Benign prostatic hyperplasia (BPH) is one of the most common diseases of the genitourinary system. The prevalence of BPH increases in men with advancing age. While transurethral resection of the prostate gland entails complications such as retrograde ejaculation, urinary incontinence, hematuria, urethral strictures, bladder neck sclerosis, and other adverse events, it is necessary to apply minimally invasive surgical methods such as superselective embolization of the prostatic arteries (PAE), particularly Proximal Embolization First Then Distal Embolization (PErFecTED). The data from 1,015 BPH patients who underwent endovascular surgery demonstrate the benefits of PErFecTED treatment during 24 months after surgery. Both Quality of Life score and International Prostate Symptom Score were around three times better in the PErFecTED group and remained stable during the entire observation period. However, the technique needs to be improved due to the high risk of postembolization syndrome.
The peculiarities of the prostate remodeling caused by long-term whole-body vibration were investigated. Vibrational prostatopathy was characterized by more incident and pronounced decrease in prostate size, blurred contours, and appearance of sites with changed density (fibrosis, calcification, cysts) in central and peripheral zones of the gland. Vibrogenic prostate remodeling is determined by marked reduction of microvessel and prostatic glands, particularly in the central (periurethral) part, smooth muscle cell hyperplasia and hypertrophy, and marked fibrosis of the stroma in the absence of inflammatory cellular infiltration. Morphological data describing reduction of microvessels in the prostate caused by whole-body vibration correlate with Doppler scanning data indicating reduced perfusion of the organ.
Aim. To evaluate the efficacy and safety of implantation of a free synthetic loop (Tension-free Vaginal Tape - TVT) in the treatment of stress urinary incontinence in women. Methods. Examined and operated were 80 patients suffering from stress urinary incontinence. Suburethral implantation of a free loop (sling) in 3 patients was performed using standard TVT kit, while in 77 - using the IVS kit (Intravagynal Sling), which has some design differences from the TVT kit. Results. The observation period ranged from 3 months to 5 years. According to a questionnaire survey designed by the authors, which includes 21 questions, the following results were obtained: good - in 72 (90%) patients, satisfactory - in 6 (7.5%), unsatisfactory - in 2 (2.5%) patients. According to uroflowmetry, after the conducted treatment the duration and volume of urination increased, the maximal urine flow rate decreased to the normal values. Conclusion. The operation of implantation of a free synthetic loop serves as a rational and effective treatment method for the correction of stress urinary incontinence in women without prolapse of the vaginal walls; the success of intervention largely depends on the proper selection of patients and on the surgical technique.
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