthetic glucocorticoidtriamcinоlon on the inflammatory mucosa of the urinary bladder.Material. The experimental study was conducted on the outbred white reproductive rats-females. The main group of the animals (40 rats) was exposed to simulation of the inflammatory mucosa of the urinary bladder. Triamcinоlon instillations (0.3 ml) were performed on 20 rats. In the other group of rats the triamcinоlon instillation was added with intramuscular injection of antibiotics. There were two compari-son groups of rats with the simulated inflammatory mucosa of the urinary bladder. The first (20 rats) re-ceived only intramuscular antibiotics injections and the second (20 rats) received no treatment. The con-trol group of animals (10 rats) received instillations of intact 0.9% NaCl.Methods. The bladder wall ultrastructure was analyzed by the method of transmission electronic microscopy.Rresults. According to the research data, decongestion of the swelling enchasing mass was observed after 5 days of triamcinоlon instillations both with antibiotics and without it in comparison with the inflammatory process without any treatment and with the antibiotics injections only. After 10 days this result in the main group was the same as in the control group. Infiltrating cells density in the main group after 7 days was obviously lower than in the comparison groups. The triamcinоlon injections induce neovasculogenesis and fibrogenesis, improve hemorheology in the vascular plexus of the urinary bladder mucosa. The results come up to a high level of statistical significance.Summary. The experimental data prove the safety of intravesical triamcialon instillation and its therapeutic effectiveness