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Our study was concerned with prognostic significance of immunophenotypical features of prostate adenocarcinoma such as Ki-67 proliferation, androgen receptors (AR), microvascular density (MVD) in the stroma and tumor glands. Ki-67, AR and MVD expression correlated inversely with PSA level during hormonotherapy (r=0.24-0.39) as well as tumor cell differentiation grade (r=0.23-0.25). High expression of the said markers involved reduced efficiency of hormonotherapy.

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The analysis of long-term results of complex surgical correction of urinary bladder extrophy in 83 patients has shown that 21 (25.3%) patients had concrements in the urethra. Multiple bacteriological tests detected urease-producing flora which was managed with specific antibacterial therapy. Two patients were exposed to extracorporeal shock-wave lithotripsy. Low-invasive lithotripsy was low effective and all the patients were operated. Chemical structure of the removed concrements was determined with x-ray difractometry. Recurrent concrements were found in 7 (33.3%) of 21 patients who had not received specific antibacterial therapy. All the stones detected were struvite. Thus, struvite concrements' risk in patients after surgical correction of urinary bladder extrophy can be reduced under the following conditions: suppression of urease-producing flora activity, catheterization regime compliance, systemic sanation of the artificial urinary bladder.

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Approximately 10.0% of tumors occurs in the lower urinary tract and morbidity and lethality are constantly on the rise. Over 90% of such tumors registered in Europe and the USA is transitional cell carcinoma. Primary bladder cancer morbidity in Russian males rose by 4.0-4.6% in 1990-1997 while the share of patients with superficial bladder cancer (SBC) went up by 1.5% for the same period. According to the National Bladder Cancer Group, the rising incidence of relapsing SBC is associated with urothelial dysplasia, positive test for urinary sediment after therapy and occurrence of four or more tumors larger than 5 cm. Prevention of muscular invasion is vital in management of SBC. Sometimes, such aggressive modalities as early cystectomy or radiotherapy are recommended in cases of high risk for this pathology. Conversely, certain palliative measures, short of transurethral resection of the bladder and adjuvant intravesical therapy, are regarded as sufficient.

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From 1996 to 2002 we examined and treated 224 patients with invasive cancer of the urinary bladder (ICUB). The examination complex included clinical, laboratory, radiation tests, endoscopic and morphological investigations of the surgical material. The patients received four types of treatment: transurethral resection (TUR) of the bladder wall (n = 102) alone; TUR+MVAC chemotherapy (n = 56); open resection of the urinary bladder only (n = 38); open resection+MVAC chemotherapy (n = 28). In diagnosis of papillary lesions sensitivity of cystoscopy (CS) was 66.6%, fluorescent CS (FCS)--95.2%. Sensitivity in diagnosis of squamous tumors was 33.3 and 91.6%, respectively. The best results were achieved in patients with pT2A tumor invasion depth, G1 differentiation of tumor cells after TUR with adjuvant polychemotherapy (PCT) recurrences in these patients arose by 41.2% less frequently than in patients after TUR only, 5-year survival in patients after TUR+PCT was 83.3%. Thus, FCS improves diagnosis of urinary bladder tumors (sensitivity of CS was 70.0% vs that of FCS--95.0%). In cancer of the urinary bladder the organ can be saved only at stage pT2G1. A method of choice is TUR of the bladder wall with adjuvant PCT.

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The paper presents the results of 114 radical cystectomies made in 1996-2002. The age of 114 patients (103 males, 11 females) ranged from 37 to 78 years (mean age 57.5 years). Transient cell carcinoma was diagnosed in 81.5% patients. Supravesical urine derivation was conducted by means of ureterocutaneostomy and transureteroureteronephrostomy in 9 (7.9%) patients, ureterosygmoanastomosis--in 43 (37.7%) patients, artificial orthotopic urinary bladder was created in 7 (6.1%) patients of a gastric segment and in 55 (48.2%) patients of the ileum. Postoperative complications were observed in 28 (24.6%) patients, intestinal obstruction being a prevailing complication. Five patients died: 2 of pulmonary artery thromboembolism, 1 of acute cardiac failure, 1 of sepsis and 1 of gastric bleeding. Continent methods of urine derivation were preferred, such as ureterosygmoanastomosis by Mainz-Pouch II and creation of orthotopic urinary bladder of the stomach or of the ileum.

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A total of 102 radical cystectomies have been conducted for 1996-2001 (94 males, 8 females, age 37-78 years, mean age 57.5 years). Most of the patients (81.4%) were diagnosed to have transitional cell carcinoma. Supravesical urine derivation was made by means of ureterocutaneostomy and transureteroureteronephrostomy in 7(6.9) patients, ureterosigmoanastomosis--in 41(40.2%), Sigma-rectumpouch--in 1(0.9%) patients, ileocystoplasty, largely by Hautmann and Studer was carried out in 52(51%) patients. Postoperative complications developed in 25(24.5%) patients who often had adhesive ileus. Four patients died: 2 of pulmonary artery thromboembolism, 1 of acute cardiac failure and 1 of sepsis. Methods of continence urine derivation were preferred, such as ureterosigmoanastomosis by Mainz-Pouch II and creation of orthotopic bladder of the ileum.

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