Extra-peritoneal Laparoscopic Resection of Benign Prostate Adenoma >150 CC with preservation of posterior wall of prostatic urethra: Dundee Technique and early outcomes

Background There are limited options for men with large benign prostates (>150cc) and bladder outflow obstruction due to benign prostatic hyperplasia (BPH). Management options include surgery (open or minimal access) and endoscopic procedures. There is a paucity of literature on outcomes for prostates >150cc. Methods In this case series we describe a step-by-step, illustrated, modified extra-peritoneal technique of laparoscopic prostatectomy with preservation of the posterior prostatic urethra. This involves creation of extra-peritoneal space, transverse incision of prostate capsule, progressive adenoma dissection, resection, and closure of the capsule. Results Ten patients underwent this procedure between 2015 and 2019. The mean age was 72.4 years and mean prostate size was 215.5cc. Mean procedure duration was 200 min and there were no intraoperative complications. Most patients were discharged on postoperative day 1. Mean intraoperative blood loss was 120 ml with no patient requiring blood transfusion. At follow up (mean 37 months) no patients had residual symptoms of BPH. Conclusion We describe a novel extraperitoneal laparoscopic technique for benign prostates of >150cc with very good outcomes. The transferability of this technique to centres with laparoscopic expertise at minimal extra cost and future adaptability in the robotic setting are some of the advantages of this technique.

On the importance of intravenous urography in prostate adenoma

A number of works by domestic and foreign authors (L. S. Erukhimov, N. V. Dunashev, A. A. Midoyan, V. M. Bliznyuk, A. A. Avdeev, Ekman, E. . Sponge, etc.).

Atonic iris syndrome in cataract surgery in patients with prostate adenoma

Первая отечественная монография, посвященная влиянию различной длительности приема альфа1-адреноблокаторов на диафрагмальную функцию радужной оболочки у пациентов с возрастной катарактой и аденомой простаты. Представлены прогностические критерии развития синдрома атоничной радужки в ходе факоэмульсификации катаракты, которые обеспечивают выявление пациентов с клинически значимым флоппи-ирис синдромом, способствуя надлежащей его профилактике. Предложен алгоритм хирургии катаракты у данной категории пациентов. Руководство предназначено врачам-офтальмологам и урологам.

Historical and modern methods of treatment of patients with bladder stones with benign prostatic hyperplasia

In this review of literature the authors provide information on the history of the development of treatment of patients with cystolithiasis with benign prostatic hyperplasia (prostate adenoma), as well as basic information regarding the most common and effective methods of treating this nosology. Cystolithiasis is one of the forms of manifestation of urolithiasis, characterized by the presence of stones in the bladder. Almost 70 % of this pathology occurs in patients with benign prostatic hyperplasia. Medical, economic and social significance is that the majority of patients from this group are of active, working age. Historical data show that this pathology has always been a serious problem requiring surgical intervention and often leading to the patient's disability. In turn, this pathology gave a serious impetus to the development of surgery and urology in particular. Only in the twentieth century it was possible to achieve a significant result in the treatment of this disease due to the improvement in the quality of nutrition, the beginning of the use of antibacterial therapy and the development of endourology.

PHYTOCHEMICAL COMPOSITION AND MEDICINAL USE OF COMMON TOOTHWORT (LATHRAEA SQUAMARIA L.)

This paper presents the results of an analysis of the scientific literature on the pharmacognostic study of common toothwort (Lathraea squamaria L.). L. squamaria lacks chlorophyll, reaches a height of 30 cm. Most of the time it develops underground in the form of a branching rhizome (often in the form of a cross), covered with ovoid fleshy scales. A flowering stem with a dense spike-shaped drooping inflorescence with red (with a raspberry tinge) flowers grows briefly in the spring and dies off after flowering. The fruit is a unilocular capsule. Currently in traditional medicine, there is considerable experience in the use of herbs and roots of the сommon toothwort. In traditional medicine, L. squamaria is used for: ascites, dropsy, edema, liver cirrhosis, hepatitis, diseases of the bile ducts and gallbladder, kidney diseases, cysts, uterine myoma and other female gynecological diseases, infertility, prostatitis, prostate adenoma, female oncology and liver organs, osteomyelitis, obesity. The chemical composition of L. squamaria has not been established yet taking into account the modern level of science and technology. Phenylethanoid glycosides, iridium glycoside aucubin and aucuboside ester, 6'-O-glucopyranosyl-aucubin, 6'-O-glucopyranosyl melampyroside, melampyroside, D-mannitol, β-sitosterol and other biologically active compounds were isolated. The desirability of studying with the aim of introducing into the conventional medicine was pointed out. Further study of L. squamaria raw materials aimed to introduce into official medicine is a very promising research field.

3D Mueller matrix mapping of layered distributions of depolarisation degree for analysis of prostate adenoma and carcinoma diffuse tissues

Prostate cancer is the second most common cancer globally in men, and in some countries is now the most diagnosed form of cancer. It is necessary to differentiate between benign and malignant prostate conditions to give accurate diagnoses. We aim to demonstrate the use of a 3D Mueller matrix method to allow quick and easy clinical differentiation between prostate adenoma and carcinoma tissues with different grades and Gleason scores. Histological sections of benign and malignant prostate tumours, obtained by radical prostatectomy, were investigated. We map the degree of depolarisation in the different prostate tumour tissues using a Mueller matrix polarimeter set-up, based on the superposition of a reference laser beam with the interference pattern of the sample in the image plane. The depolarisation distributions can be directly related to the morphology of the biological tissues. The dependences of the magnitude of the 1st to 4th order statistical moments of the depolarisation distribution are determined, which characterise the distributions of the depolarisation values. To determine the diagnostic potential of the method three groups of histological sections of prostate tumour biopsies were formed. The first group contained 36 adenoma tissue samples, while the second contained 36 carcinoma tissue samples of a high grade (grade 4: poorly differentiated—4 + 4 Gleason score), and the third group contained 36 carcinoma tissue samples of a low grade (grade 1: moderately differentiated—3 + 3 Gleason score). Using the calculated values of the statistical moments, tumour tissues are categorised as either adenoma or carcinoma. A high level (> 90%) accuracy of differentiation between adenoma and carcinoma samples was achieved for each group. Differentiation between the high-grade and low-grade carcinoma samples was achieved with an accuracy of 87.5%. The results demonstrate that Mueller matrix mapping of the depolarisation distribution of prostate tumour tissues can accurately differentiate between adenoma and carcinoma, and between different grades of carcinoma. This represents a first step towards the implementation of 3D Mueller matrix mapping for clinical analysis and diagnosis of prostate tumours.

Factor of combined pathology in geriatric patients with prostate adenoma

Samara Regional Clinical Hospital of War Veterans in the period from 2000 to 2015 examined and treated 639 elderly and senile patients with prostate adenoma, who underwent an isolated adenomectomy, transurethral prostate resection, or simultaneous surgery. Among them, 191 (29.9%) patients underwent simultanous surgery. The paper presents the nature and frequency of dominant concomitant diseases in geriatric patients with prostate adenoma in the first (2000-2006) and second (2007-2015) periods of the study. Application in the second period of the author's therapeutic and diagnostic developments, taking into account concomitant pathology, significantly affected the reduction of a number of severe intra- and postoperative complications and lethality in comparison with the first period.

Non-invasive diagnosis of infravesical obstruction in a patient with prostate adenoma

The development of urinary disorders with the formation of infravesical obstruction in a patient with prostate adenoma for 10 years is described on the basis of clinical case with the use of uroflowmonitoring. It is shown that forty-eight-hour uroflowmonitoring allows obtaining enough data to determine urinary structure and hence the functional state of the lower urinary tract.