[Protective properties of urothelium and possibilities of targeted pathogenetic therapy of chronic pelvic pain: sodium pentosan polysulfate].

The review article is devoted to the possibilities of using targeted therapy for urothelial diseases, namely painful bladder syndrome (BPS). The protective structural components of the bladder mucosa, as well as their chemical features, are described in detail. Pentosanpolysulfate (PPS), being an oral heparinoid, can be used as part of pathogenetic therapy to restore the mucous membrane of the bladder. The efficacy and safety of this drug has been proven by us in a multicenter, randomized, double-blind, placebo-controlled trial. An additional assessment of the effectiveness and safety of the use of PPS in BPS was confirmed as part of our systematic review and meta-analysis. Thus, PPS is a pathogenetically sound tool in the treatment of patients with painful bladder syndrome.

[Quality of life of elderly patients with nephrolithiasis].

Clinical findings have been analysed for 105 presenile and senile patients with nephrolithiasis. A total of 168 operations have been made: open intervention (n=22), percutaneous nephrolitholapaxia (n=12), extracorporeal lithotripsy (n=134). Quality of life was assessed according to the questionnaire survey (an original visual graphic questionnaire on the patient's attitude to his/her disease and the treatment, questionnaire on the doses of analgetics and antibiotics, conventional questionnaire EQ-SD. It was found that elderly patients note a statistically significant fall in frequency of pains (renal colics, lumbar pains, subfebrile condition), in the dose of analgetics and antibacterial drugs 6-12 months after removal of the concrement. Removal of the concrement had a positive influence on quality of life of patients with urolithiasis. Extracorporeal lithotripsy had a weaker emotional effect on the patients than open surgical interventions. It is suggested to remove nephroliths if contraindications are absent.

[Results of clinical use of the polyfunctional lithotripsy device "Dornier-U 50"]. / Rezul'taty klinicheskogo primeneniia polifunktsional'nogo litotriptora "Dornier-U 50".

The review of the results of clinical application of a polyfunctional lithotriptor Dornier-U50 in urolithiasis patients is presented. The treatment of 324 patients produced good results of lithotripsy in uroliths of any location in generating high-energy shock waves. Complete fragmentation was achieved in 86.4%, partial one--in 11.7%. Complications occurred in 9% of which 5.3% were cases of upper urinary obstruction. The Dornier-U50 lithotriptor can be used for both extracorporeal lithotripsy (under x-ray and ultrasound targeting) and various endoscopic operations under x-ray telecontrol. This allows maximal utilization efficiency of this equipment in diagnosis and treatment in urological hospitals.

[Complications of open surgical procedures in urolithiasis and their prevention]. / Oslozheneniia otkrytykh operatsii pri lechenii mochekammenoi bolezhni i puti ikh profilaktiki.

236 operative interventions for urolithiasis have been performed in 234 patients. Of them, 187 (79.9%) patients developed complications. Intraoperatively complications resulted from opening of the pleural and abdominal cavities (20 patients, 8.5%) and intraoperative blood loss < 500 ml (19 patients, 8.1%). In one case a nephrectomy was made because of repeated hemorrhage early after the operation. Among the postoperative complications most frequent were acute pyelonephritis (34, 14.5%) and aggravation of renal failure (11, 4.7%). The former demanded extracorporeal detoxication in 9 cases, in the latter hemodialysis was not required. Residual comcrements occurred in 28 (12%) patients. 17 of them had to undergo extracorporeal lithotripsy. Thus, open urological interventions in urolithiasis are now conducted in advanced disease, provoking complications. This raises responsibility of the surgeons who must take maximal preventive measures and use novel technologies in management of the complications.