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Biomedical subjects

L M Rapoport

Publications and source records attributed to L M Rapoport.

18 recordsLinked to original sources

[Transurethral endoscopic surgical procedures on the ureter].

Seven-year experience in examination and treatment of 92 patients with upper urinary tracts disease is analyzed. Potentials of modern endoscopes, technique of ureteroscopy, indications and contraindications for transurethral endo-surgical procedures on the ureter including in anomalies of the kidneys and upper urinary tracts are described. Results of surgeries for tumors, concrements, ureteral strictures and relevant complications are reported.

Endoscopy↗

[Transurethral electrosurgery in the treatment of benign prostatic hyperplasia].

The article is devoted to topical problem of modern urology, one of the lines of surgical treatment of benign prostatic hyperplasia (BPH)--transurethral electrosurgery. Physical principles which are the basis of transurethral electrosurgical interventions and influence of transurethral electrosurgery on prostatic tissue are described. Methods of necessary preoperative examination of patients with BPH are presented. The most often used transurethral electrosurgical technique for destruction of hyperplastic prostatic tissue is described. The results of 5-year use of combination of transurethral electroresection and electrovaporisation in the treatment of BPH and its complications are presented. Ways of prophylaxis of possible complications are proposed.

Adult↗

[Differential diagnosis of renal colic].

Potential of modern examinations in differential diagnosis of renal colic and other emergency states is considered. Renal ultrasonography permits in the majority of cases to make diagnosis based on dilatation of caliceal-pelvic system, sometimes with detection of obstruction cause. It is necessary to differentiate parapelvical cysts from dilatation of caliceal-pelvic system, therefore pharmacultrasonic examination of the kidneys with lasix is recommended. Color dopplerography of the urinary bladder with detection of urine ejection from ureters ostia is analogue of conventional invasive diagnostic method--chromocystoscopy. Magnetic-resonance urography is updated non-invasive, non-contrast and non-radiation method of diagnosis of urinary tract dilatation.

Colic↗

[Mineral water Volzhanka from Undorovskĭ spring in combined therapy of patients with nephrolithiasis and chronic pyelonephritis].

Water loading is an essential component in therapy of nephrolithiasis, especially in the presence of small ureteral concrements or fragments after extracorporeal shock-wave lithotripsy. Saluretics, furosemide in particular, cause side effects. One of these is dyselectrolytemia due to potassium loss. Mineral waters have advantages in the treatment of nephrolithiasis and pyelonephritis as their drinking does not lead to electrolyte loss. Low mineral waters are highly diuretic, e.g. after drinking 1 liter of Volzhanka day-time diuresis increases by 300-400 ml. This relieves ureteral and calyceal-pelvic tonicity stimulating elimination of the concrements or their fragments after lithotripsy. Intake of Volzhanka proved effective in combined therapy of nephrolithiasis, calculous pyelonephritis, urate nephrolithiasis.

Chronic Disease↗

[Magnetic resonance urography: possibilities and prospects].

A new technique of urinary tracts visualization--magnetoresonance urography (MRU)--for a year (2000) was applied in examination of 25 patients aged 17 to 63 years with ureteral concrements (n = 11), ureteropelvic stenosis (n = 10), ureteral stenosis (n = 2), urinary bladder tumor (n = 1), Ormond's disease (n = 1). MRU provides the same information about the obstruction and dilatation of the urinary tracts as excretory urography (EU). In cases of EU contraindication (allergy, renal failure) or lack of contrast substance excretion, MRU allows to avoid additional invasive diagnostic procedures. It also enables visualization of non-dilated urinary tracts in medicinal polyuria. Non-invasiveness, no need to contrast, absence of radiation load open wide perspectives for MRU application in various groups of patients including pregnant women.

Adolescent↗

[Dynamic magnetic resonance prostatovesiculography in diagnosing prostatic cancer].

Dynamic MR prostatovesiculography (DMRP) is a new method of prostatic cancer diagnosis based on the ability of cancer tissue to accumulate contrast substance (omniscan) than benign tissue. Urologists from the I.M. Sechenov Moscow Medical Academy have examined 23 patients (5 patients with prostatic cancer and 18 suspects) who have undergone standard investigations (test for PSA, finger rectal examination, transrectal ultrasound investigation) and DMRP. DMRP detected prostatic areas suspected of malignancy. Taking biopsy from such areas verified diagnosis of prostatic cancer in 2 patients.

Aged↗

[Biodegradable prostatic stents in treating patients with prostatic enlargement].

A total of 39 patients with prostatic hyperplasia (PH) admitted to the urological clinic of I. M. Sechenov Moscow Medical Academy from 1999 have been inserted a biodegradable catheter stent (BCS). Such stents degrade spontaneously to microfragments and come away with urine 4-12 months after catheterization. BCS were used in PH patients with marked urination disorders due to urethral compression by hyperplastic prostate in whom adenomectomy was contraindicated. BCS was used for elimination of a suprapubic fistula in the urinary bladder of 19 PH patients with contraindications to adenomectomy. 5-7 days before catheterization the urinary bladder was drained 2 times a day to reduce pyoinflammatory process. The cystostomic fistula closed within 24 h in all the patients. Adequate urination recovered. Urethral inflammation persisted for 4-6 weeks. It was treated with antibiotics with effectiveness 89.5% (in 17 of 19 patients). Pyoinflammation persisted in two patients who developed uroliths destructed later at endoscopic pneumatic cystolithotripsy. Control examination 6 months after the stent insertion found that the stent had destructed with evacuation of the fragments. In two patients two large fragments were locked in the urethra provoking acute ischuria. The fragments were removed by the forceps and urination became normal. None of the patients needed recystostomy. 32 stented patients 6 and 12 months after stenting had adequate urination (mean Qmax--12.3 and 10.8 ml/s, respectively). Mean residual urine--32 and 37 ml. BCS improves treatment outcomes and quality of life of PH patients with contraindications to adenomectomy.

Biocompatible Materials↗

[Drainage of the urinary tract as preparation for extracorporeal lithotripsy].

Upper urinary tract drainage in patients with chronic calculous pyelonephritis (CCP) results in not only successful anti-inflammatory and antibacterial treatment but also in more effective and safe ESWL. In 21 CCP patients with upper urinary tract drainage by means of catheter-stent, ESWL was performed using Lithostar-Plus (Siemens). Active inflammation with marked pyuria, bacteriuria and even moderate upper urinary tract dilation were indications for the upper urinary tract drainage with catheter-stent before and during ESWL in CCP patients. Upper urinary tract drainage with catheter-stent contributed to effective treatment of chronic pyelonephritis and allowed to perform ESWL. There were neither attacks of acute pyelonephritis nor upper urinary tract obstruction after catheter-stent removal. The catheter-stent allows to create closed drainage system with active evacuation function as it functions in physiological conditions. ESWL in patients with upper urinary tract drainage using catheter-stent is more effective and has lower risk of complications.

Adult↗

[Drug-induced polyuria in the surgical treatment of patients with nephrolithiasis].

Recently, drug polyuria has found wide application in diagnosis and treatment: to detect latent urinary insufficiency, to assess functional performance of the contralateral (unaffected) kidney in nephrolithiasis and calculous pyelonephritis, to stimulate elimination of fragments of the disintegrated concrement, to check up suture impermeability after surgical repair of the urinary tracts, to outline afunctional zone in hydronephrosis. Clinical experience gives grounds for use of saluretics at certain stages of pyelolithotomy for mobilization of intrarenal pelvis and its dissection, removal of the calculus and subsequent suturing of the intrarenal pelvis. Therapeutic polyuria can also facilitate ureterolithotomy.

Combined Modality Therapy↗