Introduction. The urogenital form of autonomic diabetic polyneuropathy is a specific lesion of the autonomic nervous system in diabetic patients. It is main pathogenetic cause of sexual disorders in this category of patients. The most common violation of sexual function in patients with diabetes is erectile dysfunction (ED).

Objective. Diagnosis of peripheral neuropathy with ED caused by type I diabetes and assessment of the effectiveness phosphodiesterase type 5 inhibitor (PDE5-I) in its treatment.

Materials and methods. The study included 40 patients with ED due to type 1 diabetes at the age of 25.7 ± 6.1. The duration of type 1 diabetes was 18 ± 9.7 years. All 40 patients, initially and after the course of therapy with the PDE5-Is, underwent a neuromyographic study with the determination of the excitation propagation rate for nervus peroneus and nervus pudendus, endothelial function evaluation on the EndoPat ™ device, and the questionnaire on the international index of erectile function (IIEF-5) scale.

Results. In 30 (75.0%) men, endothelial dysfunction was determined according to EndoPat ™. In the range of the gray zone of reactive hyperemia index (RHI) was detected in 7 men (16.6%). Normal function of the endothelium was revealed in 3 cases (8.4%). In the control study, the following data were found: endothelial dysfunction was detected in 6 patients (16.6%) according to Endo Pat ™, in 14 patients (33.4%) in the range of gray zone of RHI, endothelial function was normalized in 20 patients (50.0%). According to the neuromyographic study, initially all patients had diabetic neuropathy in both the distal and urogenital forms. After therapy, significant positive dynamics were shown. Based on the results of the questionnaire on the scale of IIEF-5, initially all patients showed ED of varying severity. With the control questionnaire after therapy, there was an improvement in erectile function.

Conclusions. Given the high incidence of endothelial dysfunction and its generalized nature in patients with ED due to diabetes, it is advisable for all patients with diabetes to study the state of the endothelium in conjunction with a neuromyographic study. Medicine from the PDE5-I group with individual taking course are highly effective in restoring vascular endothelial function, and also have a neuroprotective effect, which is especially important for patients with type 1 diabetes.

Introduction. Modern studies show an impressive 5-year absence of pelvic recurrence in 80% to 90% of cases and a 5-year overall and cancer-specific survival of 59% to 60% and 55% to 65% for radical cystectomy (RCE), respectively.

Objective. Analysis of the results of radical and palliative treatment in patients with bladder cancer.

Materials and methods. The study included 349 patients exposed to RCE, of which three groups were identified: RCE primary (n = 206), salvage RCE (n = 119) and CE palliative (n = 24). Calculation of survival rates for the years of follow-up was performed according to the Kaplan-Meier method, taking into account consecutive elimination from the analysis of patients.

Results. Based on the results of the performed analysis, it was established that significantly worse indices for all types of survival were revealed in palliative CE. Comparing the oncological effectiveness of primary and salvage RCE, there is no statistically significant difference in survival rates in the compared groups.

Conclusions. RCE should not be considered as second-line therapy, but in the presence of indications as a primary medical approach. The performance of early salvage RCE with progression of bladder cancer against the background of organ-preserving treatment provides oncological results similar to those in primary RCE. 

Introduction. Epidemiological studies noted a progressive increase in the incidence of renal cell carcinoma (RCC). Despite the improvement in radiation diagnosis of RCC, the number of primary metastatic forms and number of secondary progressive forms after radical surgical treatment remains high with no apparent downward trend. This may be due to changes in the biology of RCC, which is expressed in the increasing aggressiveness of the tumor tissue. However, studies on the biological characteristics of the change in tumor for a long period of time is very small.

Objective. To evaluate and compare the profiles of patients with RCC, the morphological characteristics of renal tumors, the options for surgical treatment and its results in two consecutive decades.

Materials and methods. The study included 306 operated and monitored patients with RCC. The patients were divided into two groups: 1 group - 149 patients treated from 1996 to 2005 and 2 group - 157 patients treated from 2006 op 2015. The group analyzed the profiles of patients and morphological characteristics of the tumor.

Results. In patients of the group 2, tumors >4 cm were characterized by a lower degree of tissue differentiation (G2-G3) compared to the group 1 (54.54% vs. 48.57%) and T3a (60% vs. 42.26%). A similar difference was noted for tumors measuring 4-7 cm (G2-G3 - 67.69% vs. 57.75%, T3a - 79.54% vs. 32.15%). Tumors of the group2 in the stages Tla, Tib, T2 and T3a are less frequent had a high degree of differentiation (Gl) in comparison with tumors of similar stages of group 1 (52.17% vs. 59.26%, 35.71% vs. 58.06%, 11.11% vs. 18.75% and 12.12% vs. 28%, respectively.) In the group 2, regional and distant metastasis was noted more often than in group 1 (34.6% vs. 20.33%). Survival in group 2 decreased in comparison with group 1 (3-year-old: total - 78.37% vs. 83.02%, oncological - 81.43% vs. 87.15%, 5-year-old: total - 73.86% vs. 79.21%, oncological - 78.69% vs. 83.91% ).

Conclusions. The comparative analysis showed an increase in aggressive tumor potential in group 2 compared to group 1.

Introduction. Recurrent urinary tract infection is an actual problem of modern urology.

Objective. Complex investigation of urinary tract infections including viral etiology for chronic recurrent cystitis in women

Materials and methods. The study included 31 women with recurrent infection of urinary tract. Inclusion criteria were the presence of lower urinary tract symptoms caused by infection, severe recurrent course, the lack of anatomical and functional disorders of the urinary tract, the absence of bacterial pathogens during the study, taking into account the culture of aerobic and anaerobic culturing techniques.

Results. The analysis of the clinical manifestations, the dominant in the study group were pain and urgency to urinate at 100% and 90% of women surveyed, respectively, and less frequent urination were recorded in 16.1% of patients. In general clinical examination of urine in all cases identified leukocyturia and 90% of the hematuria. By using a polymerase chain reaction (PCR) in midstream urine of all examined was verified 10 types of human papilloma virus (HPV) with the predominance of 16 and 18 types . Considering the presence of recurrent infectious and inflammatory processes of the urinary tract, cystoscopy with bladder biopsy was performed for all patients. When histomorphological biopsies of all patients surveyed noted the presence of the specific characteristics of HPV: papillary hyperplasia with squamous koilocytosis, pale cytoplasm and shrunken kernels. When analyzing the results of PCR biopsy data corresponded with the results of PCR in midstream urine in all biopsies was detected HPV.

Conclusions. Human papillomavirus infection may be involved in the development of viral cystitis. In the etiological structure of viral cystitis, both highly oncogenic and low oncogenic HPV types can act.

Introduction. Large (>2 cm) and Staghorn kidney stones are severe forms of: nephrolithiasis. Percutaneous nephrolithotomy is first line in treatment of large kidney stones, according to the recommendations of the American and European associations of urology. In the modern literature is the high frequency of complications after percutaneous nephrolithotripsy, renal bleeding is the most serious of which. Many different methods of treatment with application of nephroscope small diameters in order to achieve acceptable high performance, but with fewer complications.

Objective. We used a mini-percutaneous nephrolithotomy in patients with large and Staghorn kidney stones.

Materials and methods. From February 2014 to January 2015, one surgeon of our center made 32 mini-percutaneous nephrolithotripsy in patients with large and Staghorn kidney stones. Criteria of effective treatment was the complete removal of stones or the presence of residual calculus size <3 mm. Postoperative complications were evaluated according to modified Clavien classification.

Results. Age ranged from 25 to 67 years. Women was 62.5 percent. The average stone size was 32.4 (21- 62) mm. The average time of surgery was 67.5 (20-200) min. Stone free was 87.5 %. The complication rate was 9.4%. 3.1% - leakage of urine (Clavien 3b), 6.3% - urinary tract infection (Clavien 2).

Conclusion. Mini-percutaneous nephrolithotomy is an effective and safe treatment of patients with large and Staghorn kidney stones. It has a minimal complication rate and there is not much blood loss.

Introduction. Prostate biopsy is a routine method for diagnosing prostate cancer. However, there are a number of serious complications associated with this procedure, and especially development of infection.

Objective. Evaluation of the effectiveness of complex herbal therapy in the prevention of infectious complications in patients exposed to prostate biopsy.

Materials and methods. The study included 40 patients aged 48 to 69 years who underwent prostate biopsy. Patients with chronic prostatitis (category 4 NIH) were divided into two groups. Patients in the comparison group limited to standard antibiotic therapy, and the patients of the main group additionally received Canephron N. The efficacy of the therapy was evaluated at 1, 2 and 6 months after the start of treatment by the dynamics of leukocyte count in prostate secretion and bacterial contamination, prostate- specific atigen (PSA) level, questionnaire data, ultrasound and urodynamic survey methods.

Results. The level of PSA compared to baseline data, decreased by 56.9% in the comparison group and by 67.6% in the main group (p<0.05). A clinically significant bacterial titer and an increase in the number of leukocytes more than10 in sight, were registered in the comparison group in two times more often, than in patients of the main group.

Conclusion. The results of the study make it possible to recommend for patients with chronic prostatitis of category 4 NIH the prescription of Canephron N.

The article presents a review of methodological issues of estimation of glomerular filtration rate in urologic practice. Author examine the current international and national recommendations, in particular by KDIGO, the recommendations of the scientific society of nephrologists of Russia, Association of urologists of Russia, the results of comparative analysis of different methods of assessing glomerular filtration rate. It is shown that the currently calculated methods of assessment of glomerular filtration rate have advantages over technique of clearance. The advantages and disadvantages of methods for calculating glomerular filtration rate by the formula of Cockcroft-Gault and MDRD. The author lists the pathological conditions in urological practice, in which there is a need to assess glomerular filtration rate, given nomograms and links to online calculators for quick and easy calculation of glomerular filtration rate.

Chronic pelvic pain syndrome (CPPS) is a chronic pain disease with high prevalence rates. The etiology and pathogenesis of this problem remains poorly understood. No uniform solitary treatment is known for CPPS. As a result, a multimodal approach is most likely to demonstrate benefit for this disease. An interdisciplinary classification system is commonly used (UPOINT) which includes psychosocial domain. Nevertheless, psychosocial and psychopathological influences on CPPS only recently became a research focus. This literature review investigated the association of personality traits, mental disorders with the baseline clinical characteristics of patients with CPPS. We aimed to synthesize the existing data and to identify further research topics.

The review offers analysis of various methods used for urine derivation after cystectomy. It provides insight into the advisability of continent heterotopic urine derivation based on a comparison of complications, practical complexity, and quality of life following different variants of bladder reconstruction using intestinal segments. The problem of searching for new simpler methods for the formation of reservoir valve retention mechanisms is raised to encourage broader use of continent urine derivation forms.