Erectile Dysfunction | Department of Urologic Surgery

Erectile Dysfunction: It’s common, and it’s treatable.
If you are dealing with ED, you are not alone: nearly one in every four men over sixty years of age will experience some degree of erectile dysfunction. Younger men often struggle with ED as well. By taking the time to become involved in discussing ED, you’ve made an important first step in finding a solution to Erectile Dysfunction. There’s a lot to learn and many options to consider, so let’s get started.

Making an appointment with Dr. Clavijo
Dr. Clavijo is fellowship trained in Andrology (having also completed a Urology residency) and strives to practice up-to-date evidence based medicine when treating patients with erectile dysfunction. Along with treating patients medically for ED, he also performs a high volume of penile implants.

Please call us at 916-734-2222 to inquire about appointments.

What is Erectile Dysfunction (ED)?
Erectile Dysfunction is the consistent inability to sustain an erection sufficient for sexual intercourse.
 

Erectile Dysfunction can be:

• A total inability to achieve an erection – You can never get an erection.
• An inconsistent ability to do so – You can only occasionally get an erection.
• A tendency to sustain only brief erections – You can get an erection, but can’t keep it long enough for satisfying sex.
   

What Causes ED?
ED is most commonly caused by medical conditions such as diabetes and high blood pressure or pelvic surgeries. Age related decline in erectile function is also thought to occur.

ED can be caused by disorders such as:

• An injury
• A disease (e.g. diabetes, high blood pressure, or high cholesterol)
• Various studies have estimated that between 20% – 71% of individuals with diabetes suffer from erectile dysfunction.
• An operation (e.g. prostate gland removal)
• Substance use (e.g. tobacco, drugs, alcohol or medications)
• Stress, anxiety, depression, psychological trauma

Other facts about Erectile Dysfunction:

• Approximately 30 million American men suffer from erectile dysfunction.
• Most men with erectile dysfunction still have the ability to have an orgasm and father a child, but often have difficulty doing these things because they can’t get or sustain an erection.
• Erectile dysfunction is not normal, and is by no means an inevitable consequence of aging.
• Most men at one time or another during their sexual lives are unable to get or keep an erection. This is normal and does not indicate a problem. However, millions of men of all ages experience this inability as a continuing problem.
• In most cases, erectile dysfunction can be overcome using medical or surgical options.

 How do we evaluate you for ED?

• We typically start with questionnaires such as the International Index of Erectile Function (IIEF) to determine the severity.
• Penile injections such as Trimix may be used to assess the quality of your erection and to differentiate among the many causes.
• Occasionally a penile duplex ultrasound is indicated if there is concern for disease in the blood vessels or penile scarring.

5 Things to Know If You’re Considering a Penile Implant

TIPS TO LIVE BY

Feb. 17, 2020

No one likes to admit that they’re having issues with their sexual health. But guys, erectile dysfunction (ED) is way more common than you probably think. And, treating it doesn’t have to mean taking a pill every time you want to get in the mood. In fact, you may want to consider what many urologists consider the only true cure for ED: A penile implant.

“While many men have success with medications and other options for achieving an erection, others are looking for a more permanent solution to their ED,” says Dr. Nathan Starke, urologist at Houston Methodist. “Penile implants are the closest thing we have to a cure for men who are having trouble achieving or sustaining an erection.”

For some men, medications just don’t work. Others don’t like the idea of having to plan to get an erection. Penile implants circumvent both of these issues almost entirely.

“A penile implant offers an on-demand erection in just 15 seconds — whenever you want, for however long you want it,” says Dr. Starke.

If you’re experiencing ED and trying to figure out if a penile implant is right for you, don’t suffer in silence. Here are Dr. Starke’s answers to questions you may have about penile implants.

Is a penile implant worth it?

For people motivated to regain sexual function, penile implants are a very effective and reliable way to ensure you can have an erection when you want it.

“Studies have shown that the satisfaction rate of men with a penile implant, as well as their partners, is between 90 and 95%,” says Dr. Starke. “The vast majority of men respond that they’re likely to recommend the procedure to someone else and also have no regret over their decision to get a penile implant.”

A penile implant does involve a short surgical procedure, so whether or not you’re willing or able to undergo the procedure can be a determining factor in whether or not a penile implant is right for you. Dr. Starke says that penile implant surgery typically takes less than an hour and is often performed as an outpatient procedure.

Is penile implant surgery safe?

As with any implant surgery, the main concern is preventing infection — but the rate of infection is very low.

“The surgery is very safe and infection is incredibly rare, about 1%, largely due to the fact that we use special antibiotics and specific surgical techniques that greatly reduce the risk of post-operative infection,” explains Dr. Starke.

Like all surgeries, penile implant surgery is made safer by going to a surgeon you trust.

“Surgeon experience is very important,” notes Dr. Starke. “Make sure you choose a urologist who has extensive experience performing penile implants.”

Is penile implant surgery painful?

After penile implant surgery, you can expect mild to moderate soreness for several days, but the symptoms should go away after a week or two.

“Since we’re operating in a sensitive area, there is some soreness after the procedure,” Dr. Starke explains. “We do several things to minimize your pain, though, such as draining any fluid that’s built up, prescribing pain medication and using compressive surgical dressings.”

The length of recovery can vary based on a variety of factors, and your doctor will let you know once you’ve recovered enough to resume sexual activity.

“In our practice, we typically activate the penile implant three weeks after the procedure, at which point it’s ready for unrestricted use.” says Dr. Starke.

What type of penile implant do I need?

There are two main types of penile implants: inflatable implants and malleable implants. Your doctor can help you determine which type of implant is right for you based on your lifestyle and unique needs.

“Regardless of which type of implant is chosen, the majority of men report great satisfaction with their penile implant,” says Dr. Starke.

How long does a penile implant last?

In most men, penile implants last between 15 and 20 years.

“It’s important to keep in mind that a penile implant is a mechanical device, and it can break,” warns Dr. Starke. “However, this is uncommon and it can be corrected through another short surgical procedure.”

Next Steps:

Penile Implants: Treatments, Risks, Recovery

Overview

Why would a surgical penile implant (penile prosthesis) be used?

A surgical penile implant (also called a penile prosthesis) is a treatment option for men with erectile dysfunction (ED). The simplest type of prosthesis consists of a pair of bendable, silicone rods surgically implanted within the erection chambers of the penis. Today, many men choose a hydraulic, inflatable prosthesis that allows a man to have an erection whenever he chooses.

A penile implant is usually used when there is a clear medical cause for ED and when the problem is unlikely to resolve or improve naturally or with other medical treatments. Sometimes a penile prosthesis is implanted during surgery to reconstruct the penis when scarring has caused erections to curve.

Procedure Details

How does a penile implant work?

The inflatable penile implant consists of two cylinders, a reservoir, and a pump that are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of fluid. The reservoir is implanted under the lower abdominal muscles. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles.

To inflate the prosthesis, the man presses on the pump. This does not put any pressure on the testicles. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis.

What is sex like with a penile implant?

When the penis is inflated, the prosthesis makes the penis stiff and thick, similar to a natural erection. Most men rate the erection as shorter than their normal erection. However, newer models have cylinders that may increase the length in addition to the thickness and stiffness of the penis. Another difference is that the glans, or head of the penis, does not become engorged or hard with the inflation of the device.

A penile prosthesis does not change sensation on the skin of the penis or a man’s ability to reach orgasm. Ejaculation is not affected. Once a penile prosthesis is put in, however, it may destroy the natural erection reflex. Men usually cannot get an erection without inflating the implant. If the implant is removed, the man may never again have natural erections.

Risks / Benefits

Do penile implants work?

About 90% to 95% of inflatable prosthesis surgeries are successful, meaning the implants produce erections suitable for intercourse. Satisfaction rates with the prosthesis are very high, and typically 80% to 90% of men are satisfied with the results and say they would choose the surgery again.

Are penile implants safe?

No surgery is totally free of possible complications. Complications associated with penile implants include:

• Uncontrolled bleeding after the surgery; this condition may require an additional surgery
• Infection
• Scar tissue formation
• Erosion (of implant)
• Pump or reservoir displacement
• Mechanical failure

Recovery and Outlook

Is a penile implant noticeable?

While men who have had the prosthesis surgery can see the small surgical scar where the bottom of the penis meets the scrotal sac, other people probably will be unable to tell that a man had an implant. Most men would not be embarrassed in a locker room or public restroom, for example.

Additional Details

Will insurance cover the cost of a penile implant?

Insurance coverage for these operations is often good, as long as a medical cause of ED is established. Medicare covers the surgery, and Medicaid may in selected cases.

Erectile Dysfunction After Prostate Cancer

Nearly all men will experience some erectile dysfunction for the first few months after prostate cancer treatment. However, within one year after treatment, nearly all men with intact nerves will see a substantial improvement.

Following Nerve-Sparing Prostatectomy

Within one year, about 40 to 50% of men will have returned to their pre-treatment function. After two years, about 30 to 60% will have returned to pre-treatment function. These rates vary widely depending on the surgeon and how the extent of “nerve sparing” a surgeon can perform at the time of surgery.

Following Radiation Therapy

About 25 to 50% of men who undergo brachytherapy will experience erectile dysfunction vs. nearly 50% of men who have standard external beam radiation. After two to three years, few men will see much of an improvement and occasionally these numbers worsen over time.

Men who undergo procedures not designed to minimize side effects and/or those whose treatments are administered by physicians who are not proficient in the procedures will fare worse.

Men with other diseases or disorders that impair their ability to maintain an erection (diabetes, vascular problems, etc.) will have a more difficult time returning to pre-treatment function.

Management of Erectile Dysfunction

Oral medications relax the muscles in the penis, allowing blood to rapidly flow in. On average, the drugs take about an hour to begin working, and the erection-helping effects can last from 8 to 36 hours.

About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.

Alternative Treatments

Men who do not recovery erectile function after treatment can try injectable medication that pharmacologically induced an erection.  The most common drug used for this is Prostaglandin.

Mechanical Devices

The vacuum constriction device creates an erection mechanically by forcing blood into the penis using a vacuum seal. A rubber ring rolled onto the base of the penis prevents blood from escaping once the seal is broken. About 80% of men find this device successful.

Surgical Options

A three-pieced surgically inserted penile implant includes a narrow flexible plastic tube inserted along the length of the penis, a small balloon-like structure filled with fluid attached to the abdominal wall, and a release button inserted into the testicle.

The penis remains flaccid until an erection is desired, at which point the release button is pressed and fluid from the balloon rushes into the plastic tube. As the tube straightens from being filled with the fluid, it pulls the penis up with it, creating an erection.

Assuming the mechanics are working correctly, it is 100% effective, and about 70% of men remain satisfied with their implants even after 10 years. Because this procedure is done under general anesthesia, it is not available to men who are not considered good candidates for surgery because of other health reasons.

Erectile Dysfunction Following Radical Prostatectomy

Assuming the management of erectile dysfunction requires expert diagnosis and treatment.

Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.

Treatment follows diagnosis, and we provide a range of treatment options through the Clinic. Minimally invasive treatment options range from oral medications to medications administered directly to the penis to a mechanical vacuum device applied to the penis. Invasive treatments include implants or vascular surgery. We are particularly expert in the surgical treatment of patients with erectile dysfunction. The range of conditions we manage include penile prosthesis complications, penile vascular abnormalities, penile curvature, and abnormally prolonged erection consequences.

Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.
For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkins’ noted Sexual Behaviors Consultation Unit.

Erectile dysfunction following radical prostatectomy for clinically localized prostate cancer is a known potential complication of the surgery. With the advent of the nerve-sparing radical prostatectomy technique, many men can expect to recover erectile function in the current era.

However, despite expert application of the nerve-sparing prostatectomy technique, early recovery of natural erectile function is not common. Increasing attention has been given to this problem in recent years with the advancement of possible new therapeutic options to enhance erection function recovery following this surgery. Visit Dr. Burnett’s Neuro-Urology Laboratory

This topic area was handled thoroughly in an article written by Dr. Arthur L. Burnett, entitled “Erectile Dysfunction Following Radical Prostatectomy,” published in the Journal of the American Medical Association, June 1, 2005. Using a question and answer format, excerpts from this article are provided below.

What is the importance of preserved erectile function?

In considering the impact of the various treatment approaches for prostate cancer on their quality of life, many patients place paramount importance on the possibility of retaining natural erectile function. This matter is frequently important to young men who by age status are more likely to have intact erectile function than older men; however, for all men having normal preoperative erectile function irrespective of age, preservation of this function is understandably important postoperatively.

What are the current expectations with regard to outcomes after radical prostatectomy?

Following a series of anatomical discoveries of the prostate and its surrounding structures about 2 decades ago, changes in the surgical approach permitted the procedure to be performed with significantly improved outcomes. Now after the surgery, expectations are that physical capacity is fully recovered in most patients within several weeks, return of urinary continence is achieved by more than 95% of patients within a few months, and erection recovery with ability to engage in sexual intercourse is regained by most patients with or without oral phosphodiesterase 5 (PDE5) inhibitors within 2 years.

Why is there increasing concern at this time regarding erectile dysfunction issues following radical prostatectomy?

The reality of the recovery process after radical prostatectomy today is that erectile function recovery lags behind functional recovery in other areas. Patients are understandably concerned about this issue and, following months of erectile dysfunction, become skeptical of reassurances that their potency will return.

Why does it take so long to recover erections after the very best surgery?

A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma.

What determines erection recovery after surgery?

The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states (e.g., cardiovascular disease, diabetes mellitus), lifestyle factors (e.g., cigarette smoking, physical inactivity), and the use of medications such as antihypertensive agents that have antierectile effects.

Are there any surgical techniques that have been developed to improve erectile function outcomes?

At this time, there are several different surgical approaches to carry out the surgery, including retropubic (abdominal) or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.

Is another treatment option better for preservation of erectile function?

The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.

What current options exist to treat erectile dysfunction after radical prostatectomy?

Options include pharmacologic and nonpharmacologic interventions. Pharmacotherapies include the oral PDE-5 inhibitors (sildenafil [Viagra®], tadalafil [Cialis®], and vardenafil [Levitra®]), intraurethral suppositories (MUSE®), and intracavernous injections (prostaglandin E1and vasoactive drug mixtures). Non-pharmacologic therapies, which do not rely on the biochemical reactivity of the erectile tissue, include vacuum constriction devices and penile implants (prostheses).

Men who have undergone nerve-sparing technique should be offered therapies that are not expected to interfere with the potential recovery of spontaneous, natural erectile function. In this light, penile prosthesis surgery would not be considered an option in this select group, at least in the initial 2 year post-operative period, until it becomes evident in some individuals that such recovery is unlikely.

Can erection “rehabilitation” be applied to improve erection recovery rates?

A relatively new strategy in clinical management after radical prostatectomy has arisen from the idea that early induced sexual stimulation and blood flow in the penis may facilitate the return of natural erectile function and resumption of medically unassisted sexual activity. There is an interest in using oral PDE5 inhibitors for this purpose, since this therapy is noninvasive, convenient, and highly tolerable. However, while the early, regular use of PDE5 inhibitors or other currently available, “on-demand” therapies is widely touted after surgery for purposes of erection rehabilitation, such therapy is mainly empiric. Evidence for its success remains limited.

Are there new strategies in the near future that may be helpful in improving erection recovery after surgery?

Recent strategies have included cavernous nerve interposition grafting and neuromodulatory therapy. The former, as a surgical innovation meant to reestablish continuity of the nerve tissue to the penis may be particularly applicable when nerve tissue has been excised during prostate removal. In the modern era of commonly early diagnosed prostate cancer, nerve-sparing technique remains indicated for the majority of surgically treated patients.

Neuromodulatory therapy, represents an exciting, rapidly developing approach to revitalize intact nerves and promote nerve growth. Therapeutic prospects include neurotrophins, neuroimmunophilin ligands, neuronal cell death inhibitors, nerve guides, tissue engineering/stem cell therapy, electrical stimulation, and even gene therapy.

Penile Implant (IPP) – Advanced Urology

1. Advanced Circumcision – A circumcision can be done at the time of penile implant surgery. It is performed with perfect measurements to avoid shortening of the skin and scrotalization of the penis.

2. Advanced Plication – This treatment for Peyronie’s can be done with your penile implant. It involves suturing to correct the penile bend and straighten the penis

3. Advanced Plaque Removal – This is the treatment of choice with a penile implant for restoration of length lost because of Peyronie’s. It involves lifting the urethra or the nerves of the penis, cutting the scar tissue underneath and placing a patch to bridge the gap.

4. Advanced Fat Pad Removal – This treatment will show your penis length that is hidden and can also be done with your implant. It involves removal of the suprapubic fat above and around the penis and release of tissue tethering the penis down.

5. Advanced Scrotal Fixation – This treatment, which can be done with your implant, will also help your penis length stand out. This will help you show more of your natural penis length by moving the scrotum skin further down the shaft.

6. Advanced Length and Girth Enhancement – These advanced surgical techniques can enhance your length and girth. It can be used to help further maximize your length and girth at the time of penile implant placement

7. Advanced Sling – A urethral sling can be placed to reduce mild to moderate urine leakage. This will reduce mild to moderate urine incontinence and is especially good for urine leakage during sex (climacturia)

8. Advanced Urinary Sphincter – This is the treatment of choice for severe urinary leakage. It involves a separate prosthetic placed around the urethra and is the GOLD STANDARD to reduce or eliminate severe urinary leakage.

Penile Implant Info – El Camino, Mountain View, San Jose, Palo Alto, Fremont

The penile implant has been a mainstay of treatment for erectile dysfunction for over 30 years.There have been over 300,000 penile implants inserted worldwide allowing surgeons to offer this form of therapy with the confidence of knowing that penile implants are a safe, reliable and effective way of treating even the most severe cases of erectile dysfunction (ED). Penile implants have a greater than 95% patient and partner satisfaction rating.

What is a Penile Prosthesis / Penile Implant?

The penile implant is a synthetic prosthetic device that is inserted directly into the corpora cavernosa to provide a man an erection that is adequately rigid for penetrating intercourse. All of the components of a penile prosthesis are placed under the skin and not visible to unsuspecting people. Each penile prosthesis is custom fit to the patient at the time of surgery. There are two manufacturers of FDA approved penile prosthetics in the United States. Both manufacturers provide a variety of penile implants for treating ED. The technology involved in manufacturing a penile prosthesis is patented and has been refined over the last 30 years to provide a reliable and durable prosthetic device.

What types of Penile Implant is right for me?

There are three general different designs when it comes to penile implants. Penile implants are made in a malleable form, two-piece, and three-piece inflatable prosthesis. Based on manual dexterity, medical co-morbidities, and previous surgeries, your physician will help select the penile prosthesis that is right for you.

What about the Minimally Invasive Penile Prosthesis procedure?

El Camino Medical Group physicians are experienced in performing both the traditional penoscrotal and the minimally invasive infrapubic approach. The preference is to always perform the minimally invasive infrapubic approach because of the small (3 cm) incision, minimal dissection required, decreased healing time and convalescence associated with the minimally invasive infrapubic approach. The surgery is done under general or regional anesthesia and takes under 30 minutes for the entire procedure. Patients are able to cycle the pump mechanism and resume normal activities faster than with the penoscrotal approach.

Does a Penile Implant look and feel like a natural erection?

The patient satisfaction rate in published studies of penile implant surgery is over 95% and this is largely attributed to the natural look and feel of penile implants. Many patients are surprised to find out that there are no external devices and that everything is concealed under the skin for discretion. Oftentimes, patients will request to see photos of previous penile implant procedures. We have included pre-operative photos, intra-operative photos and final cosmetic results of the flaccid and inflated penile prosthesis in the following section.

How difficult is it to inflate or deflate an inflatable penile prosthesis?

Patients are sometimes nervous about inserting an implant into their bodies that requires manual manipulation in order to function. Below are two informative videos demonstrating how easy these devices are to use.

What is the cost of penile implant surgery?

Patients are always surprised to learn that most major insurance carriers and Medicare will cover the entire cost of penile implant surgery. For those patients with Medicare insurance and a supplemental plan, there are usually no out of pocket costs for the operation. The actual device cost of a penile implant is around $8,000. There are also additional costs for the hospital, anesthesia and professional services. El Camino Urology Medical Group can arrange a fixed cost package for patients who require a cash rate for the operation. The cash price for the entire procedure is approximately $19,000. This price compares very favorably to other centers that offer the penile implant procedure.

What is the next step?

Patients are encouraged to contact El Camino Urology Medical Group at (650)-962-4662 to schedule an appointment to discuss the treatment options available for men interested in the penile implant procedure. You can arrange an informal short phone consult at that time if you wish to discuss if penile implant surgery is right for you.

What are the post-operative instructions after penile prosthesis surgery?

• What to expect after the procedure –
  Click Here
• If you would like a copy of the instructions in Spanish –
  Click Here
• If you would like a copy of the instructions in Russian –
  Click Here

For more info, please visit our other website at
www. healthy-male.com

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Erectile dysfunction surgery | Chesapeake Urology

About Penile Prostheses

A penile prosthesis is a medical device that requires surgery to implant inside a man’s penis. A viable option when other ED treatment modalities have not been successful or produce unpleasant side effects, penile prostheses, or implants, have been in use for more than 30 years. New designs and surgical techniques utilized by Chesapeake Urology surgeons have improved the safety and efficacy of penile implant surgery over the years.
 
More than 300,000 men have benefited from penile implants, returning to an active and satisfying sex life for themselves, and their partners. Overall patient satisfaction is reportedly high with penile prosthesis, with more than 90% of patients satisfied with the outcomes as compared with 50% of patients satisfied with oral medications.  Many patients have reported that the treatment was life changing and restored the intimacy back into their life and relationships.

The Expertise Needed for Success

Chesapeake Urology surgeons are on the leading-edge of the most advanced surgical techniques and technology and perform more than 1,500 penile prosthetic implant surgeries a year. It is this high level of experience that provides our patients with the most successful outcomes. The implant surgery is typically done in an outpatient surgical center or in a hospital by one of our highly-trained microsurgeons. Surgery typically takes one hour under general anesthesia and patients whose surgery is performed in a hospital will usually stay overnight. The recovery period is typically six to eight weeks and patients can resume physical as well as sexual activity at this point.

Could a penile prosthesis work for you?

Penile Prosthesis – Working with your Chesapeake Urology Physician

Your urologist understands that choosing a penile implant is a very personal decision and will discuss with you all of your options to ensure you receive the prosthetic device that is just right for you. Because each type of prosthesis offers unique features, you and your physician will discuss the benefits and risks of the implant, and work together to determine the option that best fits with your personal preferences.

Benefits of Penile Prostheses

• Provides a long term solution to ED
• Provides the ability to attain a natural feeling, rigid erection anytime you choose
• Allows for more spontaneity when the mood strikes
• Enables you to maintain an erection as long as desired
• No costly pills or shots
• Feels natural during sexual intercourse
• Doesn’t interfere with ejaculation or orgasm

Risks

• Surgery carries risk of infection; if infection occurs, the prosthesis may need to be removed
• Can result in a slightly shorter penis
• If the implant is removed for any reason, attaining a natural erection will be impossible, even with ED medications or by other means.
• Mechanical parts may fail

90,000 ARCHIVE OF ANGIOLOGY AND VASCULAR SURGERY JOURNAL

“Angiology and Vascular Surgery” (Editor-in-Chief – Academician of the Russian Academy of Sciences A. V. Pokrovsky) – the first quarterly bilingual journal in the history of Russia, recognized by the world medical community. The journal publishes original articles by domestic and foreign experts on topical issues of ultrasound, radiation and invasive diagnostics, the principles of drug and surgical correction of cardiovascular diseases.

The publication is included in the International Register of Scientific and Periodical Press, is reflected in the Medline database and, accordingly, in the Medicus Index, in the Russian Science Citation Index (RSCI), for many years has been included in the list of periodicals, publication in which is required for VAK . The journal is cited on various foreign sites, including PubMed, Scopus, EBSCO, and others. The journal is included in the Articles Database of 652 of the highest quality and authoritative Russian journals posted on the world’s leading Web of Science platform.

“Angiology and Vascular Surgery” is the only one of all specialized editions representing Russian vascular surgery at the international level.

Today, the publication ranks 62nd out of 1238 in the SCIENCE INDEX rating on the topic “Medicine and Health Care”. The two-year impact factor of the journal, taking into account citations from all sources, is 0.519. This is one of the best indicators among Russian medical publications (see the website of the Scientific Electronic Library).

The editorial board invites you to publish the results of your scientific and practical activities on the pages of the journal. You can familiarize yourself with the requirements for the design of articles on the page “Design of publications”.

2021 • VOL. 27 • No. 3

Contents

ANGIOLOGY

Influence of antioxidant on markers of apoptosis of vascular wall cells after reconstructive operations
Kalinin R.A., Suchkov I.A., Klimentova E.A., Shchulkin A.V., Egorov A.A.
P. 8-14

Denervation of the pulmonary artery in pulmonary hypertension: physiological and clinical aspects
Evlakhov V.I., Poyasov I.Z., Ovsyannikov V.I.
P. 16-20

Are there any alternatives to dual antiplatelet therapy after peripheral artery stenting?
Bredikhin R.A., Krepkogorskiy N.V., Khairullin R.N.
P. 22-27

RADIATION DIAGNOSTICS

Possibilities of duplex scanning in the assessment of endolics after abdominal aortic arthroplasty
Bartosz F.L., Sivushchina S.V., Dudin D.S., Bazylev V.V.
P. 28-32

INTERVENTIONAL RADIOLOGY

Endovascular prosthetics of the aortic arch
T. E. Imaev, D.V. Salichkin, A.E. Komlev, A.S. Kolegaev, I.V. Kuchin, P.M. Lepilin, M.I. , Fedotenkov I.S., Balakhonova T.V., Akchurin R.S.
P. 34-39

Use of drug-eluting balloons for interventions on bifurcation lesions of coronary arteries
Kuropiy T.S., Utegenov R.B., Khelimsky D.A., Badoyan A.G., Eraliev T.K., Krestyaninov O.V.
P. 46-52

Endovascular arterialization of deep veins of the leg and foot in a patient with critical ischemia of the lower extremities
Eroshenko An.V., Eroshkin I.A., Zubova E.A., Kovylov A.O., Krasnoshchekova L.S.
P. 54-59

PHLEBOLOGY

Diagnosis of arteriovenous compression in varicose veins of the small pelvis
Faibushevich A.G., Akulova A.A., Shugushev Z.Kh., Lobastov K.V., Taranenko O.V., Chaban A.S., Maksimkin D.A., Baranovich V.Yu.
P. 68-75

Comparative efficacy of various methods of treating chronic venous edema in real clinical practice
Bogachev V. Yu., Boldin B.V., Turkin P.Yu., Samenkov A.Yu., VA-PRO-C3 research group
P. 77-82

VASCULAR SURGERY

Surgical treatment of patients with infrarenal aortic aneurysms and coronary heart disease
Ivanov L.N., Maksimov A.L., Mukhin S.A., Chebotar E.V., Naumov S.V., Nagaev R.Yu., Mironov E.A., Chukrin D.Yu.
P. 85-93

Extended lesion of the internal carotid artery: carotid autotransplantation, formation of a new bifurcation, or prosthetics?
Kazantsev A.N., Chernykh K.P., Kravchuk V.N., Vinogradov R.A., Abdullaev A.D., Povtoreyko A.V., Chernyavsky M.A., Khubulava G.G.
P. 96-102

Alternative femoral endarterectomy: technical aspects and immediate results
Vakhitov D.M., Suominen V., Oksala N.
P. 104-108

CARDIAC SURGERY

Open transaortic implantation of the “Medlab-KT” prosthesis
VV Bazylev, AB Voevodin, Ya. S. Slastin, VA Karnakhin
P. 115-119

Evaluation of the results of left ventricular reconstruction in combination of coronary atherosclerosis and diabetes mellitus
Bukhovets I.L., Vorozhtsova I.N., Maksimova A.S., Shipulin V.M., Babokin V.E., Andreev S.L., Sukhodolo I.V.
P. 125-129

CLINICAL OBSERVATIONS

Prosthetics of the aorta with a cadaveric homograft in case of infection of a bifurcated synthetic vascular prosthesis
Dmitriev O.V., Italyantsev A.Yu., Chernovalov D.A., Kozin I.I., Gryaznova D.A., Vachev A.N.
P. 132-139

Treatment of a patient with acute dissection of the thoracoabdominal aorta complicated by hemothorax
Chernova D.V., Zherdev N.N., Chernov A.V., Kudaev Yu.A., Chernyavsky M.A.
P. 140-144

A case of effective endovascular treatment of venous gangrene
Sukovatykh B. S., Sereditsky A.V., Azarov A.M., Muradyan V.F., Sukovatykh M.B., Lapinas A.A.
P. 147-152

Multiple ruptures of the great vessels and uterus in a woman in labor with Ehlers-Danlos syndrome
Chernyadyev S.A., Malgina G.B., Leshchinskaya A.Yu., Erofeev E.N., Bochegov V.S., Makarov R.A., Tarasova N.V., Krokhaleva Ya.M.
P. 153-158

TO HELP A PRACTICAL DOCTOR

Preoperative stress testing in patients before vascular interventions
Tereshina O.V., Gryaznova D.A., Vachev A.N.
P. 159-163

LITERATURE REVIEWS

Use of drug-eluting endovascular devices for lesions of the arteries of the femoral-popliteal-tibial segment
Lysenko E.R., Burov A.Yu., Gryaznov O.G., Bushueva E.V.
P. 165-171

Hybrid operations in the treatment of patients with multilevel lesions of the arteries of the lower extremities
Fataliev G. B., Arakelyan V.S., Shubin A.A.
P. 173-178

HISTORY OF CARDIOVASCULAR SURGERY

Actual Privy Councilor V.V. Pelican (1790-1873) and his “Dissertatio medico chirurgica inauguralis de aneurysmate” (St. Petersburg, 1816). Part 2
S.P., Kryukov Yu.Yu., Sochilin A.A.
P. 180-186

Surgeon, scientist and humanist, ahead of his time (to the 105th anniversary of the birth of Academician E.N. Meshalkin)
Morgoshia T.Sh., Kalashnikova V.D.
P. 188-182

Journal of Angiology and Vascular Surgery. Report for the period No. 3/2019 – No. 2/2021
Beloyartsev D.F., Litvinova S.S.
P. 193-195

3rd Surgical Department – Vidnovskaya Regional Clinical Hospital

3rd Surgical Department of GBUZ MO “Vidnovskaya Regional Clinical Hospital” – Department of planned surgery, created in 2001, in order to improve the system of organizing high-tech routine surgical care for the population and in accordance with the order of the Ministry of Health RF No. 297 of 28.07.1999

The department is located 3 km from the Moscow Ring Road, in a picturesque place near Moscow, next to the St. Catherine Monastery, whose baths are visible from the windows of the operating room, and is located in a separate three-storey building on the 3rd floor. Cozy 1-, 2- and 3-bed rooms, superior comfort (TVs, refrigerators, air conditioning) are designed for a round-the-clock stay of 15 patients. It is only 15 patients who are under the patronage of an experienced guard nurse during the day, which allows more thoroughly fulfilling the doctor’s prescriptions and spending more time on each patient.

Priority areas of work – the use of modern minimally invasive technologies for performing laparoscopic operations on the abdominal organs, operations using laser techniques, modern methods of treating varicose veins of the lower extremities, plastic surgery of hernias of any localization, corrective (plastic / aesthetic) operations on the face and body . ..

The 3rd surgical department includes a modern operating unit with an intensive care unit, the latest equipment, the use of advanced anesthesia techniques, allow patients to fully feel comfortable before and after operations.

The 3rd surgical department is a clinical base of the Federal State Research Center for Laser Medicine of the Federal Medico-Biological Agency of the Ministry of Health, which develops new laser technologies based on high-energy and low-intensity laser radiation and implements them into clinical practice.

Employees of the department:

Head of the department:

Osokin Vasily Vitalievich – surgeon of the highest category, Honored Doctor of Russia.In 1984 he graduated from 2 MOLGMI them. N.I. Pirogov. She specializes in general, endoscopic, laser surgery, phlebology. Work experience in the specialty for 30 years.

Doctors:

Dotsenko Nikolay Mikhailovich – doctor-surgeon of the highest category, candidate of medical sciences. In 1990 he graduated from the 1st Moscow Medical Institute named after I.M. Sechenov. She specializes in general and endoscopic surgery, phlebology. Work experience in the specialty for 22 years.

Kurdyaev Igor Vyacheslavovich – doctor-surgeon of the highest category, candidate of medical sciences, senior researcher at the State Scientific Center for Laser Medicine of the FMBA of Russia.In 1982 he graduated from 2 MOLGMI them. N.I. Pirogov. She specializes in plastic and laser surgery, cosmetology. Work experience in the specialty is 32 years.

Danilin Nikolai Alekseevich – Surgeon of the highest category, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences. She specializes in plastic and laser surgery, cosmetology. Work experience in the specialty is 42 years.

Bulina Svetlana Nikolaevna – anesthesiologist-resuscitator of the highest category.In 1991 she graduated from the Tselinograd State Medical Institute. In 1996, on the basis of 1 MMI named after I.M. Sechenova completed her residency in anesthesiology and resuscitation. Work experience in the specialty for 21 years.

Nurses

Senior nurse:

Ermakova Olga Valerievna – secondary specialized education, has been working in Vidnovskaya CRH since 2000, has the highest qualification category in the specialty “Nursing in surgery”.

All nurses have the first, highest categories in specialties and many years of work experience.

Surgical treatment:

• Cholelithiasis – laparoscopic cholecystectomy;
• Varicose veins of the lower extremities – mini-access operations;
• Varicocele – laparoscopic surgery;
• Hernias of various locations – modern plastics, the use of nets;
• Removal of benign tumors of various locations;
• Laser operations – phimosis, papillomas, candilomas, ingrown nails, tattoos, post-burn and keloid scars;
• Corrective (plastic / aesthetic) operations on the face and body.

Conservative treatment:

• Chronic pancreatitis and its exacerbation;
• Chronic cholecystitis and its exacerbation;
• Obliterating atherosclerosis;
• Diabetic angiopathy.

Consultations and treatment are carried out by surgeons of the highest category, with many years of experience in these areas, candidates and doctors of medical sciences.

Consultations by surgeons are carried out daily at 8.30 or 13.00. Plastic surgeon consultations – on Mondays at 10.00

Contact phones 8 (495) 548 – 81 – 59, 8 (495) 548 – 81 – 60.

The department is located at:

• Moscow Region , Vidnoe –2, Uchebny proezd, house 1.
• Directions: from Rastorguevo station (Paveletskaya railway) buses No. 2, 7, 59, 379 to the stop “Police school” (second stop).

Perm State Medical University named after V.I.Academician E.A. Wagner

Teaching staff

Kotelnikova Lyudmila Pavlovna – Head of the Department, Doctor of Medical Sciences, Professor. Chairman of the certification and qualification subcommittee in the specialty “Surgery, urology, endoscopy, traumatology and orthopedics”, “Pediatric surgery”, deputy. Chairman of the expert commission on surgery of the Ministry of Health of the Perm Territory. The main areas of scientific activity are endocrine surgery, surgical hepatology, portal hypertension surgery, bariatric surgery.

Plaksin Sergey Alexandrovich – Doctor of Medical Sciences, Professor. Member of the certification and qualification subcommittee in the specialty “Surgery, urology, endoscopy, traumatology and orthopedics”, member of the expert commission on thoracic surgery of the Ministry of Health of the Perm Territory, member of the working group on thoracic surgery of the Ministry of Health of the Russian Federation, member of the working group on plastic surgery of the Ministry of Health of the Russian Federation, chairman of the revision commission Russian Society of Plastic Surgeons. The main direction of scientific activity is breast trauma, esophageal surgery, lung cancer, plastic surgery.

Repin Maxim Vasilievich – Doctor of Medical Sciences, Professor. Member of the Coordination Council for Surgery and Dissertation Council D 208.067.03. The main direction of scientific activity is surgical gastroenterology, pancreatology.

Novikov Valery Nikolaevich – Doctor of Medical Sciences, Professor. Deputy Chief Physician for Science, PSC FMBA, Chief Freelance Specialist-Expert in Endoscopy, Perm. The main direction of scientific activity is endoluminal interventions for diseases of the chest and abdominal cavities.

Mukhamadeev Ildus Sultanovich – Doctor of Medical Sciences, Associate Professor. Chief freelance expert in vascular surgery in Perm and the region. The main direction of his scientific activity is surgery of the aorta, great and peripheral arteries. Diabetic foot surgery.
Stepanov Ruslan Alekseevich – Candidate of Medical Sciences, Associate Professor. The main direction of scientific activity is obesity surgery, surgical treatment of purulent wounds.

Sinelnikov Yuri Semenovich , Associate Professor – Doctor of Medical Sciences, Chief Physician of theS.G. Sukhanov “of the Ministry of Health of Russia (Perm). The main directions of scientific activity: surgery of congenital heart defects; surgery for acquired heart defects; surgical anatomy of the heart and blood vessels; surgical treatment of cardiac arrhythmias in children; organization of surgical care for patients with cardiovascular diseases. Total work experience in the healthcare sector: 32 years. Work experience at the department: 6 years.

Marchenko Andrey Viktorovich , Associate Professor – Doctor of Medical Sciences, Deputy Chief Physician for the Medical Department of the FSBI “FTSSSH named afterS.G. Sukhanov “of the Ministry of Health of Russia (Perm), doctor – cardiovascular surgeon. The main directions of scientific activity: surgery of the aorta and arteries; surgery for acquired heart defects; surgery of the venous system; diagnosis and treatment of obliterating vascular diseases of the lower extremities; general issues of reconstructive surgery of the arterial system. Total work experience in the healthcare sector: 25 years. Total work experience at the department: 7 years.

Orekhova Ekaterina Nikolaevna , Associate Professor – Doctor of Medical Sciences, Head.Department of functional and ultrasound diagnostics of FSBI “FTSSSH named after S.G. Sukhanov “of the Ministry of Health of Russia (Perm). The main directions of scientific activity: instrumental and apparatus methods of examination; diagnostics of congenital heart defects; echocardiography in pediatric cardiac surgery. Total work experience in the healthcare sector: 30 years. Total work experience at the department: 8 years.

Prokhorov Stanislav Nikolaevich , Assistant – Candidate of Medical Sciences, Head of the Department of Anesthesiology and Intensive Care of the Federal State Budgetary Institution “FTSSSH im.S.G. Sukhanov “of the Ministry of Health of Russia (Perm). The main directions of scientific activity: anesthesiology and resuscitation; artificial and assisted blood circulation; provision and postoperative management of patients with congenital heart defects. Total work experience in the healthcare sector: 40 years. Total work experience at the department: 5 years.

Stepanov R.A. – Ph.D.

History

In 2006, the Department of Surgery of the Faculty of Advanced Studies and Professional Retraining of Specialists was separated from the Department of Hospital Surgery.Professor L.P. Kotelnikov. In 2019, the department was joined to the course of cardiovascular surgery and invasive cardiology, the head of the course – Doctor of Medical Sciences. Sinelnikov Yu.S. The department was renamed and is now called the “Department of Surgery with a course of cardiovascular surgery and invasive cardiology.” Located on the basis of the Perm Regional Clinical Hospital (PKKB) and the Federal Center for Cardiovascular Surgery. S.G. Sukhanov.

The department employs 3 full-time teachers and 7 part-time teachers: 8 of them are doctors of medical sciences and 1 candidate of medical sciences.The staff of the department carry out a great therapeutic load. Each of them supervises, consults or directs the surgical department of the PKKB, FTSSS them. S.G. Sukhanov.

Main areas of training for surgeons

The department conducts postgraduate training of surgeons on budgetary and extra-budgetary cycles in the specialty “surgery”, “thoracic surgery and” cardiovascular surgery “in the amount of 144 hours required for the accreditation of doctors with experience who did not study annually in short cycles (36 hours ) in the CME system since 2016.

Also, the department conducts training on budgetary and off-budget short cycles in the specialty “surgery”, “thoracic and cardiovascular surgery”, “endoscopy” in the CME system with crediting points to the personal account. Within the framework of the proposed cycles, an internship at the workplace, classes in a simulation center for practicing basic skills of laparoscopic operations are possible.

Classes are held in full-time and part-time form (partly remotely).

Course of Cardiovascular Surgery and Invasive Cardiology

Clinical base at the address: g.Perm, st. Marshal Zhukov, 35, 4th floor, office. 4001-4008
Phone: +7 (342) 239-87-85
Fax: +7 (342) 239-87-78
E-mail: [email protected]

Business Schedule:

• Monday – Thursday 8:00 am to 5:00 pm
• Friday – 8:00 am to 4:30 pm
• Saturday – 8:00 to 13:00
• Sunday – Day off

Main directions of training of trainees:

1. Surgical treatment of multifocal atherosclerosis.Minimally invasive technologies in cardiac surgery (36 hours)
2. Topical issues of cardiovascular surgery (144 hours)
3. Topical issues of cardiovascular surgery (36 hours)
4. Selected questions of endovascular methods of diagnosis and treatment (144 hours)
5. Selected issues of endovascular diagnosis and treatment (36 hours)
6. Transesophageal echocardiography in cardiac surgery (36 hours)
7. Provision of critical congenital heart defects in the neonatal period (36 hours)
8. Surgery of critical congenital heart defects (36 hours)

At the disposal of the department for conducting classes – a conference room with a capacity of 165 people, two classrooms, one of which is equipped with modern computer and multimedia equipment.There is a telecommunication system “Operating – conference room” in real time, which allows to significantly increase the information content and clarity of the educational process. At the seminars, students are shown video recordings of cardiac surgery and endovascular interventions. By agreement with the regional medical library and information center, the Federal Center was provided with a licensed electronic library, which includes more than 8 thousand textbooks, teaching aids, monographs and journals on medicine and natural science, professional books on medicine, clinical guidelines.

City Clinical Hospital. M.E. Zhadkevich

Founded in 1893, a multidisciplinary medical and prophylactic institution that provides qualified medical care in outpatient and inpatient conditions. Equipped with modern equipment and staffed by experienced, qualified hospital staff. The hospital of the M.E. Zhadkevich DZM hospital operates in the reception mode for patients in emergency medical care, as well as in the provision of planned qualified and specialized medical care to patients, including high-tech in cardiovascular surgery, microsurgery, directed by polyclinics in the city.Moscow. The day hospital works in two shifts.

The hospital is an institution of the Moscow City Health Department, operates under compulsory medical insurance and provides paid medical services.

The hospital includes:
polyclinic for 850 visits,
day hospital for 20 beds, works in 2 shifts
paid department for 14 extra-budgetary beds

Deputy chapters. doctor in the medical department: Nadaraya Victor Mi hailovich – 8 (495) 440-20-93
Deputy.ch. doctor in the polyclinic section of work: Chekunchikov Nikolay Vladimirovich – 8 (495) 444-10-85
Deputy. chapters. surgeon: Nadaraya Viktor Mikhailovich – 8 (495) 440-52-51
Deputy. chapters. doctor for personnel: Pelenkova Inna Andreevna – 8 (495) 440-05-88
Deputy. chapters. doctor in economics: Vasilyeva Lyubov Valentinovna – 8 (495) 443-79-15
Deputy. chief physician for anesthesiology and resuscitation: Talyzin Pavel Andreevich – 8 (499) 737-62-42
Deputy.ch. physician on MRO: Chaly Nikolay Nikolaevich – 8 (499) 737-61-86
Chief Nurse Stukalova Nina Nikolaevna – 8 (495) 440-26-13

Provision of medicines is carried out through the pharmacy No. 20 of the company “FTK Vremya” , located on the 1st floor of the polyclinic department of the M.E. Zhadkevich DZM at the address: Mozhaisk highway, 14-4 on the basis of prescriptions issued by physicians and specialists.
The list of outpatient and polyclinic institutions providing specialized medical care to citizens residing at the outpatient department of the M.E. Zhadkevich DZM addresses:
• District oncology department: City polyclinic № 195, st. Kralatskie hills, house 30, building 2
• Anti-tuberculosis dispensary № 20 , st. Tarutinskaya, 2
• Skin and Venereal Diseases Dispensary No. 7 , Krylatskie Hills Street, 30, Building 2
• Narcological Dispensary No. 5 , st.Barclay, building 5, building 2
• Psychoneurological dispensary № 2 , Smolenskaya square, 13/21
• Dental regiment № 5 , st. Krylatskie Hills
License for medical activities No. LO-77-01-011086 dated October 15, 2015.
An anti-corruption commission has been established and is operating in the hospital

Ryazan State Medical University named after academician I.P. Pavlova

Lectures of the Department of Vascular Surgery

1. Aortic aneurysms
2. Varicose veins
3. Diseases of peripheral arteries
4. Peripheral arterial disease and diabetes mellitus
5. Complications of pacing
6. Post-thrombophlebitic syndrome and CVI
7. Deep vein thrombosis
8. Pulmonary embolism
9. Surgical anatomy of the heart and blood vessels
10. Pacing

For questions about the lecture materials, please send Igor Alexandrovich Suchkov to the address [email protected]

In 2000, at the Department of Topographic Anatomy and Operative Surgery, a course of vascular surgery was organized, in 2011 the department was transformed into the Department of Angiology, Vascular, Operative Surgery and Topographic Anatomy, later renamed into the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Surgery. anatomy. Since 2021, a course of radiation diagnostics has been added, the department has been transformed into the department of cardiovascular, X-ray endovascular surgery and radiation diagnostics.

At present, radiation diagnostics is taught in the 4th year of the medical and pediatric faculties.

In the 6th year, vascular surgery is taught to students of the Faculty of Medicine. For 4-6 year students of the medical faculty, the department conducts electives in angiology, vascular suture, endovascular operations and MRI diagnostics.

On the basis of the department, residents are trained in the specialties “Cardiovascular surgery”, “X-ray endovascular diagnostics and treatment”, “Radiology”.

Within the framework of the FDPO cycles, courses of thematic improvement and advanced training in cardiovascular surgery, X-ray endovascular diagnostics and treatment and X-ray studies in the amount of 36 and 144 hours are conducted, as well as primary retraining in X-ray and X-ray endovascular diagnosis and treatment.

The subject is taught by qualified specialists who pay special attention to the formation of the clinical thinking of the future doctor. Much attention is paid to improving the educational process: manuals for practical exercises, test tasks for intermediate and final control of knowledge, methodological recommendations and textbooks on the most difficult topics have been created for students.For students interested in vascular and X-ray endovascular surgery, radiation diagnostics, and who want to deepen their knowledge of these disciplines, a circle is organized at the department within the framework of the Student Scientific Society of the University. Many former members of the circle are now employees of the university, leading specialists in clinics in Russia.

Areas of research work

• Basic Research:
  • systemic approach to the pathogenesis of chronic venous insufficiency;
  • theory of the pathogenesis of trophic ulcers;
  • Endothelial dysfunction in chronic arterial and venous diseases.
  • regenerative medicine in vascular surgery
  • Possibilities of gene therapy in vascular surgery

• Applied Research:
  • treatment and diagnostic tactics for varicose veins;
  • analysis of various methods of PE prevention;
  • histological characteristics of the features of the vascular suture depending on the matter;
  • special studies on various drugs;
  • amputation of limbs for vascular diseases;
  • development of options for reconstructive operations;
  • development of options for various hybrid operations using endovascular methods of treatment.
  • MRI examination of the musculoskeletal system with kinematics
  • Analysis of perfusion-weighted MR images of the brain
  • Development of methods for MRI morphometry and CT morphometry of organs

Complex scientific research is carried out jointly with a number of other departments: biochemistry, eye and ENT diseases, hospital therapy, histology, pathological anatomy and medical genetics, etc.

Department grants

• Grant of the President of the Russian Federation for state support of young Russian scientists – doctors of science in 2011 (Kalinin R.E.)
• Grant of the President of the Russian Federation for state support of young Russian scientists – candidates of sciences in 2013 (Pshennikov A.S.)
• Research Grant of the European Society of Vascular Surgeons 2016 – European Society for Vascular Surgery Research Grant 2016. (Kalinin R.E.)
• Grant RFBR – competition of projects of 2018 for fundamental scientific research carried out by young scientists (Pshennikov A.S.)
• Scholarship of the President of the Russian Federation, for young scientists and graduate students carrying out promising research and development in priority areas of modernization of the Russian economy, for 2018-2020 (Pshennikov A.S.)
• Grant of the President of the Russian Federation for state support of young Russian scientists – candidates and doctors of sciences in 2020 (Krylov A.A.)

In accordance with the ideology of the department, educational work is carried out “at the patient’s bedside” at rounds, special conferences, first of all, on the personal example of employees, department workers and department workers at various levels, including scientific work, participation in ambulance trips, etc.p.

City Hospital 26 – SPbGUZ

Over the years of its existence, SPb GBUZ “City Hospital No. 26” has secured the right to be called one of the best hospitals in the city. Active development and innovation, modern broad research activities, allow the hospital to be at the forefront of the healthcare system.

Over the years, much has changed in the country, in medicine, and in the hospital itself. Today, St. Petersburg State Budgetary Healthcare Institution “City Hospital No. 26” is a complex of an outpatient clinic and a multidisciplinary hospital with a capacity of more than 1050 beds.The hospital has a highly qualified and experienced staff of doctors and nurses, including 7 Distinguished Physicians, 6 Distinguished Health Workers, 17 Excellence in Health Care, 10 Doctors of Medical Sciences and 55 PhDs in Medical Sciences. More than 60% of almost 2000 employees have the highest and first qualification categories. The staff is represented by almost all popular and popular medical specialties. The hospital is equipped with modern equipment that allows solving the most complex medical problems.Our hospital has a strong clinical and scientific tradition that allows us to provide a high level of diagnosis and treatment. We do not stop there. We continue to grow, develop, improve. We have big plans.

Information service – (812) 415-18-88 working hours 9.00 – 19.00
Office – t. 415-18-59 f. 415-19-02
Outpatient consultation department – (812) 415-18-66, 8-981-892-73-08, (812) 411-36-58
Appointment for an outpatient appointment (paid entry) – from 9 : 00 to 16:00 on weekdays 8 (812) 415-19-47
Admission department – (812) 375-32-76
Department of paid medical services (hospital) – (812) 411-36-34, (812) ) 411-36-58, fax (812) 411-36-81
Self-supporting department – (812) 375-30-22

In accordance with the decree of the Chief State Sanitary Doctor for the city of St. Petersburg from 23.06.2020 No. 31 and the order of the Health Committee dated 06.23.2020 No. 251 Hospitalization in a planned form for the provision of specialized, including high-tech medical care RENEWED from 25.06.2020. An appointment for a consultation for planned hospitalization is carried out through the outpatient consultation department. Before planned hospitalization at the prehospital stage (no earlier than 7 calendar days), it is necessary to receive a negative analysis response for COVID-19

ATTENTION

How to cope with the growing anxiety during the current epidemiological situation associated with the threat of the spread of the new coronavirus infection COVID-19.Psychologist Tips. PDF

Briefly about important (link)

Information for visitors, relatives and acquaintances of patients undergoing treatment in

SPb GBUZ “City Hospital No. 26”

In connection with the threat of the spread of coronavirus infection, according to the Resolution of the Chief State Sanitary Doctor for the city of St. Petersburg No. 2 dated 03.16.2020 “On additional sanitary and anti-epidemic measures to prevent the import and spread of a new coronavirus infection caused by (COVID-19)” , ADMISSION of visitors to the hospital departments is FORBIDDEN.

Conversations with heads and doctors of clinical departments will be held by phone from 13.00 – 15.00 on weekdays.

On weekends and holidays, patient information can be obtained from the hospital information desk.

Patient transmissions will be received daily from 13.00 – 15.00 at the hospital information desk (hall, 2nd floor).

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1st Surgical Department (Zhukovskaya City Clinical Hospital)

Head of Department

Zurabiani Vakhtang Georgievich

About the Department

The department has been organized since the opening of the city hospital.The main area of ​​work is the entire spectrum of general surgery, primarily operations on the abdominal organs: stomach, duodenum, liver, gallbladder, small and large intestines.

The department uses modern diagnostic methods, mastered modern techniques of surgical interventions, including

• laparoscopic cholecystectomy,

• laparoscopic hernioplasty for hernias of the anterior abdominal wall,

• plastics of the anterior abdominal wall with mesh explants for hernias of various localization, 9000 • percutaneous minimally invasive techniques for draining fluid formations of the abdominal cavity, treatment of liver and pancreatic cysts, treatment of obstructive jaundice under ultrasound control.

Emergency surgical interventions are performed in the department for:

• acute appendicitis;

• acute cholecystitis;

• complications of gastric ulcer and duodenal ulcer;

• intestinal obstruction;

• strangulated hernias of the anterior abdominal cavity;

• injuries to the organs of the chest and abdominal cavities;

• soft tissue wounds of acute destructive pancreatitis.

The department carries out planned surgical interventions for:

• chronic calculous cholecystitis (laparoscopic cholecystectomy),

• hernias of the anterior abdominal wall (using mesh implants), both traditional and laparoscopic operations;

• reconstructive operations on the biliary tract and organs of the gastrointestinal tract,

• operations on the thyroid gland, with nodular goiter, thyrotoxicosis, malignant neoplasms of the thyroid gland;

• surgery for benign tumors and cancer of the stomach, gastric ulcer and duodenal ulcer (gastrectomy, gastrectomy),

• surgery for benign and malignant diseases of the pancreas

• surgery for benign tumors of the skin, subcutaneous tissue ;

• various types of diagnostic and therapeutic punctures with ultrasound support and control

Also in the 1st surgical department, with the participation of specialists from the endoscopy department,

• endoscopic retrograde pacreatocholangiography,

• endoscopic papilofincterotomy for mechanical and tumorous etiology ,

• endoscopic polypectomy for benign gastric neoplasms.