Every year, there has been a steady increase in the number of rhinoplasty. At the same time, the patient’s demands for these surgery are also increasing. Therefore, unsatisfactory functional and aesthetic results after rhinoplasty require repeated (revision) operations. The secondary rhinoplasty itself is more complex than the primary operation. Incorrectly performed rhinoplasty and iatrogenic tissue damage lead to deformities that require repeated reconstructive interventions. The reasons for the unsatisfactory results of rhinoplasty can be different. In assessing the results of rhinoplasty, the surgeon’s opinion may not be ambiguous with the patient. Often, when the surgeon considers the rhinoplasty result to be acceptable, the patient may be unhappy. In the postoperative period, deformities of the tissues of the nose may be due to the rough scars, and an infectious process. Еxcessive cartilage resection, insufficient or excessive osteotomy lead to deformities that require repeated reconstructive interventions. For secondary rhinoplasty, it is necessary to take into account all tissue deformations to eliminate them in one stage. Sometimes after the second, third or more operations performed, the result of revision rhinoplasty is difficult to predict, so the surgeon must predict the expected outcome result. Keywords: Secondary rhinoplasty, nasal meatus, nasal septum deviation, septoplasty.

Aim. To evaluate the results of treatment of renal hypertension in varicocele after the formation of the proximal intervenous anastomosis.Material and methods. A survey was conducted among 167 patients with varicocele aged 16 to 39 years. The evaluation of the Varicocele degree was made by the classification of the Amerla Cubin, which is used in the WHO Classification (1997). All patients had clinical signs of varicocele. Ipsilateral testicle hypotrophy was detected in 21 (12.6%) and hydrocele 6 (3.6%) patients. All patients before and after the operation went through the analysis of ejaculate.Results and discussion. The renotesticular hemodynamic type of varicocele was found in 115 (68.9%) of 167 surveyed patients. Varicocele of 1 degree was detected in 17 (14.8%) cases, 2 degrees in 31 (26.9%) and 3 degrees in 67 (58.3%) patients. With doppler ultrasonography of the veins of the spermatic cord, the inner diameter varied from 3 to 6 mm. On average, this value was 4.3±1.1 mm. All these patients received subinguinal varicocelectomy by Marmar. Therefore, the vein drainage operations to reduce renal hypertension was carried out for 65 (56.5%) patients.Conclusion. The formation of intervenous anastomoses is a pathogenetically justified method of treating regional venous renal hypertension in varicocele.

In recent years, cases of detection of varicocele in adolescent age have increased and the using methods of treatment for this population remain controversial. The literature analysis revealed a variety of approaches to the therapy of the pathology: there are supporters of both surgical treatment and conservative therapy and dynamic surveillance. It is known that about 20-40% of adolescents with varicocele are potentially infertile, and they need early surgery for indications such as testicle hypotrophy, pathospermia. However, the existing methods of treatment of varicocele are accompanied by the recurrence, with hydrocele development, and progressive testicle injuries. Furthermore, the results of applicable methods of treatment are limited, characterized by low evidence, lack of randomized controlled researches.

Optimization of urethroplasty results in extended urethral stricture by using vascularized flaps.

Aim. To study results of unsuccessful primary rhinoplasty that require repeated interventions.Material and methods. The work summarizes the analysis of the causes of unsuccessful rhinoplasty in 106 patients who had previously suffered a primary septorhinoplasty in various health facilities in Tajikistan in the period from 1 to 7 years. The main reason for the visit was dissatisfaction with the previous rhinoplasty.Results and discussion. After primary rhinoplasty, patients most often had the following deformities: deformity of the tip of the nose (72 patients); deformity of the “parrot beak” type (14 patients); deformation similar to the inverted “V” (12 patients); deformation of the contours of the nasal dorsum (13 patients); defects of the nasal septum in the lower caudal region (21 patients). All patients underwent secondary rhinoplasty.Conclusion. Unsuccessfully executed as a primary rhinoplasty leads to respiratory dysfunction and aesthetic defects that require more complex secondary surgical operations.