Astana City Urological Center

Городской центр урологии

 

Superintendent of Astana City Urological Center

Pak Yuri Georgiyevich

High degree urologist, graduate of Novosibirsk State medical academy.

Graduated clinical residency of urology Novosibirsk State medical academy. Passed internship of endoscopic and laparoscopic urology at the university of urology clinic at Tel-Aviv, Izrael.

e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Department doctors:

Zhashenov Askar Zhumagaliyevich – urologist of first category, graduate of Kazakh State medical academy. Work experience 9 years. In 2014 passed 3 month internship by “Bolashak” program in South Korea, speciality: “Public Health”, “Urology”. Specialization subjects: “Endovideosurgery”, “Andrology”, “Urgent urology”, “Minimally invasive urology”.

Umarbayev Rustam Tokenovich – secession superintendent of laparoscopic and reconstructive urology. Urologist of first category, graduate of Semipalatinsk State medical academy. Work experience 10 years. Specialization subject: “Endovideosurgery”.

Kurmanov Adilkhan Elubayevich – secession superintendent of general surgery. Urologist, graduate of Astana Medical university, Specialization subject: “Endourology”.

Kazhitayev Almas Muralovich – secession superintendent of andrology and men health. Urologist, graduate of Semipalatinsk State medical university. Work experience 4 years.

Vinnik Victor Ivanovich – urologist, doctor of Remote lithotripsy Room.

Sushenko Aleksey Fedorovich – urologist of first category, graduate of Kazakh State medical academy. Work experience 7 years. Specialization subject: “Endourology”, “Andrology”, “Urgent urology”, “Minimally invasive urology”.

Astana City Urological Center is designed for 40 beds, equipped with the most modern diagnostic and therapeutic equipment from the firm "Karl Storz", "Olympus", "Soring" and the remote lithotriptor Modulith SLK of Storz Medical.

There is a full range of necessary diagnostic equipment in our clinic, including multispiral computed tomography, which allows you to produce a three-dimensional image of the kidneys, also in angiorzhime, making more accurate the diagnosis of virtually all urological diseases. It also allows you to determine the density of stones in the urinary tract.

Urolithiasis treatment in our clinic is made by minimally invasive methods, i.e. without a cut. Open surgical treatment is practically not applied, except for only complicated and neglected cases. The choice of necessary technique of surgical treatment is depending on the size of the stone, localization, the density of the stone.

1. The department has a remote lithotriptor Modulith SLK from Storz Medical, with which it is possible to crush small stones and stones of medium size in the kidney and ureter. Also x-ray and ultrasound guidance, in which the apparatus is applied to the skin, anesthesia is not required.

2. Percutaneous (transcutaneous) nephrolithotripsy using a holmium laser, i.e. through a puncture on the skin (without a cut) in the lumbar area, with the help of a nephroscope crush large, and even coral stones in the kidney, which occupy the whole cavitary system of the kidney, of any density, under X-ray control.

3. Transurethral ureteropyelokalikolitotrssy with the use of a holmium laser, i.e. through the natural urinary tract, under anesthesia with hard or fibraureterorenoscope, crushs stones of any localization in the ureter and kidneys, under X-ray control.

4. Laparoscopic pyelolithotomy, ureterolithotomy are performed with the help of three or four punctures of the anterior abdominal wall (without incision), finds the location of the stone of the pelvis and ureter, after which a cut is made over the stone and the calculus is removed. The postoperative rehabilitation period is 2-3 times shorter than after the open surgery.

Nephroptosis (omission of the kidney) - pathological mobility of the kidney, in our clinic this nosology is treated by 3 methods:

1) Laparoscopic nephropexy is performed with the help of three or four punctures of the fart of the abdominal wall (without a cut), the kidney is sutured to the lumbar muscle, using a special mesh.

2) Percutaneous nephropexy - an operation when makes a single puncture in the lumbar area or in the kidney cavity system, the drainage tube is left for 5 days due to the fusion in the form of a fistulous passage from the tube, the kidney is fixed in its normal position (this type of operation is used in the combination of nephroptosis with kidney stones, or stricture of the ureteropelvic segment).

3) The traditional method is open surgery, performed by Pogorelko incision, neuromuscular repair according to Revoyr-Pytel-Lopatkin (this type of surgery is performed rarely in our clinic, in cases when a revision of LMS is necessary, Vasouteroconferencing). Rehabilitation period after operation is for 10 days.

Surgery of hydronephrosis - we use a wide technique of percutaneous endopyelotomy of the stricture of the tuberculosis-ureteral segment using a holmium laser, as it was said above by the method of percutaneous access to the renal cavity through the nephroscope, a holmium laser is performed and the narrowed pyeloureteral segment is dissected, after which an endopyelotomic stent is placed on the 4- 6 weeks. This method of treatment is most optimal for combinations of the stricture of the ureterocarillary segment with nephrolithiasis and nephroptosis.

Traditional methods are also used - open and laparoscopic plastics of LMS. The choice of suitable technique for surgical treatment is depending on the variant of narrowing of the pyeloureteral segment.

Laparoscopic pyeloplasty and vasopexia are performed with the help of three or four punctures of the anterior abdominal wall (without incision), in the presence of stricture (narrowing) of the ureter, excision of the stricture (narrowing) with the plastic of the pyelourethral segment or ureter in a certain area is performed. Also, when the ureter is compressed by an additional (aberrant) kidney vessel, we perform laparoscopic suturing of the kidney vessel, which creates a violation of the outflow of urine, to the upper edge of the pelvis. Also in comparison with open types of surgical interventions, the postoperative rehabilitation period is shorter by 2-3 times.

Nephrectomy (removal of the kidney) - is performed with wrinkling, hypoplasia, terminal form of hydronephrosis, kidney tumors. In our clinic, both an open and a laparoscopic view of this operation is performed. Laparoscopic nephrectomy removes the kidney with four punctures of the anterior abdominal wall (without incision). Also in comparison with open types of surgical interventions, the postoperative rehabilitation period is shorter by 2-3 times. On the second day after surgery, patients are activated.

 

Urinary incontinence in women is stressful, when conservative therapy is ineffective, in our hospital this problem is eliminated in two ways:

1) Birch's laparoscopic operation, a sufficiently developed and effective method, under endotracheal anesthesia, with the help of 3 punctures in the anterior abdominal wall (without incision), the angle of the urethra changes with the help of non-absorbable filaments.

2) TVT-urethropexia, with the help of a special non-resorbable mesh made of tissues inert to the body, the angle of the urethra also changes through the vagina.

Benign prostatic hyperplasia (prostate adenoma) in our clinic is widely used surgery TUR-BPH (without incision) endoscopic surgery, has become the "gold standard" in recent years in the treatment of adenoma. Open adenomectomy is used in cases where the volume of the adenoma exceeds -100 cm3.

Varicocele - varicose veins of the spermatic cord. In our clinic we differentiate the types of venous reflux with a further choice of the method of optimal surgical treatment, we are mainly treat with \the method of laparoscopic occlusion of the testicular vein, using the 3 punctures of the abdominal cavity under the endotracheal anesthesia the enlarged internal seminal vein is bandaged, after the operation the patient Is free on the next day. Also, the traditional way of Ivanisevich's operation is used. A microsurgical operation is under way - subinvinal excision of varicose veins of the spermatic cord.

Andrological help, treatment of prostatitis, erectile dysfunction, infertility.

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