Publications by authors named "V V Dyakov"

10 Publications

[Diagnostic nomograms for the treatment of urogenital fistula].

Urologiia 2021 Mar(1):13-20

Department of Urology of A. I. Evdokimov Moscow State University of Medicine and Dentistry.

Aim: Studies on non-obstetric urogenital fistula provide limited information on predictive factors. The aim of our study was to specify and to analyze the predictors for long-term anatomical and functional results in women with non-obstetric urogenital fistula.

Materials And Methods: A cross-section study of surgical repair for non-obstetric urogenital fistula repairs was carried out. From 2012 to 2018, a total of 446 patients with urogenital fistulas were treated in two tertiary centers. Patients with vesicovaginal and urethrovaginal fistulas with at least 12 months of follow-up were identified and contacted by phone and/or examined in the clinic. Anatomical outcome was assessed by resolution of symptoms and/or results of clinical examination. Urinary distress inventory (UDI-6) was used for the measurement of functional outcomes. The nomogram is based on a multiple regression equation, the solution of which is performed using a computer. The nomogram is presented as a set of scales, each of which corresponds to a certain variable. The baseline parameter is assigned certain points, depending on its value, then the sum of all parameters is calculated. As a result, it is possible to determine the risk using a couple or three scales.

Results: Overall, 169 patients were studied (mean age of 49.2, mean follow-up of 34 months). The most common cause of fistulas included hysterectomy (69.4%), followed by pelvic radiotherapy (18.9%). Only 64% of cases were primary fistula. Closure rate was 90.7% (98/108). Anatomical success depended on the surgical approach. For transvesical procedure, success rate was 89.4% (42/47), compared to 84% (89/106) and 87.5% (14/16), respectively for transvaginal and transabdominal success rate. According to Clavien-Dindo, complications were grade 1 (11.8%) and grade 2 (4.7%). As UDI-6 showed, the most common symptoms were frequency (62%), urgency (50%), incontinence (73%), pain (55%) and voiding symptoms (27%). Fistula size > 3.0 cm, pelvic radiation, and previous vaginal surgeries were associated with a higher risk of failure or more severe lower urinary tract symptoms. A high number of re-do cases and complex fistulas could be a limitation of this study. Factors for successful non-obstetric urogenital fistula closure were fistula size less than 3.0 cm, absence of pelvic radiation, and previous vaginal surgeries.

Conclusion: According to our results, only fistula size > 3 cm, previous vaginal procedures and pelvis irradiation were unfavorable predictors for anatomic success of fistula repair. In addition, our results allow to determine the predictors for successful repair and risk of recurrence lower urinary tract symptoms postoperatively.
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March 2021

[Intestinal obstruction in early postoperative period after robot-assisted prostatectomy].

Khirurgiia (Mosk) 2018(4):90-93

Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia.

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October 2018

[Comparison of functional outcomes after retropubic and robot-assisted radical nerve-sparing prostatectomy conducted by surgeons with total caseloads of over 1000 prostatectomies].

Urologiia 2017 Apr(1):50-53

Department of Urology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.

Aim: To compare the functional outcomes of bilateral nerve-sparing robot-assisted radical prostatectomy (RARP) and radical retropubic prostatectomy (RRP) at 12 months after surgery.

Materials And Methods: This is a retrospective study of two groups, each of 50 sexually active patients with localized low risk prostate cancer. The first group comprised patients who underwent RRP, while the second underwent RARP. All operations were carried out sequentially from January to August 2015 using nerve-sparing technique. The study involved only two surgeons each having a total caseload of over 1000 prostatectomies of one of the two types. Patients of each group were operated on only by one of the two surgeons. Adjusted for negative treatment outcomes, the between-group comparison was conducted regarding the number of continent patients, temporal changes in urinary function, the number of patients with restored erectile function and temporal changes in its recovery.

Results: At 12 months after surgery, complete continence was reported in 49 (98%) patients of the RARP group and in 48 (96%) patients of the RRP group. Among patients with restored continence, the time to attain complete continence was 4 months in the RARP group and 6 months in the RRP group (p<0.05). Sexual function recovery at 12 months follow-up after surgery was found satisfactory in 37 (74%) patients of the RARP group and in 12 (24%) of the RRP group. Recovery of erectile function after RARP was faster: in the RARP group erections at 3 months were reported in 32% of patients, while in the RRP group only in 4% (p<0.05).

Conclusions: The study findings showed the superiority of RARP over RRP performed by nerve-sparing technique in restoring continence and erectile function.
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April 2017

[Vesicourethral anastomotic strictures and urinary incontinence following radical prostatectomy: relationship and impact on patients quality of life before and after endoscopic correction].

Urologiia 2016 Nov(5):70-78

Department of Urology, A.I. Evdokimov MSUMD, Moscow.

Aim: To assess the incidence and grade of concomitant stress urinary incontinence (SUI) and the quality of life before and after endoscopic correction of vesicourethral anastomotic strictures (VAS) and the impact of the number of endoscopic interventions on these indicators.

Materials And Methods: This is a retrospective study of medical records and a telephone survey of patients who underwent radical prostatectomy (RP) at our clinic from 2010 to 2015 and subsequently presented with VAS. The survey included data on the severity of SUI and quality of life using QoL questionnaire before and after endoscopic VAS correction; the factors primarily affecting the quality of life (SUI or obstructive symptoms) were identified.

Results: During the above period, 1453 RP were performed. There were 60 VAS cases, of which 56 (93%) were included in the study. Stress urinary incontinence after RP occurred in 64.3% of patients, the average QoL score was 3.95 ( = 0.64; Cv = 16.2%). Before endoscopic VAS correction, 87.5% of patients reported obstructive symptoms as the main cause of dissatisfaction. After endoscopic VAS correction, SUI was observed in 82.1% of patients. De novo incontinence occurred in 15 patients, higher SUI grade was observed in 29 (51.8%) patients. The observed change in the of SUI grade was not statistically significant (paired Students t-test 1.98, p> 0.05). Mean QoL score after endoscopic correction was 2.54 ( = 0.73; Cv = 28.6%, paired Students t-test 5.08, p <0.05). After endoscopic correction of VAS, 78.6% of the patients reported that SUI was the most important factor for decreased quality of life.

Conclusions: The study revealed a high incidence of VAS combined with SIU. There was a significant improvement in patients quality of life after endoscopic correction of VAS, which resulted from a change in the pattern of voiding dysfunction producing a major negative impact on the quality of life. There were no statistically significant correlations between the number of endoscopic corrections of VAS and the SUI grade and the patients quality of life.
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November 2016

Novel indolin-2-one-substituted methanofullerenes bearing long n-alkyl chains: synthesis and application in bulk-heterojunction solar cells.

Beilstein J Org Chem 2014 14;10:1121-8. Epub 2014 May 14.

A.E. Arbuzov Institute of Organic and Physical Chemistry Kazan Research Center of the Russian Academy of Sciences, Kazan 420088, Russian Federation.

An easy, high-yield and atom-economic procedure of a C60 fullerene modification using a reaction of fullerene C60 with N-alkylisatins in the presence of tris(diethylamino)phosphine to form novel long-chain alkylindolinone-substituted methanofullerenes (AIMs) is described. Optical absorption, electrochemical properties and solubility of AIMs were studied. Poly(3-hexylthiophene-2,5-diyl) (P3HT)/AIMs solar cells were fabricated and the effect of the AIM alkyl chain length and the P3HT:AIM ratio on the solar cell performance was studied. The power conversion efficiencies of about 2% were measured in the P3HT/AIM devices with 1:0.4 P3HT:AIM weight ratio for the AIMs with hexadecyl and dodecyl substituents. From the optical and AFM data, we suggested that the AIMs, in contrast to [6,6]-phenyl-C61-butyric acid methyl ester (PCBM), do not disturb the P3HT crystalline domains. Moreover, the more soluble AIMs do not show a better miscibility with the P3HT crystalline phase.
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July 2014