1
|
Alfimov AE, Shaderkina IA, Korolev DO, Gorinova DM, Enikeev ME, Tsarichemko DG, Rapoport LM. Markers of lithogenic activity in kidney stone disease. Androl genit hir 2023. [DOI: 10.17650/2070-9781-2022-23-4-36-45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- A. E. Alfimov
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| | - I. A. Shaderkina
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| | - D. O. Korolev
- Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| | - D. M. Gorinova
- Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| | - M. E. Enikeev
- Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| | - D. G. Tsarichemko
- Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| | - L. M. Rapoport
- Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
| |
Collapse
|
2
|
Chuvalov LL, Korolev DO, Azilgareeva KR, Taratkin MS, Olefir YV, Fiev DN, Lumpov IS, Gorobets YP, Enikeev DV, Rapoport LM, Enikeev ME. [Radio wave electrotherapy with a radiofrequency of 448 khz for the treatment of patients with organic erectile dysfunction: a prospective, randomized, blind, Sham-controlled, parallel-group study]. Urologiia 2022:54-58. [PMID: 35485814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM To evaluate the efficiency of radio wave electrotherapy (448 kHz) for the treatment of patients with organic erectile dysfunction (ED). MATERIALS AND METHODS A prospective, randomized, blind, sham- controlled clinical trial was carried out. Inclusion criteria were as following: 1) patients with 5 to 20 points on the IIEF-5 score; 2) patients with proven organic erectile dysfunction lasting at least 6 months; 3) patients with penile arterial insufficiency and/or venous insufficiency, confirmed by doppler study of penile vessels with pharmacological stimulation (peak systolic velocity (PSV) <25 cm/s, end-diastolic blood flow velocity (DPV) >5 cm/s, resistance index (IR) < 0.8). The participants were randomized into two groups (experimental and control) in a 1:1 ratio. The full treatment course lasted 9 weeks. Patients underwent an assessment of erectile function based on questionnaires (IIEF-5, SEP, Schramek), as well as Doppler ultrasound of the cavernous arteries before inclusion in the study as well as a after treatment. RESULTS The study included 61 men (experimental group [n=31], control group [n=30]. There was a significant difference in the IIEF-5 scores after treatment between the experimental group and the control group (19.5+/-3.2 vs. 15.1+/-5.4, p=0.017, respectively). Significant differences were also noted in mean total score of the SEP questionnaire: an increase to 3.6+/-1.0 in the treatment group compared to 2.4+/-1.1 in the control group (p=0.004). The results of the Schramek questionnaire also demonstrated a significant increase in the mean score in the experimental group compared to the control group: 4.2+/-0.6 vs. 3.2+/-1.0 (p=0.011). The response time to the drug and the detumescence time also significantly differed between the two groups: 11.9+/-4.0 min vs. 15.5+/-4.1 min, p=0.001 and 126.6+/-60.7 min vs. 66.2+/-40.9, p<0.001, respectively. Neither complications nor any adverse events were recorded during treatment or after its completion. CONCLUSIONS Radio wave electrotherapy with a radiofrequency of 448 kHz can improve the IIEF-5, SEP and Schramek scores, as well as the indicators of ultrasound Doppler ultrasonography in patients with organic ED. To assess the feasibility of this method in patients with organic ED of different stages, further studies are needed.
Collapse
Affiliation(s)
- L L Chuvalov
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - D O Korolev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - K R Azilgareeva
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - M S Taratkin
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yu V Olefir
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - D N Fiev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - I S Lumpov
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yu P Gorobets
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - D V Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - L M Rapoport
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - M E Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| |
Collapse
|
3
|
Rapoport LM, Gazimiev MA, Korolev DO, Tsarichenko DG, Svetikova YUA, Enikeev ME, Akopyan GN, Chinenov DV, Taratkin MS, Enikeev DV. [Flexible ureteroscopy for lower pole renal stones: novel superpulse thulium (TM) fiber laser lithotripsy]. Urologiia 2020:89-92. [PMID: 33427418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The SuperPulse Thulium (Tm) fiber laser (wavelength of 1.94 m) has been recently introduced as a directed-energy source for urology. Preclinical studies have shown a significant potential of the SuperPulse Tm fiber laser (SP TFL) for lithotripsy. However, clinical reports of using SP TFL to treat urolithiasis are still few and limited. Of special interest are challenging cases, e.g., lower pole stones, when extreme deflection of the instrument is required. OBJECTIVE To evaluate the effectiveness of the SuperPulse Tm fiber laser in the management of lower pole small calyceal stones during flexible ureteroscopy (F-URS). METHOD s. The SuperPulse Tm fiber laser device (Urolase 2, IRE Polus, Fryazino, Russia) has been cleared for clinical use by the Ministry of Health of Russian Federation. Study protocol has been approved by the Ethical Review Committee. Between January 2018 and February 2019, 130 patients with kidney stones have undergone Thulium fiber laser lithotripsy during F-URS. We retrospectively analyzed 15 of this patients with a single radiopaque lower pole calculus that were included in the present study. Stone size, stone density, lithotripsy time (from the first to last footswitch press) and "lasering" (laser emission) time were measured. The SP TFL was used for stone disintegration with different settings in dusting and fragmentation modes (0.1 - 4J, 7-300Hz, 6-40W) via a fiber with a 200-m core diameter. Low dose CT scanning was performed on POD 90 to assess SFR. RESULTS Stone size ranged from 4 to 17 mm and stone density varied from 350 to 1459 HU. The average lithotripsy time was 12 min (3-30 min). The average "lasering" time was 1.3 min (0.4-2.5 min) and the mean hospital stay was 1.1+/-0.3 days. In all cases we reached the lower pole stone containing calyx with a laser fiber. The complication rates were evaluated by using the Clavien-Dindo grading system and did not exceed GII (6.6%). SFR on POD 90 was achieved in 86.6% of cases. CONCLUSIONS F-URS with SuperPulse Tm fiber laser is safe and effective option in the management of lower pole small calyceal stones. The possibility of using small laser fibers gives better instrument deflection which make possible to reach lower pole calyceal stones even with acute lower pole infundibulopelvic angle (IPA).
Collapse
Affiliation(s)
- L M Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - M A Gazimiev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - D O Korolev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - D G Tsarichenko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Y U A Svetikova
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - M E Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - G N Akopyan
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - D V Chinenov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - M S Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - D V Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| |
Collapse
|
4
|
Tsoy LV, Korolev DO, Vinarov AZ, Enikeev ME, Lerner YV, Tsarichenko DG, Popov NA, Abdusalamov AF, Gorobets YP, Demidko YL, Varshavskiy VA, Zamyatnin AA, Rapoport LM. [Aberrant expression of arrestin-1 and recoverin in kidney tumors]. Urologiia 2019:48-53. [PMID: 32003167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Early diagnosis of renal cell carcinoma (RCC) is extremely difficult, due to the late development of clinical manifestations. The study of the aberrant expression of tumor-associated antigens and a production of autoantibodies to these proteins seems promising and novel method for RCC diagnosis. AIM To evaluate the possibility of using arrestin-1 (Arr-1), recoverin (Rec) and autoantibodies against arrestin-1 (AAA1) and recoverin (AAR) as a kidney tumor biomarker. MATERIALS AND METHODS Primary kidney tumors and metastases of 62 patients were investigated. For immunohistochemical studies, tissues were incubated with polyclonal antibodies against Rec and Arr1 as the main antibodies. Detection of AAR and AAA-1 in the serum of patients was performed using Western Blot analysis according to a standard protocol. RESULTS Among 62 tumors, renal cell carcinoma (RCC) constitutes 50 cases (86.4%), and oncocytoma was diagnosed in 12 patients (19.4%). In 11 (22%) cases of RCC, distant metastases were detected. Positive expression of Rec was observed in almost 71% of all types of kidney tumors. In 61.3% of patients with RCC, Arr-1 expression was seen. In the serum, AAR was found only in 1 patient (1.6%) with RCC. However, unlike AAR, AAA-1 in the serum of patients was observed much more often (75.8%). CONCLUSION According to our data, the presence of AAA1 in the serum, unlike AAR, can be considered as an early kidney tumor biomarker. The high expression of recoverin and arrestin-1 in kidney tumors suggests the use of these proteins in future as a marker for the diagnosis or even as a potential target for immunotherapy.
Collapse
Affiliation(s)
- L V Tsoy
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - D O Korolev
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - A Z Vinarov
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - M E Enikeev
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - Yu V Lerner
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - D G Tsarichenko
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - N A Popov
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - A F Abdusalamov
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - Yu P Gorobets
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - Yu L Demidko
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - V A Varshavskiy
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - A A Zamyatnin
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - L M Rapoport
- Department of Pathology of Medical Faculty named after A.I. Strukov of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- GBUZ City clinical oncological hospital No1 of the Moscow Health Department, laboratory of immunohistochemistry and molecular genetics, Moscow, Russia
- FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Laboratory of Institute for Molecular Medicine of Science of FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| |
Collapse
|
5
|
Demidko LS, Rudenko VI, Fadeev VV, Demidko YL, Amosov AV, Kuzmicheva GM, Grigoryan VA, Enikeev ME, Amosova MV. [Inluence of osteoporosis and its causative factors on the prevention of recurrence of urinary stone disease]. Urologiia 2019:26-31. [PMID: 31535801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The aim of postoperative examination, treatment and follow-up of patients with urinary stone disease is a prevention of recurrence. A choice of method of prevention is based on the results of postoperative examination with consideration of etiological factors of urinary stone disease. An analysis of influence of osteoporosis and its causative factors on the recurrence of urinary stone disease is presented in the article. AIM to clarify the influence of osteoporosis and its causative factors on excretion of calcium, uric acid and recurrence of urinary stone disease. MATERIALS AND METHODS A total of 86 patients after surgical treatment of urinary stone disease were included in the study. A physicochemical analysis of stones and their fragments, excretion of calcium and uric acid were done postoperatively. The risk factors for osteoporosis were identified using specific questionnaire. Bone mineral density (BMD) was assessed by X-ray densitometry. After X-ray phasic analysis of the stones and studying of the daily excretion of calcium and uric acid, 10 and 7 patients were prescribed to thiazide diuretics and allopurinol, respectively. In 69 patients (80.2%) there were no indications to the treatment and all of them were included in control surveillance group. RESULTS Calcium oxalate stones were predominated in patients who were under surveillance (=0,0254). A prevalence of risk factors for osteoporosis was similar in all groups (=0,2156), as well as rate of decrease in BMD (=0,64). In patients taking thiazide diuretics, a significant decrease in daily calcium excretion was found (=0,0054) without significant changes in excretion of uric acid and diuresis volume. Among patients receiving allopurinol there was a significant decrease in daily uric acid excretion (=0,021), without significant changes in excretion of calcium and diuresis volume. There were no significant changes of these values in the control group. A recurrence of urinary stone disease in treatment group was detected in 4 patients with a decrease of BMD after 381+/-61 days, while in control group there were 5 recurrences in patients with decreased BMD and I recurrence in patient with normal BMD after 836+/-64 days. CONCLUSION Treatment aimed at prevention of recurrence of urinary stone disease allows to correct detected metabolic disturbances. However, such factor as the decrease in BMD can influence on the rate and frequency of recurrence of urinary stone disease. A clarifying of risk factors for osteoporosis and diagnosis of osteoporosis allow to give reliable recommendations for its treatment and to decrease risk of recurrence of urinary stone disease.
Collapse
Affiliation(s)
- L S Demidko
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - V I Rudenko
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - V V Fadeev
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - Yu L Demidko
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - A V Amosov
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - G M Kuzmicheva
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - V A Grigoryan
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - M E Enikeev
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| | - M V Amosova
- Institute for Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology of FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
- Department of Physics and Chemistry of Materials named after B.A. Dogadkin, Physicotechnological institute MIREA-Russian technological university, Moscow, Russia
| |
Collapse
|
6
|
Demidko YL, Rudenko VI, Grigoryan VA, Enikeev ME, Allenov SN, Kasiteridi IG, Ujegov TA, Amosov AV. [Clinical value of Canephron N after surgical treatment of urinary stone disease]. Urologiia 2019:15-20. [PMID: 31162895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The drug Canephron N is a combination of extracts of centaury, lovage and rosemary. Moderate antispasmoic, anti-inflammatory, antioxidant, diuretic and antimicrobial effects are of great interest for urological practice. The optimal combination of components that were made of herbal medicine allows to use their synergistic effect for prevention of recurrence of urinary stone disease. The experience of using the drug Canephron in clinical practice is of great interest. AIM to clarify the clinical efficiency of Canephron N in patients with urinary stone disease after surgical treatment and to evaluate the changes in diuresis and calcium excretion. MATERIALS AND METHODS The results of using the drug Canephron after surgical treatment of urinary stone disease are provided. The changes in diuresis and calcium excretion in 75 patients undergone surgical treatment of urinary stone disease were studied. Patients after ureteroscopy, percutaneous nephrolithotomy and extracorporeal shock-wave lithotripsy were prescribed treatment to prevent stone formation including herbal drug Canephron N. RESULTS At baseline, there was negative correlation between 24-hours diuresis and calcium excretion in all groups. During follow-up, a positive correlation between 24-hours diuresis and calcium excretion was found in patients receiving Canephron N and other types of treatment. The average follow-up was 390 days. During this period, recurrence was noted in 1 patient receiving Canephron, 4 patients in patients who took other drugs and in 5 patients who didnt receive any treatment. CONCLUSION Risk factors of stone formation persist after surgical treatment of urinary stone disease. This is reflected in a negative correlation between 24-hour diuresis and calcium excretion. During treatment, a positive correlation between diuresis and calcium excretion was noted in patients with urinary stone disease. The use of drugs that affect stone formation as well as herbal medicine Canephron N allow to obtain comparable ratio of diuresis and calcium excretion.
Collapse
Affiliation(s)
- Yu L Demidko
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - V I Rudenko
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - V A Grigoryan
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - M E Enikeev
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - S N Allenov
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - I G Kasiteridi
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - T A Ujegov
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| | - A V Amosov
- Clinic of Urology and Male Reproductive Health, LDO 4 UKB 2 FGAOU VO VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Moscow, Russia
| |
Collapse
|
7
|
Chuhrov DA, Korolev DO, Dymov AM, Lekarev VY, Laukhtina EA, Mynaev VP, Sorokin NI, Enikeev ME, Shpot EV, Vinarov AZ, Rapoport LM. [Laser in laparoscopic urology]. Urologiia 2018:94-99. [PMID: 30575358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Nowadays, various laparoscopic instruments for tissue dissection and vessel coagulation are available. However, there are ongoing studies dedicated to "ideal" type of energy suitable for this aim. Laser radiation has been used for many years in medical practice and it is established as reliable and effective method in surgical armamentarium. The ability to provide highly precision and well-controlled action on the tissues, improved hemostasis, easy adaptability to fiber-optic and minimally invasive delivery systems, as well as the possibility of facilitating complex dissection made lasers an important tool for surgeons. The mechanism and methods of laser energy using in urology have been studied since 1980s, but there is still no consensus on the optimal type of laser and its settings during urological surgeries, which determines the importance of further researches dedicated to this promising form of energy.
Collapse
Affiliation(s)
- D A Chuhrov
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - D O Korolev
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - A M Dymov
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - V Y Lekarev
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - E A Laukhtina
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - V P Mynaev
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - N I Sorokin
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - M E Enikeev
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - E V Shpot
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - A Z Vinarov
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| | - L M Rapoport
- Department of Urology of Sechenov First Moscow State Medical University of the Ministry of Health of Russia
- Urologic Clinic of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
- Scientific and Technical Association IRE-Polyus, Fryazino, Russia
| |
Collapse
|
8
|
Demidko LS, Rudenko VI, Grigoryan VA, Demidko YL, Enikeev ME, Inoyatov ZS, Amosova MV. [Characteristic features of urinary calcium excretion and osteoporosis risk factors in patients with urolithiasis]. Urologiia 2018:5-8. [PMID: 29901287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
RELEVANCE The prevalence of urolithiasis and osteoporosis (OP) indicates that these diseases may be found concurrently in the same patient. The detection of risk factors for OP and disorders of calcium metabolism in patients with urolithiasis is of interest in the context of primary stone formation and metaphylaxis. AIM To identify risk factors for osteoporosis and disorders of calcium metabolism in patients with urolithiasis. MATERIALS AND METHODS Osteoporosis risk factors were studied in 45 urolithiasis patients undergoing surgical treatment. Patients were asked to fill out the osteoporosis risk factor questionnaire, and urinary calcium excretion was measured in 24-h collections. RESULTS Risk factors for osteoporosis were detected in 20 (44.4%) urolithiasis patients. Patients with osteoporosis risk factors identified by the questionnaire were statistically significantly older (p=0.032). Osteoporosis risk factors were found in 20% of patients with newly diagnosed urolithiasis and 24.4% of patients with recurrent urolithiasis. The study patients showed increased urinary calcium excretion and decreased diuresis. The negative correlation between urinary calcium excretion and 24-h diuresis was greater in patients who had than in those who did not have osteoporosis. CONCLUSION An increase in urinary calcium excretion and a decrease in diuresis can be a predisposing factor for the recurrence of urolithiasis. In patients with risk factors for osteoporosis, it can provide a rationale for administering drugs aimed at preventing stone formation (thiazide diuretics).
Collapse
Affiliation(s)
- L S Demidko
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - V I Rudenko
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - V A Grigoryan
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - Yu L Demidko
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - M E Enikeev
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - Zh Sh Inoyatov
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - M V Amosova
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| |
Collapse
|
9
|
Glybochko PV, Alyaev YG, Rapoport LM, Enikeev ME, Tsarichenko DG, Shpot EV, Korolev DO, Vorobyev AA, Enikeev DV. [Laparoscopic pyelolithotomy and its role in modern surgery of nephrolithiasis]. Urologiia 2017:12-17. [PMID: 28952685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM To determine the place of laparoscopic pyelolithotomy in surgical management of nephrolithiasis. MATERIALS AND METHODS We analyzed 16 laparoscopic pyelolithotomies performed in our clinic over the last few years for large and stag-horn stones of anomalous kidneys (n=8), the "giant" (>30-40 cc) monolithic stones of the large extrarenal pelvis (n=3), multiple stones of PCS with the stone burden of more or equal 40 cm (n=2) and large recurrent (after PCNL) kidney stones in patients at risk of bacteriotoxic complications of percutaneous nephroscopy (n=3). The age of the patients ranged from 39 to 72 years (mean age 51+/-8 years). The average density of stones was 1012 (160-1483) HU. RESULTS There were no conversions to open surgery. The mean operating time of laparoscopic pyelolithotomy was 137 (96-255) minutes, flexible transabdominal pyelocalycoscopy 31.2 (12-110) min. The stone-free rate was 87%. Residual clinically insignificant stones were found in two (13%) patients with staghorn horseshoe kidney calculi and complex PCS. The preoperative hospital stay was 1 day, postoperative-from 2 to 18 (mean 6) days. DISCUSSION We believe that laparoscopic pyelolithotomy supplemented by transabdominal flexible pyelocalycoscopy may be recommended for surgical management of patients with "giant", multiple and infected kidney stones, because the length of their percutaneous removal is beyond the recommended time intervals and it is accompanied by an increased risk of septic complications.
Collapse
Affiliation(s)
- P V Glybochko
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - Yu G Alyaev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - L M Rapoport
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - M E Enikeev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - D G Tsarichenko
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - E V Shpot
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - D O Korolev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - A A Vorobyev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - D V Enikeev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| |
Collapse
|
10
|
Bezrukov EA, Rapoport LM, Shpot EV, Enikeev ME, Morozov AO. [Prostate cancer of high oncological risk. urrent trends in diagnosis and surgical treatment]. Urologiia 2017:129-134. [PMID: 28952705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A group of patients with high risk prostate cancer was identified in the late 1990s. Since then, management of this group of patients has undergone some serious changes. The article provides a brief overview of the most significant changes, primarily in surgical treatment, over the past 3 years. Besides, the authors present their views on perspective treatments and possible changes in the near future.
Collapse
Affiliation(s)
- E A Bezrukov
- I.M. Sechenov First MSMU of Minzdrav of Russia, Research Institute for Uronephrology and Human Reproductive Health, Department of Urology, R.M. Fronshteyn Urology Clinic, Moscow, Russia
| | - L M Rapoport
- I.M. Sechenov First MSMU of Minzdrav of Russia, Research Institute for Uronephrology and Human Reproductive Health, Department of Urology, R.M. Fronshteyn Urology Clinic, Moscow, Russia
| | - E V Shpot
- I.M. Sechenov First MSMU of Minzdrav of Russia, Research Institute for Uronephrology and Human Reproductive Health, Department of Urology, R.M. Fronshteyn Urology Clinic, Moscow, Russia
| | - M E Enikeev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Research Institute for Uronephrology and Human Reproductive Health, Department of Urology, R.M. Fronshteyn Urology Clinic, Moscow, Russia
| | - A O Morozov
- I.M. Sechenov First MSMU of Minzdrav of Russia, Research Institute for Uronephrology and Human Reproductive Health, Department of Urology, R.M. Fronshteyn Urology Clinic, Moscow, Russia
| |
Collapse
|
11
|
Enikeev DV, Glybochko PV, Alyaev YG, Rapoport LM, Sorokin NI, Enikeev ME, Dymov AM, Sukhanov RB, Khamraev OK, Taratkin MS, Dymova AV, Inoyatov JS. [Laser enucleation of the prostate (HOLEP and THULEP): a comparative effectiveness analysis in treating recurrent prostatic hyperplasia]. Urologiia 2017:50-54. [PMID: 28952693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The estimated recurrence rate of benign prostatic hyperplasia (BPH) after transurethral resection of the prostate is about 5 to 15%. Laser enucleation of the prostate results in a much lower recurrence rate (not exceeding 1-1.5%). At the same time, laser enucleation of the prostate is still not widely used for recurrent prostatic hyperplasia since it believed to be technically difficult in cases. AIM To describe the distinctive features of thulium and holmium laser enucleations of the prostate in the management of recurrent BPH and show that the technical difficulties are not an obstacle to the wide application of this technique. MATERIALS AND METHODS This was a retrospective study comprising 676 patients aged 54 to 87 years with clinically pronounced infravesical obstruction due to prostatic hyperplasia (IPSS>20, Qmax<10). All patients were divided into four groups. Groups 1 (n=489) and 3 (n=153) underwent holmium (HoLEP) and thulium (ThuLEP) laser enucleations of the prostate, respectively. Groups 2 (n=23) and 4 (n=11) included patients with BPH recurrence after HoLEP (group 2) and ThuLEP (group 4). All patients underwent diagnostic evaluation at baseline and at 6 months after surgery. RESULTS The mean ThuLEP operating time was shorter than that of HoLEP (p=0.02). The mean duration of repeat and primary ThuLEP and HoLEP did not differ statistically significantly (p>0.05). There was no difference in the length of hospitalization and catheterization between the four groups (p>0.05). At six months after surgery, a statistically significant improvement in I-PSS, Qmax, QoL, and RUV was observed in all groups compared with preoperative values (p>0.05)). CONCLUSION We found that the technical difficulties of the re-operation, such as the difficult separation of adenomatous tissue from the prostate capsule, the multinodular nature of the adenoma, increased tissue density are easy to overcome and do not confer a significant complexity. In turn, better completeness of resection, low complication and recurrence rates and the possibility of surgery, even in elderly patients with multiple comorbidities - these features allow us to conclude that laser enucleation of the prostate is not only an effective treatment for infravesical obstruction due to benign prostatic hyperplasia, but is also a method of choice in the treatment of patients with recurrent BPH.
Collapse
Affiliation(s)
- D V Enikeev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - P V Glybochko
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - Yu G Alyaev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - L M Rapoport
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - N I Sorokin
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - M E Enikeev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - A M Dymov
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - R B Sukhanov
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - O Kh Khamraev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - M S Taratkin
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - A V Dymova
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| | - J S Inoyatov
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Research Institute for Uronephrology and Human Reproductive Health, Moscow, Russia
| |
Collapse
|
12
|
Enikeev DV, Glybochko PV, Alyaev YG, Rapoport LM, Amosov AV, Alekseeva TM, Enikeev ME, Tsarichenko DG, Chinenov DV, Kozmin LD, Dzhalaev ZK, Taratkin MS. [Ultrasound-guided percutaneous cryoablation of renal tumors]. Urologiia 2017:68-73. [PMID: 28845941 DOI: 10.18565/urol.2017.3.68-73] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Surgery remains the gold-standard curative treatment for localized (T1) renal carcinoma. However, recent medical-technological advances have led to the development of new minimally invasive treatment options, one of which is percutaneous cryoablation. AIM To assess the effectiveness and safety of ultrasound-guided percutaneous cryoablation of renal tumors. MATERIALS AND METHODS The study comprised 12 patients aged 52 to 76 years who underwent ultrasound-guided percutaneous cryoablation of renal tumors from 2015 to 2017. In 11 patients, the size of the renal mass was 3.0 cm (T1a), in 1 patient 4.5 cm (T1b). A Doppler ultrasound, contrast-enhanced MSCT and computer 3D modeling were performed in all patients pre-operatively and 6 months after surgery to assess the tumors size and extent and the spatial location of the tumor internal surface to the pelvicalyceal system. In all patients, the tumors were located along the posterior or lateral surface of the kidney, in the lower or middle segment and without sinus invasion. We used a 3rd generation Galil Medicals SeedNet Gold Cryotherapy System and IceSeed and IceRod cryoprobes. Intraoperatively, immediately before cryoablation, the tumor was biopsied. In all patients the diagnosis of renal cell carcinoma was confirmed morphologically. RESULTS Mean duration of cryoablation was 60 minutes. Endotracheal, spinal, local and intravenous anesthesia was used in 1, 6, 5 and 1 patients, respectively. Doppler ultrasound at 6 months after surgery showed that in 11 patients (T1a) the tumor size decreased on average by 8 mm, with no blood flow in the tumors. MSCT with 3D modeling also revealed a decrease in tumor size and total absence of contrast agent accumulation, or accumulation gradient not exceeding 10 HU (initially it was about 200 HU). In the patient with T1b stage renal carcinoma, MSCT showed a decrease in tumor size from 4.5 to 3.7 cm, however, there was a mass up to 1.5 cm with a high gradient of contrast agent accumulation. The patient underwent kidney resection. No intra- and postoperative complications were observed. CONCLUSION The accumulated experience allows to confirm the effectiveness and safety of ultrasound-guided percutaneous cryoablation and to consider it a method of choice for patients with stage T1a renal carcinoma located along the posterior or lateral surface of the kidney in the lower or middle segment, without sinus invasion.
Collapse
Affiliation(s)
- D V Enikeev
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - P V Glybochko
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - Yu G Alyaev
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - L M Rapoport
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - A V Amosov
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - T M Alekseeva
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - M E Enikeev
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - D G Tsarichenko
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - D V Chinenov
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - L D Kozmin
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - Z K Dzhalaev
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| | - M S Taratkin
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia
| |
Collapse
|
13
|
Enikeev DV, Glybochko PV, Alyaev YG, Rapoport LM, Vinarov AZ, Enikeev ME, Sorokin NI, Spivak LG, Sukhanov RB, Dymov AM, Khamraev OK, Taratkin MS, Davydov DS, Vinnichenko VA. [Current laser technologies for the surgical treatment of prostatic hyperplasia]. Urologiia 2017:108-113. [PMID: 28394533 DOI: 10.18565/urol.2017.1.108-113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The first medical application of lasers dates back to the mid-60s of the XX century. Since then, laser systems have undergone significant changes. No longer a science fiction, lasers are used in many medical fields as an indispensable tool in the hands of the modern physician. The article outlines advances in laser techniques (from the idea of laser radiation to the modern laser systems used as effective surgical tools). We also present our experience in using laser surgical techniques in treating patients with prostatic hyperplasia.
Collapse
Affiliation(s)
- D V Enikeev
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - P V Glybochko
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - Yu G Alyaev
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - L M Rapoport
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - A Z Vinarov
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - M E Enikeev
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - N I Sorokin
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - L G Spivak
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - R B Sukhanov
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - A M Dymov
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - O Kh Khamraev
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - M S Taratkin
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | - D S Davydov
- Urology Clinic, I.M. Sechenov First MSMU, Moscow, Russia
| | | |
Collapse
|
14
|
Enikeev DV, Glybochko PV, Alyaev YG, Rapoport LM, Enikeev ME, Spivak LG, Tsarichenko DG, Sorokin NI, Sukhanov RB, Dymov AM, Khamraev OK, Gaas MY, Taratkin MS. ENDOSCOPIC ENUCLEATION OF THE PROSTATE – A NEW STANDARD IN SURGICAL TREATMENT OF BENIGN PROSTATIC HYPERPLASIA. Androl genit hir 2017. [DOI: 10.17650/2070-9781-2017-18-3-83-88] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
15
|
Enikeev DV, Glybochko PV, Alyaev YG, Rapoport LM, Enikeev ME, Tsarichenko DG, Sorokin NI, Sukhanov RB, Dimov AM, Khamraev OK, Davydov DS, Taratkin MS, Simberdeev RR. [Holmium laser enucleation of the prostate (HOLEP) for small, large and giant prostatic hyperplasia. Practice guidelines. Experience of more than 450 surgeries]. Urologiia 2016:63-69. [PMID: 28247728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION and objectives. Most of modern endoscopic procedures (e.g., TURP) are only confined to small and medium-sized glands (up to 80 cm3), but not HoLEP, which allows to enucleate large and extremely large prostates (200 cm3). The aim of the study was to compare the efficiency of HoLEP for prostates of different sizes. METHOD s. A total of 459 patients were divided into three groups: Group 1 included 278 patients (prostate volume <100 cm3); mean prostate volume, 70.8+/-16.1 cm3; IPSS, 18.7+/-5.5; QoL, 4.1+/-0.5; Qmax, 6.2+/-1.5 mL/s; post-voided residual volume, 64.2+/-30.5 mL. Group 2 included 169 patients (prostate volume 100-200 cm3); mean prostate volume, 148.1+/-25.2 cm3; IPSS, 19.7+/-3.3; QoL, 4.2+/-0.7; Qmax, 5.9+/-0.7 mL/s; post-voided residual volume, 70.9+/-20.1 mL. Group 3 included 12 patients (prostate volume >200 cm3); mean prostate volume, 230.1+/-18.1 cm3; IPSS, 19.5+/-4.5; QoL, 4.1+/-0.3; Qmax, 4.7+/-0.9 mL/s; post-voided residual volume, 72.3+/-10.9 mL. All the patients underwent HoLEP from 2013 to 2015. For the prostate to be enucleated, a 100-W laser system, 550-micron end-fire fiber, and a morcellator for tissue evacuation were used. RESULTS The average duration of surgery in Group 1 was 56.5+/-10.7 min; in group 2, 96.4+/-24.9 min; in Group 3, 120.9+/-35 min. The average duration of morcellation in Group 1 was 37.5+/-7.3 min; in Group 2, 63.3+/-11.2 min; in Group 3, 84.0+/-25.6 min. The efficiency of enucleation in Group 3 (1.70 g/min) was significantly higher (p < 0.05) than in Group 1 (1.05 g/min) and Group 2 (1.23 g/min). Similar results were obtained for the efficiency of morcellation. It was lower in Group 1 and Group 2 (1.58 and 1.87 g/min, respectively) than in Group 3 (2.45 g/min) (p<0.05). In order to compare the long-term results of HoLEP for prostates of different sizes, all the 459 patients were followed up for 18 months. IPSS, Qmax, QoL, and post-voided residual volumes were measured. There were no significant differences (p>0.05) in the postoperative outcomes for 1, 3, 6, 12, and 18 months after surgery. CONCLUSIONS It follows from our two years experience that HoLEP is a safe, highly efficacious and a size-independent procedure, which is why it has become a new gold standard for treatment of extremely large prostatic hyperplasia in our clinic.
Collapse
Affiliation(s)
- D V Enikeev
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - P V Glybochko
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - Yu G Alyaev
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - L M Rapoport
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - M E Enikeev
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - D G Tsarichenko
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - N I Sorokin
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - R B Sukhanov
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - A M Dimov
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - O Kh Khamraev
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - D S Davydov
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - M S Taratkin
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| | - R R Simberdeev
- FSBEI HPE First MSMU n.a. I.M. Sechenov of RMH
- SRI of Uronephrology and Human Reproductive Health
| |
Collapse
|
16
|
Alyaev YG, Rapoport LM, Enikeev ME, Bezrukov ES, Shpot EV, Korolev DO, Fokin IV, Marisov LV. [Radical prostatectomy in patients with incident prostate cancer]. Urologiia 2016:63-66. [PMID: 28247663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The problem of detecting localized prostate cancer following transurethral resection of the prostate (TURP) for benign prostatic hyperplasia is fairly common. Historically, radical prostatectomy (RP) after previously performed TURP was associated with poor surgical and functional outcomes. It is believed that the periprostatic fibrosis, scar tissue and inflammation after previous TURP may interfere with the optimal RP results. The present retrospective study evaluates intraoperative characteristics, postoperative oncological and functional outcomes of RP in patients with a history of TURP.
Collapse
Affiliation(s)
- Yu G Alyaev
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - L M Rapoport
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - M E Enikeev
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - E S Bezrukov
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - E V Shpot
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - D O Korolev
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - I V Fokin
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| | - L V Marisov
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow
| |
Collapse
|
17
|
Aliaev IG, Pal'tsev MA, Grigorian VA, Enikeev ME, Lysenko AI, Chinenov DV. [Modern technologies in diagnosis and treatment of patients with late stages of hydronephrosis]. Urologiia 2008:10-17. [PMID: 18669340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
To evaluate the role of modern ultrasonic, x-ray and radionuclide methods in staging hydronephrosis; that of stimulators of stem cells of the bone marrow in combined therapy of patients with late hydronephrosis, we examined and treated 18 patients with late-stage hydro- and ureterohydronephrosis. All the patients were operated. Preoperative preparation included drainage of the upper urinary tract and stimulation of bone marrow stem cells. Organ-saving surgery was conducted with a satisfactory functional result in 14 of 18 patients. Modern methods of investigation provide an objective assessment of structural-functional condition of the kidneys and upper urinary tract in patients with late hydro- and ureterohydronephrosis, may evidence for possible reversibility of registered uro- and hemodynamic alterations. Preoperative use of stimulators of bone marrow stem cells promotes activation of repair processes in renal parenchyma which is essential for efficacy of a further reconstructive operation.
Collapse
|
18
|
Mikhaylenko DS, Kurynin RV, Popov AM, Karyakin OB, Enikeev ME, Alyaev YG, Nemtsova MV, Zaletayev DV. VHL inactivation in sporadic clear cell renal carcinoma. Mol Biol 2008. [DOI: 10.1134/s0026893308010093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
19
|
Mikhaĭlenko DS, Kurynin RB, Popov AM, Kariakin OB, Enikeev ME, Aliaev IG, Nemtsova MV, Zaletaev DV. [Inactivation of the VHL gene in sporadic clear cell renal cancer]. Mol Biol (Mosk) 2008; 42:71-77. [PMID: 18389622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Renal cell carcinoma is the most common variant of the kidney cancer, which accounts approximately 75% patients with this disease. The majority of those tumors are characterized by inactivation of the VHL gene suppressor as a result of mutations, allelic deletions and/or methylation. We have conducted the complex molecular-genetic analysis of 64 samples obtained from patients with the clear cell renal cancer. VHL mutations were detected by single strand conformation polymorphism and subsequent sequencing, loss of heterozygosity was analyzed using two STR-markers, methylation was tested by methylsensitive polymerase chain reaction. All revealed variations were statistically analyzed in respect to the parameters of primary tumors in various groups of patients. Seventeen VHL somatic mutations were detected, 12 from which were described for the first time. Allelic deletions of VHL were found in 31.6%, and methylation--in 7.8% samples of the renal cancer. As a whole, VHL inactivating events were presented in 46.9% cases of disease, in 51.7% -among renal cancer patients with first stage. We have not observed any association of mutations, loss of heterozygosity and methylation with clinical-pathological parameters of disease. Results of this investigation specify for expediency of further studies of molecular genetics aberrations in the VHL gene. Perhaps, it would promote renal cancer molecular markers evaluation, for example, a determination of suppressor genes methylated in renal cancer.
Collapse
|
20
|
Volynchik EP, Alyaev YG, Enikeev ME, Gansen TN, Kaabak MM. Morphological examinations of donor's bladder wall and the ureter in kidney transplantation. Transplant Proc 2002; 34:2774. [PMID: 12431605 DOI: 10.1016/s0041-1345(02)03407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- E P Volynchik
- Russian Research Center of Surgery, Russian Academy of Medical Sciences and Urologic Clinic, Moscow Medical Sechenov Academy, Moscow, Russia
| | | | | | | | | |
Collapse
|