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INTRODUCTION: Renal cysts are a common disease that occurs at a rate of 7-10%. Currently there are no clinical recommendations for the treatment of patients with simple renal cysts. In the current literature there is some evidence that a simple renal cyst has negative effects on renal function. Decreased renal function occurs due to partial atrophy and loss of the renal parenchyma (in the "crater" area at the base of the cyst) caused by compression. Therefore, the efforts to analyze the effect of simple kidney cysts on kidney function and identify the characteristics of the cyst that affect renal function to determine the indications for surgical treatment remains a substantial task. The aim of the study was to analyze the effect of simple renal cysts on renal function, to investigate the relationship between cyst size, atrophied parenchyma volume, and renal function, and to determine indications for surgical treatment of simple renal cysts. MATERIALS AND METHODS: We conducted a prospective cohort study. The study included 109 patients with simple renal cysts. Patients with a solitary cyst of the right or left renal kidney, grade I-II according to Bosniak classification, were included in the study. The estimated glomerular filtration rate (eGFR) of the patients was calculated using various formulas. A contrast CT scan of the urinary tract was also performed to determine the maximum size of the cyst, calculate the volume of the renal parenchyma, and the volume of the lost (atrophied) parenchyma. Patients underwent renal scintigraphy with calculation of total GFR and split renal function. We analyzed the symmetry of the function of both kidneys by comparing the GFR of the affected and healthy kidneys, analyzed the relationship between the presence of a kidney cyst and a decrease in GFR, between the maximum size of a renal cyst and a decrease in its function compared with that of a healthy kidney. We also analyzed the correspondence of total GFR values obtained in renal scintigraphy and GFR values calculated according to the formulas. RESULTS: Data from 109 patients were available for analysis; the mean blood creatinine was 87.4 mol/L. The median maximum cyst size was 80 mm. The median baseline volume of the affected kidney parenchyma was 174 ml, the median volume of the lost parenchyma was 49 ml, and the median proportion of the lost parenchyma was 28%. The median total GFR was 77.07 ml/min. The median GFR of the healthy kidney was 45.49 mL/min, and the median GFR of the kidney affected by the cyst was 34.46 mL/min. The median difference in GFR of the healthy and affected kidney units was 11 mL/min and was statistically significant. Comparison of the eGFR values obtained by the formulas with the reference values of GFR obtained by scintigraphy showed that the Cockcroft-Gault formula with standardization on the body surface area calculated closest eGFR values to the reference ones. Correlation analysis revealed a statistically significant association between the proportion of lost parenchyma volume and the maximum cyst size: =0.37 with 95% CI [0.20; 0.52] (p-value = 0). A multivariate logistic regression model revealed that a statistically significant factor influencing the probability of a significant decrease in GFR was the percent of lost renal parenchyma volume (OR=1,13; =0). CONCLUSIONS: Our study showed that growth of renal cysts associated with renal parenchyma atrophy and decrease of GFR of the affected kidney. An increase in the volume of atrophied parenchyma leads to the decrease in GFR of the affected kidney. The obtained data suggest that performing dynamic renal scintigraphy to assess the decrease in affected renal function and determine the indications for surgical treatment of renal cysts is a reasonable recommendation. According to the results of the study, the loss of 20% of the renal parenchyma can be considered an indication for renal scintigraphy. The Cockcroft-Gault formula with standardization on the body surface area allows to calculate closest GFR values to those obtained by scintigraphy and, therefore, can be recommended as the optimal formula for calculating eGFR in daily clinical practice.

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INTRODUCTION: Urolithiasis is one of the most common urological diseases in adults. Increased life expectancy of the population in developed countries, make urolithiasis topical issue and requires close attention. Due to the high risk of recurrent stone formation causing repeated surgical interventions, the issue of effective urinary stone metaphylaxis is very important today. MATERIALS AND METHODS: To study the current state of the problem of urolithiasis metaphylaxis among Russian urologists, an anonymous questionnaire was applied. A 25-question questionnaire was sent to e-mail to more than 4,000 Russian urologists. A total of 1,238 specialists completed the questionnaire. The database compiled from the received responses was processed and presented with descriptive statistics in the form of tables and charts. RESULTS: According to the survey, more than half of the 831 (67.1%) specialists specialized in the treatment of urolithiasis. It was noted that 626 (86%) inpatient urologists and 205 (40%) outpatient urologists specialized in the treatment of urolithiasis. Only 521 (69.6%) urologists specializing in surgical treatment of urolithiasis give a patient a stone fragment to analyze its chemical composition. At the same time, half of the respondents reported that less than 10% of patients come to them for further metaphylaxis. One of the main reasons for not analyzing the chemical composition of the stone was the fact that 877 (70,84%) specialists indicated the inaccessibility of analysis under the state guarantee program, 503 (40,63%) specialists indicated the patients satisfaction with the results of minimally invasive surgical treatment and lack of sufficient motivation for further examinations. At the same time, less than 3% of specialists can perform stone analysis within the framework of the state guaranty program. 1180 (96,8%) respondents practiced the prophylaxis of recurrent calculi formation, but only 336 (28,47%) performed comprehensive metabolic examination of all patients followed by prescription of drug therapy and appropriate diet. CONCLUSIONS: Our survey revealed low involvement of urologists at the outpatient level in the process of conservative treatment and metaphylaxis of urolithiasis, low activity of urologists in performing complex metabolic study and comprehensive prevention of recurrent stone formation, low percentage of performing chemical composition analysis of stone and low activity of urologists in performing primary litholytic therapy of urate stones. Based on this analysis of the responses of most Russian urologists, it is possible to formulate recommendations to remove the obstacles to providing patients with urolithiasis with quality medical care in terms of conservative therapy and metaphylaxis of urolithiasis.

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OBJECTIVES: of the study: to evaluate the effectiveness and safety of intermittent catheterization in the management of acute urinary retention and to identify factors influencing the resume normal voiding and the development of adverse events. MATERIALS AND METHODS: 129 patients admitted to urology department with acute urinary retention due to BPH were randomized into two groups. Group I had indwelling bladder catheterisation using Foly catheter. Group II was catheterized intermittently. MAIN OUTCOME MEASURES: Success rate, time to resume normal voiding, number of episodes of fever, pain, urgency and gross hematuria. Factors influencing the probability of AUR resolution and adverse events were also analyzed. RESULTS: Normal voiding was resumed in 25 (35.7%) patients in group I, and in 26 (44%) patients in group II. The probability of AUR resolution in group II was 1.5 times higher than in group I. However, this difference was not statistically significant. In group II normal voiding was restored within 1 day in 1 (3.8%) patient, in 12 (46.2%) - within 2 days, and in 13 (50%) - within 3 days. On the 7th day relapse of AUR occurred in 3 (2.3%) patients, in 2 (2,8%) patients in group I and in 1 (1.7%) patient in group II. Logistic regression analysis showed statistically significant association between the probability of developing gross hematuria and the age of the patient, as well as between possible urethrorrhagia and episodes of acute urinary retention previous to the last AUR episode. Statistically significant associations were revealed between age and the use of a-blockers at the time of the acute urinary retention episode and the probability AUR resolution. An increase in the patients age by 1 year was associated with decrease in the chances of voiding resumption by 1.07 times, and a-blockers therapy at the time of acute urinary retention increased these chances by 2.8 times. Urgency rate was statistically significantly higher in group I (30% vs. 3.4%), the chances of developing urgency were also 12 times higher in group I. CONCLUSION: Intermittent catheterization is an effective method of AUR management. The major advantages of this method are the possibility of outpatient treatment, maximum preservation of patients social and sexual activity, earlier resumption of voiding and significantly less common catheter-associated lower urinary tract symptoms.

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Percutaneous nephrolithotomy (PCNL) is the gold standard treatment of large and staghorn kidney stones. Despite technological progress and improvement of PCNL technique, this procedure is associated with complications and in some cases remain a challenge for endourologists. According to the time, complications can be divided into intra- and postoperative. Intraoperative complications include bleeding, injury of the renal collecting system, visceral organs, pulmonary complications, thromboembolic disorders, extrarenal migration of the stone fragments and incorrect nephrostomy tube placement. Postoperative complications include infection and sepsis, bleeding, persistent urinary fistula, infundibular stenosis and death of the patient. The different recommendations that might be useful for the timely diagnosis of various complications in patients undergoing PCNL are provided in the review. Additionally, information on treatment algorithms is included.

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To date, percutaneous nephrolithotomy (PNL) is the standard treatment modality for large-volume renal stones and staghorn stones in patients with urolithiasis. Despite low invasiveness, this method is not without complications. This review discusses the most common complications and suggests methods for their prevention and appropriate management. To unify the study of complications they were categorized based on the modified Clavien classification. According to the available data, about 80% of the PNL complications belong to grade I-II complications and does not require any additional treatment. The most serious complications include sepsis, bleeding, and injury to nearby organs.

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INTRODUCTION: In recent years, there has been an increasing role of ureteroscopy in managing urinary tract calculi of various locations. Several studies have reported the relationship between the efficacy and safety of ureteroscopic interventions and surgeons skills and hospital caseload volume. The aim of our study was to assess the effectiveness of urethroscopic stone removal, the changes in treatment effectiveness, frequency and types of complications along with gaining experience in these interventions. MATERIALS AND METHODS: We analyzed 4031 urolithiasis patients who were admitted to our urological department and underwent ureteroscopy from 2001 to 2013. To determine the effectiveness and safety of the method, as the experience gained, the time of observation was divided into three periods: from 2000 to 2004, from 2004 to 2009, from 2009 to 2013. The parameters were evaluated for the entire observation time and for each period. RESULTS: Complete fragmentation of the stones was observed in 3628 (90%) patients, partial - in 219 (5.4%). No treatment effect was observed in 138 (3.4%) patients. The greatest effectiveness (96.94%) was seen in stones in the lower third of the ureter. The proportion of unsuccessful ureteroscopies was 5.7%, 4.5% and 3.5% for the periods 2000 -2004, 2005-2009 and 2009-2013, respectively (p=0.027). The incidence of acute postoperative pyelonephritis in the corresponding periods was 15.4%, 3.3% and 2.9% (p<0.001). CONCLUSION: Ureteroscopy is an effective and safe treatment modality for managing upper urinary tract calculi. It is most effective in treating distal ureteral stones. The increase in the treatment effectiveness and the reduction in the incidence of complications along with gaining experience, suggests that these interventions should be practiced mainly in urology centers specializing in the care of patients with urolithiasis.

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AIM: To investigate factors affecting the compliance of patients with the combination therapy for benign prostatic hyperplasia. MATERIALS AND METHODS: Four hundred BPH outpatients treated with combination therapy were surveyed. RESULTS: The absolute majority of patients (76.16%) expected a quick positive result. 10.47% viewed their disease as too advanced, did not believe in the effectiveness of medical therapy and believed the surgery to be the only treatment option. 24.42% of patients changed the medication dosage on their own, and 11% were ready to discontinue the treatment without consulting their doctors. 76.16% of patients considered the recommended treatment to be effective, 77.33% fully trusted the doctor. In the opinion of 8.7% of patients, the doctor did not sufficiently inform them about the prescribed drug. 22.67% of patients had doubts about a physicians competence, and 5.23% believed the doctor complicated their medical treatment and changed prescriptions too often. CONCLUSIONS: The patients had a high level of trust in doctors and showed psychological adherence to therapy. However, about a quarter of patients changed the treatment regimen on their own. Many patients had exaggerated expectations of the treatment. 8% of patients reported insufficient awareness regarding the nature and appropriateness of drug therapy, and one in five patients had difficulties in perceiving, remembering and following the treatment regimen. CONCLUSION: streamlining therapeutic regimens, prescribing non-titratable or combined drugs will help improve patients therapy compliance.

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AIM: To analyze the sub-segment of mHealth devoted to assessing of the risk of recurrent stone formation and metaphylaxis of stone formation. To design a smartphone application (app.) in Russian language for urolithiasis patients. MATERIALS AND METHODS: Three working groups of urologists from three St. Petersburg clinics searched for downloadable medical applications relevant to the above requirements. After searching and analyzing existing medical applications, the most acceptable design and structure of our own application were identified. RESULTS: The developed "Urolithiasis" application is available for free download in Russian language versions in App Store (Apple, Inc.) and Google Play (Android market, Google, Inc.). It features the following sections: 1) "Take the test" (personalized calculation of the risk of kidney stone recurrence and providing relevant recommendations using ROKS nomogram), 2) "Water" (with reminders to drink water and automatic logging of the water intake), 3) "Food" (Nutrition facts on the content of calcium, oxalate, purine, protein, citrate and calories in common foods), 4) "My doctor" (in the future this option will allow for on-line communication with a patients physician), 5) "Feedback" (if the patient does not find the desired product or has a question - this section is for him/her). CONCLUSIONS: The smartphone application "Urolithiasis" in Russian may be recommended to patients with urolithiasis for improving the effectiveness of metaphylaxis.

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Laser ablation of bulk target materials in liquids has been established as an alternative method for the synthesis of nanoparticles colloidal solutions mainly due to the fact that the synthesized nanoparticles have bare, ligand-free surfaces since no chemical precursors are used for their synthesis. InSb is a narrow band gap semiconductor which has the highest carrier mobility of any known semiconductor and nanoparticles of this material are useful in optoelectronic device fabrication. In this paper a bulk InSb target was ablated in deionized (DI) water or ethanol using a nanosecond (20 ns) or a femtosecond (90 fs) pulsed laser source, for nanoparticles synthesis. In all four cases the largest percentage of the nanoparticles are of InSb in the zincblende crystal structure with fcc lattice. Oxides of either In or Sb are also formed in the nanoparticles ensembles in the case of ns or fs ablation, respectively. Formation of an oxide of either element from the two elements of the binary bulk alloy is explained based on the difference in the ablation mechanism of the material in the case of ns or fs pulsed laser irradiation in which the slow or fast deposition of energy into the material results to mainly melting or vaporization, respectively under the present conditions of ablation, in combination with the lower melting point but higher vaporization enthalpy of In as compared to Sb. InSb in the metastable phase with orthorhombic lattice is also formed in the nanoparticles ensembles in the case of fs ablation in DI water (as well as oxide of InSb) which indicates that the synthesized nanoparticles exhibit polymorphism controlled by the type of the laser source used for their synthesis. The nanoparticles exhibit absorption which is observed to be extended in the infrared region of the spectrum.

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