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Biomedical subjects

A K Chepurov

Publications and source records attributed to A K Chepurov.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

[Use of biodegradable stents in treating complex urethral strictures].

Seven men with complex urethral strictures after examination using three-dimentional and echocontrast sonourethrography were subjected to transurethral laser vaporation of the scar tissue in the region of the narrowing, implantation of the biodegradable urethral SR PLGA stents at contra cystourethroscopy. Internal drainage of the urinary bladder with the use of SR-PLGA stents provides protection against exogenous infection and complications of epicystostomic or urethral cathetarization. High informative value, low invasiveness and relative safety of sonourethrography allows one to revise the role of ultrasound investigation in the algorithm of diagnosis and choice of treatment for patients with strictures and obliterations of the urethra.

Adolescent↗
PubMedDate not supplied

[Biodegradable ureteral stents in treating patients with infravesical obstruction].

Biodegradable endoprostheses SR-PLGA and SR-PLLA were used in combined treatment of 39 patients with urethral stricture (n = 24), neurogenic urinary bladder (n = 9), benign prostatic hyperplasia (n = 4), prostatic cancer (n = 2). In definition of indications for stent implantation the leading role was assigned to preoperative diagnosis of the state of the urinary bladder, urethra and sphincters using urodynamic tests and dynamic Doppler and three-dimensional echourethrography. Introduction of biodegradable urethral stents provides adequate spontaneous urination and allows avoiding external drainage. This prevents nosocomial infection and lowers the number of inflammatory complications. Palliative usage of stents in inoperable and neurological patients is effective in their medical and social rehabilitation. Analysis of errors and complications in 8 patients demonstrates that implantation of biodegradable stents is not absolute safe and requires some caution.

Aged↗
PubMedDate not supplied

[Effect of surface roughness of polymers on thrombus formation].

Thromboresistant properties of fluoroplast-4, lavsan, polymethylmetacrylate, carbon glass, employed in various devices contacting the blood and presenting different degrees of the surface roughness, were studied. The thromboresistant properties of polymers were judged on the ground of modified methods for determining the blood coagulating time, thromboelastograms, with reference to the prothrombin complex factors concentration, the amount of fibrinogen, heparin blood tolerance, the thrombocytes adhesion index, their splitting and flattening. A higher class of the polymer surface roughness was found to raise the thromboresistant properties of the surface. In case of polymers with high mechanical and strength properties the surface roughness is of greater importance in the genesis of thrombosis than in polymers possessing elastic properties.

Biocompatible Materials↗
PubMedDate not supplied

[The treatment of stress urinary incontinence in women].

Fifty-six females with enuresis were observed in 1986-1990. Their x-ray examinations included urodynamic techniques: uroflowmetry, cystomanometry, test of the profile of the intraurethral pressure. Basing on the findings, 11 patients were excluded from the group to be operated on. Two kinds of surgery were employed: urethrovesicofixation according to Marshall-Marketti-Kranz, endoscopic submucous administration of teflon paste. The former method corrected the position of the bladder but is less effective in correction of the intraurethral pressure. The experience obtained by the authors permitted them to propose Marshall-Marketti-Kranz operation for apparent vesicoptosis whereas the teflon paste injection in enuresis without pronounced vesicoptosis. The methods can be used in combination: if, in spite of good anatomical results of the operation, enuresis persists, the paste administration is advocated to achieve better functional outcome.

Female↗
PubMedDate not supplied

[Subtotal transurethral prostatectomy in the treatment of patients with prostatic cancer].

The results are given of subtotal transurethral resection (subtotal TUR) in 21 patients with prostatic cancer (PC) operated in 1998-2004. The patients had contraindications to radical treatment. The aim of the surgical intervention was maximal possible removal of the prostatic tissue to the prostatic capsule that improves results of adjuvant hormonal and radiotherapy. Postoperative follow-up lasted from 6 months to 6 years. The control groups consisted of 20 patients subjected to palliative prostatic TUR and 24 PC patients given only hormonal or radiotherapy. Subtotal transurethral prostatectomy and TUR of the prostate were successfully made in all the patients. The number of postoperative complications and reoperations was less in patients after subtotal transurethral prostatectomy than in those after palliative TUR. The treatment reduced blood PSA levels in all the groups but the progress of this reduction depended on the treatment method. The group after subtotal transurethral prostatectomy achieved maximal PSA lowering after 2 months after surgery. The follow-up registered distant metastases in 19.04% patients of the study group and 20 and 29.4% in the control groups. One-year survival was 80.95, 80, 83.3%, respectively; 3-year survival was 80, 45.5 and 77.8%, respectively. Thus, combined treatment of prostatic cancer (subtotal transurethral prostatectomy and maximal androgenic blockade) rapidly corrects urination without deterioration of survival parameters compared to hormonal therapy alone.

Combined Modality Therapy↗
PubMedDate not supplied

[The role of ureteral function in formulation of indications for endoscopic treatment of neuromuscular dysplasia of the ureters in adults].

Function of the affected ureter was studied with multichannel impedance ureterography in 6 adult patients (age 18-35 years) with neuromuscular ureteral dysplasia (NUD). Of them, 5 patients had compensated ureteral contractility. These patients received endoscopic therapy with Ho-laser consisting of circular ablation of congenital stricture of intramural portion of the ureter. Control examinations (maximal follow-up 6 years) demonstrated a significant stable decrease in dilatation of the upper urinary tracts.

Adolescent↗
PubMedDate not supplied

[The endoscopic transurethral treatment of ureterocele].

The authors describe results of transurethral endoscopic treatment of ureterocele in 61 patients, two techniques of a relevant operative intervention, indications, complications of an early (pyelonephritis) and late (vesicoureteral reflux) postoperative period, measures of their prevention. Advancing impairment of the urine outflow via the upper urinary tracts on ureterocele side necessitates earlier surgery (transurethral dissection or resection of ureterocele). Good 4-year follow-up results (normal function of the kidney, absence of pyelonephritis attacks and vesicoureteral reflux) suggest endoscopic transurethral treatment of ureterocele to be a method of choice the failure of which implies open surgical intervention.

Adult↗
PubMedDate not supplied

[Endourethral drainage of the bladder in patients with prostatic adenoma].

Cystostomy catheterization of urinary bladder is the commonest method of choice in the treatment of patients with prostatic adenoma complicated by pronounced intercurrent pathology. To avoid the necessity of male urinals the technique of intraurethral splinting was used in 5 patients with nitinol spiral introduced in the prostatic part of the urethra. Therefore, the urination was normalized in three of them (one person had cystostomy catheter). The long-term observation evidenced of spiral stable position and step-by-step rehabilitation of detrusor function. There was a case of spiral incrustation and still another of spiral displacement when an attempt was made to pass the urethral catheter down the inside of nitinol splint. Though the aforementioned method of recovery of normal urination is a promising one, further clinical trials are required.

Aged↗
PubMedDate not supplied

[The hazards and complications of internal drainage of the upper urinary tract].

The causes, diagnosis, prevention and management of complications arising in insertion of internal ureteral stents have been analyzed basing on the results of 289 procedures in 272 patients. Dangers and complications related to drainage of upper urinary tracts (UUT) may be divided into technological (arising when inserting or removing the stent) and clinical (arising within the time of the stent location in the UUT). Technological complications emerged in 25 cases (8.7%). Of them, iatrogenic ureteral perforation occurred most frequently (9 cases, 3.1%). Clinical complications were registered in 41 patients (14.2%). Most common of them were: attacks of pyelonephritis due to vesicoureteral reflux and stent impassibility (19 and 9 patients, 6.6% and 3.1%, respectively). To ascertain the causes of the stent impassibility for urine, a complex of x-ray and ultrasound investigations was applied. The reflux is often provoked by the bladder drainage with urethral catheter. In the stent obstruction or concrement formation on it, the removal and changes of the stent were combined with extracorporeal or contact lithotripsy. Spontaneous distal migration of the stent (8 cases) necessitated its transurethral removal. Insertion of inner ureteral stents is rarely complicated by spontaneous migration of the drainage above the ureteral ostium (1 case) and by development of arterial-ureteral fistula (1 case). Thorough roentgenoendoscopical control over the stent insertion and staying in the UUT assists prevention and treatment of complications consequent to UUT internal drainage.

Adolescent↗
PubMedDate not supplied

[The complications of transurethral resection of the bladder for tumor].

Transurethral resection (TUR) is now widely used in combined treatment of urinary bladder cancer, but the procedure may be compromised if applied without evaluation of infiltration and malignancy degree and metastases responsible for frequent recurrences. The aim of this study was design of effective measures to prevent TUR complications. For 8 years the surgeons from the Moscow Medical Academy urological clinic made 824 TURs for bladder tumors in 322 patients (mean age 57.5 years, 72.6% of males, 27.4% of females). At the stage T3-4 TUR was conducted in contraindications to cystectomy or absence of distant metastases. The following intra- or postoperative complications were observed: hemorrhages (4.6%), intraperitoneal perforations (0.3%), extraperitoneal perforations (0.9%), vesicoureteral reflux (2.8%), enuresis (1.2%). The emergence and severity of the complications were dependent on the bladder tumor stage and degree of infiltration of the muscular layer. Positive TUR results are more feasible in more strict approach to the indications for surgery, adequate surgical skills and technique, high-quality anesthesia, early arrest of hemorrhage, low pressure of the washing liquid in the course of operation.

Adult↗