Chief Editor
Vol. 3 No. 3 (2023): VESTNIK of KSMA
Published:
2023-11-09
Full Issue
QUESTIONS ON UROLOGY
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SOME FEATURES OF LOCAL FACTORS IN THE DEVELOPMENT OF RECURRENCE OF URETHRAL STRICTURES IN THE LONG-TERM POSTOPERATIVE PERIOD
AbstractAfter surgical interventions for urethral strictures, despite the use of new, advanced methods of surgical treatment, the recurrence rate remains high and, according to the data obtained, ranges from 12% to 56%. This may indicate the presence of additional factors influencing the development of relapses. In this work, 340 patients were identified who received surgical treatment for urethral strictures using various methods. All of them were operated on between 1991 and 2019. The age of allergic diseases occurs from 15 to 70 years. The aim of the work was a study related to interests similar to recurrence of urethral strictures. To study this issue, all patients were divided by age and duration of the disease. Separately, accumulation by pathogenesis was carried out, where we determined the number of surgical interventions for relapses associated with a large number of operated patients. With the development of stricture urethra, exacerbations were more pronounced than frequent complications. This made it possible to conclude that the development of recurrence of urethral strictures may be associated with the occurrence of processes and formation that develops in the urethra during its stricture. Accuracy and correct influence on various factors significantly reduce the number of operations.
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RESULTS OF TREATMENT OF PATIENTS WITH URETHRAL STRICTURE CAUSED BY SCLEROATROPHIC LICHEN AT VARIOUS TIMES IN A COMPARATIVE ASPECT
AbstractScleroatrophic lichen is an idiopathic chronic inflammatory skin disease with a tendency to develop a complicated form in the form of stricture disease of the urethra in patients of both sexes. Modern reconstructive and reconstructive surgery in the treatment of urethral stricturesin men continuously replenishes its database with various modern methods, however, urethral stricture caused by lichen requires unification of indications for the choice of methods of buccal urethroplasty, since according to the literature, it is currently the most highly effective and requires studying the results of effectiveness and in the longer term.
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MINI-PERCUTANEOUS (mini PERC) NEPHROLITHOTRIPSY IN CHILDREN
AbstractRecommendations of the European Association of Urologists, percutaneous nephrolithotomy (miniPERC) is recommended as the main treatment option for large kidney stones (> 20 mm), as well as stones > 10 mm in the lower pole of the kidney. Miniaturization of instruments, especially smaller nephroscopes, and the possibility of using lasers reduce morbidity and improve treatment outcomes.
Purpose: the present study was aimed at assessing the safety and effectiveness of miniPERC in preschool children.
Material and methods. In the Department of urology of AkfaMedLine in Tashkent, from 2019 to May 2022, nephrolithotripsy using miniPERC method was performed in 43 patients aged 1 to 7 years. All procedures were performed with a Karl Storz MIP system, 12-14CH nephroscope with a 16F metal tube. Stone fragmentation was used with a holmium laser. All cases were completed by ureteral stenting without placing a nephrostomy.
Results. In all cases, access to the calyx performed by ultrasound and C-arm guiding. In most cases, access was through the lower-posterior calyx (26 cases, 60.4%). In other cases, access to the kidney was performed from middle calyx and only in 3 (6.9%) through the apical posterior calyx. In 28 (65.6%) cases, the surgical sheath was used 14-16 CH and in the remaining 15 and 12 CH. In 38 (88.4%) cases, kidney stones were removed through one access, remaining 5 (11.6%) patients, using additional access to the kidney. In 35 cases, the surgery was completed with a complete cleaning of the pelvis from stones. In 8 cases with residual stones. In these cases, the next surgery was performed after 1 month.
Conclusion: mini-PERC is a safe and effective technique in children that reduces hospital stay and possible complications. -
INDICATORS OF RENAL BLOOD FLOW IN INFRAVESICAL OBSTRUCTION
AbstractObstructive diseases of the urinary tract unite a complex of pathomorphological and pathophysiological changes that occur in the kidney and urinary tract, resulting from impaired urodynamics and leading to impaired renal function. One of the common variants of obstructive urinary tract diseases is infravesical obstruction (IVO).
The aim of the study was to study the parameters of renal blood flow in infravesical obstruction.
In order to determine violations of intrarenal hemodynamics in acute infravesical obstruction, we conducted a urological examination of 112 patients aged 51 to 86 years and older who were hospitalized in the urological departments of the National Hospital under the Ministry of Health of the Kyrgyz Republic with infravesical obstruction due to benign prostatic hyperplasia. The average age of patients was 73.2±2.4 years
Urological examination included ultrasound examination (ultrasound) of the kidneys, bladder and prostate with determination of the amount of residual urine, as well as the study of renal blood flow - ultrasound duplex scanning with color Doppler blood flow mapping (UDS with CDCC).The results of the study showed that acute IVO with the development of hydronephrotic transformation in the kidney leads to violations of renal hemodynamics, manifested by changes in the quantitative parameters of organ blood flow - an increase in resistivity (renal glomerular arterioles) and systolic-diastolic ratio, as well as a decrease in end-diastolic velocity, which leads to renal hypoperfusion.
Renal blood flow disorders eventually lead to ischemia of its parenchyma, which, in combination with acute urinary retention, are predisposing factors to the development of secondary acute inflammation of the kidneys. This circumstance must be taken into account in the treatment of patients with acute IVO in combination with hydronephrotic transformation, which implies adequate drainage of the lower urinary tract, the appointment of appropriate antibiotic therapy and drugs that improve microcirculation. -
PREVENTION OF EARLY COMPLICATIONS DURING OPEN ADENOMECTOMY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA USING A MODIFIED REMOVABLE SUTURE
AbstractBenign Prostatic Hyperplasia (BPH) is a common disease among men of advanced and senile age. This is due to the increase in life expectancy of the world's population. But in recent years, many researchers have noted this pathology at a young age. According to WHO, the mortality rate from BPH for developed European countries is approximately 23 per 100,000 male population over the age of 45 require long-term use, so the main method of treatment remains surgical. Due to late negotiability, many patients do not fall into the group for conservative treatment, and also, because of the huge size of the prostate more than 90 cm3 and the presence of bladder stones, open adenomectomy has to be done, and the appearance of modified removable suture methods is still relevant. The developed method of additional hemostasis in transvesical adenomectomy has a number of advantages: it allows to prevent and significantly reduce the risk of thrombohemorrhagic complications in the postoperative period, especially in those patients who applied very late and have a large prostate with the presence of bladder stones, and the proposed method is very simple. does not require additional costs and can be performed in any urological clinic.
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THERAPY OF METABOLIC SYNDROME AND AGE-RELATED HYPOGONADISM OF MEN
AbstractComplex therapy was performed on patients with androgen deficiency in combination with various manifestations of metabolic syndrome. The group of patients who received the treatment with testosterone tablets represented positive results in the clinical manifestations of metabolic disorders. The main manifestation of the positive dynamics of treatment is the normalization of the level of total and free Testosterone (up to 12.8 nmol / l, up to 256.9 pmol / l) (p>0.05). Also, there was a significant decrease in body weight from 109 kg to 97 kg. Glycolized hemoglobin dropped from 5.6% to 3.6%. Globulin-binding sex hormone levels have normalized to 30.6 nmol/l. There was a statistically significant decrease in cholesterol to 3.8 mmol/l, low-density lipoproteins to 3.6 mmol/l, the atherogenicity index to 3.4. The ICEF and IPSS questionnaire indicators improved. Received data confirm the need to correct androgen deficiency in the treatment of metabolic syndrome in men, since with the normalization of the level of total and free testosterone in the blood, there is a clinically significant normalization of metabolic disorders.
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INFECTIONS IN THE AREA OF SURGICAL INTERVENTION IN OPEN SURGERY IN UROLOGY
AbstractInfections of the surgical intervention area, among all postoperative infectious complications, develop in 40%, of which one third are associated with an organ or cavity and two thirds with the area of the surgical wound. The current situation is the reason for long-term treatment in the hospital, and in many cases, re-hospitalization.
Postoperative infectious-inflammatory complications associated with surgical care are a pressing issue worldwide. Regardless of modern scientific achievements in the field of surgery, the occurrence of infectious-inflammatory complications in every 5 operated patients discussed in the article is the
subject of further study of this problem. The problem of postoperative infectious complications in urology is still relevant. Frequency, structure, and peculiarities of the development of infections of the area of open surgical intervention in 577 patients of the urological profile in the tertiary care hospital were studied retrospectively. Postoperative infectious complications were noted in 23.6% of the operated patients. The presence of a drainage tube in the postoperative period increases the risk of infectious and inflammatory complications in the entire cohort of openly operated patients. On the contrary, the use of PAP in patients reduces the incidence of infectious-inflammatory complications. The obtained result is the reason for further investigation of the problem in order to improve the quality of the prevention of complications in the postoperative period, decrease the number of bed- days, decrease the financial expenses and the frequency of reapplications. -
FUNCTIONAL CHANGES OF URINARY TRACT IN GESTATIONAL PYELONEPHRITIS (LITERATURE REVIEW)
AbstractThe term “gestational pyelonephritis (GP)” refers to the infectious-inflammatory process in the interstitial tissues, pelvicalyceal system, and calcium apparatus of the kidneys which sharply arise or aggravate under the influence of urodynamic disorders during pregnancy. This publication explains the factors resulting in the development of the GP with the description of functional changes in the urinary tract in different stages of pregnancy, the epidemiological spread of GP, and defined fundamental etiopathogenetic aspects of the appearance and development of GP. It was revealed that the spread of GP in the general structure of infectious-inflammatory diseases in pregnant women is 20-40%. In 2020 the statistics of the frequency of spread of GP in Kyrgyzstan was 1.6 per 1000 births, therefore Bishkek city is 6.9 per 1000 births. It is indicated that physiological processes occurring in the background of pregnancy could lay the foundation for the development of pyelonephritis which could aggravate the pregnancy flow and negatively affect the condition of the mother and fetus. Nowadays, the study of the questions regarding the functional changes in the urinary tract by GP is continuing to be actual since the ethiopathic criteria of the emergence of the disturbance of the urine passageways in pregnant wiriomen are still examined, as well as the methods of early detection, treatment, and prevention of the appearance of GP. States that the change in the functional condition of urinary pathways in GP is connected with anatomical changes, occurring in the organism of the patient during the different stages of pregnancy, changes in the background of hemodynamics and urology with hormonal disbalance, and mechanical stress of uterus on ureters by noticeable switches in the immune system. It is indicated that the mark of functional condition of the urinary tract during the different pregnancy stages will allow diagnosing pathological conditions in kidneys and ureters, learning the disturbance of the urine tract, improving the treatment system, and increasing the effectiveness of prophylactic events directed on GP.
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RESULTS OF SIMULTANEOUS SURGERY IN UROLOGY AFTER APPLICATION OF THE DEVELOPED ALGORITHM FOR SELECTION OF THE VOLUME OF SURGERY IN PATIENTS WITH COMBINED SURGICAL DISEASES
AbstractCurrently, there is an increase in the number of comorbidities requiring surgical treatment, while simultaneous operations for urological diseases are performed quite rarely due to a number of organizational problems. Particularly relevant are the indications for simultaneous operations, the sequence of their implementation and the management of the postoperative period. The purpose of the study: to evaluate the effectiveness of simultaneous surgical interventions in patients with urological diseases in combination with surgical and gynecological pathologies.
Material and methods of research: a study of the "case-control" type with an assessment of the effectiveness of the results of treatment of 140 patients with diseases of the genitourinary system in combination with pathology and other organs. The choice of the scope of the operation was determined according to risk criteria. Conclusion. Simultaneous operations in urology are possible in the presence of concomitant diseases requiring surgical treatment. The volume of surgery for simultaneous operations should be determined based on risk criteria. The frequency of postoperative complications during simultaneous operations is statistically significant (p≤0.05) in 1.4 times less (7.2%) in comparison with the group of patients with sequentially performed operations (10%). Simultaneous operations performed for urological diseases in combination with surgical and gynecological ones slightly increase the duration of the operation and blood loss, while preventing repeated hospitalizations and, accordingly, material costs for both the patient and the state as a whole. -
COMPARATIVE STUDY OF NEPHROPROTECTIVE ACTIVITY OF SODIUM FUMARATE, MANNITOL AND FUROSEMIDE ON AN EXPERIMENTAL MODEL OF THERMAL RENAL ISCHEMIA
AbstractWhile performing surgical treatment of the localized form of renal cell cancer by means of open or laparoscopic kidney resection, renal warm ischemia (RWI) is becoming the necessary aspect of the intervention. Using RWI allows to prevent parenchymal bleeding, to optimize operative conditions, to increase significantly the efficiency of hemostasis. However, an important problem is the probability of ischemic hypoxic damage of the secured part of the kidney tissue during RWI and renal functional impairment in the postoperative period.
Aim of the study – comparative study of nephroprotective activity of sodium fumarate, mannitole and furosemide using experimental model of 30- and 60-minute renal warm ischemia in rabbits.
Materials and methods. The experiments were carried out on 360 conventional male-rabbits of the “Chinchilla” breed weighed 2,6±0,3 kg which were allocated into 10 groups. The control group №1 included intact animals, the control group №2 included the rabbits that were operated without clamping the renal artery. For the animals from the trial groups (№3-№10) the experimental model of 30- and 60-minute RWI was developed. In groups №3 and №4 medication was not provided. Other rabbits endured renal warm exsanguination against the background of sodium fumarate (groups №5 and №6 - 1,5 ml/kg IV), lasix (groups №7 and №8 - 3,0 mg/kg IV) and mannitole (№9 and №10 -1,0 g/kg IV). The influence of RWI on the renal tissue ultrastructure and the levels of NGAL, Cystatin-C and creatinine in blood and urine were studied.
Results. Experimental pharmacologically non-corrected 30-minute RWI in trial animals induced swelling and edema of the final part of microvilli of the proximal tubules epithelium, increase of lysosome number in the hyaloplasm of epithelial cells, appearance of flaky content of medium electronic density in the lumens of distal tubules and collecting tubes, as well as sharp peak-like increase of NGAL and cystatin-C in blood and urine. Increasing the time of exsanguination up to 60 minutes was accompanied by the growth of severity and range of the observed disorder. In groups where sodium fumarate, lasix and mannitole were used the observed ultrastructural disturbances were expressed to lesser extent, whereas sodium fumarate demonstrated the best nephroprotective activity. In case of using mannitole the intensity of the observed disturbances was less than in the groups where mannitole, lasix or sodium fumarate were not provided. Lasix and sodium salt of fumaric acid showed a higher nephroprotective activity. The best results were received in the animals protected by sodium fumarate.
Conclusions. The studied medications provided a nephroprotective effect regarding renal ischemia of rabbits, sodium fumarate in the greatest degree, furosemide – less and mannitole – the least. Use of sodium fumarate allows to protect and stimulate the kidney tissue maximum effectively during oxygen deprivation of the ischemized organ. -
ONE-TIME ENDOVIDEOSURGICAL INTERVENTIONS IN THE TREATMENT OF UROLOGICAL DISEASES
AbstractSimultaneous operations (SO), provided that each aspect of their implementation is sufficiently developed, can be an ideal treatment option for concomitant surgical diseases, including kidney and urinary tract. However, at present, SO are performed only in 1.5–6.0% of patients requiring in such interventions.
The purpose of this study. The comparative study of the perioperative results of simultaneousinterventions and the corresponding isolated operations on the organs of the genitourinary system. In each case the following indexes were analyzed: operative time (min), blood loss volume (ml), the urethral catheterization time (min), the frequency of infectious and inflammatory complications occurrence in the genitourinary system organs in the immediate postoperative period (%), postoperative hospital stay (the number of postoperative bed-days), the duration of the anesthesia induction and the period of awakening (in case of endotracheal anesthesia).
The research method was a retrospective analysis of the surgical treatment perioperative results of 5748 patients of the St. Petersburg State Budgetary Institution of Health Clinical Hospital of St. Luke.
Results. The advantages of simultaneous interventions over two - and more-stage urological interventions in terms of the duration of interventions, the volume of intraoperative blood loss, the frequency of infectious and inflammatory complications from the urogenital system in the early postoperative period, and other studied indicators were revealed.
Conclusion. The results of the study fully confirm the thesis of the feasibility, legitimacy and need for wider use of simultaneous interventions in the elective surgical treatment of combined diseases of the urological profile. -
REPRODUCTIVE HEALTH IN PATIENTS WITH TESTICULAR MICROLITHIASIS
AbstractIn recent years, in the Kyrgyz Republic, as in many CIS countries, the number of patients diagnosed with testicular microlithiasis or testicular microlithiasis has increased.
Testicular microlithiasis is a rather rare disease characterized by the deposition of calcium in the seminiferous tubules. According to modern concepts, testicular microlithiasis is calcium deposits surrounded by layers of collagen fibers in the lumen of the seminiferous tubules or on the basement membrane of the spermatogenic epithelium. As a rule, testicular microlithiasis has an asymptomatic course and is diagnosed most often during a random examination both in persons with urological pathology, in healthy children and adults and is detected by chance during an ultrasound examination. Modern ultrasound technologies make it possible to more accurately diagnose diseases of the scrotum, to identify conditions that were essentially unexplored before the use of high-frequency sensors. With the use of the latter possible visualization of testicular microlithiasis. Testicular microlithiasis is often an echographic finding when examining patients with andrological pathology or healthy children and adults, since it does not have specific symptoms that are unique to it.
Our practical study included 95 patients with confirmed testicular microlithiasis (Bishkek, Kyrgyzstan). Of the background urological diseases in patients with testicular microlithiasis, varicocele was detected in 42.1% of cases; in 36.8% - cysts of the epididymis; in 12.6% - dropsy of the testicular membranes; in 8.4% - testicular hypoplasia. In the study, 95 applied men did not reveal a single case of a tumor of the testicular tissue, however, given the literature data, it is necessary to remember about oncological alertness.
The morphological picture of stromal sclerosis and thickening of the walls of small arterioles indicates a violation of microcirculation in the testicular tissue, and the formation of microlith nuclei due to desquamation of the spermatogenic epithelium is the cause of the development of reproductive disorders in patients with testicular microlithiasis. -
FEATURES OF MANAGEMENT OF PREGNANT WOMEN WITH UROLITHIASIS WITH THE SELECTION OF TREATMENT TACTICS
AbstractUrolithiasis is the most common cause of urological abdominal pain in pregnant women who have had urinary tract infections. During pregnancy, the frequency of localization of stones in the ureter is twice as high as in the renal pelvis or calyces, but there is no difference between the left and right kidney or ureter. The aim of the work was to improve the results of diagnosis, treatment and ways to prevent complications of urolithiasis during pregnancy. The study was conducted at the Department of Urology and Nephrology with a course of hemodialysis of the KSMIPiPK named after A.I. S.B. Daniyarov and departments of urology of the National Hospital of the MZKR. For the period from November 2022 to April 2023, 42 pregnant women with a gestational age of 12 to 24 weeks, who were in the Republican Scientific Center of the Center for Urology of the NSMZKR, suffering from urolithiasis, were examined. In 27 (64%) patients, this pregnancy was the first, in 11 (26%) repeated. In 35 (83%) women, urolithiasis was diagnosed for the first time, in 7 (17%) pregnant women, the duration of urolithiasis was from 3 to 5 years. Thus, among the pregnant women who applied for urolithiasis, ureteral stones were detected in 12 (29%), in 10 (24%) pregnant women the stones were localized in the kidney, in 16 (38%) pregnant women the stones were localized in the pelvis. In 4 (9%) pregnant women there were no urinary outflow disorders, but uric acid diathesis was observed. In connection with the accurate diagnosis of the localization of stones, a combined treatment was selected (operative + conservative), according to the protocols for the treatment of urolithiasis, while the most informative and minimally invasive diagnostic method for urolithiasis in pregnant women is ultrasound.
Patients from the first group with caliceal stones without impaired urine outflow in the absence of an active inflammatory process do not need special treatment, and with a pronounced inflammatory process, it becomes necessary to connect antibiotic therapy, drainage of the kidney by installing a stent, with detoxification therapy. Conclusion Thus, minimally invasive surgical methods for the treatment of urolithiasis can be effectively used at gestational ages from 12 to 24 weeks. Indications for surgical intervention for obstructive urinary tract stones during pregnancy should be strict. Temporary restoration of urine outflow by placement of a renal stent is preferable. The tactics of active treatment and administration of urolithiasis during gestation can reduce the number of complications during pregnancy with urolithiasis. -
ANALYSIS OF EFFICIENCY OF SIMULTANEOUS ENDOVIDEOSURGICAL OPERATIONS IN COMBINED DISEASES OF THE ABDOMINAL CAVITY, RETROPERITONEAL SPACE AND PELVIS
AbstractIn modern medicine, the use of endovideo-surgical technologies has long been the gold standard for surgical treatment of various diseases of the abdominal cavity, retroperitoneal space and pelvis. The paper presents the results of 58 patients aged 18 to 60 years who underwent simultaneous
endovideosurgical operations for combined diseases of the abdominal cavity, retroperitoneal space and pelvis (140 combined nosologies were exposed). Thus, the use of simultaneous endovideosurgical operations on the organs of the abdominal cavity, retroperitoneal space and pelvis allowed us to conclude that it is necessary to focus the attention of practitioners on expanding the range of the diagnostic minimum of preoperative examination and it is recommended to apply the algorithm proposed by the author, where the metole of choice is simultaneous endovideosurgical oefficacy with elimination of the risk of repeated surgical intervention and improvement of the patient's quality of life after surgery. The proposed algorithm of management tactics for this category of patients and the simultaneous operations performed have shown high efficiency and are the method of choice in the surgical treatment of combined diseases. -
RETROPUBIC ADENOMECTOMY IS THE METHOD OF CHOICE IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA (BPH) OF LARGE SIZES (LITERATURE REVIEW)
AbstractThis article reviewed scientific data on the topic of large BPH and methods of surgical treatment of patients with this problem, which included domestic and foreign publications. The object of the study was data on retropubic adenomectomy as a method of surgical treatment of patients with large BPH. The advantages and disadvantages of this method, the proposed modifications to improve the operation are noted. Also, the work on methods of minimizing hemorrhagic complications, which is the leading of all complications, is conventionally divided into groups. After analyzing the scientific literature regarding retropubic adenomectomy, we came to the conclusion that this method of operation is the method of choice in the treatment of large BPH and can be used in practical urology. Thus, the search for new ways to optimize retropubic adenomectomy is a topical issue in modern urology. Which in turn will lead to a significant shift forward in the fight against large BPH.
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RESULTS OF USING MINIMALLY INVASIVE SURGERY IN PATIENTS WITH PROSTATE CANCER
AbstractCurrently, the relevance of the disease in oncourology – prostate cancer remains. At the same time, the survival outcomes of patients undergoing transurethral resection are different. It should be noted that in local scientific publications there are no works aimed at analyzing the results of treatment and survival. The aim of the study was to study the results of transurethral resection in patients with prostate cancer. The scientific work is based on a retrospective analysis of case histories of 50 elderly patients (According to the age classification of the World Health Organization) who were in the urology dapartments of the National Hospital under the Ministry of Health of the Kyrgyz Republic. The diagnoses were verified on the basis of transrectal multifocal prostate biopsies. The persistence of dysuric phenomena despite neoadjuvant therapy, as well as objective and subjective signs of infravesical obstruction, were indications for transurethral resection of the prostate. All patients included in the study were carefully interviewed, anamnestic data were collected and, if necessary, additional consultations were held with the relevant specialists in order to correct and treat comorbidies, as well as prepare for surgical treatment and anesthesia. General analysis of blood and urine, coagulogram, biochemical blood tests, markers of viral hepatitis A,B,C, Wasserman reaction, total protein and other analyzes were the basis of laboratory studies.
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THE ROLE OF CHRONIC BACTERIAL PROSTATITIS IN FERTILE WOMEN
AbstractIn this paper, the state of the fertility function of 115 women husbands who suffer from chronic prostatitis was analyzed. The distribution of these patients by age was as follows: from 18 to 29 years old - 48.6%; from 30 to 45 years - 51.4%. The age of men ranged from 20 to 50 years.
The first group consisted of 23 women whose husbands had CKD a year ago. The second group consisted of 33 women whose husbands had CKD two years ago. The third group included 59 women whose husbands had CKD three years ago. In all women, the fallopian tubes were passable. The control group of 50 women with bacterial vaginosis was identical to the main group in terms of the main indicators.
Based on the results obtained, the authors concluded that the greatest diagnostic reliability is the assessment of sperm fertility in cervical mucus at the peak of ovulation and the concentration of fructose and zinc in them in women whose husbands suffer from CKD and the degree of reversibility of impaired sperm fertility and the cytological reaction of cervical spermatozoa. mucus at the peak of ovulation is a diagnostic criterion for sperm fertility. -
THE STATE OF THE URINARY SYSTEM OF MEN LIVING IN THE KYRGYZ REPUBLIC (ACCORDING TO THE RESULTS OF THE PROMOTION OF MEN'S HEALTH WEEK)
AbstractThis article presents the results of the charitable event of the Week of Men's Health among 9770 men living in Kyrgyzstan in order to objectively assess the state of the genitourinary system and self-assessment of the state of health by respondents in 2021-2022. When applying, methods of diagnostic minimum for the detection of diseases were applied and a survey was conducted. When applying, the features of complaints were revealed and actually compared with the detection of pathology, where there is evidence that such diseases as prostatitis (in the young age group - 27.2%) and prostate hyperplasia (in the group of middle and old age - 28.4%), and also, prostate cancer is asymptomatic (6.7% in the whole republic). The survey conducted on awareness of diseases of the genitourinary system, self-assessment of health indicates distrust of doctors. The results of the study indicate the need to improve urological care for the population, including its outpatient level, covering the educational work of the population, the effectiveness of which, first of all, determines the completeness and timeliness of detection, and hence the effectiveness of treatment.
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DRUG TREATMENT OF ACUTE AND CHRONIC KIDNEY DISEASES WITH OBSTRUCTIVE UROPATHY (LITERATURE REVIEW)
AbstractObstructive uropathy is a common cause of acute and chronic kidney disease. Urinary tract decompression is the single most beneficial aspect of treatment; renal failure is often reversible, and the long-term renal prognosis is generally good. Follow-up care is an important but underestimated adjunct to surgical treatment. Acute relief of obstruction is often complicated by sodium and potassium imbalance and post-obstructive diuresis. The principles of long-term
management are the same as for other forms of chronic kidney disease. Purpose of the study: optimization of methods of treatment of obstructive uropathy in different age groups and improvement of the population. Material and methods: the work is based on the results of examination and treatment of pediatric and adult patients with congenital obstructive diseases of the urinary tract, who were treated at the NG MH KR Center for Urology and the Department of Urology of the NCM&D. Conclusions: the use of drug therapy is advisable only after surgical correction of obstructive uropathy, which is based on operations to normalize the passage of urine.
