RESUMEN
AIM: To study the prevalence of functional phimosis determined during erection in patients over 18 years of age, as well as the features of its diagnosis and treatment in outpatient practice. MATERIALS AND METHODS: A retrospective study that included 201 patients who underwent circumcision at a mean age of 42.7 years, was carried out. Complaints, history, initial examination and autophotography of the penis during erection were evaluated. The subjects were divided into 2 groups. The group I (n=38) included patients complaining of the inability to reveal the glans penis during erection, while in group II (n=163) men with similar complaints in a f laccid state of the penis were included. All patients underwent circumcision under local anesthesia. RESULTS: The proportion of functional phimosis was 18.9%. The mean age in groups I and II was significantly different (29.47+/-8.82 and 45.6+/-19.4 years, respectively, p<0.01). In 14 (36.8%) patients of group I, a short frenulum was also diagnosed. Primary phimosis was detected in 26.3% and 14.1% of patients in groups I and II (p<0.05), respectively. The acquired phimosis was diagnosed in 73.7% and 85.9% (p<0.05) of cases, respectively. There were no concomitant diseases in patients with "functional" phimosis, while in men with "pathological" phimosis, 22.7% of patients had various comorbidities, such as diabetes mellitus, coronary heart disease, hypertension, etc. CONCLUSIONS: Among patients who visit a urologist with a diagnosis of phimosis, almost every fifth man has functional form (18.9%). For the diagnosis of the phimosis, the history taking and autophotography of the penis during erection have an important role. In this category of patients, surgical treatment can be performed on an outpatient basis.
Asunto(s)
Circuncisión Masculina , Fimosis , Masculino , Humanos , Adolescente , Adulto , Adulto Joven , Prepucio/cirugía , Estudios Retrospectivos , Prevalencia , Pacientes Ambulatorios , Fimosis/diagnóstico , Fimosis/epidemiología , Fimosis/cirugía , Circuncisión Masculina/efectos adversos , Pene/cirugíaRESUMEN
The aim of this study is to improve the results of detection and treatment of patients with prostate cancer (PCa) in the Moscow. For this purpose, we performed our own clinical diagnostic, epidemiological, autopsy, experimental and comparative studies that emphasize the relevance of the stated subject in the study of the diagnosis and treatment of patients with PCa. Urology Department of A. I. Evdokimov Moscow State University of Medicine and Dentistry was at the forefront of the Men's Health program in Moscow and in early 2003 it was the first to have an office for early diagnosis of prostate diseases, as part of the Program. Over 20,000 patients were screened for PCa. For the first time in Russia, methods for the early detection of PCa were investigated on a cohort of Russian men using PCA3 and the Prostate Health Index. The role and significance of prostate saturation biopsy was examined. The investigation of aspects of the morphological assessment of prostate diseases formed the basis for the development of an electronic atlas of PCa images. A series of studies on various prostate visualization methods, including Histoscanning system and MRI, have been performed. A new minimally invasive method for the treatment of prostate cancer has been introduced - a robot-assisted radical prostatectomy and cryoablation. The concept of surgical treatment of localized forms of PCa has been developed and the factors predicting the success of treatment have been determined. This study is reflected in numerous publications both in Russia and abroad, in monographs and dissertations.
Asunto(s)
Detección Precoz del Cáncer , Neoplasias de la Próstata , Biopsia , Humanos , Masculino , Moscú , Neoplasias de la Próstata/diagnóstico por imagen , Federación de RusiaRESUMEN
Increasing prostate cancer incidence rates highlight the importance of more timely diagnosis with the ultimate aim of reducing cancer-specific mortality, while maintaining patients quality of life. Until recently, digital rectal examination and prostate-specific antigen have been used for diagnosis of prostate cancer. Recent advances in medical technologies and laboratory testing have led to introducing new cancer markers into clinical practice. The most highly demanded of them are the PCA-3, -2proPSA and Prostate Health Index. Despite the wide range of laboratory tests, a prostate biopsy with a subsequent morphological examination of biopsy tissue specimens remains the only way to definitively diagnose prostate cancer.
Asunto(s)
Antígenos de Neoplasias/orina , Biomarcadores de Tumor/análisis , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/patología , Antígenos de Neoplasias/genética , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/orina , Biopsia , Marcadores Genéticos , Humanos , Masculino , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/orinaRESUMEN
The study was aimed to the evaluation of the therapeutic effect of the drug Silodosin at a dose of 8 mg once a day in patients with symptomatic benign prostatic hyperplasia (BPH). This study included 1,000 patients. The average age of the patients was 64.99 ± 8.07 years (median 64.5 years), mean duration of BPH--3.64 ± 5.058 years (median 1.1 years). Such a large scatter is due to the enormous heterogeneity of the data; in such cases, it is advisable to focus on the median value. 12 (1.2%) patients discontinued study early, 4 of them due to adverse drug reactions, 1 patient withdrew informed consent, 7 patients were lost to follow up. Among comorbidities, cardiovascular diseases and cerebrovascular disease had the highest frequency--both in 39 (3.9%) patients. The frequency of other preexisting disease did not reach 3%. According to the history of cases, urinary retention occurred in 115 (11.5%) patients, urinary tract infections--in 131 (13.1%), prostatitis--in 171 (17.1%), abnormal ejaculation--55 (5.5%), erectile dysfunction--in 103 (10.3%). The primary efficacy variable was the change of total IPSS score. At visit 1, the average total score was 19.29 ± 5.93, at visit 2 (4 weeks)--13.30 ± 5.31 (P < 0.001), at visit 3 (8 weeks)--9.80 ± 4.95 (P < 0.001), at last available to the observation visit--9.84 ± 4.90, and the change was statistically significant compared with baseline score (P < 0.001). The study revealed the positive dynamics of lower urinary tract symptoms, as well as positive changes in the assessment of quality of life. Thus, at the time of the last available observation, the QoL score was 1.93 ± 1.03 points against 4.25 points at visit 1 and was statistically significant (P < 0.001). During the study, 12 (1.2%) patients had 13 adverse events, and doctors associated 11 of them with taking the drug (silodosin); information on relation with any drug was absent in 2 of 13 cases.
Asunto(s)
Indoles/administración & dosificación , Hiperplasia Prostática/tratamiento farmacológico , Hiperplasia Prostática/fisiopatología , Urodinámica/efectos de los fármacos , Agentes Urológicos/administración & dosificación , Anciano , Anciano de 80 o más Años , Humanos , Indoles/efectos adversos , Masculino , Persona de Mediana Edad , Federación de Rusia , Agentes Urológicos/efectos adversosRESUMEN
The effectiveness of perineal biopsy for the detection of prostate cancer (PC) using an array for brachytherapy/cryotherapy was evaluated. It is shown that perineal saturation biopsy provides high detection rate of prostate cancer in patients with suspected cancer after negative transrectal biopsies, does not increase the detection of clinically insignificant cancer and incidence of complications, but requires a lot of time and cost.