Introduction. The literature highlights isolated studies examining approaches to the treatment of patients with a combination of stones and urethral stricture. In this regard, the problem of creating optimal tactics for managing such patients remains relevant.Purpose of the study. To analyze of own experience in treating patients with a combination of stricture and urethral stone using balloon dilation with urethral stone extraction.Materials and methods. The study included 7 men with short urethral stricture and stone, who underwent balloon dilation with urethral stone extraction. The age of patients ranged from 47 to 65 years (median - 52 years). The length of the urethral stricture ranged from 3 to 10 mm (median - 7 mm). The stricture in 2 (28.6%) cases was localized in the penile part of the urethra and 5 (71.4%) in the bulbous part. An etiology of urethral strictures: traumatic - in 2 (42.9%) patients, inflammatory - in 1 (14.3%) of cases, idiopathic - in 4 (57.1%) of cases. All patients had 1 urethral stone. The sizes of the stone ranged from 4 to 9 mm (median - 6 mm).Results. The operation time ranged from 11 to 19 min (median - 13 min). No patient had any intraoperative complications. UTIs was observed in the early postoperative period in 1 patient. The duration of postoperative hospital stay ranged from 1 to 5 days (median - 3 days). Postoperative follow-up ranged from 3 to 24 months (median - 14 months). Only 1 (14.3%) patient had a recurrence of urethral stricture 18 months after treatment. Thus, the overall treatment success in this group of patients was 85.7% (6/7).Conclusion. We used this conjunction approach when combined stricture and urethral stone in men for the first time in the world. It seems quite promising given the results.
Republic of Dagestan is a region with medium and severe iodine deficiency, which is associated with the development of endemic goiter and subclinical hypothyroidism. Children with goiter with or without it with SG had the worst indicators of physical, psychological and sexual development, tended to chronic somatic pathology. Objective. To examine the connection between the elevated TSH level with indicators of physical and sexual health of boys. Material and method. There were examined 297 adolescents aged 11-13 years (76 persons) in the beginning of puberty and 14-17 years (221 people) in Резюме Республика Дагестан относится к регионам со средним и тяжелым йододефицитом, что связано с развитием эндемический зоба и субклиническим гипотиреозом. Дети с зобом или без него с СГ, имели худшие показатели физического, психологического и полового развития, отмечалась тенденция к хронизации соматической патологии. Цель исследования: изучить связь повышенного уровня ТТГ с показателями физического и полового здоровья мальчиков. Материалы и методы. Всего было обследовано 297 подростков в возрасте 11-13 лет (76 чел) начало пубертата и 14-17-лет (221 чел) середина и завершение пубертата. Проводились антропометрические исследования роста, веса, рассчитывался индекс массы тела ИМТ, оценивалась степень полового развития: Р-лобковое оволосение, G-степень полового развития, объем яичек по Prader и размеры полового члена, индекс маскулинизации, уровень тиреотронного гормона (ТТГ) Результаты показали, что физическое развитие мальчиков уже на ранних этапах нарушения функции щитовидной железы, имеет тенденцию к отставанию. Это в большей степени проявляется к середине и к завершения пубертата (юноши и подростки 14-17 лет, вторичные половые признаки у мальчиков 11-13 лет выраженнее у лиц с уровнем ТТГ 0,5-2,6 мЕд/л по сравнению со сверстниками с уровнем ТТГ от 4,2-10,0 мЕд/л. В подгруппе 14-17 летних юношей и подростков отмечается тенденция к феномену «макроорхидизма», начинающийся на этапе субклинического гипотиреоза.
Purpose. Conducting a comparative analysis and assessment of the dynamics of endemic goiter and iodine deficiency in the population of boys of the Republic of Dagestan at the age of 11–13 years for the period 2002–2013, living in different ecological and geographical zones.Patients and methods. 3457 adolescent boys 11–13 years old, living in different ecological and geographical zones, were surveyed. Methods of investigation were: determination of daily excretion of iodine in urine, palpation and ultrasound examination of the thyroid gland.Results. It was revealed that during the period of preventive measures there was an improvement in iodine supply regardless of the area of residence. However, against the background of preventive measures in the lowland zone, iodine deficiency decreased not evenly, and in some cases the aggravation occured.Conclusion. The incidence of endemic goiter and the severity of iodine deficiency in boys aged 11–13 years in the mountain and foothill ecology and geographical zones of the Republic of Dagestan are generally comparable to those of iodine deficiency and endemic goiter in the general population of the Republic of Dagestan. On a flat ecogeographical zone, endemic goiter in boys 11-13 years is less common than in the general population in this region. Preventive measures to combat iodine deficiency have led to a decrease in the frequency of endemic goiter, but constant monitoring is required. As a result, there was no correlation between the incidence of endemic goiter and the severity of iodine deficiency.
The study objectiveis to compare the characteristics of physical and sexual development of boys aged 11–13 years living in different ecological and geographical areas of the Republic of Dagestan and to determine the effect of chronic iodine deficiency on the onset of puberty.Materials and methods. In a lowland area containing 11 districts, 501 subjects were examined; in a mountain area containing 17 districts, 325 subjects were examined; in a submontane area containing 7 districts, 274 subjects were examined. In total, 1100 boys aged 11–13 years were randomly selected.Results.Physical development of the boys was mostly characterized as normal but with a clear tendency toward lower values, especially in the submontane districts. In boys living in the areas with severe iodine deficiency, delayed onset of puberty was observed 3.2 times more frequently than in their counterparts living in the districts with mild iodine deficiency. Total fraction of boys with signs of delayed sexual development was 38.5 %, and they mostly lived in the submontane area.Conclusion.Emerging in Russia tendency toward lowered characteristics of physical development of boys is observed in the Republic of Dagestan. This confirms the negative effect of chronic iodine deficiency on sexual development of boys which manifests through delayed sexual maturity.
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