Academic literature on the topic 'Urological branch'

Supernumerary kidneys are defined by the presence of a 3rd or 4th kidney that is separate from the homolateral kidney and is served by a branch of a bifid ureter or a separate (double) ureter. These kidneys are poorly documented and extremely rare. These kidneys may be the site of lithiasis. We report here the ureteroscopic management of a pyelocalic lithiasis on a supernumerary kidney revealed by right low back pain in a woman.

Prostate cancer (PCa), bladder cancer (BCa), and renal cell carcinoma (RCC) are the most common urological cancers, and their incidence has been rising over time. Surgery is the standard treatment for these cancers, but this procedure is only effective when the disease is localized. For metastatic disease, PCa is typically treated with androgen deprivation therapy, while BCa is treated with chemotherapy, and RCC is managed primarily with targeted therapies. However, response rates to these therapeutic options remain unsatisfactory due to the development of resistance and treatment-related toxicity. Thus, the discovery of biomarkers with prognostic and predictive value is needed to stratify patients into different risk groups, minimizing overtreatment and the risk of drug resistance development. Pharmacometabolomics, a branch of metabolomics, is an attractive tool to predict drug response in an individual based on its own metabolic signature, which can be collected before, during, and after drug exposure. Hence, this review focuses on the application of pharmacometabolomic approaches to identify the metabolic responses to hormone therapy, targeted therapy, immunotherapy, and chemotherapy for the most prevalent urological cancers.

Significant opportunities to increase economic efficiency in health care are associated with increased planned approach to the management of the volume and structure of care and patient flow. In 2010, the Research Institute of Urology in conjunction with the Government of the Voronezh region developed a regional program "Urology". The main objectives of which were: the reduction of morbidity, complications and disability in pa-tients with urological profile, improving the quality and accessibility of urological care to the population area. The essence of the program is to organize medical urological care according to the principles of prevention, standardization, quality control of the organization of care, optimizing the financial costs of the state of health care. In our work we have tried to move away from the principle of "negotiability" and to focus on the active identification of complaints by the survey population. The concept of preventive health care, implemented in the sub-program "Urology" in full compliance challenges of the day – simple, effective, does not cost much. On the example of BPH, it was shown that the introduction of such a system in any branch of medicine will allow maximum transfer care to a new level , away from the provision of assistance in uptake, the majority of accident and emergency assistance on a "detection", routine medical care, and accordingly to plan state assignment for each specific type of care, and as a result, plan on spending on health care , which will lead to the rational use of finance to health care, improve the quality and availability of specialized and high-tech care.

The renal artery when it reaches close to the hilum of kidney where it cleaves into anterior and posterior divisions were receives around 75% and 25% of blood respectively. Further these branches divide into many segmental branches. These segmental arteries does not have collateral system, so when there is any occlusion of these arteries which results in the ischemia of the particular segment of kidney. Anatomists believe that knowledge of presence of lower polar artery is essential for polar nephrectomy. Prior knowledge of variations in the renal vessels is required for urological surgery for preoperative investigations as there are reports of surgical complications which include enormus haemorrhage. In this study we analyzed the different variations in the intra renal branch of inferior segmental artery.

Purpose of the study. The aim of this study is to improve the quality of emergency urological care for patients with scrotal and testicular trauma.Patients and methods. The study is a comparison of the results of prospective (according to the algorithm) and retrospective fragments, including a total of 459 patients (414 retrospectively, 45 prospectively). Patients received inpatient urological care for traumatic damage to the scrotum and testicle in D. Pletnyov City Clinical Hospital Department of Health of Moscow, N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation for the period 2008-2018.Results. The article analyzes the clinical effectiveness of the developed algorithm for the choice of therapeutic tactics in different variants of scrotal and testicular injuries. The key differences between the proposed algorithm and the generally accepted tactics are the extension of indications for emergency testicular revision (to operate with hematocele of any volume) and the same type of antibacterial prevention/therapy of infectious posttraumatic orchitis, regardless of the nature of the injury.Conclusion. When using the algorithm, the following clinical advantages were noted: reducing the likelihood of acute post-traumatic orchitis 2.4 times (p = 0,0271); reduced likelihood of postoperative infectious-inflammatory complications is reduced 2.0 times; reducing the likelihood of orchiectomy or hardening of the testicle 1.4 times.

One of the main directions of improving medical care was the introduction of inpatient forms of medical care for patients who do not require round-the-clock supervision. Aim of the research: to prove the effectiveness and economic feasibility of minimally invasive procedures in outpatient conditions. Materials and methods. The study included 3524 patients in the period from 2010 to 2017, who underwent transrectal prostate biopsy on the basis of the Department of urology of polyclinic No. 195 of the Western district of Moscow. For comparison, the patients were taken, who underwent a biopsy of the prostate gland at the base hospital No. 31, No. 51, No. 17. Results. The average number of biopsies performed in hospital No. 31, No. 51 and No. 17 for the year amounted to 344 biopsies, and the average detectability of prostate cancer was 142 (41.3 %). The average number of biopsies per year in the urology department of the branch number 2 GP No. 195 amounted to 440.5, and the average detectability of prostate cancer – 152.8 (34.7 %). Thus, with comparable inpatient detection of prostate cancer in one large outpatient urology center, an average of 28 % more biopsies are performed (440.5 versus 344) than in 3 hospitals over a comparable period of time. Conclusions. Inpatient technologies can reduce the burden on hospitals. The development of hospital-replacing forms is determined by the need of the population and for efficient use of financial and technical resources of health care.

AbstractIn this paper we report the case of a nearly fatal hemorrhage in the artery of the renal upper pole that occurred in a 84-year-old woman on anticoagulation treatment in connection with aortic valve replacement 4 days prior to the incident. The artery was injured during the evacuation of a hematoma of the right pleural cavity. While the patient was in the intensive care unit recovering from cardiac valve surgery, the consulting urologist was summoned in order to cope with massive hematuria and acute urine retention. Unfortunately, conservative urological management based on catherization via a three-way catheter and constant transurethral lavage with saline was unsuccessful. Angio-computed tomography revealed a ruptured branch of the renal upper pole artery. A highly selective embolization using histoacryl injection during percutaneous angioplasty was performed. There were no complications in the following days. The patient was subject to postoperative follow-up at 3, 6 and 9 months and renal scintigraphy was performed at 6 months revealing symmetrical function of both kidneys without any changes in the upper pole of the right kidney.

<b><i>Introduction:</i></b> Although Mustafa Kemal Atatürk (1881–1938) was a national hero with his intrepid and enlightened attempts to establish modern Turkey from the remnants of Ottoman heritage, he had been suffering from lifelong “kidney disease” that appeared with intermittent flank pain and fever without an identified source. However, we think that this physical pain that he endured only increased his motivation to focus on his military and political aims. <b><i>Methods & Results:</i></b> In this historical review article, we have focused on his personal medical life and specifically his “kidneys” from the beginning of the complaint till his death through European medical and political history with geographic locations and speculated upon it via past, near past, and recent medical literature. <b><i>Conclusion:</i></b> Mustafa Kemal Atatürk, the great military and political leader for his country, had always suffered from uro/nephrological problems throughout his life. We think that this was one of the reasons that urology has been privileged and thus to be the oldest separated medical surgical branch in Turkey and to some significant extent with European urological history.

Introduction: Epidemiological data indicate an increased incidence of testicular cancer (TC), making it the most common malignant tumor in men from aged 15–45. Oncological and urological associations recommend that men with specific TC risk factors should regularly perform a testicular self-exam (TSE). The aim of the study was to discover the attitudes among Polish males regarding TSE and factors (environmental, social, educational) that affect intention to perform TSE. Methods: An original survey containing 21 questions was used to conduct a study among the Polish branch of VW (Volkswagen Poland) employees. Results: A total of 522 fully completed questionnaires were collected. The mean age of the surveyed respondents was 32 years. Information about TC and how to perform TSE was obtained by 34.4% (n = 185) of the men. It was shown that the following factors increase men’s intention to perform TSE: TC in their family member (p < 0.05; HR = 5.9; 95% CI: 1.5–23.0), GP’s(General Practitioner) recommendations (p < 0.001; HR = 6.8; 95% CI: 3.2–14.3), concern expressed by their partner (p < 0.001; HR = 3.3; 95% CI: 2.1–5.3), and social campaigns (p < 0.001; HR = 2.6; 95% CI: 1.5–4.6). Conclusions: Approximately half of young polish males do not perform TSE. Access to information on TC prevention is limited. Further action is needed to improve men’s awareness of TC and TSE.

Introduction. Blunt renal trauma is the most common urologic disturbance. For the last 2 decades, the number of renal trauma decreases: from 1-8% to 0,4%-1,07%. Men are more vulnerable than women. Usually patients are of working age and the trauma is caused with traffic accident or fall from a height. In cases of 4-5th grade of renal trauma (according OIS classification) multiple abdominal organ`s disturbances are revealed in 64,3-90,6% patients. It leads to the fact that surgery is often performed by abdominal surgeon holding another operative opinion than urologist. Nowadays, expectant approach in 1-3 OIS grade of renal trauma is common. On the other hand, no consensus is achieved in treatment strategy of 4-5 OIS grade patients. Purpose of the work: to determine the frequency of kidney injury in patients with closed abdominal trauma, to identify patients with severe injuries among patients with kidney injury, to compare the treatment tactics of this category of patients before and after the appearance of the urological service at the N.V. Sklifosovsky Institution. Material and methods. Retrospective study of 187 patients with blunt abdominal trauma was performed during the period of 2016-2019. In 32,6% cases multiple disturbance including kidney was detected. Male persons were more common (73,8%), age 18-72 (37,9±8,83), usually suffered road traffic accident (57,4%) or height fall (31,1%). Stable patients (ISS<16) were 67,2%, unstable (ISS≥16) – 32,8%. The severity of renal disturbance was appreciated with CT in 67,2% case and after laparotomy in others. Treatment strategy was defined by urologists in 5 patients with OIS grade 3-5 and by general surgeons in 15 patients. Results. In «urology» group laparotomy and renal exploration was done in 1(20%) person, embolization of renal artery branch was performed in 2(40%) and non-operative management was chosen for 2(40,0%) patients with sufficient outcome. Hospital stay amounted to 13,7±2,4 days. All patients of «general surgery» group underwent laparotomy. Among them paranephric hematoma was explored in 2(13,4%), nephrorrhaphy was done in 3(20,0%) and nephrectomy – in 10(66.6%) injured ones. Hospital discharge on 17,5±3,5 day. Discussion. All patients with renal trauma met abdominal organs disturbances too. Urologists in these cases are more prone to expectant strategy than general surgeons while less aggressive (expectant and angiosurgery) approach demonstrates better outcomes. Conclusion. In case of similar grade of renal trauma expectant approach and angioembolisation save the patient from open surgery in 80% cases, facilitates early activation and shorten hospital stay significantly. In view of paucity of such cases in our review following studies are expected.

У роботі досліджено сутнісні аспекти адміністрування та менеджменту в умовах інноваційного розвитку національної системи охорони здоров’я. Зʼясовано, що менеджмент сучасної реформованої медичної галузі – це поступове запровадження на практиці комплексу спеціальних принципів, підходів, методів і засобів управління організаціями системи охорони здоровʼя різних форм власності, спрямованих на: максимізацію прибутку від медичної (в тому числі комерційної) діяльності. Виокремлено специфічні особливості реалізації процесу адміністрування та менеджменту урологічної служби в умовах впровадження реформи вторинної ланки, зокрема: менеджмент урологічної служби в умовах впровадження реформи вторинної ланки має бути спрямований на високоякісне формування та реалізацію стратегій, спрямованих на збереження та зміцнення здоровʼя нації. Проаналізовано вітчизняну та світову нормативно-правову базу із організації профілактики і медичної допомоги споживачам медичних послуг урологічного напрямку. За результатами здійсненої діагностики показників ефективності якості надання медичної допомоги за наслідками запровадження реформи з адміністрування встановлено, що показники захворюваності, поширеності та охоплення хворих урологічного напрямку диспансерним спостереженням в динаміці за чітковизначений період часу (2018- 3 кв. 2020 рр.) в Україні мали тенденцію до зростання (на 11,7-23,7%), а первинної інвалідності – до зниження (46,8% -37,5%). Розроблено перелік рекомендацій з удосконалення системних засобів системи менеджменту та адміністрування урологічної служби в умовах впровадження реформи вторинної ланки.<br>В работе исследованы сущностные аспекты администрирования и менеджмента в условиях инновационного развития национальной системы здравоохранения. Выяснено, что менеджмент современной реформируемой медицинской отрасли – это постепенное внедрение на практике комплекса специальных принципов, подходов, методов и средств управления организациями системы здравоохранения различных форм собственности, направленных на: максимизацию прибыли от медицинской (в том числе коммерческой) деятельности. Выделены специфические особенности реализации процесса администрирования и менеджмента урологической службы в условиях внедрения реформы вторичного звена, в частности: менеджмент урологической службы в условиях внедрения реформы вторичного звена должен быть направлен на качественное формирование и реализацию стратегий, направленных на сохранение и укрепление здоровья нации. Проанализированы отечественную и мировую нормативно-правовую базу по организации профилактики и медицинской помощи потребителям медицинских услуг урологического направления. По результатам проведенной диагностики показателей эффективности качества оказания медицинской помощи установлено, что показатели заболеваемости, распространенности и охвата больных урологического направления диспансерным наблюдением в динамике за четко определены период времени (2018-2020 гг.) в Украине имели тенденцию к росту (на 11,7-23,7%), а первичной инвалидности – к снижению (46,8% -37,5%). Разработан перечень рекомендаций по совершенствованию системных средств менеджмента и администрирования урологической службы в условиях внедрения реформы вторичного звена.<br>The paper examines the essential aspects of administration and management in terms of innovative development of the national health care system. It was found that the management of the modern reformed medical industry is the gradual introduction in practice of a set of special principles, approaches, methods and tools for managing health care organizations of various forms of ownership, aimed at: maximizing profits from medical (including commercial) activities. The specific features of the implementation of the process of administration and management of urological services in the implementation of secondary reform, in particular: management of urological services in the implementation of secondary reform should be aimed at high-quality formation and implementation of strategies to preserve and strengthen the health of the nation. The domestic and world normative-legal base on the organization of prevention and medical care to consumers of medical services of urological direction is analyzed. According to the results of diagnostics of indicators of efficiency of quality of medical care following the introduction of administrative reform during the second stage of health care reform, it is established that the incidence, prevalence and coverage of urological patients by dispensary observation in the dynamics for a clearly defined period of time (2018-2020y.) in Ukraine tended to increase (by 11.7-23.7%), and primary disability - to decrease (46,8% -37,5%). The list of recommendations on improvement of system means of system of management and administration of urological service in the conditions of introduction of reform of a secondary link is developed.