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Approximately 15% of couples of reproductive age are infertile. Among patients with infertility, nearly 10-15% have azoospermia. The current treatment methods of non-obstructive azoospermia, in particular the use of mesenchymal stem cells, and the comparative analysis of the cost-effectiveness of different methods are discussed in the article.Varicocele is the most common and treatable cause of male infertility. Therefore, surgical treatment of varicocele should be recommended for motivated patients and infertile couples who do not have other identified causes of infertility. Varicocelectomy has been proved to improve sperm parameters and improve chances of successful conception in most patients. However, surgical treatment is associated with certain risks, and therefore, the choice of the optimal treatment is under discussion. A total of 78 articles using a search in MEDLINE database (PubMed) were found and included in the review, dedicated to current concepts of functional anatomy of testicular arteries and veins. The current recommendations of professional communities regarding the selection of patients for varicocelectomy are described. The efficiency and safety of various surgical procedures for varicocele is analyzed. This review suggests high inconsistences in the literature. The available information on the indications for surgical treatment, as well as comparative data on the efficiency and safety of the inguinal, laparoscopic and microsurgical sub-inguinal approaches are presented. When urologist faces with a diagnosis of varicocele, individual approach should be applied, with a discussion of both benefits and possible complications of surgical treatment. Of the many existing techniques, microsurgical ligation of dilated veins is the most preferred.A new coronavirus infection caused by SARS-CoV-2 was first identified in December 2019. It has spread quickly and caused a global pandemic. Analysis of demographic factors reveals a disproportionately large number of men with severe forms of the disease. Moreover, mortality rate is also higher in men. The currently available data regarding potential risks to the male reproductive system, including pathophysiological basics, detection of viral RNA in the reproductive tract, risk of orchitis, hypogonadism, possible influence of oxidative stress, etc. are described in the review.Angiomyxoma is a rare benign tumor prone to aggressive and invasive growth and relapse. Very few case reports of tumors with this morphology have been published in the world literature. In this paper, we report a rare case of penile angiomyxoma, which illustrates that any preoperative examination does not allow physicians to suspect this tumor type. This fact makes physicians be alert for cancer and use the active surgical tactics even if a tumor is supposed to be benign.A clinical case of the successful surgical treatment of patient with multiple primary cancers, including locally-advanced right renal cell cancer, transitional-cell cancer bladder cancer and metachronous transitional-cell cancer of the left kidney with one of the longest follow-up and survival time described in the literature.

The aim of the study was to retrospectively evaluate the efficiency of extracorporeal shock wave lithotripsy (ESWL) with ultrasound guidance and the results of treatment of children with urolithiasis, of different age groups depending on the stone location and size.

A total of 135 children and adolescents, aged from 1 to 18 years treated by ESWL at IZMIRLIAN Medical Center from 2005 to 2016 were enrolled in this study. Number, size and location of stones were evaluated. A total of 153 ESWL sessions were performed, including two sessions in 9 cases, three sessions in 1 case, and four sessions in 2 cases. Intra- and posttreatment stone fragmentation rate, number of ESWL sessions, shock-wave pulses per session, stone-free rate, and number of ancillary procedures depending on the stone location and size as well as radiation exposure were evaluated. Follow-up observation was performed after 14, 30 and 90 days.

In most cases, there was a good stone fragmentation after ESWL. From 200 to 3000 low-energy pulses efficiency of ESWL under ultrasound guidance in children and adolescents. Absence of X-ray exposure, minimal complication rate, non-invasiveness and high efficiency allow to consider ESWL as a method of choice for the treatment of urolithiasis in children and adolescents.Genetic factors cause various forms of male infertility in 30-50% of cases. The role of oxidative stress in male infertility has been broadly recognised, and the search for a new marker to determine the redox environment in semen has gained considerable interest.

to establish the association of two polymorphic loci Ile105Val, Ala114Val of the GSTP1 gene (glutathione transferase class pi-1) with the parameters of oxidative stress in men with infertility.

the main study group consisted of 160 men of reproductive age with infertility (mean age - 29,9+/-5,3 years). The control group included 104 practically healthy men with realized reproductive function (average age - 30,2+/-3,6 years). Molecular and genetic study of polymorphisms of the GSTP1 gene was performed by using real-time PCR. The material for the study was DNA samples, the extraction of which was carried out from samples of whole venous blood. The components of lipid peroxidation and antioxidant protection were determined in the blood and ejaculate us polymorphism of GSTP1(Ala114Val), associations of the studied gene were established with a decrease in -tocopherol concentration by 15%, an increase in GPO activity by 25% in blood and a decrease in SOD activity by 7% in ejaculate, in contrast, fertile men, carriers of heterozygous polymorphism GSTP1(l114Val), which have associations with an increase in the concentration of DK in blood by 19% and with a decrease in GST activity by 32% in the ejaculate.

identification of carriers of polymorphic loci Ile105Val, Ala114Val GSTP1, as well as determination of enzymes of the thiol disulfide system can be recommended for additional assessment of the risk of reproductive disorders in men.

identification of carriers of polymorphic loci Ile105Val, Ala114Val GSTP1, as well as determination of enzymes of the thiol disulfide system can be recommended for additional assessment of the risk of reproductive disorders in men.

The concept of the formation of immunological tolerance is a promising direction for correcting the renal transplant rejection. One of these methods is extracorporeal photochemotherapy (ECP), however, according to the literature, there is no single concept of its mechanisms of action in the formation of immunological tolerance in transplantology.

To assess the effect of the preventive use of extracorporeal photochemotherapy on the factors of cellular immunity that contribute to the development of long-term tolerance in patients after kidney transplantation.

A total of 24 patients after a cadaveric kidney transplantation with group matching were included in the study. During the first six months after transplantation, 15 patients of the main group (MG) underwent 10 sessions of ECP in combination with the standard immunosuppression protocol, and 9 patients of the control group (CG) received only standard immunosuppressive therapy. #link# Immunological studies were carried out by the 3rd year after transplantatioh the activation of a second co-activation pathway between B-7 and CTLA-4 molecules in the early period after kidney transplantation. As a result, a clone of tolerogenic CD3+CD4+ T-lymphocytes is formed, which differentiates into T-regulatory cells and maintains immunological tolerance in the long-term period. Using ECP as a part of combination therapy allows to normalize the indicators of cellular immunity in the long-term period.

ECP initiates immunological tolerance through the activation of a second co-activation pathway between B-7 and CTLA-4 molecules in the early period after kidney transplantation. As a result, a clone of tolerogenic CD3+CD4+ T-lymphocytes is formed, which differentiates into T-regulatory cells and maintains immunological tolerance in the long-term period. Using ECP as a part of combination therapy allows to normalize the indicators of cellular immunity in the long-term period.

To improve an early diagnosis of prostate cancer (PCa) by clarifying indications for prostate biopsy.

A prospective analysis of 251 primary prostate biopsies performed in Republican Specialized Scientific and Practical Medical Center of Urology to patients with LUTS during the period from 2018 to 2019 was carried out. link2 All patients were divided into two groups. The group 1 included 189 patients who underwent standard systematic prostate biopsy; the group 2 consisted of 62 patients, who had had baseline multiparametric magnetic resonance tomography (mp-MRI) of the prostate with risk evaluation using PI-RADS v2 score, followed by systematic biopsy in combination with targeted biopsy. The ultrasound-guided biopsy was done under local anesthesia using lidocaine gel and periprostatic nerve block with a 2% lidocaine solution. link3 Systematic biopsy was performed with 10 to 12 cores using biopsy gun. In the second group, in addition to systematic biopsy, from 2 to 6 targeted cores from suspicious areas were taken.

Itients with PSA level of less than 20 ng/ml, mp-MRI of the prostate should be performed prior to biopsy. In men with PI-RADS v2 category 4-5 lesions, systematic biopsy in combination with targeted biopsy is recommended, while in case of category 2-3 lesions and negative TRUS and DRE, it is more appropriate to follow-up patients, instead of performing biopsy.

to determine main risk factors for complications of ureterolithotripsy.

a retrospective analysis of the results of 545 ureteroscopies performed in 506 patients with ureteral stones over the past 7 years at the urological clinic named after M.F. Vladimirsky was carried out. The relationship between preoperative and intraoperative factors and complications of ureterolithotripsy was analyzed.

The overall complication rate was 22.4%. The risk of intraoperative complications was proved to increase (p<0.05) along with the stone size, location in proximal ureter, stone impaction for more than 3 weeks and the degree of hydronephrosis. No preoperative stenting or nephrostomy tube prior to ureteroscopy was associated to an increased risk of intraoperative complications (RR=2.88; p=0.03). Patients with preoperative drainage of upper urinary tract has lower probability of intraoperative complications (OR=0.35; p=0.03). The risk of developing stricture and ureteral obliteration in uncomplicated ureteroscopy was mria and intraoperative trauma complications.

Dietary supplements are successfully used in many fields of medicine, including urology. In particular, urologists often prescribe dietary supplements for patients with urolithiasis.

to study an influence of dietary supplements Nefradoz on the metabolism of the main stone-forming substances and inhibitors of stone formation in patients with urolithiasis.

Dietary supplements are successfully used in many fields of medicine, including urology. In particular, urologists often prescribe dietary supplements for patients with urolithiasis.

to study an influence of dietary supplements Nefradoz on the metabolism of the main stone-forming substances and inhibitors of stone formation in patients with urolithiasis.

A total of 60 patients with urinary stone diseases were included in a single-center prospective randomized study. All patients were divided into 2 groups of 30 people, depending on the treatment. In selleck products , patients followed standard diet, received general recommendations and dietary supplements Nefradoz for 28-30 days, 1 capsule (150 mg) 2 times a day with meals.

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