Endourology and Lithotripsy Regional Centre was established on the base of the urology department of the Regional Municipal Institution "Emergency Hospital" and the Department of Surgery and Urology of Bukovinian State Medical University (a joint order of the Chief Board of Health Protection of the Chernivtsi Regional Administration and Bukovinian State Medical University № 30/02-0 of 25.01.11).
The Center was established to improve the quality, effectiveness of treatment, a reduction of disability, on increase the life expectancy of patients with urological disorders by creating conditions for the rational use of the personnel and material technical resources of patient care and preventive institutions and Bukovinian State Medical University and by introducing corresponding modern technologies of treatment, in particular lithotripsy, marginally invasive endoscopic surgery, etc.
The organizational-methodological management is implemented by Ihor Korniiovych Ariichuk, the head of the urology department of RMA – "EmergencyHospital" and Olexandr Stepanovych Fedoruk the head of the urology course, Professor of surgery and urology ofBukovinian State Medical University,MD.
The Center is functionally formed by:
- urological room of the regional consulting polyclinic;
- urological rooms of municipal polyclinics;
- clinico-biochemical laboratory of the emergency hospital (EH);
- X-ray department of EH;
- functional diagnostics room;
- department of anesthesiology with intensive care beds;
- consulting room of ultrasound investigations.
In case of need, the department of radiodiagnostics of theRegionalDiagnosticCentermay be involved.
Endourology and Lithotripsy Regional Centre provides planned adult care according to the list of diseases and the extent of operating procedures, it also provides emergency urological care for adult citizens of the region and citizens of Chernivtsi twenty-four hours a day and every day of the week. In urgent and routine cases (urolithiasis) the Center provides children care in Chernivtsi region and in theChernivtsiCityby means of remote shock-wave splitting concrements.
In May 2011, the Center was equipped with a modern apparatus for extracorporeal lithotripsy (fragmentation) Duet Magna by Direx Group company (Israel) with blocks of ultrasound and X-ray diagnostics. Besides, the Center has a transurethral resectoscope of the Karl Storz company, ureteronephroscope of theOlympuscompany, a laparoscopic stand of the Karl Storz company, apparatus for contact lithotripsy "Calculase" of the Karl Storz company and the apparatus for ultrasound diagnostics of the Emansis company.
The center is the clinical and educational base of BSMU as well as the main base for training internship doctors practice of the full-time and correspondence course.
The Centre's staff introduces modern methods of diagnostics and treatment of urological diseases, develop and implement local protocols for the treatment of urological patients, provide consulting, organizational and methodological assistance to urban and regional urological consulting rooms and the urological department.
The introduction of new technologies enabled to improve the care of patients with urolithiasis. A great number of patients do not need material costs for going outside the region for a course of treatment. The term of disability of patients with urolithiasis has reduced considerably (1 case makes up 6 days on the average).
The list of contingents of patients who subject to referred for an examination and treatment in the Regional Center covers the whole spectrum of urological diseases, who according to the current clinical protocols may undergo a marginally invasive operative treatment in both emergency and in elective cases. Diagnostic measures and operational interferences are varied, supplemented by our own technological development of endoscopic urologic procedures, which are protected by patents ofUkraine.
Diagnostic measures undertaken at the Center:
- ultrasound investigation of the urinary system organs, including in emergency cases (traumatic damage of the kidneys, bladder and urethra, acute urinary retention).
- radiographic examinations (plain, excretory urography, descending and ascending cystography, urethrography, retrograde and antegrade ureteropyelography).
- diagnostic ureteroscopy, cystoscopy, ureteropyelography.
- bacterial urine inoculation for flora and sensitivity to antibiotics.
Types of surgical interventions which are performed at the Center:
1. Remote-controlled shock wave lithotripsy of renal and ureteral calculi.
2. Contact ureterolithotripsy in case of the presence of radioopaque calculi of the ureter, which are not subject to remote fragmentation.
3. Endoscopic ureterolithoextraction.
4. Balloon dilatation of ureteral strictures.
5. Endoscopic stenting of the ureters.
6. Endoscopic correction of congenital malformations of the ureters.
7. Transurethral resection of the prostate and prostatectomy in benign prostatic hyperplasia.
8. Transurethral forage for the prostate in case of prostate cancer sclerosis.
9. Transurethral lithotripsy of concernments of the urinary bladder and urethra.
10. Transurethral resection of urinary bladder in case of tumors.
11. Transurethral coagulation of the bladder diverticula.
12. Transurethral resection of the intramural portion of the ureter in ureterocele, bladder and prostate cancer and invading the appropriate portion of the ureter.
13. Urgent arrest of bleeding from the organs of the urogenital system.
14. Transurethral elimination of bladder tamponade.
15. Internal optical ureterotomy with urethral strictures.
16. Remote shock wave therapy of Peyronie's disease.
Remote-controlled shock wave lithotripsy has been performed since the day of the installation of the apparatus (26.05.2011) Transurethral prostate, bladder and urethra operations have been made since the foundation of the Center.
Over the period of the existence of the Center (2011-2012) 1128 patients have been operated, 958 transurethral resections of the prostate and bladder, 181 remote shock wave lithotripsies, 96 contact lithotripsies have been performed. Thereat, the operating activity for 9 months in 2012 has reached 63.5% that is significantly higher than the average number in similar specialized departments throughoutUkraine.