Laparoscopic radical nephrectomy (LRN) is presently viewed as the standard treatment for localized renal cancer. However, 5–10% of renal cell carcinoma is associated with the development of the tumor thrombus. The works of few authors have demonstrated the feasibility of laparoscopic radical nephrectomy in patients with tumor thrombus in renal vein. We describe the method and report our own experience of LRN with thrombectomy from the inferior vena cava. Two patients with renal masses with infrahepatic tumor thrombus underwent right-sided radical nephrectomy and thrombectomy. After clipping the right renal artery, we dissected the IVC above and below the level of the thrombus and introduced the vessel loops. In addition to that we mobilized the left renal vein and clipped the right gonadal vein. After occluding the IVC and the left renal vein with a vessel loops or a laparoscopic Satinsky vascular clamp, we made an incision the IVC wall, extracted the thrombus and excised the ostium of right renal vein. The defect in the IVC was closed with running sutures. Laparoscopic RN and thrombectomy were successfully performed in all the patients without conversion to open surgery. With a mean follow-up 8–20 months all patients have no signs of local recurrences or distant metastases. Laparoscopic RN with IVC thrombectomy in selected RCC-patients with differential extensions of tumor thrombus is a safe and feasible procedure. Additional studies are needed to examine the advantages of this approach.

We modified the method of retroperitoneoscopic live donor nephrectomy and evaluated results of 5 years procedures. There were no conversions to open or hand-assisted surgery. All organs have been successfully transplanted. Retroperitoneoscopic live donor nephrectomy is safe and feasible. The method has three main advantages over conventional laparoscopic nephrectomy: the absence of contact with bowel, spleen, liver and other intra-abdominal structures, more comfortable access to the renal artery, absence of intraperitoneal pressure elevation.

Extracorporeal shock wave lithotripsy (ESWL) may be associated with infectious and inflammatory complications. The dynamics of the microbial spectrum of urine and the need for antibiotic prophylaxis are still poorly understood. The study included 40 patients with simple pelvic stones, which one session was held ESWL. Bacteriological examination were taken midstream urine to ESWL, when the first urination after ESWL, 1, 3, 7 days. Patients were divided into 2 groups. Group I consisted of patients (60%) with antibiotic prophylaxis. Patients of group II (40%) of antibiotic prophylaxis was not performed. The pattern of isolated microorganisms were as follows: NAB - 92.5%, Gram-positive microorganisms - 70.0%, urease-producing microorganisms - 60,0%, E.coli - 12,5%. Dynamic study of the microbial spectrum of urine Group found that the prophylactic use of antibiotics after ESWL simple junction stones accompanied by increased frequency of occurrence and levels of contamination of urine urease-producing bacteria, Candida, Gram-positive microorganisms and increases the risk of infectious and inflammatory complications in connection with the question of the need for antibiotic prophylaxis to be decided individually.

In this paper we consider the level of anxiety problems and protections of the severity of the diagnosis stage, and in the preoperative period. The study found that patients with prostate cancer a moderate and high levels of anxiety, and also prevail such protection as «Denial», «suppression» and «intellectualization».

The article presents the analysis of morbidity from prostate cancer with consideration of regional differences in the level of the health and environmental safety. Analysis was conducted of the level of incidence of prostate cancer in the Voronezh region for the period 2001 to 2015. The Model of conditionality of distribution of oncological diseases has provided a number of results, significantly expanding the scope and use of medical and environmental monitoring. The incidence of cancer of the prostate in the Voronezh region remained high for the past decade. The use of space-time statistics in conjunction with traditional statistical methods reveals the territorial medical and environmental contrast (group of regions with a different rating, the quality of public health), the territorial heterogeneity of incidence of prostate cancer, and the presence of "hot spots" of disease. The results can serve as a basis for the directional analysis of factors causing increase risk of cancer and development on these basis strategies for monitoring and prevention of cancer diseases in the Voronezh region.

The lecture shows in detail recent advances in basic research on the problem of congenital obstruction of the upper urinary tract, refined current diagnostic algorithms to quickly identify the types of obstruction pyeloureteral segments that are a potential threat of kidney function and require execution pyeloplasty.