РЕАБИЛИТАЦИЯ БОЛЬНЫХ ПОСЛЕ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ

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. Реабилитация больных после радикальной простатэктоми

МОЛЕКУЛЯРНЫЕ МАРКЕРЫ ПРОГНОЗА ПРИ РАКЕ МОЧЕВОГО ПУЗЫРЯ

Bladder cancer (BC) remains a current problem in oncourology. Despite that bladder cancer risk factors have been studied and described in the literature, new molecular and genetic mechanisms have been identified that predisposes to the disease development. There are numerous cellular processes involve in BC pathogenesis. The less-aggressive, non-invasive slow progressing bladder cancer types are defined by Ras-MAPK system activation. Tumors that are more aggressive and have low cancer-specific survival rate are characterized by changes in retinoblastoma genes and p53. Attempts are made to develop prognostic tests to predict tumor behavior, targeted treatment. perspectively, BC patients will be treated using molecular genetic markers allowing the accurate prediction of the patient’s tumor behavior and fitting the treatment tactics on the individual basis.Рак мочевого пузыря (РМП) остается актуальной проблемой онкоурологии. Несмотря на то, что факторы риска РМП изучены и описаны в литературе, выявляются новые молекулярно-генетические механизмы, предрасполагающие к развитию заболевания. В патогенез РМП вовлечено множество клеточных процессов. Менее агрессивные, неинвазивные, медленно прогрессирующие формы РМП характеризуются активацией системы Ras-mitogen-activated protein kinase (Ras-MAPK). Более агрессивные опухоли с низкой раковоспецифической выживаемостью, характеризуются изменениями в генах ретинобластомы и p53. Предпринимаются попытки разработать прогностические тесты, предсказывающие развитие опухоли, выбор тактики лечения. В перспективе в лечении пациентов РМП будут использоваться молекулярно-генетические маркеры, позволяющие достоверно предсказать поведение опухоли у пациента и выбрать индивидуальную тактику лечения

An analysis of radical cystectomy results in cases of muscle-invasive urinary bladder cancer

Aim: to analyze the results of the surgical treatment of patients with muscle-invasive urinary bladder cancer. Materials and methods: Analysis of the treatment results of 296 patients with muscle-invasive urinary bladder cancer who have had the radical cystectomy with intestineplasty variant. Results: The implementation of a developed therapeutic approach have allowed to reduce the number of cases of post-surgery complications. Conclusion: The results of work have allowed to improve treatment results of patients with urinary bladder cancer.Цель: Оценка результатов хирургического лечения больных мышечно-инвазивным раком мочевого пузыря. Материалы и методы: Анализ результатов лечения 296 пациентов с мышечно-инвазивным раком мочевого пузыря, которым выполнена радикальная цистзктомия с вариантом кишечной пластики. Результаты: Применение разработанной тактики лечения, позволило снизить количество послеоперационных осложнений. Заключение: Результаты работы позволили улучшить результаты лечения больных раком мочевого пузыря

Treatment of erectile dysfunction in patients after kidney transplantation depending on type of vascular anastomosis: results of short-term follow up study

Introduction. The prevalence of erectile dysfunction in men with chronic kidney disease stage V is from 60 to 80%. At the same time, the prevalence of erectile dysfunction in patients after kidney transplantation remains high at up to 60%. One of the possible causes of erectile dysfunction after kidney transplantation is considered a decrease in arterial inflow to the cavernous bodies of the penis.Objectives. Тo evaluate the results of treatment of ED in patients after KT, depending on the vascular anastomosis.Materials and methods. 84 patients with a functioning kidney after transplantation were examined. All patients were divided into 3 groups: Group I – 38 patients undergoing KT with arterial vascular anastomosis with an internal iliac artery; Group II – 46 patients undergoing kidney transplantation with arterial vascular anastomosis to external iliac artery; Group III – 35 healthy volunteers (control group) with no history of urological diseases or surgical interventions on the pelvic organs. International Index of Erectile Function Index (IIEF-5) was used to assess erectile function. An ultrasound study with dopplerography of the penile arteries was performed before and after intracavernous pharmacological stress. For treating patients with erectile dysfunction after kidney transplantation were used PDE-5 inhibitors (Tadalafil® 5 mg daily for 3 months, then at a dose of 20 mg “on demand”), a special set of exercises for the muscles of the pelvic floor, vacuum therapy and physiotherapy with the device “Androgyne”.Results. Significant erectile function disorders were detected in 26 (68.4%) patients of group I, and in 31 (73.9%) patients of group II, according to data from the IIEF-5 questionnaire. Group I 27 (71.1%) patients were satisfied with sex life, group II – 39 (84.8%) by the end of the year. According to the Doppler ultrasound, after 12 months in patients of group I, the maximum systolic velocity of blood flow in the right and left cavernous artery of the penis was 25.0 ± 3.44 cm / s and 33.0 ± 3.56 cm / s, respectively. The difference in arterial inflow of 8 cm / s indicates a pronounced arterial perfusion of the penis in group I patients. At the same time, in patients of group II, the maximum systolic velocity was significantly higher than in group I and amounted to 40.1 ± 2.66 cm/s and 40.0 ± 2.77 cm/s, respectively.Conclusion. The data obtained indicate a decrease in the arterial inflow to the penis along the right cavernous artery in patients from group I, who underwent an arterial vascular anastomosis with an internal iliac artery during kidney transplantation

MOLECULAR PROGNOSTIC MARKERS OF URINE BLADDER CANCER

Bladder cancer (BC) remains a current problem in oncourology. Despite that bladder cancer risk factors have been studied and described in the literature, new molecular and genetic mechanisms have been identified that predisposes to the disease development. There are numerous cellular processes involve in BC pathogenesis. The less-aggressive, non-invasive slow progressing bladder cancer types are defined by Ras-MAPK system activation. Tumors that are more aggressive and have low cancer-specific survival rate are characterized by changes in retinoblastoma genes and p53. Attempts are made to develop prognostic tests to predict tumor behavior, targeted treatment. perspectively, BC patients will be treated using molecular genetic markers allowing the accurate prediction of the patient’s tumor behavior and fitting the treatment tactics on the individual basis.</p

REHABILITATION OF PATIENTS AFTER RADICAL PROSTATECTOMY

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. </p