[Modern endourological technologies new opportunities in the treatment of patients with urinary tract anomalies and in complex clinical cases].

The clinical examples of the use of modern endoscopic minimally invasive technologies in patients with urinary tract anomalies and in complex clinical cases are presented in the article. The techniques and features of percutaneous nephrolithotomy, retrograde intrarenal surgery (RIRS), antegrade ureteroscopy using f lexible scope in this category of patients are discussed. The paper confirms the efficiency and necessity of further development of endourological methods for the treatment of urolithiasis.

[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.

[Optimal treatment of benign prostatic hyperplasia (BPH) with comorbid chronic prostatitis (category IIIA)].

The trial of efficacy of physical factors in combined treatment of BPH stage I patients with concomitant abacterial chronic prostatitis (category IIIA) enrolled 42 patients who were divided into two groups. Group 1 received combined treatment including complex physical factors (CAP-ELM-01). The efficacy of the treatment was judged by dynamics of clinical and device indices and severity of leading CP syndromes. It is shown that physical factors contributed to noticeable improvement in the parameters of prostatic secretion, uroflowmetry, size of the prostate, hemodynamics, clinical manifestations of chronic prostatitis.

[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.