Желчекаменной болезнь (ЖКБ) - лечение холелитиаза

Желчекаменная болезнь (холелитиаз) — заболевание, характеризующееся образованием конкрементов в желчном пузыре или протоках.

Патология развивается вследствие нарушения обмена холестерина и билирубина, что приводит к кристаллизации компонентов желчи. Без своевременной терапии желчекаменная болезнь прогрессирует, вызывая хронический болевой синдром и нарушение пищеварения.

Основная опасность заболевания связана с риском развития таких осложнений, как острый холецистит, механическая желтуха, панкреатит и даже перфорации желчного пузыря.

Ранняя диагностика и правильно подобранное лечение позволяют избежать осложнений и сохранить качество жизни пациента.

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General information about varicocele

Varicocele is a dilation of the veins of the spermatic cord and testicle, predominantly on the left side (up to 80% of cases), caused by dysfunction of the venous valves and blood stagnation. According to statistics, it occurs in 10-15% of men. It is most often diagnosed between the ages of 15 and 25.

There are two forms of the disease:

  • Primary or idiopathic – caused by congenital weakness of the venous valves.
  • Secondary – develops with venous thrombosis and tumors.

Depending on the severity of the scrotal vein dilation, three degrees of varicocele are distinguished. The first degree is characterized by an asymptomatic course and is often discovered incidentally during an infertility examination. The veins are dilated, but are only visible under stress, for example, during the Valsalva maneuver.

Grade 2 varicocele is accompanied by pain and a feeling of heaviness in the scrotum. The veins can be felt while standing. Grade 3 varicocele is characterized by an increase in all symptoms. Testicular atrophy or a decrease in volume is possible.

General information about varicocele

Показания и противопоказания к операции

Существует ряд показаний, при которых операция варикоцеле рекомендована для устранения симптомов, сохранения функции яичка, улучшения фертильности. В некоторых случаях из-за сопутствующих заболеваний, возраста, отсутствия клинических проявлений хирургическое лечение не проводится.

Показания к операции

Вмешательство назначают при:

  • Бесплодии
  • Прогрессирующем варикоцеле у подростков
  • Тянущей боли
  • Варикоцеле с атрофией яичка
  • Рецидиве после предыдущих вмешательств

При выявленных нарушениях сперматогенеза операция повышает шанс на зачатие. Также она необходима при подтвержденном снижении тестостерона, хронической усталости, дискомфорте, который ограничивает физическую активность.

Противопоказания к операции

Выделяют абсолютные и относительные ограничения. Среди первых:

  • Острые инфекции
  • Декомпенсированные заболевания сердца, легких
  • Патологии печени, почек
  • Нарушения свертываемости крови

К относительным противопоказаниям относятся пожилой возраст, сахарный диабет, эндокринные нарушения, которые повышают риск осложнений.

General information

Preparation for surgery

Preoperative preparation includes:

  • Discontinuation of blood thinners. For chronic illnesses, therapy adjustments are made in consultation with your doctor.
  • Avoid heavy and fatty foods and alcohol 1-2 days before the procedure.
  • Abstain from food 8 hours before surgery, and from water 2-4 hours before (if general anesthesia is planned).

The day before the procedure, take a shower and prepare loose cotton underwear for the postoperative period. Bring your passport, test results, and referral letter to the clinic.

Post-surgery Rehabilitation

To ensure a quick and uneventful recovery, it is important to follow a number of recommendations:

  1. Avoid heavy lifting and intense exercise for the first 5-7 days after surgery
  2. Resume sports after 4-6 weeks (with your doctor's permission)
  3. Abstain from intimacy for 2-3 weeks
  4. Wear a jockstrap for 7-14 days to reduce stress on the testicles and reduce pain and swelling
  5. Keep the surgical area dry and clean
  6. Shower 2-3 days after surgery
  7. Avoid hot baths, steam rooms, and saunas for 1 month
  8. Avoid constipation, as straining increases pressure in the veins of the scrotum
  9. Consume Eat easily digestible foods with sufficient fiber.
  10. Avoid alcohol for 1-2 months.

To support blood vessels and spermatogenesis, the doctor prescribes venotonics or vitamin supplements. Painkillers and anti-inflammatory medications are also prescribed if necessary.

Important! An initial examination by a doctor is required 7-10 days after surgery. Follow-up visits are scheduled at 1 and 3 months to assess healing, then at 3-6 months to monitor spermatogenesis and rule out recurrence.

Post-surgical complications

Possible complications after the procedure include:

  • Hydrocele. Occurs after open surgery due to impaired lymph drainage. Requires observation or reoperation.
  • Bleeding, hematoma. Occurs in the first hours or days after the procedure. The doctor prescribes conservative treatment.
  • Pain and discomfort in the first few days. Associated with tissue damage, suture tension, and local inflammation. Completely resolves within 1-2 weeks.
  • Infection of the suture. Occurs due to poor hygiene.
  • Impaired sensation in the scrotal skin. Occurs after open surgery. Temporary.

Sometimes after the procedure, one testicle appears smaller or different in shape, due to tissue swelling. A small, dense scar may form in the incision area, causing discomfort when moving or stretching the skin. Over time, it softens and therefore does not require treatment.

Prognosis after surgery

Overall, the prognosis is favorable. Most patients return to their normal lifestyle within 2-4 weeks. 60-80% of men experience improvement in sperm count and regain fertility within 3-6 months. Spasms, heaviness, and a feeling of fullness in the scrotum usually disappear within 1-2 weeks after surgery.

"The sooner a varicocele is detected and treated, the higher the likelihood of restoring testicular function and improving sperm count. Long-term varicocele causes irreversible tissue changes, reduces testicular volume, damages the vas deferens, and reduces spermatogenesis."

Профилактика и образ жизни

The cost of surgery in Moscow depends on the technique, the severity of the varicocele, the type of anesthesia, and any complications. Additional services include suturing, postoperative medications, dressings, follow-up examinations, and a bandage.

You can find current prices in rubles in the price list on the K+31 website or by calling the administrator. Our medical center employs experienced specialists who conduct a comprehensive examination, explain all treatment options in detail, and select the best option for each patient. Schedule an appointment now to receive qualified care and a personalized treatment plan!

Профилактика и образ жизни

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Zhao Alexey Vladimirovich
Experience 43 years
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Alexey Vladimirovich
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Udin Oleg Ivanovich
Experience 32 years
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Oleg Ivanovich
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Korolev Sergei Vladimirovich
Experience 24 years
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Sergei Vladimirovich
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Shapovalyants Sergei Georgievich
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Sergei Georgievich
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Tsvetkov Vitaly Olegovich
Experience 40 years
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Vitaly Olegovich
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Maltsev Andrew Vladimirovich
Experience 18 years
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Andrew Vladimirovich
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Malygin Sergey Evgenyevich
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Kuzavleva Elena Igorevna
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Elena Igorevna
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Ruslan Viktorovich
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Dmitry Alexandrovich
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Adyrkhaev Zaurbek Akhsarbekovich
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Zaurbek Akhsarbekovich
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Nikitina Nina Mikhailovna
Experience 12 years
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Nina Mikhailovna
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Artashes Aramovich
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Grechin Anton Ivanovich
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Anton Ivanovich
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Magdiev Arslan Khulatdaevich
Experience 14 years
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Arslan Khulatdaevich
Surgeon, oncologist, phlebologist
No Specify
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Maxim
Surgeon
Iluridze Georgy Davidovich
Experience 9 years
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Georgy Davidovich
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Andreev Alexey Olegovich
Experience 16 years
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Alexey Olegovich
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Chukumov Rinat Maratovich
Experience 32 years
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Rinat Maratovich
Maxillofacial surgeon
Balkarov Beslan Khasenovich
Experience 17 years
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Beslan Khasenovich
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Melkonyan Lia Eduardovna
Experience 13 years
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Lia Eduardovna
Oncologist, oncologist-mammologist, surgeon, radiologist, ultrasound diagnostician
Okhotin Viktor Viktorovich
Experience 18 years
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Okhotin
Viktor Viktorovich
Oncologist-mammologist, ultrasound diagnostician
Matveev Nikolay Lvovich
Experience 39 years
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Matveev
Nikolay Lvovich
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Initial Gastroenterologist Appointment
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Reviews

The appointment went very well. The doctor bandaged the wound. I received the care I needed. The specialist was attentive and friendly.
12.01.2026
Olga

About doctor:

Samara Maxim

I'd like to thank surgeon Samara M. for his exceptional professionalism and truly skilled hands. The removal of the sebaceous cyst behind my earlobe was quick, gentle, and completely calm. I was especially impressed by how simply and clearly he explained everything—my anxiety immediately disappeared, and I felt confident that everything would be fine. Thank you for your skill and compassion!
12.01.2026
Anatoly

About doctor:

Samara Maxim

Good and responsive doctor!
29.12.2025
S. Irina Viktorovna

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Melkonyan Lia Eduardovna

CIRCUMSTANCES AND ATTENTION OF A SPECIALIST
20.12.2025
T. Elena Mikhailovna

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Ivanchik Inga Yakovlevna

A very good, responsive and competent doctor! ☀️
09.12.2025
S. Tatyana Vladimirovna

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Melkonyan Lia Eduardovna

I was very pleased with the doctor’s professionalism!
03.12.2025
S. Maria Yuryevna

About doctor:

Melkonyan Lia Eduardovna

I consulted a surgeon in Samara. I had an abscess that was really bothering me. I specifically chose this doctor because I read that he was a specialist in the removal of tumors and purulent surgery with extensive experience. During the appointment, the doctor incised and cleaned the abscess. My main impression from the appointment was complete trust. The surgery was completely painless, although I was very nervous. I want to highlight the doctor's many strengths: his high level of professionalism, amazing precision in his work, and his attentive attitude towards the patient. He explained everything in detail, constantly inquired about my well-being, and maintained a calm and trusting atmosphere. I did not notice any drawbacks. The result exceeded expectations: the wound healed very quickly and without complications. The treatment was completely successful. A huge thank you to the doctor for his skillful hands, sensitivity, and the confidence he gives his patients!
01.12.2025
Anna

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Samara Maxim

The doctor was very professional in treating this lesion. Compared to a similar operation I had in Nanjing in 2022, this time everything went better.
29.11.2025
L. Chengting
Attentive, friendly, clear language. Thank you.
29.11.2025
R. Olga Ivanovna

About doctor:

Ivanchik Inga Yakovlevna

I would like to thank the surgeon for the excellent consultation. He was competent, explained everything clearly, and inspired complete confidence. He is a true professional with golden hands. I highly recommend him!
27.11.2025
Natalia

About doctor:

Samara Maxim

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K+31 on Lobachevskogo

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