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Çäðàâñòâóéòå
Ìíå 55 ëåò. èìåþ äèàãíîç àäåíîìà ïðåäñòàòåëüíîé æåëåçû 2 ãîäà. Ñóáúåêòèâíî æàëîáû íà âÿëóþ ñòðóþ, íî÷üþ âñòàþ 1-2 ðàçà. Ñåé÷àñ ïî ÓÇÈ ðàçìåð ïðîñòàòû 54õ42õ52, îñòàòî÷íàÿ ìî÷à 80 ìë. Ïîëñëåäíèé ìåñÿö ïðèíèìàþ ñåòåãèñ 2 ìã, äî ýòîãî çîêñîí. Àíàëèç íà ÏÑÀ ãîä íàçàä áûë áåç ïàòàëîãèè.
Ïîðà ëè ìíå çàäóìàòüñÿ îá îïåðàöèè?
Ñ óâàæåíèåì
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Åñëè íåò ïðîñòàòèòà, òî ñêîðåå âñåãî îïåðèðîâàòüñÿ.
ê.ì.í. Ìàõìóäîâ ßêîâ ßêîâëåâè÷ / óðîëîã, àíäðîëîã, âðà÷ ÓÇÄ, âûñøàÿ êâàëèôèêàöèîííàÿ êàòåãîðèÿ
ê.ì.í. Ìàõìóäîâà Ëþäìèëà Àðòåìîâíà /íåâðîëîã, óðîëîã, íåéðîóðîëîã
íàø càéò :: Çàïèñü íà ïðèåì / Cïðàâî÷íèê ïî óðîëîãèè / Êîíòàêòû
çàïèñü: òåë. 8(495)517 417 2 / ICQ 279116025
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Çàäóìàòüñÿ ïîðà...
Ðåøàéòå ýòîò âîïðîñ ñîâìåñòíî ñî ñâîèì ëå÷àùèì äîêòîðîì.
Ñ óâàæåíèåì.
30.09.Âàëüäøòåéí Îëåã Ìèõàéëîâè÷,
âðà÷-óðîëîã âûñøåé êàòåãîðèè.
Ïðèåì: ïÿòíèöà ñ 9 äî 15, âîñêðåñåíüå ñ 15 äî 21
Òåëåôîí àäìèíèñòðàòîðà "Êëèíèêè íà Âëàäèìèðñêîé": 306-43-66, 306-01-52
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Ïîêàçàíèÿìè ê îïåðàòèâíîìó ëå÷åíèþ àäåíîìû ìîãóò ñëóæèòü:
ðåöèäèâèðóþùèå êðîâîòå÷åíèÿ, íå ïîääàþùèåñÿ òåðàïèè èíãèáèòîðàìè 5 àëüôàðåäóêòàçû,
ïîâòîðÿþùèåñÿ îñòðûå çàäåðæêè ìî÷è, èëè îñòðàÿ çàäåðæêà ìî÷è ñ êîòîðîé íå óäàåòñÿ ñïðàâèòüñÿ,
ïîâòîðÿþùàÿñÿ ìî÷åâàÿ èíôåêöèÿ, ðåôðàêòåðíàÿ ê àíòèáèîòèêîòåðàïèè,
ïî÷å÷íàÿ íåäîñòàòî÷íîñòü,
êàìíè ìî÷åâîãî ïóçûðÿ,
íàðàñòàþùèé îñòàòî÷íûé îáúåì ìî÷è.
Åñëè ó Âàñ íè÷åãî ýòîãî íåò, èìååò ñìûñë çàäóìàòüñÿ îá àäåêâàòíîé êîíñåðâàòèíîé òåðàïèè. Âàì áåçóñëîâíî ïîêàçàí Ôèíàñòåðèä, ïðåïàðàò, êîòîðûé óìåíüøàåò îáúåì ïðåäñòàòåëüíîé æåëåçû. Åãî ýôôåêò íà÷èíàåòñÿ ÷åðåç 6 ìåñÿöåâ ïðèåìà è ïîçâîëÿåò óìåíüøèòü îáúåì æåëåçû íà 30%.
Âòîðîå : ñåòåãèñ â äîçå 2 ìã, ýòî èçâèíèòå, íè î ÷åì.  êàêîé äîçèðîâêå Âû ïðèíèìàëè çîêñîí è ðåãóëÿðíî ëè? Äîçó íóæíî ïîäíèìàòü ïîñòåïåííî, ïðè Âàøåì çàáîëåâàíèè äî 10 ìã, òîãäà áóäåò õîòü êàêîé--òî ýôôåêò, è íå áóäåò òàêîé îñòàòî÷íîé ìî÷è. Òîëüêî ïîñëå íåýôôåêòèâíîãî àäåêâàòíîãî êîíñåðâàòèâíîãî ëå÷åíèÿ èìååò ñìûñë ïîäóìàòü îá îïåðàöèè è îæèäàåìûõ áëàãàõ, à òàêæå ðèñêàõ, êîòîðûå ñ íåé ñâÿçàíû.Ïîñëåäíèé ðàç ðåäàêòèðîâàëîñü sergei20; 30.09.2008 â 23:18.
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Îñòàòî÷íûé îáúåì ìî÷è 80 ìë â 55 ëåò ÿâëÿåòñÿ àäåêâàòíîé ïðè÷èíîé äëÿ òîãî, ÷òîáû çàäóìàòüñÿ îá îïåðàòèâíîì ëå÷åíèè.
Íàçíà÷åíèå àíòèàíäðîãåííîãî Ôèíàñòåðèäà â âîçðàñòå 55 ëåò... äæëÿ ýòîãî òðóäíî íàéòè ïîäõîäÿùèé òåðìèí. Íî è â èíûõ îáñòîÿòåëüñòâàõ äëÿ âûíåñåíèÿ ñóæäåíèé î ïîêàçàíèÿõ ê åãî íàçíà÷åíèþ íåîáõîäèìà èíôîðìàöèÿ î ìîðôîëîãèè çîíû ãèïåðïëàçèè.
Âîïðîñ î ìàëîèíâàçèâíîì îïåðàòèâíîì ëå÷åíèè íåîáõîäèìî ðåøàòü ñâîåâðåìåííî, êàê ýòî äåëàåòñÿ âî âñåì ìèðå, èíà÷å ñëåäóþò ðèñêè òÿæåëîé îïåðàöèè.
 äàííîì ðàçäåëå íå äàþòñÿ áåçàïïåëÿöèîííûå çàî÷íûå ñîâåòû ïî ëå÷åíèþ, êîòîðûå ìîãóò ïîñëóæèòü ïðè÷èíîé íàíåñåíèÿ âðåäà çäîðîâüþ ïîñåòèòåëåé ôîðóìà. È ýòî õîðîøî.ê.ì.í. Ìàõìóäîâ ßêîâ ßêîâëåâè÷ / óðîëîã, àíäðîëîã, âðà÷ ÓÇÄ, âûñøàÿ êâàëèôèêàöèîííàÿ êàòåãîðèÿ
ê.ì.í. Ìàõìóäîâà Ëþäìèëà Àðòåìîâíà /íåâðîëîã, óðîëîã, íåéðîóðîëîã
íàø càéò :: Çàïèñü íà ïðèåì / Cïðàâî÷íèê ïî óðîëîãèè / Êîíòàêòû
çàïèñü: òåë. 8(495)517 417 2 / ICQ 279116025
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Íàçíà÷åíèå àíòèàíäðîãåííîãî Ôèíàñòåðèäà â âîçðàñòå 55 ëåò... äæëÿ ýòîãî òðóäíî íàéòè ïîäõîäÿùèé òåðìèí
Ïîñëåäíèé ðàç ðåäàêòèðîâàëîñü sergei20; 01.10.2008 â 00:24.
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À ÷òî, íåóæåëè ìîåãî ïîñòà ("...Çàäóìàòüñÿ ïîðà... Ðåøàéòå ýòîò âîïðîñ ñîâìåñòíî ñî ñâîèì ëå÷àùèì äîêòîðîì.") íåäîñòàòî÷íî?
Ñ óâàæåíèåì.
01.10.Âàëüäøòåéí Îëåã Ìèõàéëîâè÷,
âðà÷-óðîëîã âûñøåé êàòåãîðèè.
Ïðèåì: ïÿòíèöà ñ 9 äî 15, âîñêðåñåíüå ñ 15 äî 21
Òåëåôîí àäìèíèñòðàòîðà "Êëèíèêè íà Âëàäèìèðñêîé": 306-43-66, 306-01-52
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Äðåâíèé Êèòàé ñâîèìè óñïåõàìè âî ìíîãîì áûë îáÿçàí åâíóõàì. "Óðîëîãè" ñïîñîáíû ïîìî÷ü Ðîññèè.
ê.ì.í. Ìàõìóäîâ ßêîâ ßêîâëåâè÷ / óðîëîã, àíäðîëîã, âðà÷ ÓÇÄ, âûñøàÿ êâàëèôèêàöèîííàÿ êàòåãîðèÿ
ê.ì.í. Ìàõìóäîâà Ëþäìèëà Àðòåìîâíà /íåâðîëîã, óðîëîã, íåéðîóðîëîã
íàø càéò :: Çàïèñü íà ïðèåì / Cïðàâî÷íèê ïî óðîëîãèè / Êîíòàêòû
çàïèñü: òåë. 8(495)517 417 2 / ICQ 279116025
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íåóæåëè ìîåãî ïîñòà ("...Çàäóìàòüñÿ ïîðà... Ðåøàéòå ýòîò âîïðîñ ñîâìåñòíî ñî ñâîèì ëå÷àùèì äîêòîðîì.") íåäîñòàòî÷íî?
1. ïàöèåíò íå ïåðå÷èñëèë íè îäíîãî ïîêàçàíèÿ ê îïåðàòèâíîìó ëå÷åíèþ, åñëè äîâåðÿòü ðåêîìåíäàöèÿì åâðîïåéñêîé óðîëîãè÷åñêîé àññîöèàöèè, à ÿ èì ïî÷åìó-òî äîâåðÿþ
2. Êîíñåðâàòèâíîå ëå÷åíèå ïðîâîäèëîñü ïàöèåíòó íåàäåêâàòíî (íèçêèå äîçèðîâêè, îòñóòñòâèå èíãèáèòîðîâ 5 àëüôîðåäóêòàçû)
Íå âèæó íè îäíîé ïðè÷èíû, ïî÷åìó íå äîíåñòè ýòó èíôîðìàöèþ äî ïàöèåíòà, îí èìååò ïðàâî åå çíàòüÏîñëåäíèé ðàç ðåäàêòèðîâàëîñü sergei20; 01.10.2008 â 23:16.
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Íåäàâíî ïåðå÷èòûâàë Ñàëòûêîâà-Ùåäðèíà. Îðãàí÷èê â ãîëîâå, êðóòî.
ê.ì.í. Ìàõìóäîâ ßêîâ ßêîâëåâè÷ / óðîëîã, àíäðîëîã, âðà÷ ÓÇÄ, âûñøàÿ êâàëèôèêàöèîííàÿ êàòåãîðèÿ
ê.ì.í. Ìàõìóäîâà Ëþäìèëà Àðòåìîâíà /íåâðîëîã, óðîëîã, íåéðîóðîëîã
íàø càéò :: Çàïèñü íà ïðèåì / Cïðàâî÷íèê ïî óðîëîãèè / Êîíòàêòû
çàïèñü: òåë. 8(495)517 417 2 / ICQ 279116025
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Âàëüäøòåéí Îëåã Ìèõàéëîâè÷,
âðà÷-óðîëîã âûñøåé êàòåãîðèè.
Ïðèåì: ïÿòíèöà ñ 9 äî 15, âîñêðåñåíüå ñ 15 äî 21
Òåëåôîí àäìèíèñòðàòîðà "Êëèíèêè íà Âëàäèìèðñêîé": 306-43-66, 306-01-52
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Âû îòìåòèëèñü. Ïðîäóáëèðîâàëè. Âàñ çàìåòèëè )
ê.ì.í. Ìàõìóäîâ ßêîâ ßêîâëåâè÷ / óðîëîã, àíäðîëîã, âðà÷ ÓÇÄ, âûñøàÿ êâàëèôèêàöèîííàÿ êàòåãîðèÿ
ê.ì.í. Ìàõìóäîâà Ëþäìèëà Àðòåìîâíà /íåâðîëîã, óðîëîã, íåéðîóðîëîã
íàø càéò :: Çàïèñü íà ïðèåì / Cïðàâî÷íèê ïî óðîëîãèè / Êîíòàêòû
çàïèñü: òåë. 8(495)517 417 2 / ICQ 279116025
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Íå îòìåòèëñÿ, à îòâåòèë...
È çàêðûë òåìó.
03.10.Âàëüäøòåéí Îëåã Ìèõàéëîâè÷,
âðà÷-óðîëîã âûñøåé êàòåãîðèè.
Ïðèåì: ïÿòíèöà ñ 9 äî 15, âîñêðåñåíüå ñ 15 äî 21
Òåëåôîí àäìèíèñòðàòîðà "Êëèíèêè íà Âëàäèìèðñêîé": 306-43-66, 306-01-52
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Äðåâíèé Êèòàé ñâîèìè óñïåõàìè âî ìíîãîì áûë îáÿçàí åâíóõàì. "Óðîëîãè" ñïîñîáíû ïîìî÷ü Ðîññèè.
Ìíå áû íå õîòåëîñü, ÷òîáû ó ïàöèåíòà ñëîæèëîñü ïðåâðàòíîå ìíåíèå è ïðåäóáåæäåíèå ïðîòèâ ïðåïàðàòà, ïîýòîìó íåìíîãî îáúåêòèâíîé èíôîðìàöèè áåç ýìîöèîíàëüíîãî êîìïîíåíòà è ýëåìåíòîâ çàïóãèâíèÿ:
Äàííûå ïðèâåäåííûå â êëèíè÷åñêîì ðóêîâîäñòâå ïî ëå÷åíèþ ÄÃÏÆ Åâðîïåéñêîé Óðîëîãè÷åñêîé Àññîöèàöèè
These are mainly related to sexual function. In the PLESS study the side effects reported were decreased libido
(6,4%), impotence (8,1%), decreased ejaculate (3,7%) and in less than 1% of the patients other disorders such
as rash, breast enlargement and breast tenderness (9). All these figures were higher than those observed for
placebo. Such side-effects are considered ‘minimal’ since they did not increase over time and did not cause
many patients to discontinue their treatment. In a recent publication from the PLESS study group it was shown
that the finasteride-related sexual adverse experiences occurred mainly during the first year of therapy (18).
Another conclusion from the PLESS study was that in both older and younger men with symptomatic BPH,
finasteride had the same safety profile and no drug interactions of clinical importance were observed
È îòòóäà æå ïî ýôôåêòèâíîñòè
Today, after the completion of many trials, the efficacy of 5-alpha reductase inhibitors is unquestionable
and has been demonstrated over large clinical trials. It can reduce the size of the prostate gland by 20-30%;
it improves symptom scores by approximately 15% and can also cause a moderate improvement in the urinary
flow rate of 1.3-1.6 mL/s (1-4).
A meta-analysis of six randomized clinical trials showed that baseline prostate volume was a key
predictor of various treatment outcomes and that finasteride was more effective in prostates larger than
40 mL (5). Various trials have concluded that finasteride significantly reduced acute urinary retention and the
need for surgical treatment in men with BPH (6-8). In a major placebo controlled trial including 3,040 men,
finasteride-treated patients had significantly less bother, activity interference and worry due to urinary
symptoms.Ïîñëåäíèé ðàç ðåäàêòèðîâàëîñü sergei20; 05.10.2008 â 11:47.
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Óâàæàåìûé Ñåðãåé Íèêîëàåâè÷, íó âåäü ÍÈÊÒÎ æå íå ñïîðèò, ÷òî ôèíàñòåðèä äîñòàòî÷íî ýôôåêòèâåí ïðè ñîîòâåòñòâóþùèõ ïîêàçàíèÿõ!
Òîëüêî ÿ âûíóæäåí â î÷åðåäíîé ðàç íàïîìíèòü, ÷òî ôîðóì íàø ÍÅ ïðåäíàçíà÷åí äëÿ íàó÷íûõ äèñêóññèé, ñàìîðåêëàìû è ðåêëàìû òåõ èëè èíûõ ïðåïàðàòîâ.
Ìíå êàæåòñÿ, ÷òî ïîêà ñòðàñòè íå ðàçãîðåëèñü, ïîðà ýòîò ïîñò çàêðûòü...
Ñ óâàæåíèåì.
05.10.
p.s. À òóò â äðóãîì ïîñòå Âû âûñòóïàåòå åùå è êàê îíêîóðîëîã...
Âñå ïðàâèëüíî ïèøåòå, íî, ïîæàëóéñòà, íå íàäî...Ïîñëåäíèé ðàç ðåäàêòèðîâàëîñü uroleg2; 05.10.2008 â 16:16.
Âàëüäøòåéí Îëåã Ìèõàéëîâè÷,
âðà÷-óðîëîã âûñøåé êàòåãîðèè.
Ïðèåì: ïÿòíèöà ñ 9 äî 15, âîñêðåñåíüå ñ 15 äî 21
Òåëåôîí àäìèíèñòðàòîðà "Êëèíèêè íà Âëàäèìèðñêîé": 306-43-66, 306-01-52