Kozlov V. The peculiarities of clinical course & the mechanisms of the ectasia development in upper urinary tracts of patients with benign prostаtic hyperplasia.

The thes is dedicated to the problem of the peculiarities of clinical course & mechanisms of the ectasia development in upper urinary tracts of patients with benign prostаtic hyperplasia. The ectasia development in upper urinary tracts of patients with benign prostаtic hyperplasia was settled & the influence to the kidney functioning was estimated. Four main mechanisms of the megaureter forming in this group of patients & the frequency of the chronic renal insufficiency reversibility after the treatment of patients with benign prostаtic hyperplasia of upper urinary tracts was determined. The factors of influencing to the treatment efficiency of these category of patients were founded. The diagnostic value of modern methods of examination the ectasia development in upper urinary tracts of patients with benign prostаtic hyperplasia was settled; basing all these facts the algorithm of diagnostics dealing with the mechanisms of the ectasia development in upper urinary tracts was developed. The ultrasonicmethod was proved to be the very method of this decease diagnostics using which it is possible to find the degree of ectacia, the reversibility of upper urinary tracts infringement. The excretory urography & the radioisotope methods have limited possibilities in the majority of patients with the chronic renal insufficiency. Basing on the achieved results of pre & postoperational periods in 3,6 & 12 months we created the list of indications & contra-indications for the surgery treatment of people with benign prostаtic hyperplasia with ectasia in upper urinary tracts in the mechanisms dependence of the last. We prove that having of еpiсystostomy in case of the mechanical orifice ureter squeezing doesn't give us medical result of the operation. The own method of simultaneous prostatactomy with upperpubis draining using additional conductor, the aim of which to decrease the traumatism of leading a urinal catheter for closing up the upperpubis fistula, was proposed.