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No 6 (2011)


The role of examination of lower urinary tract function in choice of treatment policy in patients with chronic cystitis and chronic non-obstructive pyelonephritis

Alyaev Y.G., Glybochko P.V., Gadzhieva Z.K., Alyaev Y.G., Glybochko P.V., Gadzhieva Z.K.


The latest investigations evidence for growing number of women with urination disorders in the absence of pathological changes in the urine. This fact suggests the conclusion that dysuria may be caused by neuroendocrine disorders in such women. Besides hemodynamic disorders, urodynamic ones are also involved in pyelonephritis pathogenesis. Our investigations show that chronic non-obstructive pyelonephritis and chronic cystitis can be both a cause and a result of functional disorders of the lower urinary tract related to defects in nervous regulation. Long-term dysfunction of the lower urinary tract may provoke progressive inflammation. In this case antibacterial and anti-inflammatory treatment of chronic cystitis and chronic non-obstructive pyelonephritis may be low effective without normalization of functional condition of the urinary bladder and urethra.
Urologiia. 2011;(6):4-8
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Vaginoplasty with inverted penile skin in male-to-female sex reassignment surgery

Mikhaylichenko V.V., Fesenko V.N., Novikov A.I., Vasil'ev I.S., Korolev V.V., Mikhailichenko V.V., Fesenko V.N., Novikov A.I., Vasilyev I.S., Korolev V.V.


The article presents the results of vaginoplasty in male-to-female sex reassignment surgery, technique of this operation, complications, long-term consequences, functional and social changes.
Urologiia. 2011;(6):9-12
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Etiological structure and antibiotic sensitivity of uropathogens in chronic recurrent infection of the lower urinary tract

Naboka Y.L., Gudima I.A., Ibishev X.S., Miroshnichenko E.A., Kogan M.I., Vasil'eva L.I., Naboka Y.L., Gudima I.A., Ibishev K.S., Miroshnichenko E.A., Kogan M.I., Vasilieva L.I.


While acute infections of the lower urinary tract (UT) have been studied in detail and antibiotic therapy of such infections is well known, etiology and choice of antibacterial treatment in recurrent chronic UT infection are not so clear. In our trial we aimed at elucidation of etiological structure of chronic cystitis recurrences by means of microbiological investigation of urine samples from 72 women on extended spectrum of nutrient media. In all the cases urine was infected with both aerobic and non-clostridial anaerobic bacteria. We determined prevalent pathogens and their antibiotic sensitivity and compared them with standard pathogens and their sensitivity in acute lower UT infection. We came to the conclusion that it is necessary to develop new recommendations on antibiotic treatment of recurrent chronic cystitis in women.
Urologiia. 2011;(6):12-15
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Diagnosis and treatment of pelvic disorders in patients with multiple sclerosis

Luzanova E.I., Bel'skaya G.N., Shalashov V.A., Luzanova E.I., Belskaya G.N., Shalashov V.A.


Pelvic dysfunction is a frequent severe manifestation of multiple sclerosis (MS). Basing on the experience in management of 70 MS patients with pelvic affection, we developed an algorithm of outpatient care for such patients which involves neurological, urological and gastroenterological assistence.
Urologiia. 2011;(6):16-20
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Clinicobiochemical and immunological assessment of polyoxidonium efficacy in the treatment of patients with chronic calculous pyelonephritis

Kazeko N.I., Khil'kevich S.V., Kazeko N.I., Khilkevich S.V.


Of 59 patients with chronic calculous pyelonephritis (CCP) taking preparation therapy for extracorporeal lithotripsy, 29 patients received combined basic treatment (antibacterial drugs, phytotherapy, physiotherapy) plus polyoxidonium (a course of 10 intramuscular 6 mg injections each other day). The rest 30 patients (controls) received basic therapy alone. Polyoxidonium efficacy was assessed by the results of clinical, device and immunological investigations, content of the main phospholipid fractions and cholesterol in red cell membranes. The results of the tests show that polyoxidonium has anti-inflammatory and immunomodulating effects, exhibits activity of peroxidation processes, contributes to normalization of a lipid phase of cell membranes and can be recommended as a component of combined treatment of patients with chronic pyelonephritis and urolithiasis.
Urologiia. 2011;(6):20-25
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Panavir in combined treatment of chronic cystitis with hyperplastic changes in urinary bladder mucosa

Aboyan I.A., Aboyan V.E., Zin'kovskaya O.V., Sknar V.A., Kucherov V.A., Stovbun S.V., Safronov D.Y., Litvin A.A., Aboyan I.A., Aboyan V.E., Zinkovskaya O.V., Sknar V.A., Kucherov V.A., Stovbun S.V., Safronov D.Y., Litvin A.A.


Human papilloma virus was detected by polymerase chain reaction in patients suffering from chronic cystitis with hyperplastic changes in urinary bladder mucosa. In most of the examinees (90%) it was HPV of highly oncogenic type 16. Panavir added to combined treatment of such patients produced a significant positive result in long-term period. Improvement was observed both in subjective assessment and the absence of dysuria episodes.
Urologiia. 2011;(6):25-29
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Correction of erectile dysfunction in patients with chronic abacterial prostatitis

Tkachuk V.N., Al'-Shukri S.X., Tkachuk I.N., Kornienko V.I., Tkachuk V.N., Al-Shukri S.K., Tkachuk I.N., Kornienko V.I.


A total of 76 patients with chronic abacterial prostatitis (CAP) in combination with erectile dysfunction were divided into two groups. Clinical symptoms of CAP and severity of erectile dysfunction were the same in both groups. Patients of the study group (n = 36) received pathogenetic treatment (vitaprost plus physiotherapy) and impase. The control group (n = 40) received vitaprost and physiotherapy. The results of the treatment showed that impase addition to combined treatment of CAP patients with erectile dysfunction significantly improves erectile function: 80.6% patients given impase raised their score by International Index of Erectile Function Scale to normal (26 points and higher). Impase efficacy increased with prolongation of the treatment from 4 to 12 weeks.
Urologiia. 2011;(6):29-31
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Effect of Herpes Simplex virus on spermatogenesis

Naumenko V.A., Tyulenev Y.A., Pushkar' D.Y., Segal A.S., Kovalev V.A., Kurilo L.F., Shileyko L.V., Klimova R.R., Al'khovskiy S.V., Kushch A.A., Naumenko V.A., Tyulenev Y.A., Pushkar D.Y., Segal A.S., Kovalev V.A., Kurilo L.F., Shileiko L.V., Klimova R.R., Alkhovsky S.V., Kusch A.A.


To investigate the effect of Herpes Simplex virus (HSV) on spermatogenesis, HSV in ejaculate was detected by a rapid cultural method in 268 infertile males and 47 healthy ones. The number of mobile spermatozoa in HSV infected samples was less than in non-infected samples (21 mln/ml versus 40 mln/ml, p = 0.0001). The relative number of morphologically normal gametes was 13% versus 19% (p = 0.002), respectively. The quantitative karyological test discovered that males with HSV-infected ejaculate have more degenerating sex cells while in high virus contamination (more than 10 virus particles in 1 ml) the number of spermatides and spermatocytes of the 1 order at diploten stage is low. Organic testicular culture was used for more detailed study of pathogenetic mechanisms of HSV impact on spermatogenesis. Testicular explants infection was associated with reduction in the number of spermatogones, spermatocytes and spermatides on culturing week 2. The above findings reveal some pathogenetic mechanisms underling fertility disorders in males with HSV infection: a gametotoxic effect of the virus reducing populations of spermatogones, spermatocytes and spermatide; affected mobility and morphological characteristics of spermatozoa. Detection of the mechanisms of HSV action on spermatogenesis opens a perspective of antivirus drug administration in combined treatment of male infertility.
Urologiia. 2011;(6):32-36
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Clinicopathophysiological aspects of utilization of local physiotherapy device MAVIT in combined treatment of patients with chronic prostatitis and symptomatic prostatic adenoma

Zhiborev B.N., Zhiborev A.B., Rakcheev B.Y., Zhiborev B.N., Zhiborev A.B., Rakcheev B.Y.


Clinical efficacy of combined treatment with application of MAVIT device was studied in 45 patients with chronic prostatitis. By the results of examination the patients were divided into two groups: group 1 consisted of 25 patients with the diagnosis of prostatic adenoma of stage I-II complicated with chronic prostatitis; group 2 - of 20 patients with chronic prostatitis. Biotissue effect of MAVIT on prostatic blood circulation was studied in 10 patients of group 2 who were examined with transrectal ultrasound (color Doppler mapping) before and after the physiotherapeutic session. The ultrasound examination assessed linear peak blood flow velocity, index of peripheral vascular resistance, intensity of organic vascular net. The treatment results were followed up in both groups for 3-12 months. Positive changes were registered: reduction or disappearance of dysuria, subjective improvement of urination, alleviation of genital pain. Thus, combined conservative treatment of chronic prostatitis in patients with symptomatic prostatic adenoma has a pathogenetic significance and provides adequate preparation for surgery. MAVIT device can be recommended for treatment of chronic prostatitis including patients with prostatic adenoma.
Urologiia. 2011;(6):36-42
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A comparative study of efficacy of 2-, 3- and 4-glass tests in patients with chronic prostatitis

Kul'chavenya E.V., Azizov A.P., Brizhatyuk E.V., Breusov A.A., Kholtobin D.I., Kulchavenya E.V., Azizov A.P., Brizhatyuk E.V., Breusov A.A., Kholtobin D.I.


To compare informative value of three tests (2-, 3- and 4-glass) in diagnosis of prostatitis we examined 177 patients with chronic prostatitis (CP) who were randomized into 4 groups. Group 1 patients (n = 33) were examined with standard 4-glass test (Mearls and Stamey), patients of subgroup 2a (n = 42) were examined with 2-glass test before finger rectal test (FRT), FRT was made in subgroup 2b (n = 45) before urine collection (2 portions), group 3 (n = 57) was examined by an original technique proposed by the authors. While performing the latter test special focus was given to urination continuity, then the secretion obtained at FRT was studied. Efficacy of each of the tests was assessed by comfort of the procedure for the patient and the doctor, a proportion of false-positive results. The 3-glass test proved most informative and significant. Also, it is sensitive in detection of urogenital tuberculosis. The 4-glass test is not comfortable for both the patient and the doctor. The 2-glass test often produced false-positive results.
Urologiia. 2011;(6):42-45
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Combined treatment of patients with prostatic adenoma and overactive bladder

Maksimov V.A., Khodyreva L.A., Dudareva A.A., Al'bitskaya A.Y., Maximov V.A., Khodyreva L.A., Dudareva A.A., Albitskaya A.Y.


Of late, we observe a trend to a progressive rise of overactive bladder (OB) morbidity with age. M-cholinolytic drugs are most effective in management of OB but old patients with prostatic adenoma (PA) and comorbid pathology have a risk of acute urinary retention and serious side effects. We have the experience in combined treatment of 30 old patients with PA and OB with M-cholinolytic and alpha-adrenoblocker. The results of the treatment show its efficacy and absence of complications in the control of residual urine for 3 months. Combination of M-cholinolytic with alpha-adreboblocker significantly reduced daily diuresis, improved an accumulation function of the bladder and life quality.
Urologiia. 2011;(6):46-50
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Effects of immunocorrective therapy on immunological indices in patients with chronic bacterial prostatitis

Repin E.V., Dolgikh V.T., Dolgikh T.N., Ershov A.V., Repina T.V., Repin E.V., Dolgikh V.T., Dolgikh T.N., Ershov A.V., Repina T.V.


A total of 57 patients with chronic bacterial prostatitis were divided into two groups. The control group (n = 28) received standard treatment, the study group (n = 29) received treatment including immunomodulator likopid. The tests for IgA, IgM, IgG, compliment components C3, C4, circulating immune complexes were made, immunophenotyping of peripheral blood lymphocytes was performed, chemiluminescence parameters of whole blood and plasma, content of IL-10, TNF-alpha, IL-1beta in seminal fluid were assessed. The detected abnormalities in parameters of systemic and mucose-associated immunity give ground for inclusion of immunomodulators in combined treatment of patients with chronic bacterial prostatitis.
Urologiia. 2011;(6):50-54
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Vitaprost-forte in the treatment of patients with prostatic adenoma

Shafranov D.V., Mariupol'skiy A.A., Shafranov D.V., Mariupolsky A.A.


Our study included 50 patients aged 48-67 years with moderate symptoms of prostatic adenoma (PA). Thirty patients received vitaprost-forte in the form of rectal suppositories for 60 days and alpha-adrenoblocker. A positive effect of the drug on PA symptoms and improvement of life quality by IPSS and QoL questionnaires was observed in 93.3% patients. Relief of infravesical obstruction led to a 43% reduction of residual urine. The effect was stable on day 30 after the treatment. Our findings evidence that vitaprost forte can be successfully and safely used in the treatment of PA in combination with alpha-adrenoblockers.
Urologiia. 2011;(6):54-59
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Nebido in the treatment of hypogonadism syndrome and its complications in men

Dedov I.I., Kurbatov D.G., Rozhivanov R.V., Lepetukhin A.E., Dubskiy S.A., Goncharov N.P., Dedov I.I., Kurbatov D.G., Rozhivanov R.V., Lepetukhin A.E., Dubsky S.A., Goncharov N.P.


The article presents original experience with use of undecanoate (nebido, BayerHealthcare Pharmaceuticals, Germany) in androgenic testosteron replacement therapy in males with hypogonadism. Prospective studies of nebido efficacy were made in males with vein-occlusive erectile dysfunction (n = 20), chronic pelvic pain syndrome (n = 77), metabolic syndrome (n = 170). Retrospective studies assessed efficacy of nebido monotherapy in patients with erectile dysfunction and hypogonadism (n = 34), hematological and urological safety of the drug (n = 40). Laboratory monitoring was performed in all the studies according to ISSAM recommendations. The patients were not included in contraindications to androgenic therapy. Nebido treatment significantly improved libido and erectile function, efficacy of phosphodiesterase of type 5 inhibiors used in moderate and severe erectile dysfunction. Depressive, asthenic, pain symptoms declined in males with chronic pelvic pain. Body fat reduced in metabolic syndrome with alleviation of its other components. Insignificant rise of hemoglobin level and packed cell volume was observed in some patients while a PSA level increase was clinically significant in 10% patients who had initial PSA > 2.5 ng/ml and acromegalia. Also, nebido depressed production of gonadotropins and spermatogenesis. Thus, nebido is highly effective in sexual dysfunction and other somatic disorders caused by hypogonadism. Nebido does not induce severe side effects, but clinically significant rise of PSA level requires treatment discontinuation and more careful urological examination. In view of nebido ability to suppress spermatogenesis, the drug should not be used in reproductively active men.
Urologiia. 2011;(6):59-67
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Iliac neobladder 10-year experience

Vasil'chenko M.I., Sergienko N.F., Zelenin D.A., Semenyakin I.V., Vasilchenko M.I., Sergienko N.F., Zelenin D.A., Semenyakin I.V.


Surgeons of the clinic of P.V. Mandryka Central Military Hospital have rich 10-year experience in creation of neobladders after cystectomy. So, from 2000 to 2009 a total of 90 cystectomies were made for different diseases of the urinary bladder and prostatic gland as well as in cancer of the other pelvic organs. Vesicoplasty, both heterotopic and orthotopic, was performed from an iliac segment by an original technique with creation of antireflux bypass with the ureters. The examination of the patients in different terms after operation (up to 10 years later) provided information about changes in the neobladder under the influence of urine and systemic changes in the body. The analysis of the results show that creation of the iliac neobladder in our modification is perspective, while side effects are rare. Further long-term follow-up will give new arguments for and against this procedure.
Urologiia. 2011;(6):67-72
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Kidney transplantation in recipients with renal carcinoma

Yankovoy A.G., Vatazin A.V., Trapeznikova M.F., Bazaev V.V., Shibaev A.N., Prokopenko E.I., Shcherbakova E.O., Yankovoy A.G., Vatazin A.V., Trapeznikova M.F., Bazaev V.V., Shibaev A.N., Prokopenko E.I., Scherbakova E.O.


Transplantation of the kidney in patients with renal carcinoma is disputable. The article presents the results of kidney transplantation in different cancer lesions of the patient's kidneys. Seven case histories of patients with primary renal tumors are retrospectively analysed. A clinical case of development of the tumor of own kidney in a patient after transplantation is reported. A time factor of kidney transplantation after tumor removal in a recipient is discussed.
Urologiia. 2011;(6):72-77
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The role of mutation of gene CYP1A1 and benzapirene in cytogenetic changes of urinary tract epitheliocytes in oil industry workers employed in the oil fields of the North of West Siberia

Il'inskikh N.N., Il'inskikh E.P., Il'inskikh I.N., Yamkovaya E.A., Ilinskikh N.N., Ilinskikh E.P., Ilinskikh I.N., Yamkovaya E.A.


The examination of 477 oil industry workers and office personnel (control) employed in the oil fields of the North of Tomsk and Tyumen regions has detected increased number of epithelyocytes with micronuclei and an elevated urine level of benzapilene in workers employed in oil production. Especially pronounced changes of the above parameters were observed in men with mutant alleles Val of CYP1A1 gene. An enhanced mutation process in oil production workers may be due to a resultant action of different factors on human genome. Involved may be both mutagens and factors of comutagenic nature. The results obtained in this study suggest a conclusion about urgent need of introduction of new scientifically validated criteria of selection of personnel for oil production in the North of the West Siberia. Health examination of the applicants must include genotyping.
Urologiia. 2011;(6):77-81
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Combined endoscopic treatment of patients with prostatic adenoma

Glybochko P.V., Anafin T.G., Shalekenov S.B., Glybochko P.V., Anafin T.G., Shalekenov S.B.


We studied efficacy of combined surgical treatment of patients with prostatic adenoma (PA) including laser vaporization (LV) and transurethral electroresection (TUER). A total of 294 PA patients entered the trial. Photoselective LV was made with GreenLight PVP laser (80 W) in 180 patients and Dornier Urobeam laser on the basis of diode laser (940 nm) in 34 patients. The other 60 and 20 patients after photoselective LV (GreenLight PVP 80-W laser) and (Dornier Urobeam laser), respectively, have undergone TUER of coagulative-necrotic scab after vaporization. The analysis of the treatment results show that laser vaporization on both lasers is followed with dysuria in 26.6 and 32.4% patients, respectively, while in combination of LV with TUER - in 11.25% patients. Thus, the above combined endoscopic treatment can be recommended as most effective as it rapidly improves quality of life of the patients.
Urologiia. 2011;(6):81-83
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Laparoscopic and microsurgical varicocelectomy: comparison of the results

Muslimov S.T., Bogdanov A.B., Muslimov S.T., Bogdanov A.B.


Laparoscopic and microsurgical varicocelectomy were compared by clinical and cost efficacy results. Microsurgical subinguinal varicocelectomy was performed in 129 patients, laparoscopic - 167 patients. Median of the patients' age was 27 years (16-38 years). Median of follow-up in microsurgical operation was 26 months (13-60 months), in laparoscopic method - 62 months (28-71 months). By clinical criteria (time of surgical intervention, amount of analgetic drugs in the postoperative period, stay in hospital, rate of varicocele recurrence and postoperative complications), the results of microsurgical varicocelectomy proved significantly better than those of laparoscopic operations. The rate of all complications after microsurgical ligation of the testicular veins was 8 times less than after laparoscopic intervention, the rate of varicocele recurrence - 2.4 times less. Microsurgical operations were financially more effective (by 20%) than laparoscopic varicocelectomy. Thus, microsurgical varicocelectomy is more effective than laparoscopic one both clinically and financially.
Urologiia. 2011;(6):83-87
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Radiodiagnosis of early-stage nephroangiopathy in children with arterial hypertension

Trubnikova K.E., Trofimova T.N., Novikov A.I., Nazarov T.N., Trubnikova K.E., Trofimova T.N., Novikov A.I., Nazarov T.N.


A total of 115 children aged 13-17 years (mean age 15.77 ± 1.89 years, 98 boys and 17 girls) with essential arterial hypertension (EAH) were examined. Of them, 70 children had stable arterial hypertension (SAH), 45 children - labile arterial hypertension (LAH). 24-h monitoring of blood pressure, triplex ultrasound study of the renal vessels were performed in all the patients. The assessment of renal hemodynamics showed that blood flow was more active in SAH patients. The clinostatic test revealed inhibition of circulation at the level of the basic trunk (by 26% in SAH and by 22% in LAH) and segmentary renal arteries (by 28% in SAG), IR ( < 0.52). The above findings confirm the action of arterioveinous bypass blood flow mechanism and provide diagnosis of nephroangiopathy at early stages of EAH.
Urologiia. 2011;(6):88-91
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Intravesical electrostimulation and magnetotherapy in chronic pyelonephritis and cystitis in children with urodynamic disorders

Sharkov S.M., Yatsyk S.P., Bolotova N.V., Raygorodskiy Y.M., Konova O.M., Tkacheva E.N., Sharkov S.M., Yatsyk S.P., Bolotova N.V., Raigorodsky Y.M., Konova O.M., Tkacheva E.N.


The results of the treatment of 38 children (6 boys and 32 girls, age 6-14 years) with chronic pyelonephritis and/or cystitis complicated with neurogenic dysfunction of the urinary bladder (NDUB) and/or vesicoureteral reflux (VUR) of the first-third degree demonstrate efficacy of intravesical electrostimulation (IVES) and adrenal magnetotherapy. IVES was conducted with high-frequency current impulses (2.2 kHz) by means of INTRASTIM attachment to the device AMUS-01-INTRAMAG in the region of the urethrovesical anastomosis via solution of the drugs for instillation. As the result of exposure to both physical factors in the presence of standard medication, NDUB symptoms alleviated (by E.L. Vishnevsky's criteria) by 59.5% against 38.1% in the control group. Dopplerographic examination of renal vessels stated a 24.3% increase in blood flow in the major renal artery in the study group against 10.5% in the control. The proposed complex pharmacological plus physiotherapeutic treatment of chronic pyelonephritis and cystitis in abnormal urodynamics resulted in a 2.2-fold decrease in the number of recurrences compared to the standard treatment.
Urologiia. 2011;(6):92-97
pages 92-97 views

Cranberry preparations in urological practice: view of a clinical pharmacologist

Sychev D.A., Sychev D.A.


Cranberry has been used in various urological problems from ancient times but only now cranberry preparations were studied clinically and pharmacologically in terms of prophylaxis of urinary tract infections. The active component of cranberry are protoantocianides which have no antibacterial activity but inhibit adhesion of uropathogenic E.coli due to block of P-fimbria and thus inhibit development of biofilms. When cranberry preparations are taken per os, proantocianides accumulate in high doses in urine. Efficacy of cranberry in prophylaxis of recurrent urinary infection was demonstrated in randomized clinical trials. Administration of standard cranberry preparations containing not less than 36 mg of proantocianides such as monurel is recommended by European Urological Association (EUA). Cranberry preparations are well tolerated, especially in capsules. However, they can contribute to nephrolithiasis progression and enhance anticoagulation action of indirect anticoagulant drugs.
Urologiia. 2011;(6):97-103
pages 97-103 views

Operative treatment of a patient with tuberous sclerosis in suspected renal carcinoma

Ivanov A.P., Buylov V.M., Karpov N.R., Ivanov A.P., Builov V.M., Karpov N.R.
Urologiia. 2011;(6):104-107
pages 104-107 views

Etiological hypotheses of renal carcinoma onset

Zhurkina O.V., Zhurkina O.V.
Urologiia. 2011;(6):108-111
pages 108-111 views
pages 112-112 views

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