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No 4 (2015)


Genetic risk factors for multiple kidney stone formation in the Russian population

Apolihin O.I., Sivkov A.V., Konstantinova O.V., Slominskij P.A., Tupicyna T.V., Kalinichenko D.N.


This study examines the association of multiple kidney stones with polymorphisms of urolithiasis candidate genes in the Russian population. A total of 75 adult patients with multiple stones (the main group) residing in the Central Russia and 189 healthy adults (control group) from the same region underwent genetic testing. The study group consisted of 41 (54.7%) males and 34 (45.3%) females with mean age 44.5±14 years. The material for the study was samples of venous blood. Spectrum and frequency of polymorphic variants of four urolithiasis candidate genes were determined using real time PCR: the Klotho gene (Kl, rs526906), vitamin D receptor gene (VDR, rs1540339), gene of the extracellular calcium-sensitive receptor (CASR, rs2202127), calcium release-activated calcium modulator 1 (ORAI1, rs7135617). Fisher angular conversion and x2 tests showed association between the genetic polymorphisms of ORAI1 and multiple kidney stone formation in the Russian population. No association was found between multiple kidney stones and polymorphisms of genes encoding Kl, VDR, CASR. These results indicate that genetic factors, in particular polymorphic variants of the ORAI calcium release-activated calcium modulator 1 (ORAI1, rs7135617), may affect multiple kidney stone formation in the Russian population.
Urologiia. 2015;(4):4-6
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The role of 3d-computer simulation in improving the staghorn nephrolithiasis treatment results

Aljaev J.G., Saenko V.S., Pesegov S.V.


This article presents the experience of applying 3D-computer simulation for treatment planning in patients with coral kidney stones. The impact of the kidney internal structure and the nephrolithiasis stage on the treatment results of the patients with staghorn stones are analyzed on the basis of authors own experience. They note the usefulness of computer modeling in preoperative planning for improving the treatment results and preventing intraoperative complications.
Urologiia. 2015;(4):7-10
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Rational therapy for recurrent infections of the lower urinary tract. The results of a prospective observational program to assess the effectiveness and safety of Ceforal®, Solutab® and Uro-Vaksom® in patients with recurrent uncomplicated lower urinary tract infections (FLORA)

Loran O.B., Kogan M.I., Sinjakova L.A., Ivanov A.G., Vinarov A.Z., Spivak L.G., Lokshin K.L., Zajcev A.V., Korsunskaja I.L., Kapsargin F.P., Hlebnova E.J.


Remaining generally unchanged, urinary tract infection (UTI) treatment protocols require continuing monitoring due to growing antibiotic resistance and lowered immune status of the majority of patients. The article presents the results of a prospective observational program carried out the Russian Federation in to assess the effectiveness and safety of Ceforal®, Solutab® and Uro-Vaksom® in patients with recurrent uncomplicated lower urinary tract infections (FLORA). The results of the program suggest that Ceforal® Solutab® and Uro- Vaksom® administered as a part of routine clinical practice contribute to a significant reduction in the number of UTI recurrences and have a good safety profile. These findings support recommendation to use this treatment protocol in patients with recurrent UTI, taking into account individual and epidemiological features.
Urologiia. 2015;(4):11-18
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Chronobiological aspects of the use of prolit super septo in patients with infectious and inflammatory diseases of the urinary system

Kuzmenko A.V., Kuzmenko V.V., Gjaurgiev T.A., Stroeva D.E.


This paper presents results of a study involving 120 patients with infectious and inflammatory diseases of the urinary system, divided into four groups. Groups 1 and 3 included patients with acute serous nonobstructive pyelonephritis, groups 2 and 4 - patients with exacerbation of chronic recurrent bacterial cystitis. Patients in groups 3 and 4 received a 10 day course of antibiotic therapy combined with Prolit super septo while patients in groups 1 and 2 - only the standard antibiotic therapy. The authors studied changes in the clinical presentation, chronorhythms and psycho-emotional condition of the patients. At baseline, all patients showed signs of severe desynchronosis and psycho-emotional disorders. Combination therapy with Prolit super septo more effectively suppressed inflammation, improved clinical symptoms, corrected patient psychoemotional status and restored normal chronorhythms regardless of the inflammation location.
Urologiia. 2015;(4):19-23
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Experimental Models of Stress Urinary Incontinence

Makarov A.V., Fathudinov T.H., Tuhovskaja E.A., Apolihina I.A., Arutjunjan I.V., Ismailova A.M., Elchaninov A.V., Kananyhina E.J., Teterina T.A., Bolshakova G.B., Vasilev A.V., Glinkina V.V., Murashev A.N., Suhih G.T.


Despite numerous medical and surgical treatment strategies available, the problem of stress urinary incontinence (SUI) in women is still not completely resolved. Continuing research is underway to modify the sling operations and develop new bulk-enhancing agents, including the use of tissue engineering and cell technologies. To evaluate the safety and effectiveness of new methods at the preclinical stage, adequate and reproducible experimental models of SUI in laboratory animals should be used. This article presents analysis of all SUI models described in the scientific literature and the results of an experimental study comparing two primary ways of modeling, based on bilateral pudendal nerve damage in female rats. The experiment results showed that only bilateral electrocoagulation of proximal part of pudendal nerves by the posterior approach ensured a stable and long-term SUI symptoms in animals in the form of leak point pressure reduction in the urodynamic study and increase of the of the urethral lumen according to histomorphometric analysis. The results suggest that an adequate experimental SUI model is urethral rabdomiosphincter denervation by pudendal nerve electrocoagulation by the posterior surgical approach, when the nerve is damaged in the area of its separation from sciatic nerve. In this case stable and reproducible results are obtainable.
Urologiia. 2015;(4):24-28
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Viral Infections: Human Papillomavirus and Genital Herpes Type 1 and Type 2 as a Cause of Chronic Recurrent Cystitis with Severe Dysuria in Women with Urethral Hypermobility and Hypospadias

Derevjanko T.I., Ryzhkov V.V.


Female hypospadias presenting as a misplaced urethral opening is a common cause of chronic recurrent cystitis. Cystitis occurs when urogenital infection and anaerobic bacteria enter the urethra and bladder from the vagina. The authors argue that chronic infections of the lower urinary tract in women with hypospadias should be treated surgically by meatal transposition. They present a study confirming the role of the antiviral drug Panavir in prevention of inflammatory complications in the postoperative period in patients with a history of viral infection (human papillomavirus and herpes).
Urologiia. 2015;(4):29-32
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Titanium nickelide technologies in minimally invasive surgery of kidney and upper urinary tract

Feofilov I.V.


The most common pathology of the kidney and upper urinary tract includes nephrolithiasis, ureteral strictures and renal cysts. In the treatment of patients with these diseases, the majority of surgeons prefer minimally invasive techniques, including endoscopic surgery. The complication rate of percutaneous surgery is a major factor in encouraging the search for new treatments. We have analyzed the results of 402 x-ray-endoscopic operations performed with the use of technologies based on titanium nickelide materials in patients with nephrolithiasis, ureteral strictures and kidney cysts. The high effectiveness and reliability of porous titanium nickelide cryoapplicator was noted in control of percutaneous channel bleeding and prevention. The proposed suspension nephropexy with fine titanium granules in coexisting nephrolithiasis and nephroptosis demonstrated 1.5 times greater effectiveness compared to the traditional nephropexy, reducing duration of nephrostomy and rehabilitation by almost 3 times. The proposed methods of intubation by permanent and temporary stents with shape memory after percutaneous ureteropelvic junction stricture correction are promising in the treatment of patients with this pathology of the upper urinary tract. Application of titanium nickelide implants in simple renal cyst surgery has led to a significant increase in the effectiveness of these operations, improvement in long-term results and patients quality of life.
Urologiia. 2015;(4):33-38
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Classical Radical Extraurethral Method of Adenomectomy - Beyond 30 Years

Sergienko N.F., Vasilchenko M.I., Kudrjashov O.I., Bratchikov O.I., Begaev A.I., Shershnev S.P., Rejnjuk O.L., Lotockij M.M., Zelenin D.A.


Introduction of transvesical extraurethral adenomectomy into clinical practice was preceded by the clinical and morphological study of the prostate, prostatic urethra, bladder, upper urinary tract and renal function. It was found that at any volume of adenomatous (hyperplastic) tissue in the prostate, front semicircle around the prostatic urethra remains intact, and changes occur only in the proximal part of its back semicircle. Front semicircle adherent to the anterior commissure of the prostate has no adenomatous tissue. Extraurethral method enables you to perform a prostatectomy at any size of adenomatous tissue (fragmentarily) with preservation of the prostatic urethra, urethral vascular plexus and, if necessary, to carry out the vesicourethral segment correction without blood loss. Free independent urination is recovered at days 10-12 after the healing of the suprapubic surgical wound and removal of drainage tube. Since the introduction of transvesical extraurethral prostatectomy into clinical practice, more than 3,000 radical adenomectomies at different stages in patients with co-morbidities were performed only at Burdenko Central Military Clinical Hospital and the 2nd Mandryka CMCH.
Urologiia. 2015;(4):39-43
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Comparative Analysis of Positive Surgical Margin Rates in Patients Undergoing Robot- Assisted or Retropubic Radical Prostatectomy for Prostate Cancer

Veliev E.I., Sokolov E.A., Loran O.B.


The issue of comparative evaluation of oncological and functional outcomes of robot-assisted radical prostatectomy (RARP) and radical retropubic prostatectomy (RRP) is widely discussed in the international literature. A key point in studying the oncological efficacy of both techniques is a comparative evaluation of positive surgical margin (PSM) rates as one of the main prognostic factors influencing the further course of prostate cancer. Available data so far are inconsistent, which prompted us to conduct our own research. A retrospective analysis was performed in two groups of patients who underwent RARP (n=63) and RRP (n=116) from January 2014 to April 2015. Despite a general trend towards lower PSM rates in RARP group compared to RRP group (12.7 and 21.6%, respectively, p=0.09), no significant differences were found in the stratification of patients in both groups depending on the risk of prostate cancer progression and pathological stage. These data show the potential equality of the two methods regarding intraoperative control of resection margins.
Urologiia. 2015;(4):44-47
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10 Years Experience in Using Direct Ureterointestinal Anastomosis in Urinary Intestinal Diversion after Radical and Simple Cystectomy

Loran O.B., Serjogin I.V., Hachatrjan A.L., Guspanov R.I.


147 patients who underwent urinary intestinal diversion from 2004 to 2014 were selected for the retrospective study. The authors carried out a comparative analysis of rates of complications that arise from the direct ureterointestinal anastomosis. The mean age of patients was 54.2±3.0 (36-69) years. 60 (40.81%) patients of group 1 underwent Nesbits direct ureterointestinal anastomosis, while in 87 (59.19%) patients of group 2 Wallace-1 and Wallace-2 anastomoses were performed. Average followup was 5.6 (2-10) years. Strictures of ureterointestinal anastomosis were detected in 2 (3.38%) patients of group 1 and in 1 (1.14%) patient of group 2. In all cases re-anastomosis was performed. The maximum postoperative concentration of serum creatinine in both groups was 231mmol/l. According to radioisotope kidney scan, no differences in accumulative and excretory renal functions between two groups of patients were recorded. No kidney stone formation in both groups of patients during the followup period was observed. No ureteral reflux above grade 3 was noted. The clinical manifestation of reflux pyelonephritis was observed in 3.5% of the patients. Acute pyelonephritis was cured by antibacterial therapy.
Urologiia. 2015;(4):48-51
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Non-Neoplastic Kidney Pathology in Specimens after Tumor-Related Nephrectomy

Gasanov A., Musaev D.


The aim of the study was to determine the incidence of pathological changes in the unaffected parts of tumor-related nephrectomy specimens. Tissue samples obtained from 507 patients were analyzed. Non-neoplastic pathology in the tumor-free kidney tissue along with the tumor was detected in 63 (12.42%) cases. All non-tumor diseases co-existing with tumors were found in patients of older age groups. Approximately 1/3 of the non-neoplastic pathology was nephrosclerosis lesions (30.16%), and in half of those cases (52.63%) transitional cell carcinoma was detected. It is pointed out that for the detection of glomerular lesions careful microscopic examination of the unaffected parts of renal parenchyma is needed. The examination, carried out by means of special staining techniques (histochemistry, immunohistochemistry, immunofluorescence), electron microscopy, and with the involvement of nephropathologists, can improve glomerular pathology detection rate after nephrectomy.
Urologiia. 2015;(4):52-54
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New options of endoscopic treatment for kidney and ureter stones in obese patients

Martov A.G., Dutov S.V., Andronov A.S., Kilchukov Z.I., Tahaev R.A.


Effective urolithiasis treatment, especially in overweight patients has a considerable medical and social implication. Extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotripsy (PCNL) in prone position of the patient are standard treatment options for kidney and ureter stones. These interventions are not always effective in patients with concomitant obesity and are associated with technical difficulties and an increased risk of complications. The study included 175 patients with obesity. The first group consisted of 96 (54.8%) patients treated with transurethral contact lithotripsy. The 2nd group consisted of 54 (30.9%) patients who underwent PCNL in the supine position. The third group comprised 25 (14.3%) patients with multiple stones of kidney and ureter, who underwent combined transurethral and percutaneous intervention in the supine position. The 1st and 3rd group had a higher prevalence of patients with II degree of obesity, in the 2nd group - with I degree of obesity. The mean duration of surgery in 1st group was 43.4 min, in the 2nd - 70.3 min and in the third - 84.6 min. Method of kidney drainage depended mainly on the presence, location and size of residual stone fragments. The average duration of the kidney drainage stent in patients of the 1st group was 39 days (ureteral catheter - 1.3 days). In all patients of the 2nd and 3rd groups, at the final stage of the operation a nephrostomy tube was placed for an average of 2.7 days. The average postoperative hospital stay was 2.9 days in the 1st group, 4.1 days in the 2nd group and 4.5 days in the third group. In the 1st group, the stone-free status was achieved in 81 (84.4%) patients. Another 10 (10.4%) patients later needed ESWL for the complete disposal of the stones. In the 2nd group, the complete clearance of kidney stones was achieved in 49 (90.7%) patients. Another 3 (5.6%) patients required added ESWL to achieve the stone- free status. In the third group of patients stone free status was reached in 22 (88%) cases. In the remaining patients residual stone fragments were not clinically important. The most prevalent postoperative complication in all groups was postoperative pyelonephritis. Taking into account high efficiency of transurethral lithotripsy and PCNL in the supine position, as well as their combinations we can recommend these interventions to treat patients with kidney and ureteral stones and concomitant obesity.
Urologiia. 2015;(4):55-63
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Pathogenetic Treatment of Chronic Nonbacterial Prostatitis Complicated by Sperm Disorders

Kalinina S.N., Koren'kov D.G., Fesenko V.N., Demidov D.A., Tiktinskij N.O.


This study examines the efficacy and safety of the natural complex of multi-component biologically active dietary supplement Prostatinol in the pathogenetic treatment of 45 patients with chronic nonbacterial Prostatitis complicated by sperm disorders. Within 4 weeks 25 patients of the treatment group and 20 patients of the control group received Prostatinol or traditional anti-inflammatory therapy correspondingly. The results were evaluated at weeks 4 and 12 after treatment cessation. Prostatinol was found to significantly increase the treatment effectiveness. More pronounced positive clinical effect was noted in 92% of treatment group patients receiving Prostatinol (disappearance of perineal pain, reduction of the IPSS score to an average of 2.1 points, absence of residual urine, normal Prostate echotexture, improvement of Prostate circulation, increase of sperm concentration and motility, higher pregnancy incidence among the wives of the treated patients). In the control group similar treatment effect was achieved in twice less number of patients. These results confirm that the components of the Prostatinol complex are effective, safe, have no side effects and can be used in the treatment of chronic Prostatitis, as well as for prevention of Prostatic diseases and improvement of sexual function.
Urologiia. 2015;(4):64-70
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Application of Integral Indicator for Assessment of Oxidative Stress in Men with Pathospermia and Type 1 Diabetes

Kolesnikova L.I., Kurashova N.A., Dolgih M.I., Natjaganova L.V., Vanteeva O.A., Belenkaja L.V., Necvetaeva T.D.


This study introduces a method for assessing the individual degree of oxidative stress (integral indicator) in men with pathospermia and type 1 diabetes, based on lipid peroxidation parameters. The study population consisted of three groups of patients. The study group included 15 men with type 1 diabetes (mean age 28±3.8 years) and abnormal semen analyses: oligozoospermia, asthenozoospermia and oligoasthenozoospermia. The comparison group consisted of 20 people (average age 30±2.5 years) without type 1 diabetes, but with changes in semen, similar to those in the study group. The control group was formed of 30 men (mean age 28±4.3 years) with complete reproductive function and without type 1 diabetes. The mechanisms of lipid peroxidation development were found to differ between patients with and without type 1 diabetes. In pathospermic patients without carbohydrate metabolism disorders, activation of lipid peroxidation processes was most pronounced at the stage of primary product formation - diene conjugates, while in patients with type 1 diabetes and pathospermia - at the stage of formation of ketodienes and conjugated trienes, and TBA- active products. It is recommended to take into account the integral indicator of the lipid peroxidation intensity in the development of methods for correction and prevention of reproductive disorders in men with type 1 diabetes and impaired spermatogenesis.
Urologiia. 2015;(4):71-75
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Theeffectiveness of intracavernous autologous platelet-rich plasma in the treatment of erectile dysfunction

Chalyj M.E., Grigorjan V.A., Epifanova M.V., Krasnov A.O.


This article deals with using autologous platelet-rich plasma (APRP) as a new treatment for erectile dysfunction in men. In recent years there was a significant interest in regenerative medicine technology due to its high effectiveness with a good safety and low cost. Currently APRP has been used successfully in various fields of medicine (surgery, traumatology and orthopedics, sports medicine, cosmetics). However, until now there have been no studies consistent with evidence-based medicine verifying the effectiveness and long-term results of APRP application for ED treatment. This article presents the results of a clinical study on the use of APRP in men with ED with a comparative effectiveness analysis of different ways of APRP administration and in combination with PDE5 inhibitors. Possible mechanisms of action of APRP in restoring erectile function are discussed.
Urologiia. 2015;(4):76-79
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Factors affecting spermatogenesis preservation in rats with seminiferous tract obstruction

Gamidov S.I., Ovchinnikov R.I., Popova A.J., Krasova O.M., Polivoda M.D., Dubova E.A., Pavlov K.A.


The aim of the study was to examine the effect of the seminal tract obstruction of different degree and duration on the morphological and functional condition of testicular tissue. The study was conducted in 50 male Wistar rats. Three experimental models of seminiferous tract obstruction were set up: obstruction of the proximal part of the ductus deferens, obstruction of the distal part of the ductus deferens and obstruction of at the epididymis level. Morphological evaluation of testicular tissue was performed at 3 and 6 months after the obstruction. It was found that obstruction at the epididymis level caused the most severe impairment of spermatogenesis.
Urologiia. 2015;(4):80-83
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Experience with E. coli lyophilized bacterial lysate OM-89 (Uro-Vaksom®) in men with asymptomatic bacteriospermia

Pochernikov D.G., Jakovleva L.V., Strelnikov A.I., Vinokurov E.J., Boldin D.I.


Chronic prostatitis is a significant problem of modern urology because it is the most common urological disease among the male population. We consider a 3 month course of OM-89 (Uro-Vaksom®) the most rational treatment of asymptomatic bacteriospermia caused by not only E. coli, but also by coexisting bacteria. Administration of OM-89 (Uro- Vaksom®) for 3 months to patients with asymptomatic bacteriospermia resulted in greater E. coli eradication in 98% of men and no growth of microorganisms in the ejaculate in 66%. Compared to these results, after a 3-4 week course of fluoroquinolones, E. coli occurred in significant titer in 15.2%, in non-significant - in 5.7% and the absence of microbial growth was noted only in 19% of cases. The course of OM-89 (Uro- Vaksom®), compared with fluoroquinolones, resulted in significantly increased sperm concentration and occurrence of greater number of spontaneous pregnancies. Rate of THB (Take Home Baby) for OM-89 (Uro-Vaksom®) group was 21%, for fluoroquinolones treatment group - 7%.
Urologiia. 2015;(4):84-89
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Treatment optimization in patients with erectile dysfunction

Pushkar D.J., Kolontarev K.B.


Erectile dysfunction (ED) is one of the most urgent problems of modern urology, significantly affecting quality of life of male population worldwide. According to European Association of Urology ED is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Premature ejaculation (PE) is also a significant medical and social issue as it seriously affects the quality of life, especially in the presence of more or less severe ED. The aim of this study was to determine the clinical efficacy and safety of combination therapy of phosphodiesterase type 5 inhibitors and dietary supplements NeyroDoz in patients with ED and PE. The study results demonstrate the effectiveness and good compatibility of phosphodiesterase type 5 inhibitors and dietary supplements NeyroDoz as a combination therapy in patients with ED and PE. Dietary supplement, having a good tolerance, reduced psychosomatic symptom and significantly increased duration of intercourse, thus significantly improving the quality of patients sexual life. The feasibility to prolong the effect of the therapy by the individual adjustment of NeyroDoz dosing mode after a 60-day treatment course offers new opportunities for personalized medicine, and the dietary supplement may be recommended as a complementary preparation to provide an adequate sexual functioning.
Urologiia. 2015;(4):90-95
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Treatment of erectile dysfunction following transvesical prostatectomy

Motin P.I., Andrjuhin M.I., Pulbere S.A., Alekseev O.J., Agaev N.K.


This study examines the efficacy and safety of phosphodiesterase type 5 (PDE-5) inhibitors in treating erectile dysfunction after transvesical prostatectomy. The study involved 63 men aged 55 to 68 years, divided into two groups - 29 and 34 patients, respectively. Patients in group 1 received 50 mg of sildenafil citrate (Ereksezil®) on a daily basis, in group 2 - 100 mg of sildenafil citrate (Ereksezil®) on demand. Postoperative visits were scheduled at the stage of screening, then after a month of treatment and on day 14 after treatment completion (3 visits altogether). Changes of patients' complaints according to IIEF-15 questionnaire showed a significant improvement in erectile function and its components of sexual life satisfaction in both groups of patients, but more significantly with regular medication intake, which has a positive impact on patients' quality of life. At the same time, treatment by PDE-5 inhibitors did not affect the maximum urinary flow rate and residual urine volume. Given the high incidence of the postoperative erectile dysfunction, postoperative administration of PDE-5 inhibitors is relevant and promising.
Urologiia. 2015;(4):96-101
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Nonbacterial Prostatitis Nonbacterial?

Strockij A.V., Gavrusev A.A., Rubanik L.V., Poleshchuk N.N.


The study involved 287 patients with chronic recurrent urethroprostatitis. In 83 (28.9%) of them the bacterial microflora in prostatic secretions was detected. The remaining 204 patients with nonbacterial prostatitis underwent in-depth laboratory testing. Cytological and immunological methods, electron microscopy, PCR, McCoy cell culture and developed by the authors the pre-culture pathogen accumulation technique were used to investigate urethral and prostatic smears. As a result C. trachomatis was detected in 84.8% of patients, T.vaginalis - 75.5%, and viruses of the Herpesviridae family - in 68.6%. Co-infection was diagnosed in 82.4% of patients, no infection was found in 6.9% of patients. The highest diagnostic sensitivity and specificity were observed in the pre-culture pathogen accumulation technique. According to electron microscopy, T. vaginalis was presented in several morphological shapes: flagellated, spherical and amoeboid. Thus, in 93.1% of patients who had previously been diagnosed with nonbacterial prostatitis by standard bacterial culture, the in-depth microbiological examination identified atypical infections (chlamydia, herpes virus, trichomonas), revealing that the rate of real nonbacterial (non-infectious) prostatitis did not exceed 6.9%.
Urologiia. 2015;(4):102-107
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Sildenafil citrate dose adjustment for men with erectile dysfunction: personalized approach

Korneev I.A.


The high prevalence of erectile dysfunction (ED) in men of all age groups with different psychogenic and organic disorders requires a personalized approach to the choice of treatment. Widely prescribed as first-line treatment for ED, sildenafil can be used in various dosages that are selected depending on comorbidities, tolerability and efficacy of the drug. Currently there is a wealth of accumulated experience of sildenafil dose adjustment depending on the severity of ED, its etiology and duration, as well as matched to the individual characteristics of copulatory activity. Divisible tablets Tornetis® («Sandoz») give the opportunity to choose an effective and safe dose of sildenafil for of all patients with ED.
Urologiia. 2015;(4):108-111
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Urology Lessons for Colorectal Surgeons

Aljaev J.G., Tsarkov P.V., Bezrukov E.A., Kravchenko A.J., Proskura A.V.


The anatomical and functional relationship of the pelvic organs is a prerequisite to the development of complications when performing surgical procedures in this anatomical region. Prevention and timely diagnosis of intraoperative injuries of both the urinary system organs and intestine, as well as well-coordinated work of urologist and colorectal surgeon team offer the opportunity to employ optimal tactics for the patient management.
Urologiia. 2015;(4):112-116
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3d-technologies as a core element of planning and implementation of virtual and actual renal surgery

Glybochko P.V., Aljaev J.G., Bezrukov E.A., Sirota E.S., Proskura A.V.


The purpose of this article is to demonstrate the role of modern computer technologies in performing virtual and actual renal tumor surgery. Currently 3D modeling makes it possible to clearly define strategy and tactics of an individual patient treatment.
Urologiia. 2015;(4):117-120
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Mirabegron - a new drug for treatment of overactive bladder

Kasjan G.R.


Mirabegron is the first drug in a new class of oral therapy for overactive bladder (OAB). It is a beta-3 adrenergic agonist, a class of drugs for the first time used for the treatment of urination disorders. Recently, following many years of rigorous multicenter randomized trials mirabegron has been approved for use in Europe and North America. The clinical indication for mirabegron is overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency and other storage symptoms in both men and women. Mirabegron is used in primary patients, or in patients who previously were unsuccessfully treated with anticholinergics. The drug has a good safety profile and causes no side effects typical of anticholinergics.
Urologiia. 2015;(4):121-124
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Review of clinical studies on combination therapy of 5a-reductase inhibitors and аі-blockers in patients with benign prostatic hyperplasia

Spivak L.G., Lokshin K.L., Vinarov A.Z.


The review presents the results of studies on combination therapy of 5a-reductase inhibitors and a1-blockers in patients with benign prostatic hyperplasia (BPH). These data demonstrate a significant advantage of the combination therapy versus monotherapy in terms of quality of life and subjective symptoms as well as the safety, better results in the prevention of BPH progression and acute urinary retention, and reduced need for surgery.
Urologiia. 2015;(4):125-133
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