[Combinative methods of treatment of patients with complicated urolithiasis].

The authors showed that urolithiasis is the second disease after inflammatory nonspecific kidney and urinary tract diseases and has a tendency to increase. 3-5% of patients suffer this disease, and 30-40% of all patients of urology in-patients department suffer nephrolithiasis. Introduction into clinical practice of modern minimally invasive treatment methods changed the paradigm of treatment of urolithiasis, especially coral type nephrolithiasis - cause of 15-50% of all renal calculi. The authors presented results of combinative treatment of 183 patients with different complicated forms of urolithiasis. The technique of percutaneous nephrolithotripsy (in supine position) was modified. It helped to reduce complications, time of surgery and radiation exposure. The effectiveness of simultaneous contact ureterolithotripsy and percutaneous nephrolithotripsy in patients with renal or ureters calculi, and simultaneous litholysis and distance lithotripsy in patients with metabolic disorders is shown. Combinative methods of treatment of complicated forms of urolithiasis are based on modern minimally invasive technologies and are very effective.

[Effects of pressure and flow rate of irrigation liquid on hydrodynamics of the upper urinary tract in contact ureterolithotripsy].

We studied the influence of pressure and rate of irrigative liquid flow on hydrodynamics of the upper urinary tracts in contact pneumatic lithotripsy (Litoclast lithotriptor) in 68 patients with ureteroliths and nephrostomic drainage. To a nephrostome the device was attached on which the linear change of pressure inside the pelvis was measured at the moment of visualization of the stone, its destruction and final ureteroscopy. 45 patients had nephrostome with a pelvis curl. In this group of patients at the moment of stone destruction the pressure inside the pelvis and the speed of irrigative flow were increased. In patients with marked local inflammation on the place of stone location the pressure inside the pelvis was the highest. The effect of communicating vessels was seen. The stone was completely destroyed in 34 (75.5%) patients, in 9 (20%) patients the stone was destroyed partially. In 2 cases the stone migrated in the cavitary system of the kidney. A nephrostome-intubator was placed antegradely in 23 patients. The balloon-obturator was placed in the ureter above the stone through the nephrostome. The pressure inside the pelvis during contact lithotripsy was not increased. Full destruction of the stone was achieved in 26 patients (92.8%), migration of the stone in the cavitary system and partial destruction of the stone was observed in 2 (2.2%) patients.

[The characteristics of bacteriuria in urological infections]. / Kharakteristika bakteriurii pri nekotorykh urologicheskikh zabolevaniiakh.

Bacteriological examination of the urine from 1138 elderly patients (50-80 years of age) with urogenital inflammation determined the predominant contamination of the urine with gram-negative opportunistic agents in titers 10(3)-10(7) CFU/ml. Bacteriuria arose due to primarily monocultures represented most commonly with E. coli and Ps. aeruginosa. Associated and two- three-component microflora comprised mainly S. epidermidis and S. faecalis. The degree of bacteriuria in elderly patients made up 10(5)-10(7) CFU/ml and 10(3)-10(7) CFU/ml in 69.6% and 30.4% of patients, respectively.