ONCOUROLOGY

Vena cava invasion carries a high risk for development of life-threatening complications during renal cancer surgery, mainly that of bleeding (24.0%). We analyze the evidence related to the causes and sources of the intraoperative blood loss and technical approaches for the minimization of the bleeding. During the nephrectomy stage it is recommended to avoid the traumatization of the dilated collateral veins and to ligate the renal vein early in the course of the intervention.

A study of the efficacy of new pharmaceutical composition based on the diindolylmethane (DIM) (Infemin) in patients with diagnosis of prostatic intraepithelial neoplasia (PIN). Sixty-eight patients were randomized to two groups. The first group (n=34) received Infemin for 12 months in a dosage 900 mg/day, the second group received placebo. Efficacy was estimated using the clinical, instrumental and morphologic methods. Twelve months on the therapy led to statistically significant increase in the ratio stroma/ parenchyma from 48.75 to 64.38 (p=0.015) in the Infemin group.

Osteoporosis could be present in the different conditions: oncologic, endocrinologic and rheumatologic diseases, diseases of the gastrointestinal system, kidneys, lungs and also as the complication of the intake of somemedications (corticosteroids, gonadotropin-releasing-hormone analogues (GnRH-A), etc.). According to the literature data, osteoporosis develops in 40-50% of patients with prostate cancer after 2 years on GnRG-A.

Postradiation fistulas are the severe complication of the treatment of oncological disease with the rate 1-10% after radiation therapy. Evidence related to the treatment of postradiation fistulas, being complicated problem, is sparse. Efficacy of the surgical interventions is relatively low, although the operation technique and suture materials are evolving. The recurrence rates could be in the range from 15 up to 70%; this leads to repeated surgeries.

More than 13 thousand cases of bladder cancer are registered in Russia annually that represents an actual problem in modern urologic oncology. Searching and characterization of new molecular markers of non-muscle invasive bladder cancer (NMIBC – 80% of bladder cancer cases), identified in tumor cells from urine sediment are needed. We have provided complex analysis of mutations in the key oncogenes of NMIBC using PCR and subsequent sequencing of exons 7 and 10 of the gene FGFR3, exons 9 and 20 of the gene PIK3CA.

This case report describes the first experience of laparoscopic transmesenterial resection of the lower segment of horseshoe kidney due to renal cell carcinoma. All stages were performed using the “window” in the mesenterium of the colon. The size of the “window” provided optimal ergonomics at all stages of the intervention. We consider that during isthmus dissection transmesenterial access provides more freedom compared to conventional techniques.

Prostate cancer (PCa) is one of the actual social and medical problems, taking the leading positions in the structure of male diseases. Currently prostate-specific antigen (PSA) evaluation is due to its availability and objectivity the main non-invasive screening and diagnostics modality, being used also post-operatively to control for the treatment efficacy. Specificity and sensitivity of the PSA are not high, this warrants the search for new markers and development of new diagnostic concepts.

Urinary incontinence is actual due to medical and social reasons, leading to the deterioration of the patients’ quality of life and complicating a free being in the society. Incontinence is the involuntary urine leakage through the meatus. It could be related to ureter ectopy, bladder extrophy, vesico-vaginal fistula or to neurogenic conditions, and also appears as complication of radical prostatectomy or transurethral resection due to a sphincter damage.

We have investigated and treated 54 patients (44 men and 10 women) with the mean age of 64.6±9.93 years (range 38-90) from the emergency admissions due to macrohematuria. All patients were investigated in the standard manner with additional blood analysis (IFA) regarding IgG and IgM of Herpes simplex viruses (HSV) types 1 and 2, cytomegalovirus (CMV) and EpsteinBarr virus (EBV). Urine and tumor PCR were also done to detect these viruses. Urethral swab was tested for human papillomavirus (HPV) of high carcinogenic risk.

Neuroendocrine differentiation (NED) of the prostate cancer (PCa) is a carcinoma of prostate containing neuroendocrine (NE) component. According to evidence, NED is present in approximately 40% of cases; sole NE prostate cancer is a case in 0.5-2% of patients. The most reliable marker for NED to time is Chromogranin A (ChA).