The proposed Plasticine 3D model seems to provide better preoperative renal collecting system appreciation and to serve as a reference tool during the operation, which in turn might increase SFRs and lower the complications rate after PCNL.
We report a rare case of vesico-acetabular fistula due to an improperly treated pelvic fracture with urinary stone formation in the joint cavity. This complication was related to an unrecognized mechanism of bladder wall entrapment in the acetabular floor defect during weight bearing. This situation led to several mistreatment decisions in our case and should be always considered by urologists dealing with patients after major pelvic trauma. In this case report, we analyze the publications related to this problem, discuss the main mechanisms of bladder wall damage after acetabular fracture, and propose tips for diagnosis and treatment.
To develop a tool, both simple and reliable, for postoperative percutaneous nephrolithotomy (PCNL) stone-free failure prediction. Materials and methods: We analysed a sample of 116 patients, who underwent conventional PCNL from 2011 to 2014. Cases with residual stones ⩽ 4 mm in size were regarded as clinically insignificant and 'stone-free'. Results: According to the low-dose computed tomography (CT) scan performed within 24 hours after operation, the patients were stratified as follows: 72 stone-free and 44 with residual stones. Among the analysed variables, three were derived as most important for prediction purposes: an additional stone in a calyx with an acute angle (⩽ 45°), represented by 'A'; an additional stone in a long calyx (⩾ 10 mm) with a narrow infundibulum (⩽ 8mm), represented by 'C'; and a stone size that is > 24 mm, represented by 'S'. These were abbreviated as the 'ACS' score. Depending on the absence or presence of each of these three variables, a score of 0 or 1 was assigned. If the ACS score is 0, then the probability of being a stone-free patient was about 88%; however, when the ACS score is 3, then the probability of being stone free was just 8%. Conclusion: Use of the ACS score seemed to be a simple and reliable tool for PCNL stone-free failure prediction.
The proposed method for ureteral stent removal in women under ultrasound guidance was shown to be faster and to have lower visual analog pain scale scores, in comparison with removal by a cystoscope, which makes it an attractive option for outpatient urologic praxis in uncomplicated cases, and because it is free of the risk of ionizing radiation and more comfortable, it can be used in pregnant patients.
Goal: to develop mobile application for patients with kidney stone for compliance maintenance and possible reduction of recurrence rate. Material and methods. Existing mobile applications for urolithiasis were meticulously reviewed by three groups of doctors each from different urological facilities from Saint Petersburg, Russia. Information used in our mobile application was from main urolithiasis guidelines of different urological associations. Direct application development was done by professional programmers. After application release urologist from all over the Russia were questioned about the usefulness of this product. Results. As a result of combined work application “Urolithiasis: patient assistant” was produced. Among 102 respondents 96 % evaluated this application as very useful, 3 % as useful and only 1 % considered it as a weak tool. Conclusion. Application “Urolithiasis: patient assistant” being first and single in Russian language consists of tools for compliance maintenance and plenty of other useful information regarding recurrence risk reduction and thus may be used in patients with kidney stones.
The aim of this work was to clarify and extend the existing clinical guidelines on organ-sparing treatment of muscleinvasive bladder cancer. The standard protocol of radical conservative treatment for muscle-invasive bladder cancer includes transurethral resection of the bladder, external beam radiotherapy with simultaneous chemotherapy (radiosensitization), which is usually referred to as trimodal therapy. The implementation of trimodal therapy into routine practice in Russia is limited due to the lack of distinct criteria for each of the stages. The involvement of surgeons, radiation oncologists, and chemotherapists, on the one hand, provides the required multidisciplinary approach to cancer treatment; on the other hand, it might impede the entire algorithm. To address this problem, specialists from the Department of Radiology (project moderators), Department of Cancer Urology, and Department of Chemotherapy of N.N. Petrov National Medical Research Center of Oncology under the auspices of Saint Petersburg Oncological Research Society formed a group of experts, including radiation oncologists, urologists, and chemotherapists from federal and local cancer (educational) institutions of Saint Petersburg who had an experience of treating muscle-invasive bladder cancer. The guideline was developed with the consideration of available guidelines published by leading professional associations of radiotherapy and oncology (urological), research articles, and own experience.
Цель исследования-разработать быстрый, удобный и в то же время безопасный метод удаления мочеточниковых стентов у женщин после дробления камней. Материалы и методы. С февраля 2014 г. по март 2016 г. проведено ретроспективное мультицентровое исследование, включающее 122 пациентки после дробления камней: 46-в контрольной группе (стент был удален стандартным способом-цистоскопом 22 Сн) и 76-в экспериментальной группе (стент был удален с помощью «спиралевидного устройства» 15 Сн под ультразвуковым контролем). Критериями исключения явились: пролапс тазовых органов ≥ II по шкале POPQ и осложненные стенты (со смещением или инкрустацией). Оценивали длительность удаления стентов, сумму баллов по визуальной аналоговой шкале боли, а также вероятность развития осложнений. Результаты. У всех исследуемых пациентов стенты были успешно удалены. Осложнений в обеих группах не зарегистрировано. Продолжительность удаления стента в экспериментальной группе была выше, чем в контрольной, примерно на 4 с (p = 0,0056). Различие было статистически значимым, однако клинически не важным. Наиболее существенным оказалось различие в оценке по визуальной аналоговой шкале в пользу экспериментальной группы (p = 4 × 10-5). Заключение. Предложенный метод удаления стентов петлей под ультразвуковым контролем у женщин после дробления камней оказался более комфортным-с меньшим числом баллов по визуальной аналоговой шкале по сравнению склассическим удалением с помощью цистоскопа, не требующим дополнительных затрат, связанных с использованием эндоскопического оборудования, стерилизацией последнего, а также рабочего времени сестры, что делает его привлекательной опцией в амбулаторной практике в неосложненных случаях, а будучи лишенным ионизирующего излучения, может быть рекомендован для удаления стентов у беременных пациенток.
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