[Challenges in the clinical diagnosis and treatment of encrusted cystitis].

Encrusted cystitis (IC) is a rare chronic inflammatory disorder of the bladder characterized by mucosal inflammation with encrustations. This pathological process is directly related to the activity of urea-splitting bacteria in the urine. Bladder encrustations are deposits of ammonium and magnesium phosphate, as well as struvite, on the surface of the urothelium. However, the pathogenesis of this disease has not been thoroughly studied. Treatment of encrusted cystitis is aimed to complete eradication of the uropathogen, surgical removal of encrustations, and lowering urine pH. Early diagnosis is a key prerequisite for effective treatment.

[Ureteral obstruction and segmental ureteral stents].

Currently, various types of stents are widely used in urological practice. One of the indications is the presence of upper urinary tract strictures. The factors leading to the development of strictures can be endogenous and exogenous, iatrogenic and non-iatrogenic, benign and malignant. After open, laparoscopic and X-ray-endoscopic procedures a double-J stent is usually placed or, less often, nephrostomy tube. It should be noted that both methods have certain side effects and may affect the patient's quality of life. To reduce the stent-related symptoms and increase their tolerability, various modifications of ureteral stents have been developed. In this article, we analyze the publications devoted to the most commonly used segmental stents without renal and bladder coils, such as Memokath, Uventa, Allium, Memotherm and nitinol stents manufactured by MIT LLC.

[Complications after PCNL: diagnosis and management].

Percutaneous nephrolithotomy (PCNL) is the gold standard treatment of large and staghorn kidney stones. Despite technological progress and improvement of PCNL technique, this procedure is associated with complications and in some cases remain a challenge for endourologists. According to the time, complications can be divided into intra- and postoperative. Intraoperative complications include bleeding, injury of the renal collecting system, visceral organs, pulmonary complications, thromboembolic disorders, extrarenal migration of the stone fragments and incorrect nephrostomy tube placement. Postoperative complications include infection and sepsis, bleeding, persistent urinary fistula, infundibular stenosis and death of the patient. The different recommendations that might be useful for the timely diagnosis of various complications in patients undergoing PCNL are provided in the review. Additionally, information on treatment algorithms is included.

[Design and materials for ureteral stents: past, present and future].

Ureteral stents have a long history of use. Their main goal is to provide effective drainage of the upper urinary tract. Morbidity is mostly related to low biocompatibility of materials, from which stents are made. Since stent introduction, there have been many stages of evolution and modernization. However, there is a significant problem associated with their widespread use. Despite technological progress, stent-associated symptoms, incrustation, bacterial infection are the problems that still have to be resolved while creating an "ideal" stent. The continued development of new materials and coatings also will lead to the improvement of such an indispensable urological device as the ureteral stent.

[Prognostic value of ki-67 and vimentin markers in patients with metastatic kidney cancer].

The study was aimed to determine the role of ki- 67 and vimentin markers in choosing the tactics of surgical treatment of patients with metastatic kidney cancer. The analysis of the results of treatment of 71 patients with metastatic renal cell carcinoma was performed. The first group included 16 (22.5%) patients, who underwent complete removal of distant metastases after nephrectomy. The second group consisted of 55 (77.5 %) patients who underwent cytoreductive nephrectomy only. Immunohistochemical analyses of tissues removed were performed in all patients for the evaluation of ki-67 and vimentin expression levels. When comparing the outcomes of patients after complete removal of metastases depending on the vimentin and ki-67 expression levels (< 10% and > 10%), a significant increase in the cumulative survival in the case of absence of vimentin and ki-67 expression of <10 % (log - rank test, P = 0.0001) was revealed. The same pattern was noted in the group of patients who underwent nephrectomy only. In the absence of expression of vimentin and ki-67 < 10%, survival rate in patients who underwent metastasectomy after nephrectomy was significantly higher compared with patients who underwent nephrectomy only (P = 0.001). In the case of positive expression of vimentin and ki-67 > 10%, differences in survival rate in these groups were not observed (P > 0.082). Thus, an association between the vimentin and ki-67 expression levels and the degree of spread of metastatic renal cell carcinoma was identified: the high level of expression of these markers precludes the increase of life expectancy of patients after removal of all metastases.