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Biomedical subjects

A A Kamalov

Publications and source records attributed to A A Kamalov.

At least 19 recordsLinked to original sources

[Surgical treatment of urinary bladder cancer].

Ultrasonic transabdominal and transrectal investigations, computed tomography, endoscopic photodynamic studies, polyfocal biopsy of the urinary bladder were used in examination of 1238 patients which were diagnosed to have urinary bladder cancer. 894 patients underwent transurethral resection of the bladder. Morphologically, cancer of the urinary bladder has an inductory effect on intact parts of the bladder mucosa. This means that even most radical resection does not eliminate grounds for a new tumor growth. Radical cystectomy was performed in diffuse papillomatosis, multiple stage T2 tumors of high-grade malignancy, tumors at stage T3, T4, Nx, MO, in rapid recurrent tumors after conservative or operative treatment.

Cystectomy↗

[Fluorescent diagnostics of urinary bladder cancer].

Introduction of optic markers in screening for cancer of the urinary bladder (UB) raises diagnostic significance of UB cystoscopy. Application of intravesical form of 5-aminolevulinic acid (5-ALA), precursor of photodynamically active protoporphirine IX, prevents complications in systemic use of tetracycline or hepatoprophirines. Fluorescent cystoscopy with 5-ALA (n = 59) was made in 51 patients treated in the Research Institute of Urology. UB cancer was detected in 32 patients. This procedure proved highly sensitive and specific (97.0 and 75.6%, respectively, being much more effective than standard cystoscopy and biopsy in the white light (85.1 and 81.4%, respectively). Specificity of fluorescent cystoscopy is much higher in detection of tumors and pretumor lesions (88.4%). Fluorescent diagnosis is expected to become a gold standard in the program of UB cancer detection.

Administration, Intravesical↗

[Differential diagnostic value of prostate-specific antigen in prostatic hyperplasia].

Diagnostic value of prostate specific antigen (PSA) was studied in 163 patients with prostatic hyperplasia. As PSA is not a cancer-specific test, it is recommended to obtain biopsy in patients with prostatic hyperplasia and PSA > 4 ng/ml to diagnose prostatic cancer early. Methods raising PSA specificity for differential diagnosis of prostatic hyperplasia are not absolutely reliable.

Aged↗

[Doksazozin "Cardura" in acute urinary retention caused by benign prostatic hyperplasia].

Drug treatment of acute ischuria (AI) caused by benign prostatic hyperplasia (BPH) is discussed. Catheterization of the urinary bladder is the main treatment for AI. AI is caused by anatomical obstruction, hypertone of smooth myocytes, and energy imbalance of detrusor. Use of alpha 1-adrenoblockers in AI is pathogenetically justified, as the development of stable spasm of smooth-muscle structures of the prostate, vesical cervix, and prostatic compartment of the urethra resultant from increased functional activity of alpha 1-adrenoreceptors underlies the dynamic component of obstruction. alpha 1-Adrenoblocker doxazosin (cardura) was used for arresting AI caused by BPH after 12-h randomization and catheterization of the bladder. A prospective randomized placebo-controlled study was carried out on 36 patients. Spontaneous urination was restored in 55.5% patients, in 63.3% of these after doxazosin and in 16.6% after placebo. 37.9% of patients from the doxazosin group were discharged from hospital for outpatient therapy with alpha-blockers and the rest were operated on. Hence, doxazosin increases the chance of recovery of spontaneous urination for patients with AI caused by BPH and allows time and conditions for preparation of patients to surgery. Therapy with alpha 1-adrenoblockers after resolution of AI in patients with BPH can be effective and should be further investigated.

Acute Disease↗

[Endoscopic recanalization in treating ureteral obliteration].

For diagnosis of urethral obliteration we have developed a method of complex examination including x-ray and ultrasound investigations, NMR-tomography of the small pelvis and perineum. This method provides maximal significant information about defects in the urethra and adjacent tissues and organs. Endoscopic urethral recanalization was performed in 86 patients with urethral obliteration aged from 7 to 78 years. Good and satisfactory results were achieved in 46 (53.49%) and 34 (39.53%) cases, respectively. Unsatisfactory results were obtained in 6 (6.98%) patients. Two of them had enuresis, 3 developed recurrent obliteration and 1 patient died. He suffered from concurrent cardiovascular disease and died early after surgery of hemorrhage and myocardial infarction. Secondary urethral stricture after endoscopic urethral recanalization was observed in 36 (41.86%) patients. Repeated internal optic urethrotomy and chronic urethral bouginage in combination with medication at the stage of rehabilitation resulted in stabilization of the urethral lumen in 34(94.4%) patients. Serious intraoperative complications arose in 3 (3.49%) patients: perforation of the rectum (1 patient), TUR syndrome (1 patient), prostatic perforation and hemorrhage (1 lethal outcome). The complications were in all the cases explained by erroneous direction of the endoscope movement, obliteration length more than 3 cm and underestimation of the severity of the patient's condition.

Adolescent↗

[Use of proscar in preoperative preparation of patients with benign prostatic hyperplasia before transureteral resection].

Effects of proskar-MSD used before transurethral resection (TUR) of the prostate in patients with benign prostatic hyperplasia (BPH) were studied with specification of the drug action on hematuria during and after operation. Patients with histologically verified BPH received proskar for 3 and 6 months in a dose of 5 mg/day. Control patients did not receive preoperative proskar. Of patients who received proskar for 3 months, TUR with estimation of the intraoperative blood loss and changes in microcirculation and structure of prostatic tissue induced by proskar was made in 20 patients (mean age 68 years). A 3-month course of proskar reduced prostatic volume and its hyperplasia by 18-20 cm3, on the average. Mean blood loss was about 111 ml vs control 223 ml. Dopplerography revealed consolidation of adenomatous tissue and decline of volumic blood flow in the prostate after 3-month proskar course. Thus, preoperative proskar administration before TUR of prostatic adenoma results in sclerosing of prostatic tissue, decrease of microcirculation manifesting intraoperatively with diminished hematuria and less number of subsequent complications; promotes a favourable outcome of the operation; improves life quality.

Combined Modality Therapy↗

[Minimally invasive method of the treatment of prostatic abscess].

In discussion of advantages and shortcomings of different surgical procedures in the treatment of a prostatic abscess (PA) which rarely complicates acute prostatitis the authors focus on a thin needle transcutaneous puncture of PA under ultrasound control. This low invasive operation made under local anesthesia was performed in 15 PA patients. The abscess cavity was drained using a polyethylene catheter "pigtail". The manipulation was well tolerated by all the patients with no complications in the postoperative period. A mean time of the abscess cavity draining was 4 days. A follow-up for 1.5 years discovered recurrence in none of the patients. This low invasive method is proposed as an alternative to the existing traumatic methods of PA management.

Abscess↗

[Indirect electrochemical blood oxidation in the prophylaxis of suppurative-inflammatory complications after transurethral resection of the prostate].

To investigate efficiency of indirect electrochemical blood oxidation in prophylaxis of infectious complications, 28 patients were treated with 0.06% hypochlorite solution (2 infusions, 2-3 days before TURP). These patients belonged to a high-risk group of infectious complications (80% of them had chronic prostatitis, 8 patients had bladder stones, 8 had undergone cystostomy). The results demonstrated that the complication rate in the above prepared patients fell four times as compared to the control group and the postoperati hospital stay was reduced by 3 days.

Aged↗

[Plastic surgical repair of the urethra with vascular fasciocutaneous and combined flap (experimental study)].

The experiments on 15 dogs with preformed urethral stricture or urinary urethral fistula have demonstrated that microsurgical transplantation of the vascular fasciocutaneous pedicle flap provides good functional long-term results. The best effect was achieved in cases of intraflap inclusion of previously transplanted mucosa of the urinary bladder. In all 7 experiments x-ray picture was similar to normal. Recurrent strictures or urethral fistulas were not registered. Urodynamic indices late after the experiment did not differ significantly from normal values.

Animals↗

[Operative treatment of benign prostate hyperplasia: modern aspects].

A retrospective analysis was made of the treatment results for the last 5 years of 879 patients with benign prostatic hyperplasia (BPH), 214 (24.3%) of whom had undergone transvesical adenomectomy while 665 (75.7%) had undergone transurethral resection (TUR) of the prostate. Adenomectomy had rather high effectiveness but was less safe than endoscopic intervention (higher lethality, more frequent development of myocardial infarction, pulmonary artery thromboembolism, postoperative hemorrhage). Patients operated for BPH are at risk of postoperative urethral stricture and sclerosis of urinary bladder cervix. Prebladder and postoperative stress urine incontinence appear only after open operations in BPH.

Aged↗

[Application of a free flap from urinary bladder mucosa for urethroplasty in experiment].

Experiments on 8 rabbits have demonstrated that mucosa of the urinary bladder freely transplanted into the subcutaneous fat or under the muscular fascia is engrafted with unaffected normal histological structure and revascularized with vessels invading from the adjacent tissues. Urethroplasty with a vesical mucosa graft was made in 10 dogs with experimental urethral stricture (4 animals), urethral fistula (5 animals) or a combination of urethral stricture and fistula (1 animal). A positive result with reestablishment of normal urethral passability and elimination of urinary fistula was achieved in 9 animals (followup for 1 year). One dog died of an unknown cause. Urodynamic examination of the dogs in long-term follow-up reported normal urethral resistance to urinary flow.

Animals↗

[Flap urethroplasty].

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Dermatologic Surgical Procedures↗

[Quality of life in patients after radical prostatectomy].

According to the literature, after radical prostatectomy the patients had normal micturition and erectile function in 50 and 10-30%, respectively. A total of 647 patients with diagnosis prostatic cancer (PC) stage T1a-T4 were examined in two clinics in 1997-2003. Of them, 43 patients (PC stage T1a-T3a) have undergone retropubic radical prostatectomy (RRP) by a modified nerve-preserving technique (preservation of the urinary bladder neck, puboprostatic joints in prostate size > 60 cm). Preoperative and postoperative examinations for urine continence and erectile function after RRP were made in 20 patients. The proposed operative technique of nerve-preserving RRP preserves urine continence and erectile function in many cases. This improves social adaptation of the patients and extends indications for operative treatment.

Erectile Dysfunction↗

[Impase in the treatment of erectile dysfunction].

The authors review epidemiology, classification, etiology and pathogenesis of erectile dysfunction (ED), its diagnosis and treatment with a focus on mechanisms of action and efficacy of the drug impase. Impase is the drug of superlow doses of affinitively purified potentiated antibodies to human endothelial NO-synthase. The drug regulates NO synthesis in the cavernous bodies, enhances an NO relaxing action on their smooth muscles and blood flow in the penis under sexual stimulation. The drug demonstrated its high efficacy and safety in many clinical trials. Impase trial performed in the Research Institute of Urology in 2004 has found that impase is more effective in long-term administration, most of the examinees exhibited a clinical response only after one month of regular intake. The drug can be used both as the first-line monotherapy of ED and combined treatment of this disease. Clinical recommendations for practitioners on administration of impase are provided.

Adult↗

[Pharmacotherapy of erectile dysfunction].

Among the drugs used to treat erectile dysfunction most common are prostaglandins El, viagra, iochimbin, vasodilators and desaggregants, vitamins, biogenic stimulators, etc. The comparative analysis of their efficacy was made in 360 patients with erectile dysfunction, primarily at subcompensated stage, aged 17-83 years. Organic and psychogenic erectile dysfunctions were diagnosed in 69 and 31% of the patients, respectively. Intracavernous injections of prostaglandin El (Caverject) were effective in 74%, transurethral alprostadil (MUSE) when adjusting the dose--in 38.7% of the patients. Iochimbin in patients with organic and psychogenic forms of erectile dysfunctions was effective in 25 and 40% of patients, respectively. In 26.3 and 19% of such patients the response was obtained after use of the combination including xantinol, nicotinate, trental, biogenic stimulators and adaptogens. Viagra was effective in 60 and 77.3% of patients with psychogenic and organic erectile dysfunctions, respectively.

Adolescent↗

[Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention].

Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications.

Endoscopy↗

[Transurethral endoscopic dissection of the bladder neck and prostate].

Transurethral endoscopic incision of the neck of the bladder and the prostate was conducted for elimination of infravesical obstruction due to benign prostatic hyperplasia (BPH) of a small size and sclerosis of the bladder neck or prostate. 37 patients aged 22-85 years were treated: 17 had BPH and 20 had bladder neck sclerosis (primary in 2 and secondary in 18 patients). In 4 cases the incision was combined with internal urethrotomy, in 4 with cystolithotripsy and in 2 with transurethral resection of the bladder. The diagnosis was made basing on routine blood counts, urinalysis, x-ray, ultrasonic, uroflowmetry and pathomorphological investigations. The last stage of the examination was urethrocystoscopy made shortly before operation. The symptoms were evaluated according to answers in the J-PSS questionnaire. Anesthesia was only intravenous or epidural. A spicular Collins electrode cut at 5 and 7 of the assumed dial. After hemostasis an urethral catheter was inserted for 24-48 hours. The intervention lasted 15 minutes, no lethal outcomes occurred. Marked symptomatic improvement was achieved in 36 patients (97%). BPH cut was uneffective in one patient who subsequently underwent transurethral resection.

Adult↗