Actuality. Classification of postoperative complications Clavien-Dindo is designed to monitor complications and compare data between different centers. But for an objective assessment of complications, for each method of surgical treatment, a generally accepted norm of postoperative course should be developed, taking into account the specifics of the intervention. The absence of such a norm in the endoscopic treatment of urolithiasis leads to mistakes in the evaluation of postoperative complications.

Purpose of research. Critical assessment of Clavien-Dindo grading system for surgical complications and its adaptation for evaluation of postoperative complications of endoscopic surgery for urolithiasis.

Materials and methods. Retrospectively evaluated 1027 patients with urolithiasis who were operated endoscopically. The average age was 38.9 ± 15.6 (4 to 84) years. From the position of endoscopic surgery patients with “simple” stone were 446 (43.4 %), with “complex” — 581 (56.6 %). In 765 (74.5 %) patients stones were located in PCS, in PCS and ureter — in 60 (5.8 %), only in the ureter — in 202 (19.7 %). Size of stones in 1027 arranged 30.3 ± 0.6 (3 to 150) mm; located only in the ureter — 14.4 ± 0.5 (3 to 55) mm.

From 1027 cases in 948 stones were removed via PC access (in the prone position), in 79 - transurethral. Regardless of the type of access only pneumatic lithotripsy were performed, which made possible to objectively evaluate the effectiveness of treatment in different groups. For systematization of complications Clavien-Dindo (2004) grading system was used.

Results. Based on many years of experience of the RSCU’s staff in the endoscopic treatment of urolithiasis, as well by determining the category of complexity urinary stones from the position of endoscopic surgery, a clear boundary was determined between the normal postoperative period and the complicated one. Deviations from the standard of the postoperative period were found in 195 (19.0 %) patients with 250 complications, which were systematized by the way of critical evaluation and correction of the ClavienDindo classification: I – 64 (6.2 %), II – 111 (10.8 %), IIIa – 33 (3.2 %), IIIb – 39 (3.8 %), Iva – 3 (0.3 %), IVb – 0, V – 0.

Conclusions. In order to optimally adapt the classification of surgical complications Clavien-Dindo, in relation to endoscopic surgery for urolithiasis, it was necessary to develop indicators standard of normal postoperative course of endoscopic treatment for urolithiasis. In turn, standard course must be accepted by Urology society. And only thereafter it will be possible to objectively compare the results of treatment between different centers.

According to adapted Clavien-Dindo classification 70 % of complications of endoscopic treatment of urolithiasis were I - II grade and they were eliminated by conservative therapy, 30 % — attributed to grade III-IV, and to eliminate them were required additional invasive interventions and intensive care.

Introduction. Endoscopic radical prostatectomy is a highly effective treatment for localized prostate cancer. Intrafascial prostate dissection ensures early recovery of urine continence function and erectile function. This article sums up our own experience of performing intrafascial endoscopic prostatectomy.

Materials and methods. 68 patients have undergone this procedure.

Results. 12 months after surgery 88.2 % of the patients were fully continent, 11.7 % had symptoms of minimal stress urinary incontinence. We encountered no cases of positive surgical margins and two case of biochemical recurrence of the disease.

Conclusion. Oncologically intrafascial endoscopic radical prostatectomy is as effective as other modifications of radical prostatectomy and has the benefits of early recovery of urine continence function and erectile function.

Introduction. Currently, there are no generally recognized indications for the choice of methods of drainage of the upper urinary tract in obstructive uropathy. Both external and internal drainage involve a number of shortcomings affecting the quality of life of the patient.

Purpose of research. To evaluate the effectiveness of internal stenting (IC) and puncture nephrostomy (PN) as a method of temporary drainage of the upper urinary tract in acute obstructive pyelonephritis.

Materials and methods. During 2012-2017 we observed 156 patients of both sexes aged from 25 to 74 years with the clinic of acute obstructive pyelonephritis against the background of urolithiasis. To restore the passage of urine is made stenting jj-stent or puncture nephrostomy. Materials and methods. During 2012-2017, we observed 156 patients of both sexes aged 25 to 74 years with a clinical picture of acute obstructive pyelonephritis on the background of urolithiasis. To restore the passage of urine is made stenting jj-stent or puncture nephrostomy.

Results. Clinically, fever in the PN group was stopped for 1.8±0.5 days, and in the IC group this indicator was 5.5±2.8. In the IC group, 18 (58.1%) patients complained of irritative symptoms of varying severity, and in 9 (29.0%) patients pain syndrome in the lower back associated with myction was noted. No similar complications were observed in the PN group. The inability to install and inadequate function of the IC group in 45.5% of cases required conversion in the PN group. The need for revision of the kidney after the PN group was noted in 0.8% of cases (p<0.01).

Conclusion. Subject to adequate techniques of puncture of the kidney and the combined (ultrasonic and radiographic) control the conduct of puncture nephrostomy is a safe method of drainage of the kidney in acute obstructive pyelonephritis, ensuring laying of drainage is of adequate diameter that allows you to get the best results for the relief of pyelonephritis in comparison with the inner stent.

Relevance. Prosthesis of the testicle is a matter that is sharply discussed in the literature, accompanied by significant polarity of opinions regarding indications, techniques, choice of implant and evaluation of results. Publications relating to prosthetics about the bloat in childhood, are single and do not give an unambiguous answer to emerging questions.

Goal. Optimize the indications, techniques and develop optimal terms for prosthetic testis after its turn in adolescence.

Materials and methods.70 patients who lost gonad after torsion with critical ischemia at the age of 11-18 years, an average of 15.5 ± 2.3 years. In 49 patients, endoprosthetics were performed after orchiectomy for torsion. In 21 patients, orthhectomy was preceded by prosthetics due to the atrophy of the testicle preserved after the twist. The interval from an acute episode to endoprosthetics was from 6 months to 15 years.

Three techniques of implantation of the prosthetic testis were used: prosthetics with inguinal access without suturing the entrance to the scrotum (n = 14); prosthetics by inguinal access with suturing the entrance to the scrotum according to the original developed technique. (n = 34); prosthetics with scrotal access (n = 22).

Results. Sewing the entrance to the scrotum reduces the risk of implant migration in the proximal direction, due to anatomical prerequisites. Access through the scrotum is free from this deficiency, but increases the risk of inflammatory complications.

The aesthetic result of the prosthesis directly depends on the age at which the orchiectomy is performed - the older the patient who underwent the operation, the better the cosmetic effect.

Inguinal access with suturing the entrance to the scrotum with a comparable number of good results makes it possible to obtain a greater number of satisfactory and does not lead to complications.

The most favorable results of prosthetics are noted at the time that has elapsed since the moment of turning - not more than three years; all unsatisfactory results were noted at a term of more than five years from the moment of torsion.

Conclusions. 1. Prosthesis of the testis is an integral stage in the rehabilitation of the patient after an orchectomy for a bloat. 2. Prosthetic groin access according to the proposed original technique is optimal from a technical point of view and provides the most physiological standing of the implant. 3. The results of prosthetics directly depend on the period after the primary operation. 4. Complications of prosthetic testis can be minimized with the accumulation of experience and their rational prevention.

Patients, after radical prostatectomy with the use of nerve-sparing techniques, without carrying out penile rehabilitation, are at risk of forming cavernous fibrosis with the emergence of subsequent persistent erectile dysfunction. In order to minimize damage to cavernous tissue and early restoration of erectile function during the period of neuropraxia, it is necessary to ensure a sufficient level of oxygenation. The role of applying vacuum in penile rehabilitation for the prevention of hypoxia of cavernous tissue is not fully understood, due to the lack of data on the gaseous composition of the blood at the time of reaching the vacuum of erection. The purpose of this work was to review the scientific studies devoted to the study of vacuum induced penile erection in animals or humans, which indicates high results due to increased oxygenation of cavernous tissue.

In 2014, we celebrated 130 anniversary of Grawitz’s report suggesting that the renal carcinoma originates from intrarenal adrenal rests and the name «hypernehproma» was subsequently accepted. The discussions continued until the middle of 20th century when electron microscopic studies finally approved the Virchow’s postulates and showed that the renal tumors originate from the canalicular epithelium. This period became to be also a keystone for uropathology as independent sub-specialization in pathology.

During that period numerous classification of male genital tract tumors were accepted, as well as the histological grading of the tumors, which started to be a part of routine medical practice. The invention of immunohistochemistry and new cytogenetic techniques affected a great influence and increased the significance of role of pathologist in detailed assessment and standardization of morphological criteria of urological tumors.

Side by side, the wide applying of blood test for prostatic specific antigen (PSA) and invention of fineneedle prostatic biopsy technique were performed. The results of this technological breakthrough influenced dramatically to worldwide clinical practice. Such increased clinical interest for early diagnosis and treatment of prostatic cancer made push to wide range of scientific investigations, concerning the morphology of prostate. Due to rapid growth of knowledge about etiology and pathogenesis, as well as biological behavior the different urological malignancies, the significance of multidisciplinary teams (MDT) with participation of urologists, oncologists and pathologists is essential. Such co-operation in urological oncology provides better understanding of the patient’s status, his tumor diagnosis, stage and treatment of the patient. Therefore, participation of the pathologist is the as equal among equals. Such teams can offer more detailed consideration and modern attitude to the oncological problems and can help to design new directions that will be useful to both, patients and clinical physicians (oncologists and urologists), as well as diagnostic pathologists. This co-operation will rapidly increase the self-awareness of the pathologist as ‘diagnostic oncologist’. These multidisciplinary teams might be a good example for other specializations in practical medicine and the organization of such teams and there guidance to the everyday practice is the main aim of this article.

Prostate specific membrane antigen (PSMA) is expressed in unfavorable prostate cancer. PSMA is basis for new diagnostics and theranostics. 177Lu-PSMA radioligand therapy is mainly used for patients with endstage prostate cancer. This report describes two patients: one patient with a multiple recurrences and one with extensive metastastic disease during the first visit. Both these patients were treated with 177Lu-PSMA radioligand therapy with major response, i.e. complete response by imaging and substantial reduction of PSA. 177Lu-PSMA radioligand therapy gave only mild adverse effects. In conclusion, patients with metastatic prostate cancer, 177Lu-PSMA-617 radioligand therapy had an attractive therapeutic profile which had to be adjusted according to the patient´s need.

Cystic Ureteritis (ureteritis cystica) is an uncommon pathology characterized by the formation of cysts beneath the mucosa of the upper urinary tract, usually with a diameter of a few millimeters up to a centimeter. They belong to benign conditions and are associated with chronic irritation of the ureter as a result of recurrent infection or urolithiasis. As a rule, this pathology is seldom accompanied by any specific clinical manifestations. They are usually found incidentally during routine radiological investigations of the upper urinary tract. Management involves the treatment of the underlying disease and eradicating any infection. In this article we present a clinical case of a patient with bilateral obstruction of the ureters by intralumenal cystic lesions.

All aspects of radical major surgery for prostate cancer, performed by the retropubic way, are covered extensively in the lecture. It is shown for the practicing surgeon, complications of operations and ways of dealing with them. The current functional and cancer results of the operative intervention are described. There is no doubt that the present book will be very useful for urologists and oncologists by improving their skills in performing this type of radical prostatectomy.

Summary. The past year has been saturated with information from new research, many of which have already been introduced into the standards. Of course, in a short message it is impossible to cover all the significant works of the year, but at the ESOU congress summarized all the trends that are relevant for actual and promising for the future in the diagnosis and treatment of major oncological diseases.