Introduction. In recent years, there has been more and more research on the creation of artificial intelligence (AI) to help diagnose and treat patients in various fields of medicine. The use of algorithms allows us to reduce the time for processing large volumes of information and give a «second opinion» to a specialist in complex and non-standard clinical cases. In order to increase the effectiveness of percutaneous nephrolithotripsy, we have created an AI algorithm to personalize approach in the surgical treatment of nephrolithiasis. Purpose. To develop a universal tool for predicting the most optimal tactics of percutaneous nephrolithotripsy depending on the clinical case. Materials and methods. The total number of patients treated at N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology and those who took part in the study amounted to 1000 people. The number of men was 419 (41.9%), women 581 (58.1%). The age of patients included in the studies ranged from 18 to 88 years (52.3±13.47). The division into Training and Holdout partitions varied depending on the target variable to obtain the most accurate result. The maximum difference in the samples was 600n and 400n (60% and 40%), the minimum 800n and 200n (80% and 20%). Data processing was carried out using IBM SPSS Statistics and Modeler programs using the neural network modeling method. Results. The accuracy of prediction for the choice of nephroscope size was 82.2%, requirement for intraoperative stent placement 93.9%, requirement for ureteroscopy or contact ureterolithotripsy 98.5%. The accuracy of the forecast for the number of puncture accesses was 92.6%, for access through the upper group 95%, for access through the middle group 91.2%, for access through the lower group 91.2%. The algorithm allows us to predict the presence of residual stones with an accuracy of 84.1%, the duration of surgical intervention is 87.3%.The number of test observations was 30. The algorithm demonstrated high accuracy of prediction (from 73.8% to 94.5%) of surgical tactics in complex clinical cases. Conclusion. The results of using the algorithm for personalized prognosis in the surgical treatment of nephrolithiasis showed high accuracy and efficiency. Further development of technology to create algorithms for each nosology and surgical interventions will reduce the time of data analysis by the attending physician, provide a «second opinion» to young specialists and standardize the approach to treatment in rare and complex clinical cases.

Introduction. Today, ultrasound examination (ultrasound), due to a number of advantages over other diagnostic methods (low cost, lack of ionizing radiation, the ability to perform without restrictions on age, gender, body weight, the presence of metal objects, etc.), is widely implemented in clinical practice. However, the accuracy in detecting urinary stones in the gray-scale mode varies from 33 to 95% and depends on the experience of the specialist performing the study and the quality of the ultrasound apparatus. One of the ways to increase the diagnostic accuracy of the method is to detect the twinkling artifact (ТA). However, data on its diagnostic accuracy in detecting urinary tract stones also vary (from 50% to 97%). The reason for this is the methodological features of the conducted scientific research, as well as the technical features of the ultrasound devices used in them, in some of which (devices 2000-2010) the ТA is programmatically turned off to improve vascular visualization. In some devices developed in the last decade, the possibility of obtaining AM has been returned. However, there are no methods for detecting ТA, optimal settings of the Doppler mapping mode for better visualization. In this regard, experimental work was carried out to develop a methodology for testing the ultrasound device in order to determine the possibility of using AM. Materials and methods. In 2023, the staff of the Lopatkin Research Institute of Urology and Interventional Radiology – a branch of the Federal State Budgetary Institution «NMIC of Radiology» of the Ministry of Health of the Russian Federation and the Bauman Institute conducted a series of experiments and developed a device (phantom) that allows AM to be studied in laboratory conditions. Ultrasonic devices were used to test the device during the development process: Philips Affinity 70 and ALOKA Ultrosound F75. To test the working properties of the device, an assessment was made of the possibility of obtaining AM on a number of ultrasonic scanners: BK Specto 5000, Simens, Samsung RS65, Samsung Rs 85, Mindrey Kesona, Hitachi Arienta 750. Fragments of urinary stones of various chemical compositions were used as the studied material. Results. A device has been developed, which is a plastic container 4*10*5 see, with a side wall thickness of 0.2 cm. A substrate made of platinum- based silicone is placed inside the device, the size of 10*5*2 cm. Along the central line of the substrate, at a distance of 2 cm from each other, there are 3 recesses for fixing the concretion, with a diameter of < 5 mm. To prevent the migration of the ultrasonic sensor during the study, a fixation system is provided in the form of 2 clamps located in the upper part of the container, connected to each other by means of a toothed connection. ТА was able to register in the area of all stones, including those artificially prepared from calcium sulfate dihydrate. The optimal settings of the color Doppler mapping mode have been determined for visualization. ТА was determined in all contact media, but the most accurate, corresponding to the contours of the concretion, was obtained using ultrasonic gel. Conclusion. The conducted experimental work on ТА visualization in laboratory conditions has shown that it is possible to obtain AM in vitro using the device developed by us. The developed device greatly simplifies the configuration of the Doppler mapping mode of the ultrasound device for better visualization of ТА and makes it easy to assess the possibility of using ТА on a specific ultrasound scanner.

Introduction. Urolithiasis is a serious medical, social and economic problem. Over the past decades the world has seen a progressive, approximately 3% per year, increase in its incidence. Urolithiasis occupies a leading position in the structure of urological diseases and has a high recurrence rate in the absence of metaphylaxis. In turn, the effectiveness of properly selected anti-relapse therapy has been proven by many studies and is about 50- 80%. The development of “tools” for rational metaphylaxis represents a potential “growth area” for improving the effectiveness of treatment for patients with urolithiasis. One of these tools is the correction of urine pH levels, since its violations are the most common. However, drugs used to correct pH levels have a number of limitations, which greatly complicates their use. One of the possible solutions to these shortcomings may be the creation of combined drugs that can comprehensively influence the factors that provoke the recurrence of stone formation such as the line of Litcontrol® Litura® products from Devicare (Spain). The purpose of this publication is the scientific rationale of the clinical effects of Litura® Up and Litura® Down in the metaphylaxis of urolithiasis. Materials and methods. A literature search and analysis of foreign and domestic literature was carried out from 1990 to 2024 with the selection of relevant publications in the еLibrary, PubMed databases and Google including keywords – the active components of Lit-Control® pH Up – potassium-magnesium citrate, theobromine, zinc, vitamin A, and Lit-Control® pH Down – phytates, L-methionine, zinc, vitamin A. References in included sources were reviewed to identify additional potentially relevant studies. 189 sources were found, based on the relevance of which 60 articles were selected. Results. The use of Litura® Up and Litura® Down has a scientific basis, and the included substances and their combination potentiate the clinical effect in the metaphylaxis of urolithiasis. However, controlled clinical studies are necessary to assess the prospects for using these complex agents. Conclusions. Based on foreign data from experimental and clinical studies, we can conclude that the Lit-Control® Litura® line of products used to correct urine pH levels and inhibit crystallization in various types of stone formation can be considered as a new promising approach to the metaphylaxis of urolithiasis.

Introduction. Over the past 30 years in reconstructive urology there has been a tendency to reduce the frequency of use of minimally invasive methods of surgical treatment of urethral strictures of various localizations and the predominant use of reconstructive plastic interventions with the expansion of the narrowed area of the urethra using inserts from various tissues. Buccal dilation urethroplasty is currently recognized as the optimal treatment option for urethral strictures of various locations and of varying length. Thus, the issue of choosing the most appropriate method of surgical intervention for recurrent urethral strictures, in the context of a possible increase in the risk of complications, requires additional research. Purpose. To analyze and evaluate the results and complications after plastic surgery of recurrent urethral strictures using a free autograft of the buccal mucosa. Materials and methods. The analysis included data on 51 patients operated on at the Research Institute of Urology and Interventional Radiology named after. N.A. Lopatkina–branch of the Federal State Budgetary Institution National Medical Research Center of Radiology of the Ministry of Health of the Russian Federation for the period from 2014 to 2021 regarding recurrent urethral stricture. The average age of the patients was 36.2±1.6 years (from 18 to 58 years). The diagnosis of recurrent urethral stricture was confirmed by anamnesis, clinical and laboratory examination according to a standard protocol, and special examination methods (uroflowmetry, ultrasound examination of the bladder, retrograde or antegrade cystourethrography, voiding urethrography). According to indications, fibrourethrocystoscopy was performed. According to radiological research methods, the localization and extent of urethral stricture were determined. The functional state of the bladder and the severity of bladder outlet obstruction were determined by the volume of residual urine determined by ultrasound of the bladder, as well as by uroflowmetry data. Results. An analysis of the results and complications after plastic surgery of recurrent urethral strictures using a buccal flap was carried out after repeated operations. As the length of the stricture increases, the risk of its recurrence increases significantly. The most significant factors are the location of the stricture in the penile region and its extent. No other long-term complications (newly developed urinary incontinence/erectile dysfunction) were observed in any case in the analyzed group of patients. Conclusion. Repeated operations for recurrent urethral strictures can eliminate urinary disorders with an effectiveness close to (or equal to) that of primary operations. When choosing a method of surgical treatment of recurrent strictures, both the extent of the stricture and its location should be taken into account. The presence of an extended stricture of the penile urethra may be a risk factor for its recurrence. Complications that develop after repeated operations in the vast majority of cases are not life-threatening. The question of the effectiveness of different types of surgery requires additional research with the accumulation of clinical material.

Introduction. The second most common pathology of the ureterovesical segment, after vesicoureteral reflux (VUR), is megaureter. At the moment, it is necessary to optimize the approach to performing various types of surgical interventions in children with megaureter. The question of the timing and indications for surgery, their number and the sequence of treatment stages remains open. The aim: to analyze the causes of repeated surgical interventions for megaureter and their prevention. Materials and methods. In the pediatric uroandrology department of the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, pneumovesiscopic reimplantation of the ureter (UR) according to Cohen was performed in 26 repeated patients over 9 years. 52 interventions were recorded before pneumovesicoscopic UR. 4 (15.4%) patients were previously operated on at a research institute, 4 (15.4%) at the place of residence and then received staged treatment at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, 18 (69.23%) patients at the place of residence. Patients underwent from 1-6 surgical interventions, the average value was 2 interventions per 1 patient. Ureteral plication was required in 7 patients. In rare cases, megaureter was combined with ureterocele, duplication of the upper urinary tract and neurogenic bladder dysfunction. Results and Discussion. We combined the reasons for repeated surgical interventions into two blocks: 1inadequate drainage of the ureter, requiring repeated manipulations, including under anesthesia; 2 – complicating factors affecting the quality of the formation of ureterocystoanastomosis, surgical errors in the reimplantation technique and tactical errors that can lead to VUR or obstruction requiring re-operation. The use of original methods: intravesical plication of the ureter, fixation of the ureter at two levels (the entry point of the ureter into the bladder and in the area of the neoostium) is used to increase the length of the submucosal tunnel and create a better anti-reflux mechanism. Conclusion. Understanding the causes of possible complications of ureteral reimplantation allows you to more carefully carry out the stages of the operation, pay attention to key points and improve the results of megaureter correction.

Prostate cancer is a very important problem in modern urologic oncology. The reason for this is a steady increase of morbidity and mortality in Russia and worldwide. Surgical treatment and hormonal/radiation therapy combination are the golden standard of radical therapy in patients with local and locally advanced prostate cancer. Vast experience has been accumulated worldwide in radical prostatectomy using various types of access: open retropubic, perineal, laparoscopic, and robot-assisted. Many studies focused on finding advantages of using minimally invasive for this surgery, but the results are quite contradictory. The article presents a systematic review of literature data, evaluation of the effectiveness of each access in radical prostatectomy in patients with prostate cancer.

Introduction. In the structure of urolithiasis, the predominant number of patients have stones consisting of calcium oxalate. These stones have a dense structure that is not amenable to litholysis and grows quickly. At the moment, there are no medications that can non-invasively relieve patients of this type of stones. In this connection, the main methods of treatment, depending on the size of the stones, are either lithokinetic therapy or surgical treatment. However, stone removal does not eliminate the cause of stone formation, and with this approach, relapse of the disease occurs within 5 years in 30-50% of patients. Today, the search for new approaches and means to reduce the risk of recurrence of calcium oxalate stones does not stop. One of these products is a representative of the Lit-Сontrol® Litura® line from Devicare (Spain) – Litura® Balance. The purpose of this publication is to theoretically substantiate the potential clinical effects of Litura® Balance in the metaphylaxis of calcium oxalate stones. Materials and methods. A literature search and analysis of foreign and domestic literature was carried out using the databases SCOPUS/ScienceDirect, PubMed/MEDLINE, eLibrary, Google Scholar, from 1990 to 2024 using keywords – the active components of Lit-Control® pH Balance – phytate, phytic acid, magnesium and polyphenols, vitamin A, zinc. References in included sources were reviewed to identify additional potentially relevant studies. 167 sources were found, based on relevance, of which 52 articles were selected. Results. The use of Litura® Balance has a scientific basis, and the included substances and their combination potentiate the clinical effect in the metaphylaxis of calcium oxalate stones. However, controlled clinical studies are necessary to assess the prospects for using these complex agents. Conclusions. The results of international experimental and clinical studies allow us to conclude that the complex product Litura® Balance, used to inhibit the processes of calcium oxalate crystallization and antioxidant protection of the urothelium, can be considered as a new promising approach to the metaphylaxis of calcium kidney stones.

Introduction. Literature data and our own research indicate that therapy with immature cell secretion products (secretome) has a pronounced nephroprotective effect both in acute kidney injury and in chronic renal failure (CRF). Considering that the source of the complex of signaling molecules stimulating reparative processes in organs are low-differentiated cells of functionally and anatomically immature organs in a state of deveopment, the question arises to what extent tissue transplantation of these organs reproduces the effect of therapy with a secretome of stem cells in relation to the progression of CRF. Material and methods. The experiments were carried out on 40 outbred male rats weighing 260-290 g, in which CRF was modeled by resection of 4/5 functionally active renal parenchyma. In the 1st series (control), no therapeutic actions were performed. In the 2nd series, after modeling CRF, a course of therapy with Cellex, the active component of which is the secretome of pig embryonic brain cells, was carried out in the form of 2 10-day courses with a 10-day break between them. In the 3rd and 4th series, immediately after CRF modeling, kidney or testicle tissue obtained from newborn baby rats (1-2 days after birth) was injected under the capsule of the resected kidney as a source of immature cells. Tissues of different organs were used to assess the severity of the tissue-specific effect of therapy. Results. 7 days after the modeling of CRF in all series, a deterioration of more than 2 times of all functional parameters was revealed. After 1 month, in the control and in the 2nd and 3rd series, a tendency to an increase in GFR was revealed, which did not reach statistical significance, whereas in the 4th series, the increase in GFR turned out to be statistically significant. After 2 months in the control series, there was a repeated decrease in the GFR index, whereas in all experimental series, GFR continued to increase or remained at subnormal values. The activity of tubular reabsorption of sodium and calcium after a significant decrease after 7 days to 1 month in the control series increased slightly (but unreliably), and after 2 months they again decreased to values 2 times lower than normal. In all experimental series, after 1 and 2 months, the reabsorption of these electrolytes was at values close to normal. The improvement was especially pronounced in groups 2 and 4. After 7 days, the activity of intracellular enzymes (aspartate aminotransferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH)) in the blood increased in all series with a gradual decrease in hyperfermentemia after 2 months, more pronounced in group 4, as well as in all experimental groups with respect to LDH. Histological examination of the condition of neonatal transplants revealed the destruction of transplanted kidney tissue and a viable testicular graft. Conclusion. Transplantation of neonatal organ tissue under a kidney capsule to rats with CRF has a comparable nephroprotective effect with therapy with the secretome of embryonic cells (Cellex drug). A more pronounced improvement in functional parameters during testicular tissue transplantation is explained by the preservation of the viability of the graft.

Introduction. We will try to show the place of acid-base balance (ABB) study in urolithiasis patients. There is the second article in a series of works devoted to the study of ABB in urolithiasis patients. This work is devoted to the study of the level of basic acid base indicators: blood pH, pCO2, pO2, BE. Materials and methods. The study was conducted prospectively at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation. We analyzed data of 83 urolithiasis patients (39 men and 44 women). All patients underwent an analysis of the urinary stones chemical composition, biochemical analysis of blood and daily urine, blood acid-basic balance, blood parathyroid hormone. Urine pH morning was determined for all patients. Results. Patients with acidemia (blood pH <7.32) had significantly higher concentrations of chlorine, creatinine and ionized calcium in the blood than in the group of patients with 7.32 51 mmHg) than in patients with 41< pCO2 <51 mmHg. Patients with a BE level <-2.5 had significantly higher levels of creatinine, urea and chlorine in the blood, and higher urine pH (p<0.05) compared to patients with BE>2.5. Patients with BE < -2.5 also had significantly lower level of blood pH, pCO2 and ionized calcium compared to the group of patients with BE >2.5. Conclusion. Normalization of blood pH is capable to correct the metabolism of the main lithogenic substances in urolithiasis patients.

Introduction. Urolithiasis remains one of the most common urological pathologies that deserves due attention in the healthcare system. A current direction in optimizing percutaneous nephrolithotripsy (PСNL) is a personalized prognosis for patient management based on artificial intelligence (AI) decisionmaking algorithms. In our work, we applied an algorithm to create the most optimal tactics for patient management after PCNL. Purpose. Optimize the management of patients after PCNL based on AI. Materials and methods. The total number of patients treated at N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology andthose who took part in the study amounted to 1000 people. The number of men was 419 (41.9%), women 581 (58.1%). The age of patients included in the studies ranged from 18 to 88 years (52.3±13.47). The division into Training and Holdout partitions varied depending on the target variable to obtain the most accurate result. The maximum difference in the samples was 600n and 400n (60% and 40%), the minimum 800n and 200n (80% and 20%). Data processing was carried out using IBM SPSS Statistics and Modeler programs using the neural network modeling method. Results. The accuracy of prediction for the choice of nephroscope size was 82.2%, requirement for intraoperative stent placement 93.9%, requirement for ureteroscopy or contact ureterolithotripsy 98.5%. The accuracy of the forecast for the number of puncture accesses was 92.6%, for access through the upper group 95%, for access through the middle group 91.2%, for access through the lower group 91.2%. The algorithm allows us to predict the presence of residual stones with an accuracy of 84.1%, the duration of surgical intervention is 87.3% Conclusion. Further development of AI technology will not only provide a «second opinion» and reduce the time for processing large volumes of information, but will also standardize the approach to the treatment of complex clinical cases and help optimize the work of the urology department.

Introduction. Currently, stents are used in the treatment of various benign and malignant diseases of the upper urinary tract and urethra. Modern stents made of a superelastic alloy, coated with a polymer, regardless of location, are characterized by higher and longer-lasting patency in terms of decompression and relief of obstruction, fewer irritative symptoms of the genitourinary system and no need for frequent replacement, which leads to improved quality of life in addition to cost savings. Despite promising results, there are few studies in the literature regarding their use, and these tend to be peer-to-peer, retrospective, involving small numbers of patients, and based on the surgeon's personal experience. Materials and methods. In literature review used data about using minimally invasive methods for treatment of ureteral strictures, published in PubMed’s base (https://www.ncbi.nlm.nih.gov/pubmed/), scientific electronic library of RF – Elibrary.ru (https://elibrary.ru/) and also professional endourological association websites. The databases were searched using the following keywords: «ureteral stent», «urethral stent», «allium», «uventa» and «memokath». At the first stage, 93 sources no older than 5 years were found that were relevant to the topic of the review. Conference abstracts, short communications, and duplicate publications were excluded. Then, based on the relevance of the data, the reliability of the sources, the impact factors of the journals and the sequence of presentation of the material in the manuscript, 43 articles in scientific international peer-reviewed journals, practical guidelines and clinical recommendations were selected directly for citation in the review. Results. The stent is one of the most common urological prostheses used in the treatment of obstructive uropathy. The main causes of obstruction of the ureter and urethra include benign and malignant factors. Active introduction of minimally invasive technologies into everyday urological practice using ureteral or urethral stents are effective and safe methods of urine diversion (especially in comorbid patients), however, unfortunately, side effects from the use of these prosthetic systems continue to reduce the quality of life of patients. The use of polymer materials in urology has made it possible to introduce a huge number of non-metallic stents used by urologists, however, due to the occurrence of various kinds of complications, an attempt has been made to introduce a new generation of stents – made of a superelastic alloy, coated with polymer. Stents made of superelastic alloy coated with polymer have been used in the treatment of various pathologies of the ureter and urethra for more than two decades. The need for reliable long-term urinary tract drainage has led to the development of improved urinary tract stent designs such as Memokath, Allium, and Uventa. The main advantages of the latter are a convenient delivery system, a self-expanding mechanism, low adhesive properties, no tissue ingrowth, ease of removal, and no need for frequent replacement. Despite the evolution of ureteral and urethral stent designs, complications continue to arise that limit their use and the search for «ideal» drainage systems continues. Conclusion. Today it is difficult to overestimate the role of drainage systems in the treatment of obstructive urological and oncological diseases. However, despite significant success in their use, prostheses are constantly subject to constant modifications and developments aimed at increasing their suitability, durability, ease of implantation and functionality, while reducing the complications associated with them. Future developments in the field of urogenital prosthetic surgery and urology in general continue to attract interest, and ongoing research into new biomaterials, stem cells and tissue engineering is expanding the boundaries of possible interventions in the human genitourinary tract.

Introduction. Metaphylaxis of urolithiasis is an important link in the effectiveness of treatment of patients suffering from urolithiasis. However, this direction in the Russian Federation has not become widespread and is implemented, as a rule, only in large medical centers. To identify the reasons for this, an assessment of the existing regulatory framework for the possibility of urolithiasis metaphylaxis in state institutions of the Russian Federation was carried out Materials and methods. The normative legal documents regulating the provision of medical care to patients with urolithiasis in the Russian Federation are analyzed. Results. Regulatory legal acts regulating the provision of medical care to patients with urolithiasis allow for the prevention of urolithiasis at the regional level. The development and introduction of clinical guidelines on urolithiasis as the main regulatory document has greatly simplified the work of the urologist. It is necessary to further coordinate the standards of medical care and quality criteria for its provision with clinical recommendations for urolithiasis. All citizens of the Russian Federation, as well as stateless persons insured in the insurance system, have the right to receive a metabolic profile assessment for urolithiasis at the expense of budgetary funds. Conclusion. The modern regulatory framework allows for the metaphylaxis of stone formation in budgetary medical institutions of the Russian Federation as part of the implementation of the state guarantees program. At the same time, coordination of efforts at the regional level is required to organize this work.

Introduction. It is believed that Urolithiasis men of working age are most often affected. However, recent studies have shown that the difference between the incidence of this disease among men and women is rapidly decreasing due to the increased incidence of urolithiasis in women. The purpose of the study: to determine the prevalence of urolithiasis among women over 45 years of age as part of screening study in the Republic of Chuvashia. Materials and methods. A population study of 658 women over 45 years of age was conducted on the basis of hospital № 1 in Cheboksary (Republic of Chuvashia) in 2021-2022. All participants underwent ultrasound examination of the urinary system organs to detect urinary stones. The diagnosis was confirmed by CT of the abdominal cavity and retroperitoneal space. Statistical data processing was carried out using the Statistics 10,0 program and Microsoft Excel. Results. Of 658 women, 147 had previously noted urolithiasis in past, 124 of them were associated with this disease (the group with a positive history of urolithiasis), 511 had not previously sought medical help from a urologist for stones of the urinary system (the group with a negative history of urolithiasis). In total, 95 (14.4%) women with calculi in the urinary tract were identified. In the group with a positive history of urolithiasis, stones were detected in 22.4% of cases, with a negative one – in 12.1%. The most frequent localization of concretions in all groups was the lower group of calyx. The size of the concretions varied in the group with a negative history of urolithiasis from 5.70±0.77 mm to 7.50±0.50 mm, in the group with a positive history of urolithiasis – from 5.00±0.56 mm to 21.75±8.24 mm. Conclusion. The present study showed that the true incidence of urolithiasis is 14,4%, which is several times higher than the official figures. To study the true incidence of urolithiasis, it is necessary to conduct large epidemiological studies in the russian population.

Introduction. Growth of urological infection caused by antibiotic-resistant pathogens require the search for alternative antimicrobial treatments. Bacteriophage (phage) preparations are currently the only viable alternative to antibiotics. The therapeutic effect of bacteriophages is significantly different from antibiotics, making them active against multidrug-resistant bacteria. Bacteriophage therapy - creation of viral infection in bacteria. However, the effectiveness of treatment depends primarily on the quality of commercial bacteriophage preparations. The collections of bacteriophages is constantly updated in industrial production but in order to increase the lytic activity of bacteriophage preparations to the uropathogens of our clinic, it is necessary to constantly determine the sensitivity of the main pathogens of infection to commercial bacteriophage preparations and regularly update (adapting) commercial phage preparations. Purpose. Improve the lytic activity of commercial bacteriophage preparations; adapt them to the pathogens of a particular hospital. Materials and methods. From 2017 to the present, at the Research Institute of Urology and Interventional Radiology named after N.A. Lopatkin, a branch of the National Medical Research Center of Radiology of the Ministry of Health of Russia (hereinafter referred to as the Research Institute of Urology), regular work has been carried out to update (adapt) commercial bacteriophage preparations to the uropathogens. The most problematic multidrug-resistant microorganisms -pathogens of urological infection- were send for phage production. Wastewater from the clinical building of the Institute of Urology was also send to phage production. Results. Analysis of data on antibiotic- and phage resistance of uropathogens for 2022 indicates multi-resistance of microorganisms in our clinic. Antibiotic resistance phenotypes of pathogens in the urine of outpatients and inpatients have been defined as a whole: extended-spectrum beta-lactamases (ESBLs): 5.3-1.6%, respectively (E.coli-38%; Klebsiella spp. 62%; Proteus mir. 38,5%; P. aeruginosa -61%) methicillin-resistant Staphylococcus aureus (MRSA) 9.9-8.4%; carbapenem-resistant enterobacteria (CRE) 1.7-4.5% (E.coli-1.9%; Klebsiella spp. 29%); Proteus mir. 5%; P. aeruginosa -47.7%) and bacteriophage resistance of uropathogens 4-16.3% . After adaptation of bacteriophage preparations, an increase in their lytic activity to specific microorganisms was obtained by an average of 14% (from 78% to 92%), and an increase in the lytic activity of Sextafag, a polyvalent piobacteriophage containing phagolysate filtrates of Staphylococcus spp., Streptococcus spp., Proteus (P. vulgaris, P. mirabilis), Pseudomonas aeruginosa, Klebsiella pneumonia, E. coli by 16% (48% to 64%) Conclusions. To improve the lytic activity of bacteriophage preparations and improve the effectiveness of urological infection treatment, it is necessary to constantly update the composition of the cocktail of commercial bacteriophage preparations with phages from hospital wastewater and adapt them to freshly isolated microorganisms from urological patients.

Introduction. Chronic kidney disease (CKD) is a global medical problem. The long-term latent course of the disease leads to a progressive increase in its incidence. Along with laboratory methods of research in the arsenal of the diagnostic service, there are tools that allow you to detect a violation of the kidneys functional ability. Purpose. To analyze modern instrumental methods for diagnosing the functional ability of the kidneys. Materials and methods. The review was conducted based on data published in PubMed databases (https://www.ncbi.nlm.nih.gov/pubmed /) and еLibrary.ru (https://elibrary.ru) and was limited only to articles in scientific peer-reviewed journals. It was carried out until January 2023, by keywords: kidney ultrasound, computed tomography, positron emission tomography, magnetic resonance imaging, kidney function. Results. We found 189 sources not older than 10 years (published after 2012) that were relevant to the topic of the review. Conference abstracts, short messages, duplicate publications were excluded from them. After that, based on the relevance of the data, reliability of sources, impact factors of journals and the sequence of presentation of the material in the manuscript, 46 articles were selected directly for citation in the review. Also, when writing the review, original articles published before 2012 were used. Conclusion. The available modern instrumental methods for assessing renal function open up broad prospects for their clinical application and require further research.

Introduction. Foreign bodies of the lower urinary tract in children are a rather rare pathology in the practice of a pediatric urologist and pediatric surgeon. There are not many cases of this condition described in the literature, despite the trend towards an increase in the incidence of foreign bodies in children. Foreign bodies in the lower urinary tract are most common in adolescents and are usually self-introduced to satisfy sexual desire or curiosity. Cases of calcified foreign bodies of the bladder are described, which may not manifest themselves for a long time. Timely diagnosis and removal of foreign bodies is an effective, but in some cases very difficult, treatment that avoids possible complications. However, in pediatric patients it is difficult to obtain a reliable medical history, especially in those who use objects for sexual pleasure. Сlinical case. A clinical case of treating a 14-year-old child with an encrusted foreign body (a wax candle) is presented. This foreign body was in the cavity of the bladder, presumably about 8 months at the time of surgery. This observation demonstrates a rare case of a bladder foreign body with an unusual structure, with a description of the features of its diagnosis and endoscopic removal. Conclusion. Foreign bodies of the lower urinary tract in children are a very rare clinical situation. These conditions require accelerated diagnosis in order to start treatment early and reduce the risks of possible complications. The use of modern minimally invasive endoscopic methods is possible for the removal of foreign bodies of the lower urinary tract in children.

AIM:To perform language and cultural adaptation and validation of the OABSS (Overactive Bladder Symptom Score) questionnaire among patients with overactive bladder (OAB), proposed as an effective tool for assessing the severity of symptoms and the efficiency of treatment in clinics of the Russian Federation.MATERIALS AND METHODS:In accordance with the protocols for carrying out such studies, the procedure of standardized forward-backward translation of the OABSS questionnaire was performed. Further, the intermediate Russian-language version was applied to 15 patients with subsequent correction of deficiencies and approval of the final Russian-language version of the questionnaire. In total, the study group included 176 patients of both sexes with OAB symptoms who filled out the questionnaire twice (test-retest) with an interval of 10-14 days.RESULTS:Based on the statistical analysis (Cronbach's alpha = 0.961), there was a significant degree of internal consistency of the sample. This fact is also supported by the very high retest reliability of the questionnaire (ICC >0.9).CONCLUSION:Our data showed that the Russian version of the OABSS questionnaire is a reliable and valid tool for subjective assessment of the severity of OAB symptoms.

ntroduction. Diagnosis and determination of treatment tactics in patients with urolithiasis are based on determining the causes of lithogenesis. At the moment, the standard of examination in patients at high risk of recurrence of urolithiasis is the detection of metabolic disorders based on the results of a biochemical analysis of blood and daily urine, as well as an assessment of the chemical composition of the urinary stone. The violations determined using this approach are a manifestation of the physico-chemical processes of stone formation, the assessment of which is currently practically not performed by urologists, due to the lack of simple diagnostic methods and tools. Materials and methods. The review was conducted on the basis of data published in PubMed databases (https://www.ncbi.nlm.nih.gov/pubmed) and Scientific Electronic Library еLibrary.ru (https://elibrary.ru/), and was limited only to articles in scientific peer-reviewed journals. The search was devoted to the study of the crystal-forming activity of urine, factors affecting the lithogenic properties of urine, as well as methods for assessing the risk of stone formation in the most common metabolic types of urolithiasis. We found 189 sources no older than 10 years (published after 2012) that were relevant to the topic of the review. Conference abstracts, short messages, duplicate publications wereexcluded from them. After that, based on the relevance of the data, reliability of sources, impact factors of journals and the sequence of presentation of the material in the manuscript, 41 articles were selected directly for citation in the review. Also, when writing the review, original articles published before 2012 were used. Results. The analyzed literature sources demonstrated a large number of methods for determining the crystallization properties of urine. However, none of them, in view of the complexity, as well as the ambiguity of the results obtained, have not been widely introduced into clinical practice. In view of this, it is required to develop a simple and informative method for diagnosing the crystal-forming properties of urine, which will increase the percentage of non-reactive urolithiasis. Conclusions. The methods available to doctors for determining the crystal-forming properties of urine are extremely laborious. The development of an easy-to-use and sufficiently accurate real-time determination of the crystallization and anti-crystallization properties of urine, will significantly improve the diagnosis, treatment and metaphylaxis of urolithiasis.

Abstract Study question Is it possible to establish prognostic criteria for response to short course of multidose menotropin therapy in men with sperm pathology. Summary answer We found the increase of the effectiveness of menotropins with an increase in the duration of their use and an increase in dosage. What is known already Currently, menotropins are widely used to treat male infertility, both to stimulate spermatogenesis and to compensate for hormonal imbalance. But the actual practice of using menotropins may differ from the recommendations given by the manufacturer. Therefore, observational programs are particularly important, which allow assessing the effectiveness of a drug in routine practice. In real-world practice, hormonal treatment of the infertility is often carried out during the preparation of a couple for IVF and lasts no more than 4-6 weeks. At the same time, there is almost no scientific data in the literature of the effectiveness of such short treatment regimens. Study design, size, duration The study was designed as a multicentre, prospective, observational cohort study. The study included 1117 men with infertility enrolled between January 2020 and April 2021. Participants/materials, setting, methods The study included men with the absence of pregnancy during 12 months of regular unprotected sexual activity. The average duration of infertility was 20.6 months. As a treatment, men received multidose menotropin at a dosage of 75 IU, 112.5 IU or 150 IU every other day with hCG 2000 IU 2-3 times a week. Sperm parameters and hormones (total testosterone, SHBG, LH, FSH, Inhibin B, estradiol) were evaluated before treatment and 4 weeks after. Main results and the role of chance The age of the patients was 18 to 65 years (33.6 ± 7.0 years). The sperm concentration after 1 month of treatment increased by 23.8% from 17.6±18.1 to 23.1 million/ml, the total sperm count increased by 32.1% from 40.2±41.7 to 53.1± 49.1 million, progressive motility increased on average from 26.5±16.2 to 32.0±16.5%, the proportion of morphologically normal spermatozoa increased from 2.3±2.5 to 3.0±2.7 %. The level of total testosterone increased by 33.3% from 11.1±4.6 to 14.8±6.3 nmol/l. The levels of Inhibin B and estradiol did not change significantly. In a comparative analysis of the effect of dosage on the parameters of the ejaculate, the dose of 112.5 IU showed the greatest effect. Limitations, reasons for caution The main limitation of this study is the large heterogeneity of enrolled patients. There will be a very large variability in the age of men, as well as the severity of deviations from the norm in the analysis of ejaculate. Wider implications of the findings Thus, multidose menotropin, already when used for 4 weeks, can significantly improve the quality of the ejaculate (concentration, total count, progressive motility, morphology). In case of insufficient effectiveness of a short course (1 month), it is advisable to continue treatment for at least 3 months or increase the dosage. Trial registration number not applicable