Varicose veins of the pelvis men

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The article describes a clinical case of treatment of complications of the May–Thurner syndrome. Asymmetry of blood flow in the iliac veins and signs of their narrowing were observed. Phlebography showed special characteristics of pelvic vessels, trajectory of the surgery was planned. Stenting of the left iliac vein is considered the optimal treatment for such patients if the pressure in it is above 5 mmHg compared to the inferior vena cava. Specialized venous self-expanding stents are an efficient choice for stenting. Access can be performed through the popliteal vein on the unilateral side and / or the femoral or humeral artery, jugular or subclavian access can be used depending on the patient’s anatomy and the size of the delivery device. The female patient underwent coil embolization of varicocele of the lower pelvic veins. At repeat examination after 3 months, pelvic pain was minimal, no pain during sex, no varicocele in the groin and lower extremities. Contrastenhanced spiral computed tomography with 3D reconstruction of the pelvic veins didn’t show any signs of pelvic congestion syndrome.

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Complications of X-ray endovascular treatment of the May–Thurner syndrome

Жуков¹,

Алекян

Васильев

2019

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Left renal vein stenting: indications, disputable points, immediate and long-term results

Васильев

Жуков²,

Синицын

et al. 2021

The article presents the results of stenting of the left renal vein in 35 patients with proven hemodynamically significant compression of the vein in “aorto-mesenteric tweezers”. Clinical manifestations of lesions of the left renal vein are very diverse, and pathogenetic mechanisms remain not fully understood. Therefore, the determination of indications for stenting and perfect technical performance are predictors of success in the near and long-term periods of postoperative follow-up. Our experience in stenting the left renal vein demonstrates the possibility of achieving intraoperative technical success in 100 % of cases, as well as a significant improvement in the quality of life in most patients after endovascular intervention, due to a significant reduction in the clinical manifestations of the pathological phenomenon.

Peptide bioregulator amprost® in the correction of pathospermia in various types of secretory infertility

Жуков¹,

Брагина

Евдокимов

et al. 2021

The aim of the study was to evaluate the clinical and laboratory effectiveness of the peptide bioregulator Samprost® in the correction of pathospermia in men with secretory type of infertility caused by chronic nonbacterial prostatitis (CNP) and varicocele in the postoperative period.Materials and methods. The multicenter study included 30 patients between 23 and 51 years of age: 15 patients with CNP (1st group) and 15 men with infertility due to varicocele in the postoperative period (2nd group). Patients of all groups received Samprost® for 20 days in the form of intramuscular injections of 5 mg daily. The study design provided for a traditional clinical, laboratory and specialized examination with the study of the level of antisperm antibodies, the study of sperm DNA fragmentation by the TUNEL method, the assessment of oxidative stress, a cryotolerance test, and an electron microscopic examination of the ejaculate. Statistical processing of the material was carried out using the paired Student's t test for dependent samples, and the Wilcoxon nonparametric T test was also used. The calculations were performed using the SigmaPlot 12.5 program.Results. The average age of the study participants was 36.91 ± 4.5 years (23-51 years). Among the concomitant and past diseases, the most common were patients with recurrent varicocele, May-Turner syndrome, varicose veins of the pelvis. When evaluating the effectiveness, the results of the study showed a more significant effect of the drug Samprost® in the group of patients with CNP. This concerned an increase in ejaculate volume by 11.5 %, an increase in sperm concentration by 19.4 %. Progressive sperm motility increased more in the group of patients with varicocele by 12.2 %, compared with the CNP group - 11.4 %. Similar data were obtained during cryotest.After 20-day use of the Samprost® a significant decrease in the level of free radicals in the ejaculate was noted: by 2.5 times in the group with CNP and by 2.3 in the group of patients with varicocele. Analysis of these indicators may indicate an antioxidant effect on the effect on the sperm cell, which is under serious stress in the fight against free radicals. This assumption is also confirmed by the EMIS data, which showed a positive dynamics in the number of intact heads of normal form with a normal structure of chromatin and acrosome, the number of spermatozoa with insufficiently condensed immature chromatin.Conclusion. Samprost® is an effective and safe drug for patients with secretory type of male infertility. Based on the methods of statistical analysis, including statistically significant differences in the study groups, Samprost® is more effective in patients with secretory type of male infertility in the case of CNP than in patients with varicocele in the postoperative period. More significant changes relate to the volume, concentration of sperm viability and a decrease in the level of free radicalsThe 20-day course of Samprost® increases progressive sperm motility during cryotest in patients with varicocele and CNP and can be used for substantiated preparation of patients for gamete cryopreservation and its use in preparatory assisted reproductive technologies programs using intra cytoplasmic sperm injection. A decrease in DNA fragmentation and the received electron microscopic examination of the sperm data indicate a possible influence of Samprost® on sperm morphology and require further research in this area.