The way intraoperative prevention of inflammatory complications of transurethral manipulations and operations

 

(57) Abstract:

The invention relates to medicine, surgery. Carry out selection of the VAS deferens. Them alternately through the puncture in the distal and proximal direction injected procaine antibiotic solution of 10 ml. Method prevents the occurrence of postoperative inflammatory complications on the part of the seminal tract.

The invention relates to medicine, namely to urology and andrology, and can be used for the prevention of inflammatory complications on the part of the seminal tract with transurethral manipulations and operations of the men taken for malignant and benign tumors of the prostate and its sclerosis, chronic prostatitis, tumors and stones in the bladder, transurethral lithotripsy, ureterorenoscopy and endoscopic interventions on upper urinary tract, as well as the use of thermal methods of treatment of prostate cancer. The method can be useful if you need long-term catheterization of the bladder, performing dilations of the urethra and diagnostic contrast basaveshwara or urethrocystoscopy, Les is about the prevention of inflammatory complications of the seminal tract with transurethral manipulations and operations through bilateral vaporesection, adopted as a prototype (Vozianov, A. F., Lyulko A. C. Atlas-manual of urology: 3 so - So 3 - N-450). The disadvantage of this method is its relatively low efficiency: even when performing duplex vaporesection the frequency of the most common inflammatory complications on the part of the seminal tract - epididymoorchitis and funiculata - is 4-6%. In addition, bilateral WaterSense cause unwanted changes in the reproductive and hormonal aspects.

The technical result of the invention is the prevention of inflammatory complications on the part of the seminal tract with transurethral manipulations and operations.

The technical result is achieved by introducing into semyavynosyaschy path after separation of the VAS deferens at the level of the top departments of the scrotum procaine solution of the antibiotic (antibiotic is selected by determining the sensitivity of flora urine, or use of broad-spectrum antibiotic).

The proposed method intraoperative prevention of inflammatory complications of the seminal tract with transurethral manipulations and operations is carried out by lederjacke the tubes that carry sperm, then through the puncture in the last in the proximal and distal direction injected procaine solution of the antibiotic in the volume of about 10 ml Procaine antibiotic solution at the rate of pay (as a single) dose of antibiotic in 20 ml of 0.25% or 0.5% solution of novocaine. Using intraoperative ultrasound studies have shown that the solution, extending in the proximal direction, fills the seminal vesicle, and in the distal - epididymis. Next, the skin wound is sutured.

Using the above method performed 9 transurethral resection of the prostate about her hyperplasia and one transurethral resection of neoplasms of the urinary bladder. Frequency funiculitis and epididymoorchitis in the group of patients operated using traditional methods, amounted to 4%, and the use of the method described above, these complications were not observed.

Example. Patient K., 61. Diagnosis: the Hyperplasia stage II 31.01.2003 performed a transurethral resection of the prostate using the above-described method. Under epidural anesthesia after processing operating margins in the upper divisions of the scrotum alternately on both side is in the proximal and distal direction entered procaine solution of Cefazolin (1,0) in a volume of 10 ml. Skin wounds on both sides stitched. Next executed Subtotal transurethral resection of the prostate. The postoperative period without features, phenomena purulent-inflammatory complications of the seminal tract is not marked.

Example. Patient S., aged 65. Diagnosis: Transitional cell bladder cancer, T2NxM030.01.2003 performed a transurethral resection of bladder tumors using the described method. Under epidural anesthesia after processing operating margins in the upper divisions of the scrotum alternately on both sides highlighted and fixed ligatures-taped the tubes that carry sperm, and then through the puncture in the last in the proximal and distal direction entered procaine solution abaktal (0,4) in a volume of 10 ml. of Cutaneous wounds on both sides stitched. Next performed a transurethral resection of bladder tumors. The postoperative period without features, phenomena purulent-inflammatory complications of the seminal tract is not marked.

The way intraoperative prevention of inflammatory complications of transurethral manipulations and operations by alternately allocating semjavynosjashchim the direction of the injected procaine antibiotic solution of 10 ml.

 

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