Search

The authors showed the result of complication treatment of lower urinary tracts in 128 patients with localized prostate cancer. The patients underwent radical prostatectomy. Urinary discomforts included enuresis, urinary incontinence in postoperative period. Abnormalities of urine outflow due to urethral stricture were revealed in 6 (4,6%) patients by the 6 month after operation. These complications required surgical treatment. Urinary incontinence was noted in 20 (15,6%) patients in this period. It was stressful urinary incontinence in 16 (12,6%) and urgent - in 4 (3%). Patents with stressful urinary difficulty were advised to use the conservative treatment (pelvic floor muscle training and electrostimulation), but in case of inefficiency - surgical treatment.

Forty three patients with unsatisfactory outcomes of surgical treatment of benign prostatic hyperplasia (BPH) were examined urodynamically. Thirty five patients complained of daily and nocturnal pollakiuria, incomplete evacuation of urine from the bladder, imperative voiding. Eight patients had postoperative enuresis. Seventeen control patients had satisfactory surgical results. The urodynamic findings showed that postoperative dysuria was caused by detrusor pathology: detrusor hyperactivity (n = 27, 62.8%), contractile hypoactivity (n = 4, 9.3%), infravesical obstruction (n = 4, 9.3%). Diuresis patients had low maximal cystometric capacity of the urinary bladder, detrusor hyperactivity was diagnosed in 5 (62.6%) patients. Enuresis patients had also very low indices of urethral profilometry characterizing function of the sphincter. The urodynamic examination detected true stress urine incontinence in 3 enuresis patients due to sphincter impairment. Five patients had enuresis of mixed nature. Thus, urodynamic examination of patients with unsatisfactory results of surgery determined cause of dysuria. Accurate diagnosis of characteristics and causes of lower urinary tracts dysfunction decides choice of adequate therapeutic policy.

To improve reliability of the diagnosis of infravesical obstruction (IVO) in patients with benign prostatic hyperplasia (BPH), we examined 80 BPH patients (mean age 58.2 +/- 2.1 years). The examination included evaluation of complaints by IPSS, ultrasound investigation with determination of prostatic size and residual urine, and urodynamic tests: uroflowmetry, miction cystometry. We came to the conclusion that symptoms of BPH, size of the gland, amount of residual urine and maximal volumetric miction velocity not always evidence for IVO. To raise reliability of IVO diagnosis we propose the following formula: D1 = 0.818 x S(max) +0.0006 x S(min) +0.215 x Q(max) - 0.478 x Q(aver), where D1 is a discriminant function; S(max) is a maximal linear size of the prostate; S(min) is a minimal linear size of the prostate; Q(max) is maximal volumetric flow rate; Q(aver) is mean volumetric flow rate. If D1 > or = 2.85, IVO is definite. If D1 < or = 2.85, IVO absence is more probable. Thus, the proposed formula provides more reliable diagnosis of IVO in BPH patients than assessment of clinical indices.

The authors have performed urodynamic investigations pressure-flow in 39 males (mean age 57.9 +/- 1.8 years) to detect infravesical obstruction. Interpretation of the findings rested upon Abrams-Griffits index (AGI) derived by the formula AGI = PdetQmax - 2xQmax, where Qmax is the maximal speed of urine flow and PdetQmax is detrusor pressure when the maximal urine flow is reached. Definite conclusion on the presence or absence of infravesical obstruction was feasible for 21(53.8%) of 39 examinees, was not possible for 18(46.2%) patients. Statistical processing yielded non-linear relationship between PdetQmax and Qmax (cubic parabola) requiring correction for AGI (coefficient K calculated according to the formula K = 58.7 - 0.00554x(Qmax)3). This correction for nonlinearity K allowed classification of 11 out of 18 patients who were initially indefinite. By standard AGI technique, the uncertainty zone made up 46.2% while correction for nonlinearity reduced this zone to 18.0% (p < 0.008). Thus, the account for nonlinearity of the relationship between PdetQmax and Qmax may contribute to a rise in diagnostic value of urodynamic investigations.

Experimental verification of prostatilen prophylactics of changes in the urogenital organs consequent to g-loads was the idea of the work. The experiment was performed with 37 mongrel white male rats weighing 200-250 g who were exposed to the head-pelvis g-loads (+Gl) at 10 units. Behavior reactions of the rats were assessed with the "open field" technique immediately after centrifugation; weighing coefficients of the urogenital organs (the organ/body mass relation) were determined, and histological and morphometric analyses of prostate, testis and kidney were made. A significant moderating effect of prophylactic prostatilen on the stress-reactions in animals was first revealed; prostatilen was also found to speed up adaptation. This was concluded from normalization of the hemodynamics, a decrease in venous plethora and epithelial dystrophy, absence of basophilia in conjunctive tissue of the urogenital organs. Distention and overfilling of acini by secret and the number of epithelial acinus hulled into the lumen were markedly less in prostate. Spermatogenesis in testis was normalized, too. The histological profile of kidney approached the norm. Results of the experiment showed that prostatilen is a promising preparation from the standpoint of moderation of stress-reactions and counteraction of disorders in the urogenital organs caused by g-loads.

The purpose of the present study was to examine the effects of the animal renal peptide complex renaline obtained via acid extraction on the cause of acute pyelonephritis in the experiment. Renaline was found to be highly effective in treating experimental acute pyelonephritis in rats. This is manifested as improved changes in the parameters of leukocytosis, leukocyturia, rectal temperatures, and bacteriuria along with the regression of abnormal changes and the reduction in renal mass differences, as compared to the similar parameters in untreated animals. The findings indicate that the clinical use of renaline in the combined therapy for acute pyelonephritis.