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CONCLUSIONS.

1. The transurethral prostatectomy before brahiterapiej at sick of a cancer of a prostate with initially high risk infravezikalnoj obstructions allows to eliminate available risk factors of its development in 89,6 % of cases at the expense of reduction of volume of a prostate, augmentation of volume rate of an emiction and reduction of volume of a residual urine, not rendering negative influence on current RPZH.

2. At patients with high risk of development infravezikalnoj to obstruction in postimplantatsionnom the period neoadjuvantnaja medicamental hormonal therapy in a regimen of the maximum androgenic blockade within 3 months leads to authentic reduction of volume of a prostate (on the average on 35,5 %) at 71,0 % of patients, but thus does not render positive influence on indicators urodinamiki the bottom urinary ways.

3. At patients, with initially high risk infravezikalnoj obstructions,

By which before brahiterapiej the transurethral prostatectomy is executed, in postimplantatsionnom the period of signs infravezikalnoj obstructions is noted. At application

Medicamental hormonal therapy, as a preventive maintenance method infravezikalnoj obstructions after brahiterapii, at 9 (33,3 %)

The acute delay of an emiction, at 6 (22,2 %) is diagnosed -

Chronic delay of an emiction. Thus a risk factor of development of an acute delay in early postimplantatsionnom the period are initially low indicators Qmax and Qm, without dependence from prostate volume. Initially great volume of a prostate (more than 100 see cubic), even at satisfactory indicators urodinamiki, is a risk factor of development of a chronic delay on late terms after implantation.

4. Clinical features of a current postimplantatsionnogo the period at sick by the localised cancer of the prostate, not having risk factors infravezikalnoj obstruction and patients by whom before brahiterapiej the transurethral resection of a prostate is executed, it is not taped.

5. At satisfactory value of indicators urodinamiki and point IPSS< 15, исходный объем предстательной железы не оказывает достоверного негативного влияния на течение постиплантационного периода, поэтому пациентам с объемом простаты до 80 см. куб. брахитерапия может выполняться без предварительной подготовки. Гормональная терапия, как метод профилактики инфравезикальной обструкции в постимплантационном периоде, может быть использована у больных с объемом простаты от 80 до 100 см.

куб., при удовлетворительных значениях показателей уродинамики (Q max > of 15 ml/with; Q m> 5 ml/c) and IPSS< 15 баллов. Объем простаты более 100 см. куб. и/или наличие других факторов риска развития инфравезикальной обструкции в постимплантационном периоде, являются показанием к трансуретральной резекции перед брахитерапией.

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A source: GORELOV Victor Pavlovich. PREVENTIVE MAINTENANCE INFRAVEZIKALNOI of OBSTRUCTION AT PLANNING BRAHITERAPII of the CANCER of the PROSTATE. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg. 2014

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