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No 1 (2022)


The role of angiotensinconverting enzyme and angiotensin II receptors of the second type in the pathogenesis of proliferative diseases of the prostate

Chibichyan M.B., Chernogubova E.A., Avetyan A.V., Lapteva T.O., Pavlenko I.A., Kogan M.I.


Angiotensin converting enzyme, angiotensin II, angiotensin II receptors of the first and second types represent the “classical” axis of regulation of the renin-angiotensin system. Objective: to analyze the role of the components of the renin-angiotensin system in the pathogenesis of proliferative lesions of the prostate glan Materials and methods. The study included 63 patients who underwent transrectal prostate biopsy. The first group consisted of 19 patients with benign prostatic hyperplasia, the second group consisted of 19 men whose prostate cancer was detected during repeated biopsy, the third group consisted of 25 men with prostate cancer detected during primary prostate biopsy. The expression of angiotensin II type II (AT2-R) receptors in prostate tissue was evaluated using primary polyclonal antibodies Angiotensin II Type 2 Receptor and the EnVision FLEX imaging system (Dako, Denmark) according to a standard technique. The activity of angiotensin converting enzyme (ACE) was determined in the secret of the prostate gland, Results. It was found that the activity of ACE in the secret of the prostate gland in proliferative diseases is significantly higher than in the “healthy” prostate. The highest activity of ACE was noted for benign prostatic hyperplasia, and the minimum - for prostate cancer. The expression of AT2-R in prostate tissues in proliferative diseases of the prostate gland has its own characteristics. The expression of AT2-R in the prostate stroma turned out to be the same, in the nuclei of epithelial cells, the level of expression of AT2-R decreased in the range of BPH-PIN-CP. Thus, an increase in the activity of ACE, the accumulation of angiotensin II in prostate secretions in proliferative prostate diseases against the background of a deficiency of AT2-R is the metabolic basis of malignant transformation of the prostate gland. Conclusion. The levels of ACE activity in prostate secretion and the expression of AT2-R in prostate tissue during primary prostate biopsy can be considered as promising prognostic tools for early detection of prostate malignancy.
Urologiia. 2022;(1):5-10
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Results of percutaneous nephrolithotomy using two accesses in the treatment of patients with staghorn stones

Merinov D.S., Kazachenko A.V., Artemov A.V., Arustamov L.D., Gurbanov S.S., Konstantinova O.V., Shamkhalova K.K.


Introduction. In order to improve clinical efficiency and reduce the risk of postoperative complications in patients with staghorn stones, we compared the results of original technique of biportal percutaneous nephrolithotomy (PCNL) with the standard PCNL. Materials and methods. The total of 221 patients with staghorn stones of K3-K4 was included in the study. The biportal PCNL was used in 109 patients, while the control group consisted of 112 patients. Inclusion criteria were stone size ≥2 cm, age over 18 years, absence of coagulopathy and width of the renal parenchyma ≥1 cm. On 1st postoperative day, ultrasound or plain urography was performed, while in patient with radiolucent stones, multi-slice computed tomography was used. In addition, complete blood count and biochemical profile were done. The main difference from the standard PCNL with sequential renal tracts is the simultaneous creation of the main and additional accesses when performing biportal PCNL. This method allowed two surgeons to simultaneously and synergistically perform lithotripsy and stone extraction from two accesses using a standard nephroscope in the main tract of 24 Ch and a miniaturized nephroscope in the additional tract of 16.5 Ch. Results. The stone-free rate in the group of biportal PCNL was 80.7% (n=88), compared to 72.3% in the control group (n=81). Secondary interventions and additional procedures were required in 29 (26.6%) and 40 (39.2%) cases, respectively. The total number of infectious and hemorrhagic complications was higher in the control group. Discussion. According to our data, significant advantages are observed in the group of biportal PCNL compared to the standard technique. Conclusion. Biportal PCNL can be recommended as a promising advancement of the technique traditionally used in the clinical practice.
Urologiia. 2022;(1):11-16
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Functional state of kidneys and cardiovascular risk in patients with urolithiasis in an outpatient setting

Murkamilov I.T., Aitbaev K.A., Fomin V.V., Murkamilova Z.A., Yusupov F.A., Schastlivenko A.I.


Aim. To analyze the functional state of the kidneys and vascular stiffness in patients with urinary stone disease in an outpatient setting. Material and methods. A total of 110 patients with urinary stone disease aged 17-72 years were included in the study. The stone size was 2,67 (1,90 -3,49) mm. A clinical examination included evaluation of vascular stiffness, serum level of creatinine, cystatin C, calcium, phosphorus, sodium, magnesium, uric acid and total cholesterol. The glomerular filtration rate (eGFR) was calculated based on the formulas CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) and MDRD (Modification of Diet in Renal Disease) and Hoek's equations using creatinine and cystatin C, respectively. Results. Most often, urinary stone disease was associated with arterial hypertension (75%), a sedentary lifestyle (66.3%), hypercholesterolemia (53.6%), obesity (47.2%), hyperuricemia (44.5%) and smoking (40.9%). The median and interquartile range of eGFR according to CKD-EPI, MDRD and Hoek's equations was 100.00 (78.00;113.00) ml/min, 96.00 (71.00;106.00) ml/min and 77.65 (61.50; 93.60) ml/min, respectively. The normal GFR was significantly more often detected by the formula CKD-EPI (66.3%) in comparison with the Hoek's equations (52.7%), p<0.05. A decrease in mild GFR was found in 21 (19.0%) patients according to CKD-EPI and 33 (30.0%) according to Hoek's equations (p<0.05). In the subgroup of patients with a mild to moderate decrease in GFR according to the Hoek's equations, stiffness index and resistive index were significantly higher than in the similar subgroup of patients with decrease of GFR measured using the CKD-EPI formula (p<0.05). A negative correlation between GFR calculated using three formulas and Augmentation Index was established. Conclusions. In patients with urinary stone disease, potential cardiovascular risk factors are very common. The study of serum cystatin C level with calculation of GFR according to Hoek's equations in individuals with urolithiasis allows to evaluate total renal nitrogen excretion, as well as the level of the cardiovascular risk in the early stages of the disease.
Urologiia. 2022;(1):17-22
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Retrospective analysis of the results of whole-body PET/CT as a possible tool for clinical examination of the population in order to identify subclinical manifestations of chronic kidney disease (pilot study)

Berdichevsky B.A., Berdichevsky V.B., Sapozhenkova E.V., Romanova A.V., Rasulov F.R., Korabelnikov M.A.


Introduction. Every year in Russia, more than 200 thousand whole body PET/CT are performed for various diseases in patients without clinical and laboratory manifestations of chronic kidney disease (CKD). However, only the “area of interest” of the attending physician is analyzed, while the rest of the organs or rather their metabolic activity is neglected during the standard procedure of this contemporary and high-tech research method. Aim. To perform a retrospective study of whole-body PET/CT as a tool for prophylactic clinical examination of the population in order to identify subclinical manifestations of chronic kidney disease Materials and methods: The results of whole-body PET/CT with 11C-choline were retrospectively analyzed for the detection of CKD in 100 patients of the Tyumen region who underwent a study for various indications outside the genitourinary system without history, clinical and laboratory manifestations of CKD. Results: According to the results, 22% of patients had different manifestations of 11C-choline hypometabolism, indicating a decrease in the viability of the parenchyma. In 14% of patients, there was a local decrease in the uptake of 11C-choline without CT-signs of kidneys damage, and in 8% of cases there was a total decrease in their metabolism, coinciding with X-ray signs of renal scarring. Conclusions. The possibility of early molecular study of nephropathy can be used for wider retrospective PET/CT clinical examination as one of the highly effective methods for detecting CKD, which needs further research.
Urologiia. 2022;(1):23-27
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Management of lower urinary tract symptoms in patients with benign prostatic hyperplasia during COVID-19. results of an all-russian observational study “ATLANT”

Neymark B.A., Neymark A.I., Yakovets Y.V., Nozdrachev N.A., Ibishev K.S., Kuzmin I.V.


Background. COVID-19 aggravates lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). The optimal treatment regimen for patients with this disease during the COVID-19 pandemic is still under question. Objectives. The aim of the All-Russian observational study of Afalaza in the Treatment of LUTS in pAtieNTs with BPH during COVID-19 (ATLANT) was to obtain additional data on the efficacy and safety of Afalaza in this patient group. Methods. The study enrolled 73 men aged 46-65 years with LUTS and diagnosed BPH who suffered from COVID-19. All patients received Afalaza for 16 weeks. The dynamics of BHP indicators, erectile function, and quality of life were assessed after 4, 12, and 16 weeks of treatment. Results. Patients with LUTS/BHP who suffered from COVID-19 had a decrease in the total IPSS score from 21.6+8.6 to 6.4±2.4 (-70.4%) points after 16 weeks of treatment. There was a direct correlation between COVID-19 duration (and beginning of therapy) and the severity of symptoms after Afalaza treatment. According to the subjective assessment of patients, there was a significant increase in the quality of life and erectile function after 16 weeks of treatment. 9 mild AEs were registered in 12.3% of patients and were unrelated to the study drug. Conclusions. Results show that Afalaza may be a perspective drug for the treatment of LUTS/BPH in patients with COVID-19 and be used for this urological disease in the current COVID-19 pandemic.
Urologiia. 2022;(1):28-34
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Practice of urological departments during the COVID-19 pandemic

Kulchavenya E.V., Kholtobin D.P., Telina E.V., Neymark A.I., Plugin P.S.


Introduction. The pandemic of novel coronavirus infection has had a strong impact on the whole medical system, including urological departments. Material and methods. We assessed the impact of restrictions due to the pandemic on the work of urological departments of private (Medical Center "Avicenna", Novosibirsk) and community (KGBUZ "City Clinical Hospital No. 11, Barnaul”) hospitals; GBUZ ofthe Novosibirsk region "City Clinical Emergency Hospital" (GBUZ CCEH) No. 2, Novosibirsk) clinics, as well as the urogenital department of the TB Research Institute of Ministry of Health of Russia during the period from 2019 to 2020. The changes in the spectrum of surgical procedures, as well as the structure of patients' visits to a urologist were evaluated. Results. In March 2020, the urogenital department of the TB Research Institute of Ministry of Health of Russia was redesigned into an observational one. Community departments worked with small restrictions or without any limitations. In KGBUZ "City Clinical Hospital No. 11, Barnaul”, an increase in the number patients with bladder cancer, ureteral stones, concomitant kidney and ureteral stones by 3-27% was noted (p<0.05), as well as those with acute epididymo-orchitis, including testicular abscess. At the same time, a significant decrease in the number of patients with varicocele, pyelonephritis, chronic cystitis, chronic prostatitis, and phimosis was found. A surgical department of GBUZ CCEH from October to December 2020 was restructured to an infectious hospital; this led to a decrease in the volume of urological care and the number of procedures. The Avicenna Medical Center also established anti-epidemic measures, which made it possible not only not to reduce, but in a number of procedures to increase the volume of surgical care. Conclusion. Owing to anti-epidemic measures, including the patient flow distribution, an introduction of mandatory testing, an early detection of patients and carriers among employees, mask regime, the opening of an observational department, single rooms, the lack of contact between patients, short length of stay, it was possible to prevent an outbreak of coronavirus infection among patients and personnel. Both in the municipal and private urological clinics, well-organized work precluded the negative impact of the pandemic.
Urologiia. 2022;(1):35-40
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Possibilities of monotherapy with Prostatex in patients with chronic abacterial prostatitis

Neymark A.I., Davydov A.V., Neimark B.A., Nozdrachev N.A., Mel’nik M.A., Voronin A.A.


Aim. To study the efficiency of the treatment of patients with chronic abacterial prostatitis using the drug Prostatex. Materials and methods. A total of 72 patients aged 22 to 43 years with chronic abacterial prostatitis were included in the study. All patients received Prostatex in the form of suppositories 10 mg QD within 20 days. The duration of the follow-up was 1 month. Results. By the third visit from the start of treatment, there were almost no symptoms of the disease, according to the NIH-CPSI and IPSS questionnaires. In 67 (93.1%) patients, the prostate became an elastic, while in 69 (95.8%) men it was painless at palpation. In addition, a decrease in the prostate size, volume of residual urine and an improvement in urine flow rate were seen. Conclusion. Our results showed that monotherapy with Prostatex in patients with chronic abacterial prostatitis was effective and had pathogenetic rationale. This drug has a positive effect on the main symptoms of the disease, significantly reduces pain, urination disturbances, helps to reduce the prostate size and the volume of residual urine, improves prostate microcirculation and can be recommended for this category of patients.
Urologiia. 2022;(1):41-45
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Evaluation of the efficacy of dapoxetine in primary and secondary forms of premature ejaculation

Gamidov S.I., Popova A.Y., Shatylko T.V., Li K.I., Safiullin R.I.


Objective: to compare the efficacy of dapoxetine in treatment of primary and secondary premature ejaculation. Materials and methods. The study included 60 patients with premature ejaculation (PE). Depending on the form of premature ejaculation they were divided into two groups: 27 patients with primary PE (group 1) and 33 patients with secondary PE (group 2). Patients were recommended to take dapoxetine 30 mg 1 hour before intercourse. A follow-up visit was scheduled on day 30 after receiving the drug. The intravaginal ejaculation latency time (IELT) and the Premature ejaculation diagnostic tool (PEDT) score were evaluated before dapoxetine was given and after 30 days from the start of the study. The significance of differences between baseline and follow-up values were compared using Wilcoxon’s test. In both groups, the proportion of patients with an incomplete response (IELT less than 2 minutes, PEDT more than 10) to symptomatic therapy with dapoxetine was evaluated. The proportion of patients with incomplete response to therapy was compared using the chi-square test. Results. The median IELT among all patients before starting therapy was 63 seconds (interquartile interval [IQR]: 28.75-94). After one month of therapy median IELT increased to 119 seconds (IQR: 58.75-321.75). Median PEDT score was 16 (IQR: 13-19) at baseline and 7 (IQR: 4-12) at follow-up. In group 1, the median IELT increased from 57 to 83 seconds (p = 0.02088), and in group 2, the median IELT increased from 70 to 173 seconds (p<0.00001). The mean PEDT score decreased to 7 in both groups (p<0.00001). Incomplete response to therapy was observed in 66.7% of patients in group 1 and in 39.4% of patients in group 2. The difference between two groups was statistically significant (p=0.035456). Conclusion. Symptomatic therapy with dapoxetine has a positive effect on the intravaginal ejaculation latency time and patient satisfaction in both primary and secondary premature ejaculation. However, the incidence of incomplete response to therapy is higher in patients with primary premature ejaculation, which may be due to characteristic differences in the pathogenesis of primary and secondary premature ejaculation.
Urologiia. 2022;(1):46-49
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Results of using the BESTFertil preparation in patients after microsurgical sub-groin varicocelectomy (Marmara’s operation)

Kotov S.V., Iritsyan M.M., Badakva G.V.


Introduction. Up to 15% of couples around the world face the problem of infertility, while male factor in infertile marriages occurs in up to 50% of cases. Varicocele occurs in 15% of the male population and in 35% of men with infertility. For now, the only effective method of treating varicocele is operative. After surgical treatment, there is an improvement in spermogram parameters, however, it is not always possible to achieve normal value of each parameter. Purpose of the study. To assess the efficiency of BESTFertil in patients after varicocelectomy. Materials and methods. The single-center, prospective, randomized study at the University Clinic of Urology, Russian National Research Medical University named after N.I. Pirogov was conducted comparing the postoperative parameters of patients who underwent varicocelectomy, followed by the course of BESTFertil (main group) and without it (control group). A total of 63 patients were included in the study: the main group - 33 patients and the control group - 30 patients. The inclusion criteria for the study were: the presence of varicocele as the cause of pathospermia and / or the absence of pregnancy in marriage for 12 months or more ofregular sexual activity without contraception, in the absence of other organic pathology as a possible cause of infertility, age from 18 to 45 years. Patients from both groups underwent surgical treatment of varicocele - microsurgical subinguinal varicocelectomy according to the standard Marmar technique using an operative microscope. Patients from the main group received BESTFertil for 3 months according to the recommended scheme. Results. In the main group an average increase in the volume of ejaculate in 6 months was 0.48 ml (11.2% of the initial), the increase in concentration was 24.4 mln / ml (59.1%), the increase in motility was 25.2% (69.2%), morphologically normal forms - 3.4% (106.3%). A relapse of the disease was revealed in one patient, according to ultrasound and angiography, however, there was also a positive dynamic of spermogram parameters: an increase in ejaculate volume - 0.8 ml; increase in sperm concentration - 22 mln/ml; A + B motility-32%; morphologically normal forms - 1%. Four patients (16.7% of the total number of patients with infertile marriage in the main group) reported pregnancy. In the control group, an average increase in the volume of ejaculate in 6 months was 0.07 ml (1.7% of the initial), the increase in concentration was 11.7 mln / ml (27%), the increase in motility was 10.6% (32.7%), morphologically normal forms - 0.6% (9.8%). Two patients (9.1% of the total number of patients with infertile marriage in the control group) report pregnancy after treatment. One patient had a relapse of the disease, confirmed by angiography, despite his spermogram parameters correspond to normospermia. Conclusions. These results allow us to conclude that the course of BESTFertil in patients after treatment of varicocele allows to achieve a clinically and statistically significant increase in spermogram indicators such as ejaculate volume, its concentration, sperm motility and the number of morphologically normal forms, which can help patients achieve natural pregnancy or resort to assisted reproductive technologies.
Urologiia. 2022;(1):50-54
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Robot-assisted partial nephrectomy with selective ischemia

Guliev B.G., Komyakov B.K., Yagubov K.K.


Introduction. Clamping of the renal artery during partial nephrectomy leads to renal ischemia and a deterioration of its function. An alternative to total ischemia is to isolate and clamp the segmental branch of the renal artery supplying the tumor. Aim. To evaluate the efficiency of robot-assisted partial nephrectomy (RAPN) with selective renal ischemia. Material and methods. A total of 42 patients with renal tumors of stage T1a (n=34) and T1b (n=8) undergoing RAPN were included in the study. There were 25 men (59.5%) and 17 women. The mean age was 56.0 ± 7.5 years, the tumor size ranged from 2.5 to 6.8 cm. Patients with a solitary kidney, multiple tumors, and those who underwent partial nephrectomy with clamping of the renal artery were excluded from the study. CT angiography with 3D reconstruction were used to detect the segmental branches of the renal artery, that supply the tumor. To determine the complexity of renal tumors, the RENAL nephrometric scale was used. Complications were assessed according to the Clavien-Dindo classification. In addition, mean operative time and volume of blood loss, warm ischemia time, pre- and postoperative renal function, and oncological outcomes were analyzed. The RAPN was considered successful if it was performed with selective clamping of the artery. Results. RAPN with selective ischemia was effective in 38 (90.5%) of 42 patients. In 4 (9.5%) cases with tumors of T1b stage and high RENAL scores (> 8), total ischemia was eventually used in order to control bleeding. According to CT angiography, these patients had ≥ 2 branches of renal artery, supplying the tumor. Mean operation time, volume of blood loss and warm ischemia time were 130.0±35 min, 185.0±80.0 ml and 14.0±3.2 min, respectively. In one case, there was an injury to the renal vein, which was sutured. Postoperative complications were observed in 5 (12.0%) patients. The glomerular filtration rate pre- and postoperatively was 76.5 and 72.0 ml/min/1.73 m2, and its decrease 1 month after RAPN was not significant (p> 0.05). Conclusion: Preoperative evaluation of renal arterial anatomy allows to detect the segmental branch that supplies the tumor. By its clamping, it is possible to perform efficient and safe robot-assisted partial nephrectomy without total ischemia.
Urologiia. 2022;(1):55-60
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Endoscopic marsupialization of parapelvic renal cysts

Martov A.G., Yagudaev D.D., Ergakov D.V., Baikov N.A., Andronov A.S., Dutov S.V., Martov A.A., Abdullaev D.A.


Introduction. Parapelvic renal cysts are very common. Indications for surgical treatment are upper urine tract obstruction, pain and recurrent gross hematuria. Aim. To analyze the efficiency and safety of endoscopic transurethral and percutaneous laser marsupialization of parapelvic renal cysts. Materials and methods. A total of 9 patients were undergone to transurethral intrarenal marsupialization of parapelvic renal cysts from March 2016 to February 2021 (4 men, 5 women, aged 42-78 years). Another 2 patients (2 men, aged 46 and 52 years) were treated by percutaneous approach. The average size of the cyst according to contrast-enhanced multi-slice computed tomography (MSCT) was 3.1±1.8 cm. In two cases, papillary tumor of the pelvis was suspected. The anteroposterior diameter of the pelvis was 2.6±1.3 cm; 9 patients had pain in the loin area, while in 7 patients recurrent gross hematuria was also an indication for surgical treatment. For marsupialization, a holmium (Ho:YAG) laser Auriga XL (Boston Scientific, USA) was used in 4 patients, and in other cases (n=7) a procedure was performed using a thulium fiber laser (Tm Fiber) Fiberlase U1 (IRE-Polus, Russia). In 3 patients, to clarify the site of incision of the cyst, intraoperative ultrasound was used. In all cases, after draining the cyst, an internal stent was placed inside the cyst for a period of 4-6 weeks. Results. The duration of transurethral surgery was 26±11 minutes, while percutaneous marsupialization of the cyst, which was performed in combination with percutaneous nephrolithotomy, took 10 and 18 minutes, respectively. The average catheterization time was 12±8 hours. Nephrostomy tube was removed on the 2nd day. The length of stay was 4±2 days. Febrile fever was noted in 1 patient (9%), which required a change in antibiotic therapy. During ultrasound control at discharge, the dilatation of the collecting system was not detected in any cases, while the residual cavity was found in 2 patients (18%). Follow-up contrast-enhanced MSCT and ultrasound within 3-30 months in all patients (n=11) showed no dilatation of the collecting system. In 1 (9%) patient, the residual cavity was preserved with a decrease in size to 1.2 cm without signs of upper urinary tract obstruction; the initial diameter of the cyst in this patient was 4.9 cm. There was no recurrence of gross hematuria. Conclusions. In our opinion, transurethral and percutaneous laser marsupialization of parapelvic renal cysts is an effective and safe method that allows definitive treatment for cysts up to 4 cm in size. If the cyst is larger than 4 cm, endoscopic removal should be balanced with the possibility of preserving the residual cavity. The most common complication of endoscopic treatment of intrarenal cysts is acute pyelonephritis with a rate of 9%.
Urologiia. 2022;(1):61-66
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Our experience of holmium laser enucleation of the prostate

Kutluev M.M., Safiullin R.I.


Introduction. Surgical treatment of benign prostatic hyperplasia (BPH) is influenced by a rapidly growing number of technologies. Aim. To determine the surgical potential ofholmium laser enucleation of the prostate (HoLEP) and the rate of postoperative complications during the learning curve. Materials and methods. A total of 98 patients undergoing HoLEP in the surgical department of the Clinical Hospital “Mother & Child” during the period from January 2018 to May 2020 were included in the study. HoLEP was performed by a single surgeon with previous experience in transurethral procedures. The criteria for inclusion in the study group were as follows: moderate-to-severe lower urinary tract symptoms, prostate volume > 40 cm3, maximum flow <15 ml/ sec, the volume of residual urine > 50 ml. The exclusion criteria were the following: inflammatory process in the lower urinary tract, genitourinary malignancy, previous urinary tract interventions. The evaluated criteria included age, prostate size, International Prostate Symptoms Score (IPSS and QoL), bladder diary, PSA, uroflowmetry, total operative time, length of catheterization, complications according to the Clavien-Dindo Classification, and length of stay. Results. During pathologic study, two cases of incidental prostate cancer (2.1%) were detected. The relationships between the prostate size and operative time (p<0.05), operative time and length of stay (p<0.05) were found. The total rate of complications was 16.3%. There were no complications >IIIb according to the Clavien-Dindo Classification. The most dangerous complications were injuries of the bladder wall and ureteral orifice (31.25% and 18.75% among all complications, respectively). Discussion. It should be considered that a large "middle lobe" is associated with a high risk of injury of the ureteral orifices. In our series, there were 5 cases of bladder tamponade, while bladder injuries during the morcellation developed in the first 10 patients. Conclusion. HoLEP is a reasonable alternative to TURP for surgical treatment of BPH and is considered a safe procedure for patients taking anticoagulant and antiplatelet drugs. Past experience of TURP allows to learn the technique faster and to reduce the number of complications.
Urologiia. 2022;(1):67-71
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Testicular torsion in polyorchism

Gusniev N.M., Guseynov M.M.


A clinical case of a 21-year-old patient with polyorchism and torsion of the right testicle described. Polyorchism revealed in 2016. According to urgent indications, the operation performed on the right orchipexy. The postoperative period was uneventful. A control study after 2 years of pathology from the organs of the scrotum not revealed.
Urologiia. 2022;(1):72-73
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Spontaneous rupture of kidney tumor. Successful surgical treatment

Neymark A.I., Neymark B.A., Nozdrachev N.A., Borisenko D.V., Razdorskaya M.V., Tachalov M.A., Besklubova Y.V., Boyarkov M.V., Slavova Y.Y., Shashev N.S., Davydov A.V.


A clinical case of spontaneous rupture of the kidney lesion that occurred after physical exercise is presented in the article. During the examination (ultrasound, multi-slice computed tomography of the kidneys), the diagnosis was unclear, and therefore, the patient underwent surgical treatment. Given the risks of complications and impossibility to exclude the malignancy, a decision was made to perform nephrectomy. The diagnosis was clear cell adenocarcinoma. We consider the prompt nephrectomy in this clinical situation as a success.
Urologiia. 2022;(1):74-77
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The tale of two stones in an obstructed partial duplex kidney: case presentation

Yusof M.R., Fairuz M.S., Lee F.Y., Arvind V.J., Fahmy O., Lee C.K., Saiful Azli M.Z., Arunasalam A.P., Khairul-Asri b.M.


Duplex renal systems is a common anomalies. Incidence rate of 0.8% in healthy adult population and 2-4% in patients investigated for urinary tract symptoms. Urolithiasis management for patients with anomalies is complex and require proper imaging and planning. We have a patient with a partial duplex collecting system presented with a right renal calculus in a non-functioning lower moiety and multiple distal ureteric calculi. Preoperative planning done and surgery performed with good outcome without any early and late complications.
Urologiia. 2022;(1):78-80
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Biofilm control in urological practice

Zaitsev A.V., Vasilyev A.O., Shiryaev A.A., Kim Y.A., Arefieva O.A., Govorov A.V., Pushkar D.Y.


Urinary tract infections (UTIs) have long been among the most common diseases. In the structure of the general infectious morbidity, UTIs rank second after acute respiratory viral infection. Every year, researchers note an increasing number of mutations in the genomes of bacteria that cause infectious diseases, which leads to the formation of more and more aggressive forms of pathogens. Patients with infectious diseases of the urinary system have the highest risk of biofilm formation, the frequency of which is directly proportional to the length of time the urethral catheter is located and accounts for more than half of all nosocomial infections. The presence of resistant strains of pathogenic bacteria and the development of bacterial biofilms are major problems in the treatment of urinary tract infections. The increasing number of nosocomial bacterial strains in the hospital increases the postoperative bed-day, the frequency of readmission and the number of antibacterial drugs used. In light of increasing antibacterial resistance, the use of medical resources is dramatically increasing, which ultimately leads to an increase in the cost of treatment. Along with this, the selection of resistant strains brings to the fore both the rational use of antibacterial drugs and the search for alternative methods of therapy. This review of publications on the problem of bacterial biofilm formation in urological practice demonstrates updated information on the role of enzymes, probiotics, and bacteriophages in preventing biofilm formation on various medical biomaterials, such as urethral catheters.
Urologiia. 2022;(1):81-88
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Application of laser technologies in the treatment of non-muscle-invasive bladder cancer

Teodorovich O.V., Shatokhin M.N., Kholimenko I.M., Abdullaev M.I., Borisenko G.G., Naryshkin S.A.


This review includes the facts of bladder treatment by means of laser technologies application in historical perspective. Advantages and disadvantages of different laser technologies were considered in comparison with the traditional TUR of the bladder wall.
Urologiia. 2022;(1):89-95
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A systematic review of radiotherapy for primary renal cell carcinoma

Gladilina I.A., Shabanov M.A., Kushlinskii N.E., Bliganov P.I., Sergeev A.N.


Renal cell cancer accounts for 2% of all cancers. The gold standard for managing patients with no evidence of distant metastasis renal cell cancer remains is complete surgical resection. The clinical data investigating preoperative radiotherapy failed to reveal benefited from this methods. The role of routine postoperative radiotherapy in the management of renal cell cancer is not established in patients with localized disease after complete surgical resection. Renal cell cancer is radioresistant tumor for conventional radiation therapy. Although renal cell carcinoma is related to radioresistant tumors, in recent years new promising directions in radiation therapy have become apparent. To overcome the radioresistance of renal cell carcinoma, the use of modified radiation therapy regimens with high doses per fraction is justified. A new technologies of radiation therapy, which include stereotactic radiation therapy allows to accurately deliver doses of ionizing radiation to a tumor, without the risk of damage to neighboring tissues and organs. Recent data showing that with the use of high-precision methods, such as SBRT, unresectable local renal cell carcinoma can successfully be treated with durable local control and low toxicity. Nonetheless, prospective, randomized trials and comparative effectiveness studies are needed to further evaluate this ablative modality in the treatment of renal cell carcinoma.
Urologiia. 2022;(1):96-101
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Oxidative stress and male infertility - a clinical perspective

Korneyev I.A.


The review of recent literature suggests that oxidative stress plays a significant role in the etiology of male infertility, life style and environmental factors contributing to oxidative stress are common in males. Antioxidant defence system is described as a complex network of internally synthesised and externally supplied components. In men with oxidative stress infertility antioxidants (β-carotine, vitamin E, vitamin C, selenium, and zinc) intake decreases reactive oxygen species production, improves sperm parameters and pregnancy rate.
Urologiia. 2022;(1):102-108
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Disorders of lipid metabolism as a risk factor for male infertility

Kurashova N.A., Dashiev B.G., Rychkova L.V., Kolesnikova L.I.


The presented literature review analyzes and summarizes data on studies by domestic and foreign authors on one of the most pressing problems of modern andrology - the pathogenetic relationship of excess body weight and male infertility. Modern clinical, epidemiological and experimental data indicate a negative effect of obesity on the reproductive function of men. According to the WHO, in Russia 54% of men are overweight, 15% of whom are obese. The problem of obesity is independent of age, area of residence, as well as the social and professional level of men. Obesity is a predisposing factor in the development of concomitant somatic pathological processes. Oxidative stress of sperm, androgen deficiency, neuropathy is far from an exhaustive list of the most important mechanisms for the realization of the neuroendocrine and reproductive effects of overweight and obesity. The increasing number of infertile couples annually dictates the need for a reliable monitoring system to get a correct picture of the development of the obesity epidemic, as well as to quickly assess what preventive measures should be taken.
Urologiia. 2022;(1):109-112
pages 109-112 views

Ultrastructural features of histological variants of renal cell carcinoma

Osmanov Y.I., Kogan E.A., Gadzhieva Z.K., Prochenko D.D.


The article presents the main electron microscopic signs of the main histological variants of renal cell carcinoma. The ultrastructural profiles of rare forms of renal cell carcinoma included in the latest International Histological Classification of Kidney Tumors (WHO, 2016) are considered.
Urologiia. 2022;(1):113-116
pages 113-116 views

Development of clinical recommendations “Cystitis in women”

Perepanova T.S.


The article is devoted to the stages of developing clinical recommendations on bacterial cystitis in accordance with the order of the Ministry of Health of Russia. Principles of evidence - based medicine (meta-analyses, systematic reviews and randomized clinical trials) are given. The Evidence Validity Level Assessment Scale (TDS) and Recommendation Credibility Level Assessment Scale (TDS) are given. In accordance with these requirements, modern methods for diagnosing bacterial cystitis have been selected, including the Acute Cystitis Symptom Score (ACSS), and the urination diary. Current approaches to treatment of asymptomatic bacteriuria, antimicrobial treatment regimens of acute and recurrent bacterial cystitis are given. Evidence-based methods of cystitis recurrence prevention are presented. Information is also provided for patients, including lifestyle recommendations, water regime, risk factors for cystitis recurrences, and explanations for completing questionnaires and diaries.
Urologiia. 2022;(1):118-125
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Urological complications of N.A. Nekrasov’s disease

Davidov M.I.


Object: to study the medical history of N.A. Nekrasov and to determine the nature of his urological disease. The work was carried out from 1977 till 2021. He studied 2616 sources related to the biography of N.A. Nekrasov and medical history. The work was carried out in the archives of Moscow, St.Petersburg, Yaroslavl, Karabikha from 1998 till 2020. The Russian poet N.A.Nekrasov had an illness, which ended in death, during 3 years, from December 1874 till December 27, 1877. He was treated by famous doctors S.P. Botkin, N.V. Sklifosovsky, E.I. Bogdanovsky, N.A. Belogolovy and an operation was performed by Theodore Bilroth. Retrospective analysis revealed the following diagnosis of N.A. Nekrasov: rectal cancer at the stage of T4NXMOP4 with invasion of the sacrum, bladder and compression of the pelvic parts of both ureters, bilateral ureterohydronephrosis with the loss of the left kidney function, chronic renal failure, purulent cystitis, partial intestinal obstruction, suppuration of the wound after colostomy performed on April 12, 1877, Acute purulent paraproctitis, paranephritis, phlegmon of the left retroperitoneal space, purulent effusion to the thigh, phlegmon of the buttock area and the left thigh, sepsis, cerebral stroke. Urological complications of the rectal cancer accelerated the lethal outcome of the poet N.A. Nekrasov who died of sepsis and uremia.
Urologiia. 2022;(1):128-132
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To the anniversary of Professor Valery V. Dutov

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Urologiia. 2022;(1):134-134
pages 134-134 views

To the anniversary of Professor Magomed A. Gazimiev

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Urologiia. 2022;(1):135-136
pages 135-136 views

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