Background. The prostate cancer wins a first place among men oncological diseases by rates of an incidence and mortality. The late detection is a main reason of high mortality (approximately 52,0% patients starts treatment after more than 1 year of symptoms existence). A screening allows improve detection dramatically, but current methods of screening almost impossible to use widely. System of oncological urology needs new effective approaches for population screening. Aim. To develop empirical approaches for a model of population urological screening with a telemedicine as a key element. Material and methods. The research are backgrounded on systemic approach. Methods of analysis, synthesis and information modeling were used. Methodological documents recognized by WHO used for model evaluation. Results and discussion. National program of an urological screening should be backgrounded on methods of selective staged examinations of target population group, telemedicine technologies must be a key integrative element. The formal information model of prostate cancer telemedicine screening was developed. The key element of the model is an information system which consist from: - web-questionnaires and online risk assessment forms, - Electronic health records module, - Laboratory module, - PACS. The model was developed according to criterion for screening programs recognized by WHO. Conclusion. Approaches for an urological screening organization had been developed empirically. All issues joints the formal information model of prostate cancer telemedicine screening. The model are valid according to WHO methodological documents. Further researches will be focused on model introduction and evaluation in the field.

Introduction. cytokines may serve as markers of the inflammatory process during exacerbation (i.w. active phase) and further progression of chronic pyelonephritis. The estimation of cytokine constellation in this field is important problem of clinical nephrology. Purpose of the study. the aim of the study was to evaluate the severity of chronic pyelonephritis during its exacerbation by measurement of cytokines concentration in urinalysis. Materials and methods. In 64 patients with active phase of chronic pyelonephritis at the age of 25 to 65 years, the results of the study of the content of proinflammatory (iL-1β, iL-6, iL-8, TNFα, iFNγ) and anti-inflammatory (iL-2, iL-4, iL- 10) cytokines in urine taken from the ureter, bladder and blood plasma to determine the severity of exacerbation of chronic pyelonephritis. Results. The level of proinflammatory cytokine iL-8 in urine from the ureter of the affected kidney can serve as the main marker determining the severity of the active phase of chronic pyelonephritis. With a mild degree of exacerbation of the inflammatory process, the content of iL-8 in urine from the ureter is 4 times higher than normal values; at an average degree - in 8 times, and at a serious current of an exacerbation of a chronic pyelonephritis - in 54 times. Conclusions. Determination of proinflammatory cytokines in the diagnosis of the severity of pyelonephritis flow has a large diagnostic and differential diagnostic significance that will allow for differentiated therapy depending on the severity of the inflammatory process and improve the results of treatment.

Introduction. In the study determined accessible and highly specific morphological research techniques to diagnose the severity of the connective tissue dysplasia (CTD) in children with anomalies of the urinary system (AUS). Materials and methods. The work is based on the results of treatment of 143 children aged 6 months to 18 years with the diagnosis of PUS obstruction with hydronephrosis and vesicoureteral reflux I-V degrees. In children with AUS (hydronephrosis and vesicoureteral reflux), there is a strong direct correlation between the degree of CTD and the severity of the disease (p = 0.001, χ2 = 20.985). Results. In the morphological study of ureters using immunohistochemistry in patients with severe vesicoureteral reflux and hydronephrosis against the background of severe manifestations of CTD, significant changes in the structure of connective tissue fibers were observed in the form of significant fragmentation and chaotic arrangement of the fibers of collagens type I and type IV. The elastric ureteric framework was subjected to significant changes (p = 0.001, χ2 = 26.796). Conclusions. Thus, the surgical approach in the treatment of AUS in children must be differentiated depending on the degree of CTD expression.

Introduction. The actual problem of modern urology remains differential diagnostics of various diseases of the prostate gland. The purpose of the study. Increasing the effectiveness of differential diagnosis of diseases of the prostate. Materials and methods. In the biopsy specimens of patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa), an immunohistochemical study of the production of the Ki-67 proliferation marker, matrix metalloproteinase-9, the matrix metalloproteinase inhibitor TIMP-1, and the distribution of collagen type IV was performed. Results. A moderate positive correlation was found between Gleason gradation and the cell proliferation index for Ki 67 (rs = 0.674) and a moderate negative correlation of Gleason gradation with the level of production of matrix metalloproteinase-9 (rs = -0.660). A weak significant negative correlation was established between the level of proliferative cell activity and the production of  MMP-9 tumor cells (rs = -0.369). A significant decrease in the level of MMP-9 and TIMP-1 in adenocarcinoma of different grades was revealed. The invasive properties of tumor cells, expressed in the destruction of collagen of the IV type of the basal membrane and connective tissue prostatic stroma, are mediated by the imbalance between MMP-9 and the protein blocking this enzyme - TIMP-1, whose production decreases in adenocarcinomas of different grades compared with BPH. Conclusions: 1. BPH is characterized by high production of MMP-9 type, which destroys the collagen of the basal membranes and stroma, the proteolytic action of which is blocked by the high content of TIMP-1.

Introduction. Extracorporeal shockwave lithotripsy (ESWL) allowed to improve the treatment results for patients suffering from the kidney stone disease (KSD), decrease the number of complications, optimize the nearest and distant therapy results; however, its success depends on the initial size and shape of the stone. Purpose of the study. Тo examine the clinical effectiveness and safety of electromagnetic ESWL used on simple renal calculi taking their sizes into account. Materials and methods. The survey included 110 patients with simple renal calculi who passed electromagnetic ESWL procedures. The first group consisted of 75 patients with calculi ≤ 15 mm in diameter, the second group included 35 patients with stones > 15 mm. Results. Complete disintegration of stones ≤ 15 mm was accomplished in 74,7% of cases in 1-2 lithotripsy sessions, and after 3 months residual fragments were found in 4% of cases only. Elimination of stones > 15 mm from the renal collecting system takes considerably longer, all patients require more than 1 lithotripsy session. In 3 months following the ESWL residual stones were found in 17,2% of analysed cases. Stone sizes had no bearing on the pain syndrome frequency and severity as well as activation of urinary infection. Macrohematuria, renal haematomas, and an increase of blood creatinine level compared with the original value were more frequent in patients with stones > 15 mm. Conclusions. Electromagnetic ESWL is an efficient and safe method for monotherapy of patients with uncomplicated pelvic concrements. Clinical ESWL effectiveness for stones ≤15 mm by the 3rd month of monitoring reaches 96,0%, for stones > 15 mm it is 82,8% (р<0,05). The level and severity of complications is higher in case of pelvic stones >15 mm compared with the stones < 15 mm in diameter (р<0,05).

Male infertility is a multifactorial syndrome, which includes a wide range of disorders. It is a symptom of many different pathological conditions affecting both the reproductive and other body systems: endocrine, nervous, blood-vascular, and immune systems. Low level laser therapy is a method of modern physiotherapy, in which the impact is carried out by lowintensity laser illumination (LILI). It is widely used in all areas of modern medicine, due to its high efficiency, simplicity of use, the absence of contraindications and side effects. The results of clinical studies on the subject of the article were analyzed, various variants of low level laser therapy techniqueswere suggested: locally, rectally, laser acupuncture, ILBI (intravenous laser blood illumination), on the projection of various organs, paravertebrally and etc.

The review dedicated by the diagnosis of recurrent infection of the lower urinary tract of the papillomavirus etiology. The search was conducted using Medline, PubMed, EMBASE, CNKI and WANG FANG databases. Human papillomaviruses included in the human virome and may be implicated in the development of the recurrent lower urinary tract infection. There are limitations of modern molecular-genetic methods for diagnosis of papillomavirus infection of the bladder. The gold standard for diagnosis of papillomavirus infection of the bladder remains cystoscopy and morphological study of the bladder biopsies.

Interstitial Cystitis/Bladder Pain Syndrome is a chronic and debilitating condition that negatively impacts quality of life. Several causes have been postulated in the pathogenesis of this condition; however, the etiology remains unknown. Interstitial сystitis may go undiagnosed for many years because the condition often co-exists with other chronic pain syndromes. Furthermore, the symptoms of Bladder Pain Syndrome vary considerably across patients, therefore no one treatment has shown to be consistently effective in providing relief. Thus, the goal of management of interstitial сystitis remains to provide relief of symptoms in order to improve a patient’s quality of life. intravesical Botulinum toxin A is emerging as a potential new pharmacologic treatment for interstitial сystitis refractory to conventional treatment modalities. The aim of our short review is to assess the efficacy of intravesical Botulinum toxin A in Bladder Pain Syndrome.

Currently, urogenital fistulas are one of the most actual and socially significant problems of medicine. A common type of urogenital fistula is the vesicovaginal fistula. The most difficult for surgery treatment is postradiation vesicovaginal fistula, which appear after uncontrolled radiation exposure on the pelvic. This is due to decrease of tissue vascularization, the prevalence of fibrosis in the lamina, muscle tissue in the vaginal and bladder mucosa, chronic lymphocytic inflammation and hyperkeratosis which destroy epithelium. Conservative therapy of vesicovaginal is not usually effective and in rare case leads to fistula closure. Thus, surgical approach remains the accepted strategy for the treatment of vesicovaginal fistulas. This article contains the most actual literary data with optimal strategy for the treatment of vesicovaginal fistula.

The article presents the result of laparoscopic ureterocalicostomy. We observed the patient 39 y. who was admitted with complaints of aching pain in right lumbar part. 10 years ago he was underwent open pyeloplasty. In 2017 again there were pain in right kidney. At examination on CT with intravenous urography is revealed extended stricture of ureteropelvic junction, intrarenal pelvis, dilated pelvi-caliceal system and thin parenchyma under lower calyx. In flank position using transperitoneal approach we mobilized upper third of right ureter, transected distally of stricture and performed anastomosis with lower calyx.  Operative time 110 min, bloodloss – 50 ml. No intra- and postoperative complications. Drain removed in 2 days, nephrostomic drain – in 7 days. Stent removed after 6 weeks. In a follow-up survey the patient haven’t any complaints, and a moderate expansion of the renal pelvicaliceal system on ultrasound.

The article describes the clinical case in a patient with bilateral nephrolithiasis, chronic kidney disease of the 4th stage, after which bleeding from the left kidney developed after simultaneous bilateral percutaneous nephrolithotomy (PNL), leading to severe hemic hypoxia. Conservative therapy, blood transfusion did not lead to a persistent effect, the bleeding continued to recur. Given the presence of chronic renal failure (CRF) from the embolization of the branches of the renal artery, it was decided to abstain, given the extremely high risk of aggravation of nephropathy after the administration of the contrast drug. Left-sided nephrectomy would inevitably lead to the development of terminal chronic renal failure. Patients performed an electrocoagulation of the fistula wall with a Karl Storz 26C resectoscope in 60W mode. The bleeding was completely stopped. The patient is discharged from the hospital in a satisfactory condition. At the time of discharge in the conduct of replacement renal therapy did not need. When analyzing publications in The Cochrane Library, PubMed, Medline and Web of Science, we did not find a description of such a method of hemostasis.