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CNAA / Theses / 2018 / June /

Differentiated endoscopic treatment of urological obstructive infravezical pathologies


Author: Ghicavîi Vitalii
Degree:doctor habilitat of medicine
Speciality: 14.00.40 - Urology
Year:2018
Scientific consultant: Adrian Tănase
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 29 June, 2018
Approved by NCAA on the 23 November, 2018

Abstract

Adobe PDF document – 1.53 Mb / in romanian

Thesis

CZU [616.62+616.643+616.65-006]-072.1

Adobe PDF document 11.64 Mb / in romanian
284 pages

Keywords

adenoma, prostate hyperplasia, urethral obliteration, adenomectomy, transurethral resection, infravezical obstruction (IVO), endoscopic resewage, electrovaporisat ion, laser

Summary

Structure of the thesis: the work is exposed on 235 pages and includes: introduction, 6 chapters, general conclusions and recommendations, bibliography from 368 titles, 54 tables, 102 figures, 4 appendices.

The obtained results are reported in 46 scient ific works. Keywords: adenoma, prostate hyperplasia, urethral obliteration, adenomectomy, transurethral resection, infravezical obstruction (IVO), endoscopic resewage, electrovaporisat ion, laser.

Study field: Urology. Purpose: determination of implementation opportunities and differentiated usage of new endoscopic miniinvasive methods and extension of indications and possibilities of making transurethral treatment in the diseases and pathological obstructive states of the urinary infravesical paths more efficient based on comparative analysis of results of surgical treatment and risk factors in the development of intra- and postoperative complicat ions. The objectives of the work: assessing the effect iveness of various methods of endoscopic transurethral treatment with determination of possibilities and their implementation needs in complex, differentiated treatment of the lower urinary paths diseases and their complications, manifested by the IVO; study of frequency and structure of infravesical obstructions, argumentation of indicat ions for various methods and modalities associated endoscopic transurethral through the analysis of results effect iveness and intra- and postoperative early and late complicat ions in the endoscopic treatment of the lower urinary paths diseases wit h PBH of various sizes and shape, sclerosis of the cervix bladder and prostate and urethral strictures obliteration; establishment the causes o f the occurrences and study the effectiveness of endoscopic metho ds of treatment of postoperative recurrent IVO with elaboration of prevention measures and of patients monitoring.

The novelty and scientific originality: it was determined the different ial using of endoscopic transurethral treatment in infravesical obstruction caused by prostate benign hiperplasia (PBH), extended strictures and urethral obliterations, prostate and urinary bladder cervix sclerosis. It was studied the impact of different endoscopic transurethral interventions on the functional condition of lower urinary paths with determination of their effectiveness in normalizing of the urodinamic parameters and of recurrent IVO treatment. The main new obtained results for science and practice: the individualizing and optimizing of the endoscopic treatment of lower urinary paths diseases, responsible for IVO, will create new perspectives to prevent and exclude of infravesical urodinamic disturbances; elaboration of the endoscopic transurethral methods algorithm, including the new ones envisaged for implementation will contribute to the improvement of urologies act ivit y, to streamline and improve the qualit y of the treatment thanks to the reduction of complicat ions, ensuring in the same t ime a co nfortable lifest yle for the pat ients. Theoretical significance and applicative value of the work: implementation and differentiated usage of the various endoscopic transurethral interventions in the treatment of urological infravesical obstructive pathologies contributed to the expanding of their usage range and improvement the treatment results, reducing the duration of hospitalization and rehabilitation. Efficient endoscopic transurethral methods and less harmfull represent a preferable alternative to traditional open surgery, allow significantly to restore urination when respecting indications for their execution. The results of this thesis were implemented in the didact ic and curative process at the Department of urology and nephrology surgery of SMPU “Nicolae Testemitanu”, Urological Clinic of clinical Republican hospital and urological departments MIPH in Republic of Moldova.