卷 10, 编号 2 (2020)

Relevance. In 2013, the Wisconsin Stone Quality of Life Questionnaire (WISQoL) was developed – a specific tool for assessing the quality of life (QoL) in patients with urolithiasis.

Aim. To determine the possibility of using the WISQoL and SF-36 questionnaires to study the treatment results of patients with kidney stones.

Materials and methods. The study included 218 patients with nephrolithiasis. Patients were divided into 2 groups: the first – the size of the stone up to 10 mm and the second – from 11 to 20 mm. At the first stage, the efficacy of treatment patients by the extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolitholapaxy (PNL) 1 week, 1 and 3 months after surgery was compared. Questionnaires were used to study factors affecting the QOL of patients, including: gender, age, number, density and size of stones, hydronephrosis, stone free rate (SFR), type of surgery. At the next stage, the dynamics of changes in scores for the domains of questionnaires at different stages of treatment was evaluated.

Results. The efficacy of treating kidney stones up to 1 cm in size after 3 months with ESWL was 86,1% and PNL – 94,4 %, while stones up to 20 mm using ESWL – 73,4% and percutaneous techniques – 90,6%. Gender, age, stone size, SFR affected the QoL of patients with nephrolithiasis, while the number and density of stones, the presence of hydronephrosis and the type of operation were not significant. Patients 1 week after PNL had lower QoL scores in the domains of social impact and impact on vitalyty of WISQoL and mental heals of SF-36. After 1 month, these changes were determined only in the social impact domain and completely regressed by the 3^rd month.

Conclusion. SFR after ESWL and PNL in the first group is comparable, in the second group, percutaneous operations were 17,2% more effective. Male gender, age up to 40 years, stone size more than 1 cm, and also not reached SFR negatively affects patients with nephrolithiasis. Compared with ESWL and PNL is accompanied by the worst dynamics of QOL scores only 1 week after the operation; upon further observation, negative changes are leveled.

Purpose. Assess the safety of postoperative radiation therapy on the area of the prostate bed (PB) using extreme dose hypofractionation (5 fractions of 6.6–7 Gy).

Materials and methods. from April 2019 to March 2020 at the National Medical Center of Oncology named after N.N. Petrov of the Ministry of Health of the Russian Federation in the first 15 patients of the prostate cancer carried out stereotactic radiation therapy (SRT) on the PB. Depending on the clinical situation, adjuvant and salvage SRT were distinguished. Linear electron accelerators with 6 MeV energy are used for treatment. Three factional regimes were evaluated: 5 factions of 6.6 Gy, 5 factions of 6.8 Gy and 5 factions of 7 Gy. The clinical target volume is defined by RTOG (2010).

Results. The median of follow-up was 7.6 (1.3-11.6) months. Of the 15 patients, adjuvant SRT performed three observed, and the remaining 12 patients – salvage SRT (4 – early, 8 – delayed). Acute radiation toxicity was estimated in 12 patients. Early impairment from the lower urinary tract 1 degree was observed in 8 (66.7%) 12 of them. Toxicity of 2 or more degree in the early period was not observed. Clinical signs of early 1^st degree toxicity from the rectum were found in five (41.7%) of the bowel of the 12 observed. One patient (8.3%) there was a mixture of blood in the feces, which required a medical correction, which was considered as toxicity of the 2nd degree.

Conclusions. Postoperative SRT of the PB region is a promising modern method of radiation treatment of patients with prostate cancer. The presented methods of adjuvant and salvage SRT are feasible in clinical practice and are characterized by an acceptable level of early radiation toxicity.

观察中有28位膀胱粘膜白斑女病人，临床上症状表现为排尿困难和膀胱疼痛。所有患者都有慢性尿路感染史。当纳入研究时没有发出膀胱炎恶化的迹象。对所有患者执行了膀胱粘膜的激光绕蚀。手术1个、3个和6个月后进行了对照检查。所有接受手术的妇女均表现出积极的临床指标。激光绕蚀耐受性合适，没有术后的并发症。根据对照膀胱镜检查，6个月后，手术区域的尿路上皮完全恢复。研究结果显示对粘膜白斑病患者执行膀胱异常粘膜的激光绕蚀结果的高效性和安全性。

A review of the main causes of male infertility in the aspect of the relationship with the degree of sperm DNA fragmentation is presented. Information is provided on the main methods for assessing sperm DNA fragmentation and its effect on male fertility. The effect of oxidative stress on the integrity of sperm DNA structure, the reparative capabilities of antioxidant therapy, and the effect of varicocele on male fertility are described.

与腔内外科治疗结果无关的自发性肾盂系统破裂的病例在文献中很少被描述。这种并发症通常发生在尿石症患者身上。本文对泌尿系中风的文献资料进行了分析，并提出了自己的临床观察。