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Biomedical subjects

V Ia Simonov

Publications and source records attributed to V Ia Simonov.

At least 19 recordsLinked to original sources
PubMed1989

[Shockwave destruction of stones in the kidneys and ureters].

Experience gained in the use of the first Soviet unit and western lithotriptors is based on the treatment of over 2500 patients of different age groups. Comparative characteristics of lithotriptors are provided to mark substantial advantages of the Soviet unit. Distant lithotripsy (DL) is much more effective and atraumatic as compared with conventional surgical interventions. The use of DL provides positive effect in 97-99% of cases. The rate of complications is extremely low, amounting to 5-10%. Indications and contraindications as to the use of DL are given. Contraindications include cases requiring reconstructive surgical interventions and the presence of coral-like calculi and acute inflammation. The Soviet unit appeared especially effective in the treatment of children with urolithiasis. The cure was attained in 97.2% of the patients, no serious complications occurred. Functional studies of the kidneys did not reveal any changes both in the short- and long-term periods after DL.

Adolescent↗
PubMedDate not supplied

[Telelithotripsy in the treatment of staghorn nephrolithiasis in children using the URAT-P lithotriptor].

The paper presents the results of telelithotripsy monotherapy for 34 staghorn stones in 32 nephrolithiasis children carried out at the RSFSR Research Institute of Urology, Moscow. Commonest manifestations of the disease were leukocyturia (87.5% of cases) and Proteus bacteriuria (31.8% of cases). Basing on roentgenological findings, the stones were classified into 3 groups: initial (K1), incomplete (K2) and complete (K3). All the children underwent treatment on Soviet lithotriptor "URAT-P" under a delicate regime using different techniques of disintegration which started from the periphery and advanced to the pelvic part of the calculus. No pretreatment drainage of the pelvicaliceal system was performed. The intended staged disintegration of the stones was achieved in 94.2% of cases at 2.4 sessions, on the average, and overall number of impulses 1973.1 per each stone. At discharge 76.4% of the children were free of the main mass of the stone dust. Acute pyelonephritis which appeared the most frequent postoperative complication developed in 7.8% of the patients one of which required open nephrostomy and one percutaneous puncture nephrostomy. Other cases were treated by specific antimicrobial therapy. Complete series of investigations in the postoperative period did not reveal any intra- or pararenal hematomas. Radioisotopic renography revealed improvement in renal function in 62% of cases in early postoperative follow-up. Thus, 93.8% of children with stag-horn stones were spared of traumatic operative intervention or invasive manipulations. This makes the method of telelithotripsy a valuable therapeutic tool in childhood staghorn nephrolithiasis.

Adolescent↗
PubMedDate not supplied

[The anesthesiological support for children in extracorporeal lithotripsy on the Urat-P apparatus].

The Urat-P lithotriptor made in this country was employed for remote lithotripsy (RLT) in 94 children with urolithiasis. Altogether 132 sessions were conducted. In 120 cases the concrement disintegration progressed in a sparing regimen (impulse duration 0.3-0.4 ms, shock wave energy 5-8 J). In the rest 12 cases there were additional hard impulses (0.5-0.6 ms, the energy 10-12 J). Anesthesiological and transfusiological problems are considered. It is shown that choice of anesthesiological defense is based on the clinical form of the disease, the concrement size, the child's age. Intubation anesthesia with artificial pulmonary ventilation is indicated for young children (under 5). Intravenous balanced anesthesia under normal respiration accompanies RLT in large coral calculi treated in senior children (6-14 years of age). Single stones (up to 1.5 sm) in them are managed under local infiltration anesthesia. It is stated that a valid choice of anesthesia and transfusion therapy warrants favourable conditions for RLT sessions, adverse effects of the impulses on the renal parenchyma and adjacent tissues lessen facilitating the fragments elimination and reducing the number of complications in the postoperative period.

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

[Ureteral remote shockwave lithotripsy].

UNLABELLED: During 1-year exploitation of a Lithostar remote lithotriptor (Siemens) 221 patients with concrements of various parts of the ureter were treated. The patients' ages were from 6 to 86 years. It the course of treatment 170 patients needed only 1 session of remote shock wave ureterolithotripsy; 44--2 sessions; 5--3; and 2--4 sessions. The ureterolithotripsy was carried out under intravenous and local infiltrative anesthesia, as well as under intravenous analgesia or without any anesthesia. According to presence or absence of the inflammation process, the time a concrement stood in the same place, the severity of obstructive nephropathy the following ureterolithotripsy methods were used: 1) "on the spot" (in the absence of inflammation and duration of concrement standing in one place no more than 6-8 weeks); 2) in the presence of an ureteral catheter (in more prolonged periods of concrement standing); 3) in the presence of transcutaneous puncture nephrostomy (in inflammatory process and severe signs of obstructive uropathy). Better treatment results were obtained in patients with a small concrement standing period and in those whose ureter concrements were shifted or passed the catheter. The retro- or anterograde concrement perfusion by physiologic saline and diuretic therapy increased the efficacy of remote shock wave ureterolithotripsy. The therapy was effective in 206 of 221 patients (93.2%); in case of failures 7 patients underwent an open ureterolithotomy; 5--retrograde and 3--anterograde ureteral stone extraction or lithotripsy. COMPLICATIONS: 6 patients had a pyelonephritis attack because of fragments crashed stone renal occlusion; 3 were operated on by the method of transcutaneous paracentetic nephrostomy; other 3 patients' kidneys were catheterized.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[The prevention and treatment of complications from extracorporeal lithotripsy].

Since October 1987, remote lithotripsy (RL) has been performed at the Research Institute of Urology, RSFSR Ministry of Health, over 3 years. "Specific" complications associated with RL made with a Urat-P lithotriptor are common in the immediate period following the procedure. The paper describes the analysis and outlines complications, causes of their occurrence, and prophylactic measures. A total of 2,300 lithotripsies conducted in 1988-1990 were analyzed. The incidence of the complications was 2.4%, which is similar to the values observed with foreign lithotriptors. The occurrence of acute pyelonephritis caused by RL is likely to increase when there is a baseline active inflammatory process in the urinary tract. The paper proposes a procedure for selecting patients in RL, antibacterial preoperative therapy, methods for lithoclasty with the use of the national lithotriptor. Involving two lithotripsy regimens. The authors find it necessary to drain the urinary tract within the first days of the appearance of signs of acute pyelonephritis by renal catheterization or paracentetic nephrostomy.

Acute Disease↗
PubMedDate not supplied

[Epidural anesthesia in urology].

Indications for epidural anesthesia have been analyzed on the basis of 1483 cases of its application. They include transvesical adenomectomy, transurethral electroresection of prostatic adenoma, distant renal and ureteral lithotripsy. It is emphasized that epidural anesthesia is an advantage in older and senile individuals with associated respiratory and circulatory diseases. Epidural anesthesia provides some protection against complications like a transurethral resection syndrome and coagulation disorders. The practical use of epidural anesthesia during urologic operations is safe when its level does not extend above the 9-10th dermatome. A range of measures is offered to prevent complications of epidural anesthesia by stabilizing the hemodynamics and improving blood rheology, coagulation, and humoral status.

Aged↗
PubMedDate not supplied

[Transurethral electroresection in chronic prostatitis and its complications].

A discussion on possible application of endoscopic surgery for the treatment of chronic prostatitis and its complications is presented. Surgical treatment was performed in 102 patients with chronic prostatitis and isolated or combined prostatic lesions. Most patients were aged 40 to 69 years. Conservative treatment had been ineffective for an average of 5 years. All patients were divided into 6 clinical groups. The most numerous one included patients with chronic prostatitis, complicated by sclerosis of the vesical cervix. Careful patient selection was based on the use of all available up-to-date diagnostic procedures. Principal indications for transurethral electroresection were infravesical obstruction, complicating the underlying disease; persistent pain and dysuria, uncontrollable by conservative means and exhausting the patient, as a result of prostatic retention or calculous or sclerotic complications. Two principal surgical methods were transurethral and subtotal prostatic resection. Possibilities of ultrasonic scanning in the diagnosis of prostatic retention are pointed out. Complication rates and types and surgical results are reported. The results were good in 55%, satisfactory in 36% and poor in 9%. The effect of surgery on sexual capacity is described.

Adult↗
PubMedDate not supplied

[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↗