The main indicators of organization of urological care in Sverdlovsk region were analyzed. The structure of urological and oncourological morbidity in dynamic from 2000 to 2018 was presented. The data of the personnel structure and bed stock of urological service was shown. The effective methods of men treatment with prostate cancer in the year of 45-80 by the modern methods of SOKB №1: brachytherapy, robot-assisted operations, ultrasound ablation HiFU, radical prostatectomy, laser ablation, hormonotherapy - allow us to prove for the soon improvement and use in regions of Sverdlovsk region (Governor’s program “Urological men’s health» in Sverdlovsk region)

In this article, we present the main information about some promising markers of urolithiasis-substances formed on the surface of the transitional cell epithelium and involved in the inhibition or induction of crystal formation. The reason for their formation is still not fully understood. There is a hypothesis that they are inducers of calculus formation in the renal calyceal system and are directly related to Randall's plaques, whose role in the pathogenesis of ICDD remains a subject of discussion. In this regard, the study of the relationship of certain markers of urolithiasis with dysfunction of urothelium in the zone of formation of Randalla plaques is important for understanding the pathogenesis of this disease, for which an attempt has been made to thoroughly study Russian and English literature in databases (MEDLINE, PubMed, Medscape). A total of 126 sources were studied (all studies for the period 2000 - 2017), of which 15 publications of the most significant and relevant studies were selected for this review.

The aim of this work is to study the results of superselective embolization of bleeding renal vessels after percutaneous aids for urolithiasis. 1723 percutaneous nephrolithomies performed in the urology clinic of the First Moscow State Medical University named after I,M,Sechenov until 2015 were analyzed. Hemorrhagic complications were detected in 83 (4.8%) patients, transfusion was required in 37 (2.1%) observations, SSE in 28 (1.6%). 2 (0.1%) patients underwent nephrectomy at the stage of development and introduction of PNL and lack of the possibility of performing SSE. In all the observations, it was possible to achieve a good clinical effect without resorting to open surgery. Complications during embolization and postembolization period were not observed. SSE is an effective minimally invasive method for endovascular diagnosis and treatment of bleeding caused by iatrogenic AVF kidney. This method avoids the organ-carrying benefit and eliminates a formidable complication.

In order to assess the efficacy and safety of a combination of standard and minimally invasive multi- percutaneous nephrolithotomy in coral nephrolithiasis, we analyzed 55 patients with coral stones, who were treated at the urology clinic of the First Moscow State Medical University named after I.M. Sechenov, where combined standard and minimally invasive percutaneous nephrolithotomy (PNL) was performed. Nephroscope 24 Ch or 26 Ch and Amplatz-casings 28-30 Ch, ultrasonic lithotriptor; for minimally invasive - minnefroscope 12 Ch with tubes 16,5 Ch, ultiminefroscope 7.5 Ch with a tube 11 Ch, laser lithotripter were used during standard PNL. 2 access were performed in 48 (87.3%) observations, 3 - in 6 (10.9%), 4 - 1 (1.8%). Complete renal sanation after the first procedure was achieved in 47 (85.5%) observations, 6 patients underwent repeated nephroscopy, the remaining 2 residual stones were in isolated calyces and did not require additional treatment. Intraoperative complications were recorded in 3 patients in the form of hemorrhage, who underwent second nephroscopy. Among the postoperative complications, fever above 38 ° in 8 patients was noted. The obtained results demonstrate high efficiency and safety of combined standard and minimally invasive PNl from multi-access.

The purpose of this work is: to evaluate the effectiveness of X-ray endoscopic methods of treatment of strictures of the upper urinary tract. Patients and methods: the results of examination and treatment of 134 patients (age 24 to 78 years, 51 men, 83 women) with supravesical obstruction due to stricture or obliteration of the hospital, who were on inpatient treatment at the Urology Clinic UKB №2 of the First MGMU them. THEM. Sechenov, who underwent endoscopic treatment (balloon dilatation, endopyelotomy, endoureterotomy, recanalization of the ureter, installation of the stent Memokat). Results: 116 (86.6%) patients achieved good and satisfactory results. The best results were obtained in patients with stricture up to 1 cm, which performed a combination of balloon dilatation and laser endotomy (95.8% efficacy). Unsatisfactory results of endotomy were noted in 18 (13.4%) observations. 15 patients underwent various reconstructive operations. Nephrectomy was performed in 3 (2.2%) patients due to loss of kidney function in case of severe stricture recurrence. Conclusion: in the presence of strictures of the VMP, endotomy is indicated for patients with primary or postoperative strictures of the VMP up to 2 cm. The best results are achieved in the treatment of patients with strictures up to 1 cm and with the combination of balloon dilatation and laser incision. The obtained data point to the effectiveness and expediency of the selected minimally invasive treatment tactics, which makes it possible to reduce the likelihood of open surgical benefits in some patients.

The aim of the work is to develop a minimally invasive method for restoring the function of the sphincter of the urinary bladder using autologous fat in the stromal-vascular fraction (SVF). Materials and methods. Patients with a diagnosis of stress urinary incontinence of moderate severity were given a transurethral injection of an autologous SVF into the zone of the external sphincter of the bladder. Isolation of SVF was performed by a nonenzymatic method using tumescent lipoaspiration. The resulting material was sent to the laboratory for the study of cellular composition. Results. Based on the Pad test and ICIQ-SF questionnaires, QoL received the first positive clinical results and improved quality of life after 4 weeks. Conclusions. In this work, it is noted that transplantation of SVF from autologous adipose tissue appears to be an effective and safe method of treatment of patients with incontinence.

The aim of the study was to evaluate functional results of microlaparoscopy compared with standard laparoscopy in pyeloplasty in adults. Patients and methods. The study included 120 patients who underwent microlaparoscopic pyeloplasty (MLP) - and 101 standard laparoscopic pyeloplasty (SLP). MLP was performed with two or three 2.5-3 mm trocars (Storz) and one 5 mm trocar for the Hd-laparoscope installed through the navel. In all cases Hynes- Anderson procedure was performed with antegrade insertion of stent. Two continuous 5-0 biosyn sutures were used for anastomosis. Stent was removed after 6 weeks and evaluation of renal function was performed in 3-6 months. Results. All options of laparoscopic pyeloplasty provide good postoperative results: 100% - MLP and 98% - SLP (defined as absense of pain and/or T1/2 improvement). There was no conversion. There were no statistically significant differences in complications, duration of hospital stay. After 3-4 months postoperative scars were almost invisible in the navel, and the sites from 3 mm trocars were like little moles, at the same time SLP postoperative scars were more noticeable. Conclusion. In our study MLP showed the same functional outcome and safety in comparison with the SLP. MLP with Hd-vision allows the use of thin filaments № 5-0 for anastomosis to provide greater operative precision that made it a standard method of pyeloplasty in our clinic with regard to a better cosmetic result achieved.

F Introduction: In most patients with obstructive symptoms, micturition disorders are caused by both mechanical and functional factors. The study of urination disorders and correct interpretation of the findings can reveal the severity of the disease, clarify its prognosis, and influence in the determination of the timing and method of therapy. Aim: to determine the functional state of the lower urinary tract in men with bladder outlet obstruction. Materials and methods: We have analyzed the medical history of 270 patients with various obstructive diseases of the lower urinary tract who were treated at the Urological Clinic of Sechenov University. A combined urodynamic study was performed in 206 patients to find out the functional state of the lower urinary tract. Results: In 120 (58.25%) patients detrusor overactivity was revealed, low compliance of detrusor - in 45 (21.85%) patients, high compliance of detrusor - in 30 (14, 56%), normal compliance - in 11 (5.34%). The average length of complaints in patients with detrusor overactivity was 5.34 years, with low compliance of detrusor - 6.16 years, with high compliance of detrusor - 4.34 years. The maximum cystometric volume of the bladder in patients with OAB was 183.59 ml, and the average wave of detrusor pressure was 73.44 cm H2O. Functional component of the bladder outlet obstruction after surgery operation was detected in 12.5% of patients. Conclusions: According to our results, the most frequently in urodynamic study of patients revealed detrusor overactivity (58.25% of patients). This bladder dysfunction was the main leading link in the development of complications of the bladder outlet obstruction, vesicoureteral reflux, ureterohydronephrosis and as a result of pronounced disturbances in the urodynamics of the upper urinary tract - chronic renal failure.

In the comparative analysis of the methods of patients treatment with acute obstructive calculous pyelonephritis without preliminary drain of renal cavity system (retroperitoneoscopic approach) was submitted the article, transurethral lithotripsy was performed after preliminary drain of renal cavity system by stent (comparative group 1), and percutaneous nephrolithotripsy, performed after nephrostomy (comparative group 2). Retroperitoneoscopic lithotomy was performed on the first day apply in the hospital. Lithotripsy were performed after treatment the attack of acute pyelonephrit. All patients of 3 groups were with hyperthermia, pain, inflammatory symptoms in analysis of urine, blood. By bacteriologica investigation of urine Escherichia coli, Enterococcus faecalis, Klebsiella were determined in all groups. All stones were R-positive. Retroperitoneoscopic method is more effective and safety in the treatment of patients with acute obstructive calculous pyelonephrit. The stone is removed completely, there are not residual fragments and risk of development bacteriotoxic shock, medical load and time of working disability are less than in comparative groups.

Currently one of the main methods of treatment of patients with ureteral stones is contact ureterolithotripsy (CULT). Despite the high effectiveness of the method, the problem of early detection and prevention of exacerbation of inflammatory complications of nephrolithiasis remains urgent. To improve the diagnosis of pyelonephritis after CULT in patients with urolithiasis, a study of the diagnostic efficacy of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, ß2-microglobulin, and interleukin-18 was performed in 123 patients with ureteral stones. The greatest value in preoperative diagnostics of pyelonephritis was demonstrated for serum NGAL of blood, urine NGAL, and urine ß2-microglobulin. The most significant increase during early term (2 hours) after CULT was observed for urine ß2-microglobulin and IL-18. The concentration of urine NGAL among all the studied markers remained elevated for a relatively longer period.

Introduction. Coronal nephrolithiasis is a serious disease that occupies one of the leading places among diseases of the urogenital system. Choose of the least traumatic benefit in this category of patients is one of the most difficult tasks in urological practice. Objective. To evaluate the effectiveness and safety of RIRH in the treatment of coral nephrolithiasis. Materials and methods. Retrospective analysis of RIRC performance in 65 patients with coral nephrolithiasis of various degrees was performed. Resultants. Positive result after PIRC was noted in 42 (64.6%) patients. Remote shock wave lithotripsy was performed in 17 (26.2%) patients with residual calculi. Six (9.2%) patients underwent repeated retrograde nephrolithotripsy. The conclusion. Thus, RIRC is a comparatively effective method for treating patients with coral stones, and is a method of selecting a particular patient for patients who are unable to perform CNlT or are at high risk for complications.

Introduction. Urolithiasis is one of wide-spread in the urological diseases distribution and considered socially significant one. In various regions of Russia, Republic of Bashkortostan is one of them, the endemicity of this pathology is revealed and statistically proved. The formation of stones in the urinary system is caused by a number of social and genetic factors. Nowadays, there are many methods of treatment of urolithiasis. According to the National recommendations and Guidelines of the European Association of urology, the choice of operational intervention method depends on the size of the concrement and the form of nephrolithiasis. despite the low invasiveness of surgical treatment, 10-15% end up in sequela. Taking into account the mentioned above it is important to analyze efficacy and safety of nephrolithotripsy through one’s own experience. Aim: To evaluate the efficacy and safety of nephrolithotripsy in various forms of nephrolithiasis. Materials and methods. The study group included 365 patients who underwent percutaneous nephrolithotripsy in the clinic of the Bashkir state medical University. In the preoperative period, patients were examined according to the standard scheme, according to the results (localization, size of concrements), the most suitable access for percutaneous nephrolithotripsy was selected. In the preoperative period, patients were examined according to the standard scheme, according to the results (localization, size of concrements), the most suitable access for percutaneous nephrolithotripsy was selected. The efficacy of the surgical treatment was evidenced by the complete removal of concrements or calculi up to 4 mm. Clavien-dindo classification served as a scale of evaluation of postoperative complications. Results. By the gender type-men 175(47.9%), women 190 (52.2%). The age of patients was from 22 to 83 years. The average size of the calculus was 2.4 cm (0.8 - 7.8 cm). The average operation time was 83 min (23-258 min). The average bed day was 5.6. According to the classification of Clavien-dindo complications of 1 degree were observed in 123 (33.7%) of patients, 2 degree in 2 (0,5%) patients, 3a degree 1 (0.3%) and 4b degree was observed in 1 (0,3%) patient, there were no complications of 5 degree. Summary. Percutaneous nephrolithotomy has come out as one of the highly effective and safe methods of treatment of nephrolithiasis.

Purpose of the study. To assess the effectiveness and advantages of using 3d computer technologies for performing organ-saving operations in patients with localized cancer of the kidney parenchyma from laparoscopic access. Materials and methods. In retrospect, the results of surgical treatment of 558 patients with renal cell carcinoma (RCC) in the Urology Clinic of the First Moscow State Medical University named after IM Sechenov were analyzed in a retrospective for the period from January 2012 to May 2017. The mean age of the patients was 55.85 ± 10.5 (25-78) years. There were 307 men (55%), women - 251 (45%). The organ-carrying operations were performed in 244 patients (43.7%) with laparoscopic access. In 314 (56.3%) observations, laparoscopic resection of the kidney (lRP) was performed. In addition to the standard methods of preoperative examination, 248 (44.4%) patients underwent 3d modeling and multivariate virtual implementation of operations using the 3d modeling program "Amira" based on the performed multi-helical computed tomography (MSCT). Intraoperational data of virtual constructions were used by surgeons for the purpose of navigation. Benefits were performed by 7 urologists of the clinic with different experience of performing laparoscopic operations. To conduct a correct statistical analysis of the treatment results from each group of patients with and without 3d planning, comparable pairs were selected according to the main characteristics: accounting for the homogeneity of the operators and their experience in performing the operation, tumor size and location (ratio to the segment, front and back surfaces ), a variant of surgical access. After the selection of homogeneous pairs, we obtained two homogeneous groups of patients with lRP performed n = 106 patients with lRP performed in 53 patients in each group with and without 3d planning. Results. With 3d virtual planning of surgical care in patients with RCC in the volume of lRS in homogeneous comparison groups (n = 106), there is a statistically significant advantage over patients without virtual planning: according to the time of thermal ischemia 12.0 ± 6.4 min (p = 0.010), the time of the operation was 113.4 ± 39.4 min (p = 0.0001), the blood loss value was 102.8 ± 98.2 ml (p = 0.001). Twenty-four hours after lRP in both groups, the reduction in GFR was <10% of the baseline level, there was no statistical difference between the two groups of patients (p = 0.088). After 6 months, the level of GFR in the group with 3d planning was reduced by 9.09% and in the group without 3d operations planning by 13.89% (p = 0.047). Twelve months after lRP in homogeneous analysis groups, it was found that the GFR level did not reach the level before surgery in both groups, in the group with 3d surgery planning, GFR decreased from baseline to 7.14%, in the group of patients without 3d, 9.89% (p = 0.023). The conclusion. The use of computer-assisted technologies in the scope of 3d planning and virtual implementation of operations makes it possible to improve the immediate and functional results of real operational benefits in patients with RCC in performing organ-preserving operations from laparoscopic access.

The aim of this work is to evaluate the results of endoscopic treatment of patients with urothelial cancers of the upper urinary tract (URCoUUT). Materials and methods: 99 patients with a tumor of the upper urinary tract (UUT) were examined, 24 of them in the Urology Clinic of the First Moscow State Medical University named after I.M.Sechenov performed endoscopic treatment (in 21 cases, retrograde removal of pelvic and ureter malignant neoplasms was performed, in 1 - percutaneous removal of papillary cancer of the pelvis of a single kidney, per 1 percutaneous removal of papillary cancer of the pelvis of a single functioning kidney and in 1 - percutaneous removal of papillary cancer of the calyx lower half of the l-shaped kidney). Results. In all cases, during a follow-up examination at different times after the operation, there was no evidence of a relapse, the passage of urine along the upper urinary tract was not disturbed. The conclusion. due to its effectiveness, safety and minimal invasiveness, URS is an alternative for the treatment of patients with urothelial carcinoma of low-grade. Percutaneous methods for the removal of URCoUUT can be used in patients with low-grade calyceal tumors, which are impossible or very difficult to achieve, even with flexible URS, with relatively large pelvic lesions or with technical impossibility of performing the intervention retrograde.

Pelvic evacuation in recent years has ceased to be used as a palliative method and has proved to be an effective method of surgical treatment of locally advanced pelvic tumors. Performing these operations with minimally invasive methods helps to reduce the number of postoperative complications and improve the quality of life. Purpose of the study. Demonstrate the feasibility of performing robot-assisted pelvic evisceration and compare perioperative parameters with the experience of open pelvic eviscerations. Materials and methods. A 44-year-old woman with progressive local advanced cervical cancer, with a complication of the tumor process, presented by bilateral hydronephrosis. The patient was provided with an anterior robot-assisted PE with the formation ileoconduit by the Brikker method. Results. The total operation time was 515 min, the time in the console was 430 min. The estimated loss of blood was 600 ml, and the stay in the intensive care unit (ICU) - 1 day, the patient was discharged on the 7th day after the operation

Purpose of the study. To assess the diagnostic capabilities of the Raman spectroscopy method in detecting prostate cancer. Materials and methods. Material selection: 13 samples of the prostate gland (histologically confirmed the diagnosis of "Benign prostatic hyperplasia” (BPH). 47 prostate tissue samples (histologically confirmed diagnosis "Prostate cancer." The samples were examined on the apparatus (HoribaScientific) .Configuration : wavelength 785 nm, grating 1200 gr / mm, 100% filter, confocal hole 300 pm. Integration time 50 s. Analysis of spectral data was carried out using Matlab software, Statistica, FreeSpectraBase, Sp ectralDatabase IndexBio-Rad. Results. Raman spectra of tissue fragments of BPH and PCa correspond to a range of 700-1800 cm-1. Samples with PCa have higher peaks compared to BPH samples at 1280 cm-1 (C-NH2, included in adenine, guanine, cytosine), 1323 cm-1 (CH3 / CH2 collagen), 1378 cm-1 (guanine, adenine, DNA), 1560 cm-1 (adenine and guanine). The spectra of the samples with BPH have higher peaks at 752 cm-1 (tyrosine), 1662 cm -1 (bond amides I: C = O proteins, C = C-bond of lipids). Conclusions. In the study of tissue samples with confirmed diagnoses of BPH and PCa, an increase in the intensity of Raman light scattering of DNA in tissues with confirmed PCa was noted, and a reverse decrease in the intensity of Raman scattering of DNA light in tissues with BPH. Raman spectroscopy showed spectral differences in the biochemical composition of tissues with BPH and tissues with PCa. In the future, this method of investigation can be used to develop a diagnostic algorithm for detecting prostate cancer.

Objective: To evaluate the possibilities and significance of preoperative multiparametric magnetic resonance imaging (mpMRI) in assessing the local staging of prostate cancer (PCa) versus postoperative pathomorphological examination. Materials and methods: The study included 83 men aged 54 to 87 years (median 66 years) with a verified diagnosis of prostate cancer. All patients underwent mpMRI of the pelvis prior to performing radical surgical treatment (radical prostatectomy-RP). The RP was performed no later than 2 weeks after the mpMRI. Results: Sensitivity, specificity, diagnostic accuracy, prediction of positive (PPV) and negative (NPV) results in the evaluation of extracapsular proliferation were: 89.5%, 90.6%, 91%, 88.0% and 92.3% respectively; in the evaluation of tumor invasion of seminal vesicles - 85.2%, 95.4%, 90%, 85.7% and 95.6%. Conclusion: The results of preoperative staging of patients with PCa through the use of mpMRI demonstrate high sensitivity, specificity and overall diagnostic accuracy, as well as high NPV and PPV. The introduction of extensive use of preoperative staging of patients with PCa by mpMRI can help to more personalize stratify groups of patients when choosing the tactics of radical treatment. The prescription of hormone therapy before the mpMRI can reduce the detectability of local advanced forms of PCa.

Several options for salvage treatment of radiation-recurrent prostate cancer exist. The main option is a salvage radical prostatectomy, which offers optimal cancer control and allows to perform specimen pathology, but it is technically challenging and poses increased risk for certain complications. Alternative modalities of salvage therapy are HIFU-ablation and cryoablation. This review covers the role for those methods, their oncological efficacy and morbidity.

Objective. To determine a possible role for HistoScanning technique in surveillance for patients who underwent HIFU-ablation for prostate cancer. Material and methods. Eighty patients who underwent transurethral resection and HIFU-ablation in university clinic with different follow-up duration (range: 36 - 84 months; median - 52 months) were included in this study. All patients underwent prostate specific antigen (PSA) testing, transrectal ultrasound examination and HistoScanning of residual prostatic tissue during follow-up. Results. Overall, 72 patients of 80 had suspicious lesions on HistoScanning during post-HIFU surveillance. Eleven patients had VHS value, which is the sum of volume of suspicious lesions, exceeding 1 cm3; 10 patients experienced biochemical relapse by Stuttgart definition (90.9%). Significant predictors of biochemical relapse were PSA nadir over 1.0 ng/ml (hazard ratio [HR]: 3.1; confidence interval [CI]: 1.7 - 3.5) and VHS / Vres. ratio over 0.5 (HR: 4.9; CI: 3.9 - 5.5). Ten patients reached VHS / Vres. threshold value (> 0.5) > 3 months before meeting criteria for Stuttgart biochemical failure. Conclusion. HistoScanning may prove useful for surveillance for patients who underwent HIFU-ablation for prostate cancer, but it still requires further standardization and validation in this setting.

We conducted a study of the efficacy of Vitaprost forte suppository rectal for 40 patients with prostate adenoma (APH). It is proved that the use of the drug positively affects both subjective and objective symptoms of AH, it improves obstructive and iritative symptomatology. Vitaprost forte significantly reduces the clinical manifestations of the disease and improves the quality of life of patients, the volume of residual urine decreases.

The widespread introduction of radical prostatectomy as the main method of surgical treatment of patients with prostate cancer provided satisfactory oncological results. Nowadays, research work is focused on improving the functional. The problem of restoring the function of retention of urine in the early period after the operation is becoming more relevant. Robot-assisted radical prostatectomy demonstrates proven advantages in maintaining the natural anatomy of the pelvis and sphincter apparatus. A discursive subject is the use of various techniques for reconstructing the urethro-vesical anastomosis zone. Variants of reconstruction of anterior, posterior semicircle of urethro-vesic anastomosis and total are described. In a number of cases, the techniques complement each other. It is necessary to accumulate knowledge and experience in order to optimize and standardize the technique of surgery to improve the functional results and quality of life of patients.

Currently, prostate cancer is one of the most common oncological pathologies in Russia. We analysed the early results of surgical treatment of 259 patients with prostate cancer who were under our surveillance from 2016 to 2017. These patients were divided into two groups: first group underwent cryoablation of the prostate (31 patients), second group underwent radical prostatectomy without lymphadenectomy (39 patients). According to results of the preoperative examinations there was obtained no data on extracapsular tumour process, as well as on regional lymphadenopathy. All patients had no interest in sexual function. Prostate volume ranged from 12 to 65 cm3, PSA level ranged from 4.1 to 10 ng / ml, Gleason score ranged from 5 to 8 points. According to the first results we observed PSA level decrease in both groups of patients. Retention of urine, as well as the intensity of postoperative pain in patients undergoing cryoablation of the prostate is better in comparison with Laparoscopic radical prostatectomy, however, we continue evaluation of long-term oncological and functional results.

Renal cancer takes the 10th place on incidence among malignant new growths, and on the level of an increase concedes only to a prostate cancer. Today surgical treatment remains by the single efficient method of treatment of the localized renal tumors. In recent years low-invasive surgical interventions at new growths of renal began to be applied more often. In this article experience of realization of 74 operations executed by laparoscopic and open access on the basis of USMU chair of urology in the urological department of MAI "City Clinical Hospital №40" during the 2013-2018 years is explained. The comparative analysis of partial nephrectomy depending on access is carried out. The analysis of 35 patients treatment is made.

In a survey of 1012 married couples, the male factor of infertility was detected in 54.7% (p<0.05). For the reliability of evaluation of the results of spermatogenesis correction and the effectiveness of IVF (ICSI) procedures, 292 men (28.8%) were selected with an infertility factor and healthy wives. At the same time, in 196 people, the etiologic factor was known and in 96 patients idiopathic form of infertility was established (32,87%, р<0,05). Patients were given 2 courses of stimulating therapy depending on the etiologic cause or empirical therapy in cases of the presence of an idiopathic form. In the absence of effect, couples were sent to IVF (ICSI). The effectiveness of the treatment, depending on the presence of 1, 2 or more 2 factors of infertility, was analysed in the SPSS® 17.0 (© SPSS Inc.) tables, the reliability was considered a program Biostat, 6.1. A direct correlation was found between the clinical variant of infertility and the frequency of pregnancy in the study group, and as well as a direct correlation between the number of external factors and the results of treatment.

In this study, we analyzed the features of cardiac rhythm variability accord-ing to computer cardiointervalography (ICG) in healthy young men aged 18-23 years in the dynamics of the implementation of the first morning act of urination (during the emergence of an imperative urge to urinate, empty the bladder and immediately after the exercise. Within the framework of this section of the work, combined studies of heart rhythms and urination have shown that the process of filling and emptying the bladder is normal (8 daily mixes d) occurs in three stages: The first stage of the imperative urge to urinate according to the indices of IN, is characterized by the phenomena of moderate parasympatheticotonia.The act of urination is realized with a significant increase in parasympathetic influence, but immediately after urination the bladder falls under the dominant influence of the sympathetic part of the autonomic nervous system.

Within the framework of the present work, features of indicators of computer cardiointervalography depending on the rhythm of urination in adolescents are discussed. The results of the study allowed to connect the deviations of the rhythm of urination in young people from standard indices with the dominant influence of the parasympathetic department of the VNS, which can be regarded as an intermediate stage in the formation of clinical manifestations of urination disorders.

Antiholinergic drugs remain the most popular treatment of the low urinary tract dysfunction in patients with multiple sclerosis, but often they are not effective or followed by marked side effects. Moreover, the evidence for their efficacy in multiple sclerosis is quite poor. In the review, the efficiency and safety of botulinumtoxin for neurogenic low urinary tract dysfunction in multiple sclerosis patients were analyzed according to the literature database.

The lack of consistent standardized approach and variety of suggested methods for strictures treatment are still complicated problems for the modern urology. In this article, we investigate surgical treatment methods of urethra strictures, taking into account the aetiology, localization, extension and intensity of spongiofibrosis. The method for estimation of optimal resection zone in anastomotic urethroplasty, fixation zones of buccal graft and flap, using optical coherence tomography, is proposed. This will give the opportunity to improve the surgical treatment results for this category of patients