Introduction. The intensive introduction of modern endovideosurgical techniques creates the prerequisites for the further expansion of minimally invasive surgical interventions. Literature reviews` data on the results of retroperitoneoscopic operations suggest that endovideosurgery in urology has broad prospects for further development.

Purpose of the study. To estimate of the efficacy and safety of the retroperitoneoscopic operations for renal cysts.

Materials and methods. Retroperitoneoscopic operations (renal cysts deroofing) were performed for 152 symptomatic patients with Bosniak I kidney cysts (from 4.4 х 3.8 cm to 14.5 х 14.0 cm). Proposal of the operations were classified according to the technical difficulty as “Easy” in 147 (96.7%) cases (Е: sum of scores 3-5), in 5 (3.3%) cases – «Slightly difficult» (SD: score 7). Statistical analyses of the results performed by the program Microsoft Office Excel 2007, StatSoft Statistica 8.0 with using the Student-Fisher`s criteria.

Results. The mean duration of the operations was 35.7 ± 6.1 min (30-90 min); there were not any intraoperative complications; the mean blood loss was 23.0 ± 4.1 ml (10-100 ml); there was no need for blood transfusion; incidence of postoperative complications were 2.4% - in 4 cases there were manifestation of urinary tract infection during the postoperative period (II category of the complications according to Clavien-Dindo classification); mean hospital stay was 2.2 ± 0.1 day (1-6 days); drainages were removed on second postoperative day; there were not any conversions to open operations and additional procedures in postoperative period.

Conclusions. Retroperitoneoscopic renal cysts deroofing is effective and safe procedure for the treatment of simple kidney cysts. This method has the advantages of minimal invasiveness, minimal complications, short in hospital stay and fast recovery of the patients.

The study did not have sponsorship. The authors have declared no conflicts of interest.

Introduction. Difficulties in the management and treatment of patients with uncomplicated recurrent lower urinary tract infection (LUTI) are largely because bacterial, viral and other components remain unexplored in the etiological structure of the disease.

Purpose of the study. To study the urine bacterial-viral associations in uncomplicated recurrent infections of the lower urinary tract (LUT).

Materials and methods. The study included 14 patients with uncomplicated recurrent infections of the LUT, the average age was 33.0 ± 4.7 years. The object of the study was the average portion of morning urine collected prior to the appointment of empirical antibiotic therapy. Urine was divided into 3 aliquots: 1 for general urine analysis, 2 for bacteriological examination, 3 for polymerase chain reaction (PCR).

Results. Aerobic-anaerobic associations were found in urine in all cases. Enterobacteriaceae family representatives were discovered in 92.8% of cases; they were represented by E. coli (78.6%), Klebsiella spp. (14.2%), Proteus spp. (7.1%). Moreover, in one patient at the same time (7.1%) E. coli + Klebsiella spp was isolated from urine.

The gram-positive microflora pattern consisted of 7 genera and / or species and in various combinations was found in all patients. The taxonomic structure of the gram-positive flora was represented by E. faecalis (64.3%), S. lentus (21.4%), Corynebacterium spp., S. warneri, E. faecium (14.3% each), S. epidermidis + E. coli was recorded in 4 (28.6%) women, E. faecalis + E. faecium + E. coli + Klebsiella spp. - in 1 (7.1%), E. faecalis + E. faecium + E. coli also in 1 (7.1%) patients.

Non-clostridial anaerobic bacteria (NAB) were isolated from urine in all cases with Eubacterium spp dominating. (57.1%). The taxonomic structure of NAB was represented by 5 genera: Eubacterium spp., Peptostreptococcus spp., Peptococcus spp., Bifidobacterium spp., Propionibacterium spp.

Viruses were detected in urine in 6 (42.9%) patients. Epstein-Barr virus (EBV) was detected in 4 (28.6%) of them, moreover, in 1 case, in association with human papillomavirus (HPV53), in two other cases (7.1% each), cytomegalovirus (CMV) was verified and human herpes simplex virus type 6 (HHV6), respectively.

Conclusions. In patients with uncomplicated recurrent LUTI, viruses with a prevalence of EBV were verified in urine in 42.9% of cases (28.6%). Apparently, the treatment of this patients` cohort should be directed not only to the bacterial, but also the viral components of the urinary microbiota.

Introduction. The causes and mechanisms of interstitial cystitis / painful bladder syndrome (IC / PBS) remain poorly understood. The pathogenesis and the etiology of the disease is still not clearly defined. Of great interest is the role of epidermal growth factor (EGF). Due to the complexity of the pathophysiology of IC / PBS, several animal models are used to better understand the mechanisms of this disease.

Purpose of the study. to determine the level of epidermal growth factor (EGF) and its association with leukocytes and mast cells of the bladder tissue in animals with experimental models of interstitial cystitis / painful bladder syndrome.

Materials and methods. IC / PBS modeling was carried out on 29 individuals of white New Zealand female rabbits, which were divided into 4 groups. EGFs were determined in blood and urine by ELISA. Cellular changes in tissues were assessed by histological method.

Results. A high level of EGF in urine was detected in groups 1 and 2, exceeding the intact group by 33.3% (p <0.05) and 34.6% (p <0.05), respectively. In group 1, after 14 days, EGF decreased in blood by 16.2%, in urine - by 35.5% (p <0.05). In group 2, the level of EGF increased in blood (by 61.2%, p <0.01), in urine (by 28.7%). The greatest number of lymphocytes was detected in animals of the group 2 (p <0.001). Mast cells were determined only in groups 1 and 2, and in the latter their number was greater (p <0.001) than in group 1. A strong correlation was found between the value of EGF in the blood and mast cells, as well as between the level of EGF in the urine and eosinophils in group 1. In group 2, there was a direct weak relationship between the concentration of EGF in the urine and the number of lymphocytes and mast cells

Conclusion. A statistically significant increase of EGF in blood and urine was obtained in animals with simulated IC / PBS by introducing urine into the wall of the bladder. This modeling option contributed to the activation of mast cells of the bladder tissue. The association of EGF with mast cells in IC / PBS was revealed. Changes in EGF levels may be associated with IC / PBS.

The study did not have sponsorship. The authors have declared no conflicts of interest.

Introduction. The prevalence of acute pyelonephritis (AP) in pregnant women varies from 3% to 18%. There is an increase in the AP incidence in pregnant women over the past two decades with the growth of purulent-destructive forms incidence. Currently, there is no unity of views on the issues of therapeutic tactics in pregnant women according to the literature data. Besides, there are no clear criteria for the timing and choice of the method of upper urinary tract (UUT) drainage. This circumstance determines the relevance of the study of the effectiveness of minimally invasive methods of AP treatment and UUT obstructive lesions in pregnant women.

Purpose of the study. To study the effectiveness of minimally invasive methods of AP treatment in pregnant women.

Materials and methods. The results of AP treatment and various UUT obstructive lesions in 293 pregnant women from 2013 to 2018 years were analyzed. Patients` age: from 15 to 42 years (mean is 25 years). At the same time, 237 (81%) patients were in the second and third trimesters of pregnancy. Urodynamic disorders were resolved in 123 (42%) patients with stenting, ureter catheterization, and percutaneous nephrostomy (PNS). In 28 (9.5%) cases, UUT obstruction was caused by kidney stones, in 7 (2.4%) cases contact ureterolithotripsy (CULT) was performed on this occasion.

Results. In 16 (5.4%) patients developed complications, such as sepsis and septic shock. Purulent-destructive AP forms were observed in 8 (2.7%) pregnant women. AP was stopped in all patients against the background of the restored urine passage and ongoing conservative therapy. The need for lumbotomy, kidney`s decapsulation, carbuncles` excision, nephrectomy did not arise in any case. Eventually, 221 (75%) pregnant women had timely deliveries. Preterm birth was observed in 52 (17%) pregnant women. Maternal mortality has not been reported. Antenatal fetal death was detected in 2 (0.6%) cases within 1-2 months after discharge from the urological division.

Conclusion. Timely conservative managment of AP in pregnant women with adequately restored of urine passage allows to minimize severe septic complications and avoid traumatic open surgical interventions.

The study did not have sponsorship. The authors have declared no conflicts of interest.

The article presents an analysis of the treatment results of 1122 patients with pyelonephritis in pregnancy at different gestational periods (from 6 to 39-40 weeks of pregnancy). The age of the patients was from 16 to 41 years, the average age was 26.15 ± 7 years. The indications and methods of urinary tract drainage in pregnant women were analyzed depending on the causes of urodynamic disturbances (kidney stone disease, decreased urinary tract tone, ureters compression by the uterus, vesico-urethral reflux) pregnancy term; pyelonephritis in pregnancy stage (serous/ purulent). Errors in the patients’ management after purulent pyelonephritis in pregnancy are considered. The expediency of examining and treating patients with risk factors for urinary tract infections during pregnancy were indicated at the stage of preparing a woman for pregnancy. Antegrade draining of the urinary tract is indicated for pregnant women from the 31st pregnancy week (and even shorter periods with a pronounced violation of urodynamics) with the presence of knee-shaped deviation in the ureter`s upper third and with suspected purulent process. Therefore, nephrostomy draining provides a more adequate outflow of urine from the affected kidney and makes it possible to control daily diuresis. It is necessary to conduct active monitoring of pregnant women with the presence of internal ureteral stents and their timely replacement. It is advisable to remove the drainage 3-4 weeks after birth, depending on the causes of the urodynamics` disorders. Symptom build-up dynamics, severity of intoxication, multi-organ lesion, the possibility of antenatal death of the fetus require urgent choice of the method of urinary tract drainage and the early initiation of intensive therapy in patients with suspected purulent process. Antimicrobial therapy should be carried out in accordance with the Russian guidelines on Urinary tract infections.

TThe study did not have sponsorship. The authors have declared no conflicts of interest.

Male accessory glands infections (MAGI) are considered one of the causes of male infertility. Chronic prostatitis is the most prevalent form of MAGI. Researches that assessed the influence of chronic prostatitis on conventional semen parameters have shown contradictory results, so the debate regarding this issue continues. Conventional semen parameters are imperfect markers of male fertility, as many men remain infertile despite being normozoospermic. The search for reliable predictors of male fertility continues to this day. Oxidative stress is considered one of the main pathogenetic mechanisms of male infertility. Free radical oxidation is the leading cause of spermatozoa DNA damage. Spermatozoa DNA fragmentation caused by oxidative stress was associated with a number of unsuccessful reproductive outcomes. There are several factors that are responsible for making spermatozoa vulnerable to free radical damage including abnormal maturation characterized by insufficient chromatin protamination. Acrosin activity defines the ability of spermatozoa to penetrate the ovum membrane and is therefore an independent marker of spermatozoa fertilizing capacity. Possible mechanisms of chronic prostatitis influence on male fertility and current scientific data regarding its association with novel predictors of male infertility are discussed in this article.

The study did not have sponsorship. The authors have declared no conflicts of interest.

A clinical case of treatment of a 19-year-old patient with hydrocele on the left, polyorchism is described. In 2012, a patient underwent surgery on the left for varicocele on the left. Hydrocele developed one year after Ivanissevich’s surgery on the left, in 2013. Before going to the clinic polyorchism was not diagnosed. When contacted: complaints about the main disease - hydrocele: the increase of the left half of the scrotum, the patient’s condition was assessed as satisfactory, laboratory indicators ‒ within the normal range. Rapid treatment of hydrocele by Bergman was carried out. During the operation: the left half of the scrotum was opened, about 60 ml was evacuated. The straw-yellow liquids were assessed by the condition of the testicles, taking into account the presence of independent appendages in each organ and the common ejaculate - the decision was made to preserve both testicles. The postoperative period went smoothly. During the control examinations - pathological changes were not revealed: control analyses of the.

The study did not have sponsorship. The author has declared no conflicts of interest.

The lecture details the current understanding of renal replacement therapy and current advances in this field. The current diagnostic and treatment algorithms have been clarified, allowing timely assistance to the population with chronic kidney disease. I tried to identify the main milestones on the way to increasing the availability of renal replacement therapy in our country, where many regions have a very large area and low population density. Obviously, much effort remains to be done to achieve a good level of security and accessibility of renal replacement therapy for our population. I hope that this manuscript will serve to some extent the aims that have been set.

The study did not have sponsorship. The author has declared no conflicts of interest

The article presents a report of the 33rd European Congress of the International Union against for Sexually Transmitted Infections (IUSTI-Europe) from September 5 to 7, 2019, as well as an advanced course on sexually transmitted infections in the framework of the Congress (IUSTI -Europe advanced course) from September 4 to 5 in Tallinn, Estonia. This article will also highlight some important points about the prevalence, diagnosis and treatment of sexually transmitted infections, as well as the problems of resistance of the main causative agents of STIs to standard therapy, which were voiced by various experts in their presentations, lectures during round tables, plenary sessions and symposia both during the advanced course of IUSTI-Europe, and during the main congress.

The study did not have sponsorship. The authors have declared no conflicts of interest.