Varicosity of testicular veins is a widespread urological disease and one of the most common reasons of male infertility. In 40-80% changes in sperm parameters may be the only clinical sign of varicocele. Some literature data report on the fact that varicocele leads to the decrease of testosterone level and worsening of erectile function, and varicocelectomy contributes to testosterone levels elevation and improvement of erection. We compared the effect of microsurgical varicocelectomy and stimulation of spermatogenesis on the sperm parameters, sexual function and hormonal levels in males with varicocele suffering from sexual disorders and infertility.

Microsurgical varicocelectomy leads to testosterone elevation by 47.2%, decrease of estradiol by -3.1%, of progesterone by -2.3% by the end of the 12th month after operation, and stimulation of spermatogenesis increases testosterone levels by 10.8%, decreases estradiol by -8%, progesterone by -2.8% during the same period. In the group of surgical treatment concentration of spermatozoa increased 2.5 –fold as much, and in the group of stimulation 1.5-fold only. Questionnaire data demonstrated that the mean index “erectile function” in operated patients increased by 46.2%, “orgasm” increased by 21.5%, index “general satisfaction” by 39.3%, index “satisfaction with sexual act” by 35%, index “libido” improved by 26.6%. In the group of stimulation of spermatogenesis similar indexes were as follows: erectile function improved by 20.6%, orgasm by 7.4%, general satisfaction by 8%, satisfaction with sexual act by 13.6%, libido by 8.9%. According to AMS questionnaire in the group of varicocelectomy summarized scores decreased by 8%, in stimulation group only by 2%. Moreover a summarized enlargement of testicular volume was by 41.1% better in the group of operative interventions and by 5.2% in the group of spermatogenesis stimulation.  

Abstract. Analysis of urine culture in 72 patients with acute obstructive pyelonephritis within 6 months. When hospitalization was performed urine culture before and after the elimination of the upper urinary tract obstruction (VMP). Over the next 5 days the patients received empirical antibiotic therapy until the results of the microbiological examination of urine, after which all patients were divided into two groups. 1 group of patients consisted of 38 people who received antibiotic therapy based on antibiotic susceptibility obschedokazannyh pathogens (E.coli, Proteus sp., Klebsiella sp., Enterococcus sp., Etc.), The 2 group of patients included 34 men treated with antibacterial treatment based antibiotic susceptibility of microorganisms isolated from urine. After the completion of antibiotic therapy, all patients underwent clinical and laboratory and bacteriological monitoring of urine through the 1,3 and 6 months follow-up.

 

The article is devoted to clinical and organizational aspects in helping childless couples with the supposed male factor. A three-stage system for curative-diagnostic process is proposed by the authors. Modern demands to the equipment of andrologic laboratories and to the techniques of sperm quality evaluation are described. The authors have backgrounded their idea to have a three-stage complex prophylactics of reproductive function disorders in males.

 

Surgical treatment of children with inguinal hernias emissions is the responsibility of pediatric urology, andrology. Conventional methods of operations increase the risk of iatrogenic injury of the genitals and subsequent reproductive disorders. Describes a new original low-impact technology endoscopic removal of inguinal hernias in children that minimizes this risk. Described in detail the technical features of the intervention, used tools, ways to reduce the complexity and cost of treatment. The advantages of the new technology are shown in a large clinical material (237 patients, 261 operations).

Morphological changes in the kidneys of patients with staghorn nephrolithiasis at the time of endoscopic surgery staghorn calculi. In all cases, the morphological study of biopsy specimens revealed varying degrees of renal parenchyma lesions that may be predictors of chronic renal failure in patients with staghorn nephrolithiasis. Assessment of the extent of damage of the renal parenchyma is necessary for the timely implementation of renoprotective therapy.

 

Authors summarize the experience of management of children with different disorders of reproductive system and emphasize typical mistakes of practitioners, leading in future to decreased human fertility and to deterioration of demographical problems in Russia. Necessity of pediatric andrology/gynecology development as special area of medicine is proved and problems of its establishment are discussed. Authors bring up debatable issue about age qualification for choice of sex in patients born with malformations of externalia. Borderlines and content of new research area – science about human sex – are determined with emphasizing of its interdisciplinary character and problems of professional education which is in prevalence individual. Necessity of terminological unification in pediatric andrology/gynecology is emphasized because inaccurate terms lead to erroneous decisions and actions with long-term sequels.