From 1995 to 2012 radical cystectomy were performed to 326 patients. Orthotopic intestinocistoplastika performed by Studer 69 (18.7%) patients, including short mesostenium was in 48 (69.6%), which are combined into two groups. Group I - 15 (31.3%) patients with orthotopic intestinocistoplasticy by Studer, II group - 33 (68.7%) patients who made modification techniques Studer - inverts orthotopic ileocistoplastics. Cases of leak of the tank or anastomosis were not observed. Medium capacity of neobladder after removal of urethral catheter – 110 ml., in 3 months – 350 ml, in 12 months – 490.0 ml. Maximum pressure in the tank does not exceed 40 cm water column (average 30 cm H2O). Day retention – 94,7%, night confinement at a forced night miction – 79.0%. The proposed method of inverting orthotopic ileal neobladder can be recommended when overlapping of orthotopic urinary reservoir is impossible or associated with leaks of the anastomosis due to the insuf-ficient length of the mesentery using known techniques of orthotopic ileal bladder reconstruction.

We studied the condition of the blood proteolytic systems (activity of kallikrein (К) and level of prekallikrein (PK), the total proteolytic activity of serine proteinases and elastase-like activity, the leukocytic elastase (LE) activity, the angiotensin-converting enzyme (ACE) activity, and the inhibitor activity of the α1-proteinase inhibitor (α1-PI) and α2-macroglobulin (α2-MG) in 36 patients after radical prostatectomy (RPE). Group I was composed of 28 patients without biochemical recurrence (BR) after RPE. In this group, 18 patients had locally limited cancer, and 10 patients had рТ3. Group II included 8 patients after RPE with development of BR. The prostate cancer stage in Group II was as follows: рT3 in 7 patients, and pT4 in one patient. The average age of the patients in the groups was 61.44±1.39 years. The median PSA before RPE was 8.05 ng/ml (LQ=5.01; UQ=12). The average prostate volume in the groups was 52±2.74 cm3 . The median of observations was 18 months. The control group consisted of 20 healthy males. In Group II patients at 1 month after the RPE, the ACE activity was 136.5% (p1<0.001) higher, and the LE activity was 29.0% (p1<0.05) lower than the corresponding indicators in Group I. The median PSA in Group I at that time was 0.02±0.01 ng/ml, and in Group II it was 0.2±0.04 ng/ml. Thus, increased activity of ACE against the background of the reduced antiproteolytic potential of the blood in patients after RPE is the metabolic basis for development of biochemical recurrence, and can be a marker of its progression. Increased activity of ACE and reduced activity of EA are predictors of BR development as early as at 1 month after RPE, when the PSA level is not yet elevated.

 

Extracorporeal shock wave lithotripsy (ESWL) in spite of the low invasiveness and high efficiency is accompanied by an infectious- inflammatory complications and renal parenchymal injury . Dynamics of microbial spectrum urine and the impact of postoperative antibiotic therapy currently remains unexplored. The study included 30 patients subjected to ESWL. Bacteriological study was midstream morning urine before ESWL, 1, 3 days after ESWL, and midstream urine in the first urination after ESWL. All patients were divided into 2 groups. Group I consisted of patients (46.7%) with antibiotic therapy . Group II patients (53.3 %) antibiotic therapy was performed. In most cases (97.8 %) were bacteriuria , while in 75% of cases highlighted in the various options bacterial associations representation aerobic- anaerobic mixed infection, among which was dominated by non-clostridial anaerobic bacteria in all samples. Revealed that after ESWL microbial spectrum urine does not change in any case within 3 days , except for Enterobacteriaceae, but the frequency of occurrence and level of bacteriuria vary for different periods after surgery and fees or absence of antibiotic therapy.

This article analyzes the structure of the example receiving outpatient urological Cabinet city polyclinic №26 Novosibirsk. Revealed a clear predominance of inflammatory diseases of the genitourinary system, benign prostatic hyperplasia and urolithiasis. This group of diseases should be given due attention in the medical examination of the population.

 

The article describes the clinical observation of toxic chronic tubulointerstitial nephritis due to prolonged use of herbal drug Agrimonia Eupatoria. The toxic effects of A.Eupatoria more associated not with specific toxicants, and the presence of a large number of coumarin glycosides and its metabolites. Earlier in the literature descriptions of nephrotoxicity A.Eupatoria ordinary does not. In conducting the study of the morphological characteristics were described tubulopathy, characterized by a pronounced hydropic dystrophy tubular epithelium up to vacuolization, weak and small focal diffuse interstitial fibrosis. Special attention in the clinical picture itself drawn the progressive increase in proteinuria, hypertension due to lower filtration function of the kidney and renal tubular dysfunction. Key words: toxic nephropathy, Agrimony ordinary, Agrimonia Eupatoria, coumarin, phytotoxins

Renal cell carcinoma (RCC) accounts for 90-95% of all neoplastic lesions of the kidney. In Russia in 2008 defined 17 563 new cases of RCC. In this common tumor found in 45.6 % of cases. A metastatic forms are still a significant part of RCC – 28-32%. In the last decade the proportion of localized tumors increased to 55.4% and the 5-year cancer survival for local forms of RCC is 86-98%. However, it is not accompanied by a significant increase in overall survival. This situation is definitely needed in the analysis. First of all, to assess the impact of surgical treatment on survival . Radical nephrectomy remains the gold standard for surgical treatment of RCC, including the treatment of small tumors and produced more than 80% of cases. Assessing the impact of surgery on renal function is necessary also due to the fact that in 26% of patients with localized tumors , the opposite kidney healthy and normal preoperative serum creatinine glomerular filtration rate (GFR ) less than 60 ml/min . Even at baseline GFR from 60 to 90 ml/min, patients subjected to radical nephrectomy have 58% risk reduction of its <60 ml/min. In this group of patients in the 2-fold increased risk of cardiovascular complications and 4.5 times the risk of death. Within three years after radical nephrectomy in 21.6% of patients have progression of cardiovascular disease and 6.0% of patients die from complications associated with them.

The lecture gives an overview and comparative analysis of the original alpha-1-blockers and their generics, as well as the choice of drug for the treatment of benign prostatic hyperplasia in the light of prospects of the Russian pharmaceutical industry.

 

The article presents a report on the international conference «Urogenital infections and tuberculosis», held in Novosibirsk from 24 to 26 October 2013.