Biomedical subjects
Publications and source records attributed to N S Bukurov.
In spite of the impressive progress in medical science, surgery remains an empirical skill. Surgery of the ureterovesical junction is a permanent challenge for all generations of urologists. Half a century of intensive development of modern surgery evidences the efforts to reestablish function by a perfect copy of natural anatomy.
A DANTEC 2100 mictometer type 21C10 with uroflow transducer type 21KO2 was used for investigation of 50 men with urethral strictures (mean age 59 +/- 14 years). The patients underwent a total of 334 clinical evaluations of replicate voiding (minimum 4, maximum 16) before and after successful urethral dilatation on an outpatient basis. Using t-paired comparison test, significant increase in maximum urinary flow rate (P less than 0.01) after the treatment procedure was evidenced in each of the patients. The variability of other urinary flow parameters suggested a lower significance in evaluation of urine stream quality. The McNemar test showed a significant shift from one to another zone of classification suggested by Drach et al. (P less than 0.01), i.e. 64% of patients reached normal or overlap zone in the first spontaneous voiding after urethral dilatation. Furthermore, no significant difference could be established with one-way ANOVA between urodynamic variables of mean values of repetitive voidings in cases of urethral stenosis of different aetiology either before or after urethral dilatation (P greater than 0.05), suggesting that urethral stenoses of different aetiology are characterized by similar urodynamic features. A highly significant linear correlation was found between the maximum flow rate and the voided volume only after urethral dilatation (r = 0.522, P less than 0.01), while correlation with urethral sound sizes could not be established (r = 0.207, P greater than 0.5). We conclude that uroflowmetry provides reliable information on the patient's ability to void. The use of maximum flow rate may predict the time at which urethral dilatation becomes necessary and provides objective evidence of the efficacy of treatment.
A retrospective analysis of ureteric reimplantation in adults showed that a high proportion (71%) had been treated by non-antireflux procedures. Analysis of the ureteroneocystostomy success rate in aetiological groups where either antireflux or non-antireflux techniques were used indicated the superiority of antireflux surgery in the prevention of reflux. The risk of stenosis at the site of anastomosis was equal in both groups. No significant difference in the preservation of renal function was detected in the 2 groups. It was concluded that antireflux procedures offered no advantage over non-antireflux ureteric reimplantation in adults.
Papillary transitional cell tumors of the renal pelvis and ureters occur more frequently in the Balkan countries than in other areas in the world. The populations involved are the same as those who are at risk to develop Balkan endemic nephropathy (BEN). Seventy-seven patients were treated in the Urology Clinic for papillary cell tumors of the renal pelvis and ureters (UTT) from 1986 to 1988. Forty-four of the patients were from areas where BEN is endemic. The at-risk population is estimated to be less than 2% of the control population. Eleven of the 77 were on hemodialysis when UTT were detected, and all but one of those were from BEN areas. This finding emphasizes the need for continual monitoring of end-stage renal disease patients for evidence of these tumors. Comparing the frequency of the tumors from our study (1986 to 1988) with that of early studies indicates that the risk of developing the tumors remains very high in the BEN areas. We conclude that the causative agent(s) is still prevalent in the involved areas.