Urothelial transitional cell cancer in developed countries is the 4th most common. In terms of frequency, it is outstripped only by prostate, breast, lung, and colorectal cancer. In the vast majority of cases, urothelial carcinoma develops in the bladder. It accounts for 90—95 % of all cases of transitional cell cancer of the urinary tract. Much less often, in 5—10 % have to deal with its localization in the upper urinary tract (in the calico-pelvic system or ureter). In 17 % of upper urinary tract cancers, bladder cancer is simultaneously diagnosed. The incidence of urothelial transitional cell cancer has increased over the past few decades as a result of improved diagnosis and improved survival of patients with this nosology. The use of modern, high-tech equipment for visualization and direct surgical intervention contributes to such results. The use of laser energy as the main tool for tissue dissection in endoscopic oncourology reveals the undeniable advantages of this method in comparison with the traditional electrosurgery.We present a clinical observation of the diagnosis and surgical treatment of urothelial bladder cancer with invasion of the ureter, performed by en-bloc tulium laser. An operation was performed-transurethral resection of a urothelial bladder tumor with invasion of the ureter, performed by en-bloc tulium laser. Intraoperatively, ureteropieloscopy was performed, and the tumor did not spread to the upper urinary tract beyond the intramural part of the ureter. Thanks to the precision of the action of the tulium laser on the tissue, not resection, but, in fact, dissection of the bladder wall, a high-quality macropreparation was obtained, which made it possible to establish a final diagnosis. Histological conclusion: from the bladder — non-invasive urothelial cancer G2-3; from the mouth of the left ureter — fragments of fibrous tissue lined with urothelium from atypia. 3 months after the operation — no recurrence of urothelial cancer was revealed, which indicates a high quality of the operation.This clinical observation demonstrates the superiority of laser en-bloc dissection compared to the treatment of bladder tumors. Obtaining a macro-product of urothelial transitional cell cancer of the highest quality can contribute to avoiding unjustified radical nephrureterectomies and conducting organ-preserving treatment, for absolute and elective indications. The 1.94 µm Tulium Erbium laser is an effective tool for performing minimally invasive transurethral interventions in non-invasive bladder cancer.

Цель исследования-анализ и систематизация данных литературы об эндоваскулярных методах диагностики и лечения тазовой венозной конгестии у мужчин. Результаты. Дано полное описание клинических проявлений, этиопатогенеза, классификации, диагностики и эндоваскулярного лечения синдрома венозной конгестии. Приведены примеры успешной спиральной эмболизации, склеротерапии гонадных вен, комбинированного использования окклюдирующих технологий. Представлен алгоритм диагностики и лечения синдрома Мея-Тернера. Заключение. Возможности эндоваскулярной коррекции гемодинамических нарушений при венозной конгестии весьма широки. Новое высокотехнологичное направление-хирургическая ангиоандрология-требует создания междисциплинарной бригады специалистов с опытом использования методов трехмерной визуализации, чрескатетерной хирургии и применения эмболизирующих материалов, внутрисосудистых стентов. Продолжается накопление опыта в области лечения венозной конгестии с целью разработки наиболее эффективной операции.

Представлено клиническое наблюдение успешного рентгенохирургического лечения при двустороннем варикоцеле путем спиральной окклюзии правой тестикулярной вены.

The study objectiveis to investigate the effectiveness of conservative treatment of Peyronie’s disease using antifibrotic agents.Materials and methods. The study included 32 patients aged 44–65 years with diagnosed Peyronie’s disease. The patients were examined using the International Index of Erectile Function, Visual Analog Scale, tunica albuginea of the penis elasticity testing, ultrasound examination (with intracavernous pharmacological testing and dynamic spiral tomography if necessary). The patients were divided into 2 groups. The patients in the treatment group (n = 16) received magnetic laser therapy at the area of the plaque with the “Mustang-urolog” device, as well as vacuum laser treatment with the “Yarovit” device and bovhyaluronidase azoximer as injections and later suppositories. In the comparison group (n = 16), similar therapy was used without bovhyaluronidase azoximer. Control examination was performed 3 months later. If conservative treatment was ineffective, the patients were forwarded to surgical treatment.Results. As a result of conservative treatment, density of the tunica albuginea and cavernous bodies, structure of the cavernous bodies improved; the International Index of Erectile Function increased, and pain intensity decreased. In the treatment group, a stronger tendency toward improvement was observed compared to the control group. Decrease in the plaque size was observed in 63.3 % of the patients in the treatment group and in 43.7 % of the patients in the control group. At the control examination, plaques weren’t detected in 6 and 3  patients, respectively.Conclusion. Conservative treatment is effective in patients with early stage of Peyronie’s disease with moderate curvature of the penis (<30°) and plaque size <2 cm. We recommend including bovhyaluronidase azoximer in the combination treatment regimen of these patients for increased effectiveness.