Introduction. Various criteria are used to assess the quality of lithotripsy-treated urolithiasis, the main of which is the stone free rate (SFR). Along with this criteria, the risk of complications, the duration of lithotripsy, the amount of retropulsion, the length of hospital bed-days and others are also considered when comparing lithotripsy methods. However, each of these criteria evaluates only one side of lithotripsy-treated urolithiasis.

Objective. To develop a universal integral criterion for the effectiveness of urolithiasis treatment using lithotripsy.

Materials and methods. The method of expert assessments was used to determine the factors affecting the overall effectiveness of lithotripsy. Expert survey was carried out using the questionnaire method. Mathematical methods of the operations research theory and the criteria importance theory were used to construct an integral efficiency criterion.

Results. It is suggested that a weighted sum of factors determined in the process of conducting expert assessments be used as an integral criterion for the effectiveness of lithotripsy-treated urolithiasis. Factors are SFR coefficient, average surgery length, complications and average hospital bed-day. The weight factors to consider the degree of influence of these factors are w₁ = 0.436; w₂ = 0.143; w₃ = 0.240; w₄ = 0.181, respectively

Conclusion. The proposed integral indicator can find wide application in urological practice, since it allows considering not only the relative proportion of patients who do not have stones after lithotripsy, but also the probability of complications, as well as the length of hospital bed-days, which affect the treatment cost and the patient's quality of life.

Introduction. Today, due to the insufficient diagnostic accuracy of existing tools for determining clinically significant forms of prostate cancer, the search for new indicators that predict the course of the disease and the effectiveness of radical treatment is relevant. Various malignant tumors could increase glucose consumption and grow under hypoxic conditions. It seems promising to assess the expression level of glucose transporter type 1 (GLUT1) and carbonic anhydrase IX (CAIX) in prostate adenocarcinoma cells of different malignancy score.

Objective. To determine CAIX and GLUT1 expression in ISUP grades 1-5 prostate adenocarcinoma cells for evaluation of the disease prognosis and radical prostatectomy effectiveness.

Materials and methods. Immunohistochemical study of postoperative material after radical prostatectomy with determination of GLUT1 and CAIX expression by tumor cells was carried out. The presence or absence of biochemical recurrence within one year after surgery was determined. The correlation between the level of expression, the presence of biochemical relapse and a few other clinical parameters was determined.

Results. GLUT1 expression level statistically significant correlated with ISUP 4 and 5 (r = 0.457, p < 0.0001), prostate-specific antigen (PSA) level (r = 0.378, p < 0.0001), pT3b disease stage (r = 0.380, p < 0.0001), extracapsular extension (r = 0.355, p = 0.001), and inversely correlated with ISUP 1 (r = -0.274, p = 0.009). CAIX immunoexpression was observed in 10.0% of samples and the intensity was low (< 20% of cells).

Conclusion. Elevated expression of glucose transporter type 1 (GLUT1) by prostate adenocarcinoma cells among patients after radical prostatectomy is associated with high grade of malignancy (ISUP 4 and 5), pT3b disease stage, extracapsular extension of the tumor, as well as high PSA, which allows using it for the prognosis evaluation.

Introduction. Multi-stage urethral surgery is used in cases of the most complex urethral strictures. The evaluation of surgical treatment results given by patients is a significant criterion for the efficacy of urethroplasty along with the assessment of urethral patency through instrumental examinations.

Objective. To evaluate the long-term efficacy of multistage urethroplasty for complex anterior urethral strictures considering the patients' quality of life and satisfaction with the surgical outcomes.

Materials and methods. The study included 73 patients aged 18 – 84 years with anterior urethral strictures who underwent multi-stage urethroplasty in 2010 – 2019. Surgical and functional outcomes of urethroplasty were assessed through general blood and urine tests, physical examination, uroflowmetry, and retrograde urethrography and urethroscopy in case of urinary disorders.  Subjective parameters of treatment efficacy were studied using questionnaires: International Prostate Symptom Score (IPSS); Quality of life (QoL); Patient-reported Outcome Measure for Urethral Stricture Surgery (USS-PROM); Patient Global Impression of Improvement (PGI-I).

Results. Recurrent urethral stricture was detected in 19 (26,0%) patients with the average follow-up period being 65 months. Independent urination was restored in 71 (97.3%) cases, including repeated interventions. After surgery, there was a significant increase in urinary flow rate parameters (Q max: 8.1 vs 19.1 ml/s, p < 0.0001; Q ave: 5.5 vs 10.7 ml/s; p = 0.0004), decrease in residual urine volume (62.4 vs 18.6 ml, p < 0.0001), decrease in total IPSS score (18.7 vs 5.7 points; p < 0.0001) and QoL index (4.3 vs 1 .8 points, p < 0.0001). A comparative analysis of preoperative and postoperative USS-PROM questionnaire results demonstrated an improvement in indicators assessing LUTS (12.9 vs 3.4 points; p < 0.0001; 3.6 vs 1.7 points; p < 0.0001), and urination-associated quality of life (2.6 vs 0.6 points; p < 0.0001) and overall health (EQ-5D index: 0.73 vs 0.91 points; p = 0.025; EQ-VAS: 68.0 vs 88.1 points, p = 0.004). Fifty-seven (81.4%) men were “very satisfied” or “satisfied” with the treatment outcomes, while nine (12.9%) respondents noted a moderate effect of residual urinary disorders on the quality of life. Significantly higher satisfaction was observed among cystostomy patients and in cases where repeated interventions were unnecessary.

Conclusion. Multi-stage urethroplasty for complex anterior urethral strictures achieves efficacy in 97.3% of cases and is accompanied by high levels of quality of life and patient’s satisfaction during long-term follow-up.

Introduction. The tactics of managing and treating patients with chronic recurrent bacterial prostatitis (CRBP) in some cases is a difficult-to-treat condition for a practicing urologist. This circumstance occurs because the disease has several predisposing factors, a complex and multifaceted pathogenesis, and certain difficulties in diagnosis and treatment.

Objective. To study the effectiveness of recombinant interferon α-2b medications in post-COVID-19 patients with chronic recurrent prostatitis against the background of antibiotic multi-drug resistance of microorganisms verified in prostate secretion.

Materials and methods. The treatment of 52 post-COVID-19 patients with CRBP was analyzed, divided into three therapy-dependent groups. Group 1 patients (n = 18) received antibiotic therapy (ABT): Levofloxacin 500 mg q.d. PO for 28 days. Group 2 patients (n = 18) underwent combined therapy: ABT supplemented with recombinant interferon α-2b with an antioxidant complex of vitamins E and C (“Viferon®” rectal suppositories) 3.000.000 IU b.i.d. PR q12h for 28 days. Group 3 patients (n = 16) received monotherapy with recombinant interferon α-2b with an antioxidant complex of vitamins E and C (“Viferon®”rectal suppositories) 3.000.000 IU b.i.d. PR q12h for 28 days. The follow-up period was 6 months with monitoring of clinical and laboratory parameters assessed before treatment, after 1, 3 and 6 months from the start of therapy.

Results. Based on the monitoring of the clinical picture and laboratory parameters, after 1 follow-up month, there was a significant decrease in the symptoms of the disease in all study groups. However, after 3 and 6 follow-up months, this trend was observed only in patients of groups 2 and 3 receiving recombinant interferon alfa-2b with an antioxidant complex (vitamins E and C).

Conclusions. Strengthening the standard CRBP-therapy with recombinant interferon α-2b with an antioxidant complex of vitamins E and C makes it possible to normalize both clinical and laboratory parameters in most patients.

Introduction. Autonomic dysreflexia (AD) is a life-threatening dangerous condition in patients with spinal cord injury (SCI) above the T6 segment level. It is characterized by a sudden rise in systolic blood pressure more than 20 mmHg, and unpredictable reactions from the autonomic nervous system. An episode of autonomic dysreflexia can lead to several cardiovascular catastrophes – heart attack and/or acute cerebrovascular accident up to a lethal outcome. Currently, there is no diagnostic algorithm and no way to determine risk factors for the occurrence of autonomic dysreflexia.

Objective. To search for the most informative diagnostic criteria for autonomic dysreflexia in patients with spinal cord injury.

Materials and methods. The study included 40 patients with SCI above the T6 segment. Depending on the SCI degree, two groups were distinguished. Group 1 (n = 14) included patients with complete spinal cord injury, advising category A on the ASIA scale. Group 2 (n = 26) included patients with incomplete spinal cord injury, classified as ASIA-B, C, D. For a preliminary assessment of the risk factors for the development of AD, an ADFSCI questionnaire was used, then a urodynamic study was conducted with simultaneous registration of systolic / diastolic blood pressure (SBP / DBP), and heart rate, which confirmed or denied the presence of AD in patients.

Results. According to the ADFSCI questionnaire, most patients showed a high degree of severity of autonomic disorders, suggesting the presence of AD. Subsequently, this assumption was confirmed by the results of a urodynamic testing with simultaneous monitoring of SBP / DBP and heart rate. When comparing the groups, statistically significant differences were found in the parameters of the ADFSCI questionnaire, as well as in the indicators of SBP / DBP (at the points of maximum detrusor pressure and when the cystometric capacity is reached).

Conclusion. The obtained results allow us to draw conclusions about the high incidence of AD in patients with SCI above the T6 segment and the need for a preliminary assessment of the risks of developing this condition based on the ADFSCI questionnaire before conducting a urodynamic study. Considering the possible complications of AD, the urodynamic testing should be accompanied by continuous monitoring of the indicators of the cardiovascular system.

Introduction. Currently, various methods and modifications of radical prostatectomy (RP) have been developed and tested, aimed at preventing and minimizing the development of urinary incontinence (UI). However, UI remains an urgent problem in patients who undergo RP, especially at the early follow-up stages.

Objective. To evaluate and compare the effectiveness of modified reconstructive techniques for vesicourethral anastomosis in radical prostatectomy for the prevention of urinary incontinence with respect to the standard technique at different follow-up periods.

Materials and methods. Design: single-centre, clinical, simple, comparative, parallel-group study with retrospective and prospective material evaluation, conducted in 2017 – 2022. Patients: men with verified prostate cancer cT1a – 2cN0 – xM0 without decompensated comorbidities. Age: 45 – 78 years. Retrospective part — group (G) 1: 90 patients who underwent non-nerve-sparing open retropubic RP with a "classic" vesicourethral anastomosis (VUA). Prospective part — G2: 46 patients who underwent similar surgery with modified VUA in two variations: without and with prostatic urethra-sparing — G2a (n = 25) and G2b (n = 21), respectively. Initial examination: standard preoperative laboratory and instrumental examination, assessment of lower urinary tract symptoms (LUTS) using the IPSS-QoL questionnaire. Follow-up examination: objective evaluation of UI according to established criteria and subjective assessment using the ICIQ-SF questionnaire, tracking the dynamics of LUTS using IPSS-QoL. Follow-up periods: 0-point (after catheter removal), 1, 3, 6, and 12 months (exit-point); the dynamics of recovery of urinary continence (UC) was determined monthly. Statistical analysis: Statistica ver.10.0 (StatSoft Inc., Tulsa, OK, USA) using non-parametric methods (CL p < 0.05 at a = 0.05)

Results. Preoperative demographic, questionnaire and instrumental statistics did not differ (p > 0.05) between the groups, confirming the homogeneity of the samples. After RP, the urethral catheter was removed in a period of 7 to 21 days. There was no difference (p > 0.05) in the duration of drainage between the groups. Total urinary continence (TUC) immediately after catheter removal was detected in G1, G2a and G2b in 20.0%, 44.0% and 57.1% of cases, respectively. Subsequent objective monitoring of UC recovery from 1 month showed differences (p < 0.001) between the groups in the dynamics of rehabilitation during the year. The improvement in UC over the one-year follow-up period was cumulatively achieved in G1, G2a and G2b in 48.9%, 44.0% and 33.3% of cases, respectively. Total UI persisted in G1 and G2a by month 12 in 22.2% and 8.0% of patients, respectively, and was not detected in G2b. The severity of UI by the end of the follow-up according to the ICIQ-SF data was the most pronounced (p < 0.001) in patients from G1. TUC-patients in all groups from 1 month showed a marked decrease in the severity of obstructive and irritative LUTS and improved quality of life, with no differences (0.157 < p < 0.390) in IPSS-QoL values between groups.

Conclusions. The use of modified VUA reconstruction techniques made it possible, compared with the standard one, to achieve high continence rates in patients both immediately after the removal of the urethral catheter and at subsequent follow-up periods, without the formation of severe iatrogenic obstruction. Prostatic urethra-sparing modification is the most effective technique that provided the rehabilitation of UI to a complete and/or social level in all patients within a year after surgery.

Introduction. Reinfection after drainage of obstructive pyelonephritis exacerbates the postoperative course of the disease and delays the possible surgical intervention aimed at eliminating the cause of obstruction.

Objectives. To determine the percentage of re-infection in patients drained with double-J stent or nephrostomy catheter for obstructive pyelonephritis. To assess the relationship between the timing of drainage removal and development of re-infection. To establish risk factors for the development of re-infection.

Materials and methods. Medical records from 1022 patients who were treated from January 2019 to December 2021 and underwent drainage for obstructive pyelonephritis. The data in patients after nephrostomy and stenting were evaluated separately. A retrospective analysis of the time and frequency of the development of re-infection, as well as the effect of diabetes mellitus on pyelonephritis relapse, was carried out.

Results. Re-infection during drainage developed in 16 (4.8%) patients with a nephrostomy and 45 (6.5%) patients with a stent. Among those who had re-infection in the nephrostomy-group, 4 (25.0%) patients noted it within two weeks from the moment of drainage, and 11 (69.0%) at three-four weeks. In the stent-group, the number of patients who had a complication during the first two weeks was 15 (33.0%), and it was 22 (49.0%) during the next two weeks, The proportion of patients with diabetes mellitus was higher among those who developed pyelonephritis again.

Conclusion. The percentage of patients hospitalized with clinical re-infection after drainage of the upper urinary tract was 6.0%. There was an increase in the number of hospitalizations with recurrent pyelonephritis in cases where the drainage period lasted more than two weeks (p < 0.05).

Introduction. The problem of endoscopic treatment for urethral strictures and obliterations remains unresolved. It is necessary to note that the effectiveness depends not only on the right indications, but also on the surgical technique and the study of the postoperative period management.

Objective. To evaluate the efficacy and safety of endoscopic treatment of patients with bulbar-membranous urethral obliteration.

Materials and methods. The study included 103 patients aged 20 to 89 years with bulbar-membrane urethral obliteration, who, for some reason or another, cannot perform urethroplasty. The patients underwent endoscopic recanalization of the urethra under X-ray control with further circular transurethral electroresection (TUR) of the scar tissues in the urethral obliteration zone (after 6 – 7 days).

Results. The average age of the patients was 61.1 ± 18.3 years. After the operation, self-urination was restored in all patients. The average maximum urine flow rate (Q max) before discharge from the hospital was 12.6 ± 0.5 ml/s. Throughout the follow-up period, Q max tended to increase and at the end of the study (36 months) reached values of 16.5 ± 0.5 ml/s. During the first year of follow-up, 18 (17.5%) patients developed recurrent urethral stricture. Seventeen (16.5%) patients underwent repeated circular TUR of scar tissue in the zone of recurrent stricture. The effectiveness of the treatment was 90.0%.

Conclusion. Endoscopic urethral recanalization followed by TUR of scar tissue in the obliteration zone is an effective and safe method in the treatment of bulbar-membranous urethral obliteration with length less than 1.0 cm.

Introduction. Transrectal biopsy under US-control has been standard diagnostic method for prostate cancer (PCa) detection for over 30 years. However, TRUS-guided biopsy is not without well-known drawbacks. MR-targeted biopsy methods were proposed to eliminate the drawbacks and improve detection rate of clinically significant Pca. Cognitive and mpMR/US-fusion biopsies have become the most widely used MR-targeted biopsies. However, there are contradictory data on detection of clinically significant Pca when comparing mpMR/US-fusion and cognitive biopsies.

Objective. To compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US-fusion biopsies.

Materials and methods. Inclusion criteria: PSA > 2.0 ng/ml and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 score ≥ 3. The outcomes evaluated are the detection of clinically significant Pca (ISUP ≥ 2), the overall PСa detection, the detection of clinically insignificant Pca, histological yield (proportion of positive cores, maximum cancer core length).

Results. Retrospective data analysis was performed: cognitive biopsy was performed in 102 patients and mpMR/US-fusion biopsy in 176 patients. The median age was 63 years, prostate volume 46 cc. The median PSA was 6.4 ng/ml in the mpMR/US-fusion and 6.7 ng/ml in the cognitive biopsy group. MpMR/US-fusion and cognitive biopsies were comparable about the detection rate of clinically significant (30.3% vs 25.0%; p=0.329) and overall Pca detection rate (50.5% and 42.1%; p = 0.176). It was detected to be less clinically insignificant Pca in the cognitive biopsy group (11.8% vs. 25.5%; p = 0.007).  The proportion of positive cores (30.5% and 29.5% respectively; p = 0.754) and maximum cancer core length (6.6 mm vs 7.6 mm; p = 0.320) were equal when comparing cognitive and mpMR/US-fusion biopsies. The proportion of positive cores with clinically significant Pca was higher in the cognitive biopsy group (18.6% vs 13.1%; p = 0.029).

Conclusion. Both cognitive and mpMR/US-fusion biopsies are equally accurate for clinically significant Pca detection. Therefore, cognitive biopsy may be an alternative to mpMR/US-fusion biopsy in hospitals where mpMR/US-fusion technology is not currently available.

Introduction. A combination of antiandrogen and cytostatic drugs was justified in the neoadjuvant therapy of patients with high-risk prostate cancer (HiRPCa) in some clinical trials. The effectiveness of such therapy in each individual case depends on the sensitivity of cancer cells to the applied drugs. It makes possible the development of the new technologies to personalize therapeutic approach. MicroRNAs (miRNAs) are a class of regulatory molecules whose expression is altered in PCa cells and can be associated with the sensitivity/resistance of cancer cells to specific cytostatics, for instance, taxanes.

Objective. To identify the potential-marker miRNAs of PCa cells sensitivity to taxanes.

Materials and methods. Samples of PCa tissue (n. 56) obtained from patients underwent neo-adjuvant therapy (antiandrogen and taxanes) and radical prostatectomy; PCa cell lines (PC-3, DU-145, LNCap). Total RNAs isolation was carried out using miRNeasy FFPE Kit, LRU-100-50; miRCURY LNA miRNA Focus PCR Panel, All-MIR kits were used for semi-quantitative analysis of potentially marker microRNA molecules using sequential reverse transcription and PCR.

Results. The effect of taxanes on PCa cells is associated with up-regulation of miR-106b expression and down-regulation of miR-200c expression in both in vivo and in vitro conditions.

Conclusion. MiR-106b and miR-200c miRNAs are involved in the response of PCa cells to taxanes, and therapeutic modification of these molecules in PCa cells may present a potential strategy to increase their sensitivity to taxane-containing therapy. Appropriate innovative technology may be in demand in the treatment of HiRPCa-patients.

Introduction. Up to 50.0% of postpartum women experience stress urinary incontinence (SUI) and pelvic organ prolapse (POP). One of the most common and pathogenetically substantiated methods for surgical correction of severe SIU and POP is prosthetic reconstruction of the pelvic floor, involves the use of monofilament polypropylene surgical meshes through vaginal or laparoscopic access.. However, this way is associated with specific problems, i.e., primarily mucosal erosions, and pelvic pain. This has served as a trigger for the development of new materials that reduce the likelihood of such side effects.

Objective. To develop the new-generation synthetic implants for surgical correction of stress urinary incontinence and pelvic organ prolapse.

Materials and methods. The main development stages: 1. design of an experimental sample of a synthetic implant (evaluation of basic, physical and mechanical properties). 2. test of an experimental sample obtained in vitro.

Results. A bioresorbable polypropylene ligature delivery system was developed and manufactured in two variants: for the POP correction (mesh tape with a width of 13 – 15 mm) and for the SUI correction (mesh tape with a width of 10 – 11 mm).

Conclusion. Based on the results of the in vitro tests, we can conclude that the synthetic implants developed are able to provide physiological longitudinal (axial) support of the necessary pelvic floor sections and reduce the risk of postoperative complications. Further in vivo studies are required to assess the response of living tissue to the implantation of this type of synthetic implants.

Urolithiasis is a common multifactorial disease characterized by a high recurrence rate. This review is devoted to the urine pH as one of the main factors determining its lithogenic properties. It affects the excretion of lithogenic substances and stone formation inhibitors, the solubility, and the crystallization of substances involved in stone formation. The urine pH significantly affects the solubility of uric acid in urine, which decreases at a pH < 5.5. This explains the high incidence of uric acid concretions in patients with metabolic syndrome. Their insulin resistance leads to a decrease in the excretion of ammonium ions in the proximal tubules, leading to persistent urine acidification. The activity of many transport processes involved in the processing of calcium, citrates and phosphates is sensitive to changes in systemic or local pH. The data on the effect of urine pH on the solubility of calcium oxalate remain contradictory. At the same time, there is no doubt about the determining role of urine pH in the excretion of citrate, the most important stone formation inhibitor. The alkaline urine pH promotes the formation of concretions containing calcium phosphates. In conditions of constantly elevated urine pH in patients with persistent urease-producing urinary tract infection, a rapid growth of "infectious" concretions occurs. The review summarizes information on the causes of the decrease and increase in the urine pH, as well as the possibilities of medicinal and non-medicinal methods of modifying the urine pH during the prevention of stone formation recurrence.

Severe course of COVID-19 among men compared to the female led to a detailed study of the hormonal status of men with COVID-19. The earliest works about this focused on the incidence and severity of COVID-19 depending on the intake of androgen deprivation therapy. At the same time, different classes of androgen deprivation therapy have different effects on androgen concentration that was not always considered in the analysis. In this regard, we conducted a review of the available literature data with a targeted study of works that included androgen deprivation therapy with a unidirectional effect on the concentration of male sex hormones. In addition, we conducted a review of studies focused on the relationship between COVID-19 and androgens (testosterone and dihydrotestosterone).

Introduction. Transurethral resection of bladder tumor (TURBT) is the gold standard treatment for patients with non-muscle invasive bladder cancer (NMIBC). However, the high recurrence rate after TURBT makes necessary not only regular following to reveal recurrence disease timely, but it also talks about a necessity of adjuvant antitumor therapy in some cases, that allows to prevent disease recurrence and progression. In this regard, patients belonging to high- and sometimes intermediate- risk progression groups are shown to undergo postoperative adjuvant intravesical Bacillus Calmette–Guérin (BCG) therapy. Despite the long experience of using BCG therapy for NMIBC treatment the question of the existence of possible prognostic markers and response predictors to intravesical BCG therapy remains open.

Objective. To review cutting-edge data on different markers that can be used as predictive response markers to ongoing intravesical BCG therapy in NMIBC-patients.

Materials and methods. A literature search was conducted using PubMed/ Medline and Google Scholar databases. We used terms 'bladder cancer', 'non-muscle-invasive bladder cancer' in conjunction with 'recurrence', 'progression', 'BCG', 'intravesical therapy', 'immune response', 'molecular markers' to choose relevant articles published between 2000 and 2022.

Results. Clinical and pathological characteristics of the tumor and the patient himself remain leading in predicting the response to intravesical BCG therapy in NMIBC-patients. However, to improve the effectiveness of assessing the risk of developing adverse BC outcomes and choosing the most appropriate strategy for monitoring and treatment in each case, it is necessary to introduce additional assessment parameters. Molecular and genetic markers could be considered as such parameters, make it possible to reveal differences between tumors at a deeper level.

Conclusion. Currently, there are no markers that have high-evidence in predicting response to intravesical BCG therapy in NMIBC-patients compared with the cliniсal and pathological characteristics of the tumor and the patient himself. The clearer awareness of molecular genetic pathways of BC pathogenesis, the mechanism of BCG antitumor effect will make it possible to competently select markers that have the highest specificity for BC, which will increase the predictive ability of currently existing tools to assess the risks of BC recurrence and progression.

Introduction. Calyceal fistula is a rare complication of a renal transplantation. This complication can lead to postoperative graft failure. The treatment approaches range from a partial nephrectomy to a routine nephrostomy.

Objective. To present the successful application of the retrograde endoscopic-assisted percutaneous treatment of transplanted kidney calyceal fistula.

Clinical case. A patient after kidney allotransplantation is under our care. Control postoperative ultrasound examination revealed a pararenal fluid mass in the left iliac region. Its percutaneous drainage was performed. Biochemical analysis revealed high levels of creatinine and urea in the drainage discharge. Despite ureteral stent and urethral catheter drainage, about 500 to 600 ml of urine per day was excreted by the drainage. Percutaneous puncture nephrostomy could not be performed due to the absence of dilatation of the renal cavity system. In the lithotomic position, the damaged calyx was identified by performing flexible ureteropyeloscopy. Then we percutaneously targeted the injured calyx and the distal end of the ureteroscope inserted transurethrally, so that the needle tip appeared in the paranephral cavity opposite the injured calyx. Under the control of a flexible ureteroscope the needle was inserted into the kidney pelvis, a nephrostomy tube 12 Ch was placed along the string. The discharge through the drain stopped within a week and it was removed. Follow-up examination nine weeks after surgery revealed that the patient had no complaints and renal ultrasound showed no features, so the nephrostomy tube was removed.

Conclusion. The described method is the minimally invasive, affordable, and efficient method for the treatment of transplanted kidney calyceal fistula.

Giant ureteral stones in young children are extremely rare and their surgical treatment tactics are variable. The present case describes a case of effective and safe endoscopic treatment of giant ureteral stones in a young child. The patient is a 3-year-old male child. Examination findings of abdominal pain and fever verified a left distal ureteric stone up to 30 mm complicated by ureterohydronephrosis. The first treatment stage was ureteral stenting, in which the stone migrated to the middle ureteral third. The second treatment stage was contact ureterolithotripsy with a 9 Ch semi-rigid ureteroscope («Richard Wolf» GmbH, Knittlingen, Germany) and Swiss LithoClast® 2 pneumatic lithotripter («E.M.S. Electro Medical Systems» S.A., Nyon, Suisse), ureteral stenting (2-way PigTail, 4.5 Ch). The third treatment stage in the delayed period was extracorporeal shockwave lithotripsy of the steinstrasse using the Dornier Compact Sigma («Dornier MedTech» GmbH, Weßling, Germany) and stent removal. Residual stones were not revealed according to the follow-up examination. No treatment complications were registered. The multimodal staged treatment of a giant ureteral stone resulted in its complete elimination. Next-step ureteral endoscopy made it possible to identify concomitant pathology of the proximal ureter, which required its evaluation in the delayed period. Ureteral stenting contributed to the restoration of renal function. The result achieved reflects the maximum efficiency and high safety of the surgical technique applied.

The International Alliance of Urolithiasis (IAU) would like to release the latest guideline on percutaneous nephrolithotomy (PCNL) and to provide a clinical framework for surgeons performing PCNL. These recommendations were collected and appraised from a systematic review and assessment of the literature covering all aspects of PCNLs from the PubMed database between January 1, 1976, and July 31, 2021. Each generated recommendation was graded using a modified GRADE methodology. The quality of the evidence was graded using a classification system modified from the Oxford Center for Evidence-Based Medicine Levels of Evidence. Forty-seven recommendations were summarized and graded, which covered the following issues, indications and contraindications, stone complexity evaluation, preoperative imaging, antibiotic strategy, management of antithrombotic therapy, anesthesia, position, puncture, tracts, dilation, lithotripsy, intraoperative evaluation of residual stones, exit strategy, postoperative imaging and stone-free status evaluation, complications. The present guideline on PCNL was the first in the IAU series of urolithiasis management guidelines. The recommendations, tips and tricks across the PCNL procedures would provide adequate guidance for urologists performing PCNLs to ensure safety and efficiency in PCNLs.

The article provides an overview of the most significant publications on male infertility. The main selection criteria were the practical relevance of the article, as well as the impact factor of the journal it was published, according to the SCImago Journal Rank (SJR). As a result, a list of 10 papers published in Q2-Q3 (April — September) 2022 was formed. The summary overview includes articles on the following topics: role of coronavirus infection in disorders of spermatogenesis, efficacy of hormonal stimulation before surgical sperm extraction, therapy consequences of diabetes mellitus on progeny reproductive health, new methods for selecting spermatozoa in ICSI, the efficacy of antioxidants, the safety of vaccines against SARS-CoV-2, the importance of genetic tests and predictive factors for micro-TESE success.