The aim was to study the role of nicotinamide coenzymes (NAD+) in the occurrence of fertility disorders in patients from infertile couples.
Material and methods. To study the concentration of NAD+, patients with idiopathic infertility were divided by age into three equal groups of 15 men. The first group included men aged 20-30 years, the second group included men 31 to 40 years of age, and the third group included men over 40 years of age. The comparison group consisted of 26 fertile donors. The level of NAD+ in ejaculate was determined by colorimetric method (NAD/NADH Cell-Based Assay Kit, Cayman Chemical, USA) according to the manufacturer's instructions.
Results. In patients with infertility of unclear genesis, statistically significant changes in the form of an increase in NAD+ level depending on the age of the patients were established. Negative correlation between the concentration of NAD+ in the ejaculate and sperm quality parameters, including the concentration, sperm motility number, was found.
Conclusion. The ejaculate is assessed as fertile when the NAD+ concentration is in the range of 91-120 nmol/L, regardless of a patient's age. Measurement of NAD+ level enables to reveal early disorders of redox processes in male gametes, pathology of gametogenesis and DNA repair. 

Urolithiasis is still a growing problem. In the Russian Federation in recent years, the increase in people suffering from urolithiasis amounted to 25.1%. The choice of the optimal method for eliminating renal localization stones with a size of 10 to 20 mm remains debatable. Extracorporeal shock-wave lithotripsy (ESWL), despite a number of unconditional advantages, has a significant traumatic effect on the renal parenchyma. When the predicted effectiveness of ESWL is low, it is advisable to consider alternative endourological techniques. The «gold standard» of diagnostic imaging in patients with urolithiasis and the main tool for preoperative prediction of the success of surgical treatment is multi-section computed tomography (MSCT).
The aim of the study is to improve the results of treatment of patients with urolithiasis by searching for additional diagnostic capabilities of MSCT in predicting the results of ESWL in patients with nephrolithiasis.
The study provides data on the analysis of the results of surgical treatment of 127 patients with urolithiasis, who underwent clinical, laboratory and radiological examination, and performed ESWL in the conditions of the urology clinic №1 of the Saratov State Medical University in the period of 2021-2022.
The main prognostic criteria for the success of ESWL, along with anamnesis and clinical data, are still localization, the maximum size of urinary stone and its average density (HU). The most promising direction is to evaluate the structure of the stone in vivo, using additional MSCT parameters, such as «uniformity» and the number of density «cores». Such a differentiated approach allows optimizing the clinical algorithm for choosing surgical tactics in patients with nephrolithiasis, increasing the number of successful lithotripsies, avoiding excessive traumatization of the renal parenchyma. 

Objective to determine the clinical and psychological portrait of a male patient with psychosomatic disorders in the urogenital area.
Material and methods. 34 patients aged 18 to 38 years (mean age 29±5.2), who were followed up by urologists for a long time and underwent unproductive treatment associated with chronic prostatitis (95%), chronic pelvic pain syndrome (67%), myofascial pain syndrome (36%) and overactive bladder (3%). All patients were assessed by their mental status, the state of the emotional sphere (the level of situational and personal anxiety, the level of depression), coping behavior, they also underwent sexological counseling with an assessment of the type of sexual constitution, the nature of existing sexual disorders, disorders of psychosexual development and the state of interpersonal relationships.
Results. The vast majority of patients had anxious and suspicious character traits, felt pronounced situational (over 70% of patients) and personal (65% of patients) anxiety. Over half of the men (56%) noted a depressed mood, which was of a neurotic nature. Anxious (35%), hypochondriacal (24%), obsessive-phobic and neurasthenic (12% each) prevailed among the types of attitude towards the disease. More than half of the patients (56%) had an average type of sexual constitution, and its strong type was noted in 4% of patients. All patients had various true sexual disorders: sexual failure anxiety syndrome (53%), erectile dysfunction (51%), decreased or absent sexual desire (37%), orgasm disorders (18%), and ejaculation disorders (20%). Imaginary sexual disorders were detected in 31% of patients, and in 60% of cases, sexual disorders were mixed. The majority of men (95%) had psychosexual developmental disorders and problems in interpersonal relationships.
Conclusions. A patient with a psychosomatic disorder of the urogenital sphere, as a rule, has anxious and suspicious character traits with severe situational and personal anxiety, psychosexual development disorders, various sexual disorders, and problems in family relationships. The identified features of such patients indicate the need to involve a psychotherapist-sexologist in the diagnostic and therapeutic work, which will improve the quality of care provided and comply with the principles of an interdisciplinary approach. 

Objective is to improve patient compliance by introducing hybrid case management techniques that reduce the risk of unintentional refusal of treatment, and adverse effects of self-medication providing users with expert-grade medical information.
Material and methods. IPSS and QoL tests, NIH-CPSI, MIEF-5, ICF, AMS, Body Mass Index Calculator, Waist Measurement, Urination Diary, Uroflowmetry, Complaints, Medical History, Prostate and Renal Ultrasound, Urinalysis, Prostate Specific Antigen, Testosterone, Creatinine, and Blood Glucose levels were used to acquire, collect and process information by each mobile app user. The principle of messenger is used for information exchange in the application. The principle of digital library is used for search of relevant medical information. The server part is implemented using Node.JS technology, the client part using Flutter technology.
Conclusions. Reliable medical information offered in the SAU app helps minimize the risks associated with self-medication, and the self-diagnosis section increases the availability of medical care for people who have difficulty going to clinics (remote places of residence and work, high cost of medical services or their low quality, non-compliance with the norms of medical ethics and deontology of individual medical workers). Constant monitoring of the state of one's health and the possibility of direct communication with the doctor provided by the SAU app contributes to the timely resolution of all issues in patients, reducing the threat of loss of time, the development of complications or the aggravation of the condition. 

Objective is to analyze the effectiveness of percutaneous nephrolithotripsy in patients with large (up to 2.5-3 cm) and small (up to 1-0-1-5 cm) stones in the kidneys and ureters.

Material and methods. In the city clinical hospital №8, Ufa, the treatment of urolithiasis, namely the finding of concretions in the kidneys, has been represented by minimally invasive technologies using percutaneous access since 2016. An analysis of 152 patients operated on for nephrolithiasis in the Department of Urology of the city clinical hospital №8 from 2016 to 2021 was carried out.

Conclusion. Currently, minimally invasive operations in urology (mini-nephrolitholapaxy) are the most relevant. The short duration of the operation, complete elimination of the concretion, the absence of changes in the renal parenchyma, rapid recovery of renal function, reduction of time to restore the patient's ability to work ‒ these are the main advantages of this method of minimally invasive technologies.

Objective: To study of chemical composition of kidney stones and evaluate the therapeutic effect of metaphylaxis using a phytopreparation based on cumin, ruyan and honey.
Material and methods. The material for the investigation was kidney stones removed from 12 patients during surgery, and stones removed from 20 patients aged 18 to 65 years who were conservatively treated with medications at the “Ultramed klinik” medical clinic.
Results. As a result of X-ray diffractometry, the phase composition of kidney stones removed from patients was obtained. A diffractogram of a kidney stone in the patient is provided as an example.
Conclusion. The therapeutic efficacy of the herbal blend used for therapeutic and metaphysical purposes in patients with nephrolithiasis was evaluated – 95% and 100%, respectively. 

Objective is to evaluate the effectiveness and safety of using a thulium fiber laser in laser in retrograde ureterolithotripsy.

Material and methods. A prospective study of the results of retrograde ureterolithotripsy using a thulium fiber laser was conducted in 352 patients. Postoperative complications were classified according to the Clavien–Dindo system. Stone-free rate (no re- sidual fragments ≥ 3 mm) was assessed 3 months after surgery.

Results. The median (minimum-maximum) age of patients was 39 (18–71) years. Median (minimum-maximum) stone diameter was 9 (5–26) mm. Median (minimum-maximum) stone density was 1050 (345-1500) Hounsfield units. Intra- and early postoperative complications (during the first 3 months) according to the Clavien-Dindo classification developed in 71 (20.2%) patients, late complications (more than 3 months after surgery) developed in 41 (11.6%) patients. At the 3-month follow-up, a stone-free rate of 90.6% (in 319 of 352 patients) was evaluated.

Conclusions. The use of a thulium fiber laser is a safe and effective method for ureterolithotripsy.

Percutaneous nephrolithotripsy (PCNLT) is considered one of the main methods of treating urolithiasis with stones of more than 2 cm. The most dangerous complications are injuries to neighboring organs, bleeding, and exacerbation of chronic pyelonephritis.
The study included 463 patients with urolithiasis who underwent PCNLT. The analysis of complications and ways of their correction was carried out.
Exacerbation of calculous pyelonephritis occurred in patients with pre-existing retention of the cavitary system, as well as with existing bacteriuria.
The most formidable complication of PCNLT is bleeding from the cavitary system of the kidney. To stop the bleeding, in case of damage to the vessel along the nephrostomy access, superselective embolization of the branches of the renal artery can be successfully applied.
A considerable number of complications after PCNL are associated with infected large calculi. In such cases, it is preferable to perform preliminary drainage of the cavity system.
In cases of fornic bleeding, additional percutaneous drainage of the cavitary system minimizes blood loss due to adequate decompression of the cavitary system.

Partial nephrectomy (PN) provides comparable outcomes compared to radical nephrectomy and should be considered a priority intervention in patients with renal cell carcinoma (RCC).
Material and methods. During the period of 2010–2022 we performed 173 PN. The mean age of the patients was 60.5±11.4 years. The male/female ratio was 1,14:1, the right-sided/left-sided localization of the tumor ratio was 1,04:1, respectively (р>0,05).
Results. Laparoscopic approach was used in 54.9%, open PN in 45.1% of patients. Regression analysis of groups of patients distributed according to access did not reveal any dependence on gender, age, comorbidity, side of the lesion, or body mass index. A positive correlation was registered for tumor size and resection complexity. The ratio between laparoscopic and open PN for tumors up to 4 cm (T1a) was 70.5% and 28.2%, respectively. In the group of patients having undergone laparoscopic PN, the median nephrometric index on the RENAL scale was 5.3 points, which was significantly less than in the group who underwent open PN, with this indicator equal to 10.4 (p<0.01). The median time of warm ischemia in open PN was significantly lower, amounting to 13.1 minutes, the same indicator in the laparoscopic PN group was 28.2 minutes (p<0.05).
Discussion. A retrospective analysis showed the heterogeneity of patient groups depending on the access used for PN. Open PN was used in patients with larger and more technically complex tumors, which was mainly dictated by oncological expediency and reduced risks of surgical complications.
Conclusion. The T category and the RENAL nephrometric index are decisive for the choice of approach for PN in patients with RCC. Open PN is associated with shorter ischemia time and a higher incidence of segmental (partial) ischemia. 

Incontinence, without bringing global problems to somatic health, leads to a pronounced social maladjustment of the patient. We conducted a retrospective analysis of the results of treatment of 252 women with incontinence. The mean age of the patients was 51.9±13.2 years. Isolated stress incontinence at the preoperative stage was found only in 6.7% of women, the remaining 93.3% had a mixed form. These patients underwent 271 operations for incontinence, i.e. 7.5% of cases were associated with relapse after primary treatment. Synthetic transobturator sling was placed in 75.6% of patients; autologous slings were used in 6.3% of patients; and in 18.1% of cases laparoscopic Berch colposuspension was used. Simultaneous surgery accounted for 87.1% of the total number of surgical interventions. The recurrence rate after the autologous sling placement was 47.1%; after the synthetic sling placement it accounted to 5.4%; after the Berch operations, recurrence rate was 4.1%. The recurrence rate of stress incontinence after re-correction was 5.2%. Signs of urgency persisted in 72.6% of patients. 

Urethral strictures in men are one of the basic causes of infravesical obstruction. The Enhanced Recovery Program (ERP) is a special strategy of perioperative care aimed at reducing the duration of treatment with improved postoperative outcomes. There are critically few works on the problem of enhanced recovery in urethroplasty.
The aim of the study was to analyze the effectiveness of the enhanced recovery program during planned surgery for urethral stricture.
Material and methods. A prospective randomized clinical trial was conducted in 80 patients treated in the period 2018-2022. All patients were divided into two comparison groups: the standard treatment protocol (n=42, group I; St), and the group cured by the ERP protocol (n=38, group II; ER).
Results. Both protocols lead to the restoration of independent adequate urination equally (85.7% vs 94.7%; p=0.758). The logrank criterion did not reveal statistically significant differences in the frequency of survival (p = 0.398) or relapse (p=0.218) in the long-term postoperative period in the comparison groups.
A comprehensive assessment of outcomes demonstrates better results when using the enhanced recovery protocol (p=0.0006) in comparison with the standard therapeutic approach due to less perioperative stress, speedy recovery and better perception of therapeutic and diagnostic procedures.
Conclusion. The use of the developed protocol of enhanced recovery makes it possible to improve the results of surgical treatment of urethral stricture disease. 

The purpose of the study presented in the article was to perform macroscopic, microscopic and qualitative analysis of Oxytropis rosea Bunge.
Material and methods. Grass and roots harvested from the wild plants in the Kyrgyz Republic were used for the research.. For qualitative chemical analysis, aqueous, water-alcohol and alcohol extracts with 70%, 96% ethyl alcohol were obtained. Known chemical reactions to flavonoids, polysaccharides, alkaloids, saponins, coumarins, anthracene derivatives, tannins were carried out with the aqueous and alcoholic extracts obtained from this plant. Alkaloids were also studied by thin-layer chromatography. Thinlayer chromatography was performed on Sorbfil aluminium foil analytical plates (PTLC-AF-A) of 100x150 mm in a benzeneethanol system (9:1). The chromatograms were developed with Dragendorf reagent.
Results. Diagnostic morphological and anatomical features of the plant have been established, which can be used to identify raw materials. The presence of groups of biologically active substances such as flavonoids, coumarins, saponins, tannins, alkaloids, has been established. Chemical and chromatographic studies have shown that the raw materials contain alkaloids, however, to establish their group affiliation and structure, a more detailed study using instrumental analysis methods is necessary. These studies can be used to develop regulatory documentation for O. rosea raw materials. 

Urological complications (UС) can become the main cause of prolonged hospitalization, transplant loss, septic condition and pose a threat to the patient's life, despite the constant emergence of new preventive measures and increasingly advanced treatment methods. The incidence of UC in kidney transplantation (KT) ranges from 2.5 to 14.1%, which determines the relevance of scientific research in this field of medicine.
Objective: To study the features of the clinical course and the possibility of using native ureter during reconstructive operations after KT.
Material and methods. In the Republic of Bashkortostan over the period from 1996 to 2022, 568 kidney transplantations were performed. UC associated with ischemia and necrosis of the ureter of the renal graft were detected in 16 (2.8%) cases. For the first time, native ureter for KT in the Republic of Bashkortostan was used on 26.11.2009 in a patient with 4th kidney transplant.
We present our own experience of pyeloureteroanastomosis reconstruction using a native ureter for total ureter necrosis of a transplanted kidney. Reconstructive plastic surgery using a native ureter became a forced measure and allowed to achieve the desired clinical effect.
Conclusions. The use of pyeloureteroanastomosis with the recipient's own ureter can be considered a fairly universal way to restore the passage of urine through the urinary tract in the case of both «high» necrosis and stricture of the ureter of the transplant. 

The cause of the development of sclerosis of the bladder neck after surgical treatment of benign prostatic hyperplasia (BPH) is seen in the presence of concomitant chronic prostatitis, and the process of sclerosis begins in the postoperative period, as a consequence of injury or exacerbation of the inflammatory process in the neck of the bladder. At the same time, sclerotic processes are most active in hypoxia, and the inflammatory process only aggravates the situation. The method of transurethral laser incision of the bladder neck in secondary sclerosis is one of the justifiable in clinical practice. However, some patients have relapses of the disease in the early and long-term postoperative period.

Nowadays, the stromal vascular fraction (SVF) has attracted increasing attention of doctors as a source of progenitor cells, or cellular material, for regenerative processes. Given the content of various populations of progenitor stem cells, SVF can be isolated and used in various pathological conditions.

The article is devoted to the long-term results of the use of perineostomy (perineal urethrostomy) in the treatment of four patients with extended strictures and obliterations of the anterior urethra of different etiologies. The analysis of the performed opera- tions made it possible to determine the optimal variant of open perineostomy, which, in fact, is our modification of the Johanson‘s operation. The results obtained allow us to consider our proposed option as optimal.

Objective is to analyze the results of simultaneous surgical correction of the pathology of combined stress urinary incontinence (SUI) and cystocele II-III.
Material and methods. The results of surgical treatment of 25 women with SUI and cystocele II-III according to the ROP-Q international classification. Simultaneous surgical treatment of women with SUI and cystocele II III degree with the accurately diagnosed absence of apical prolapse is possible. We performed surgical correction of SUI using the synthetic tape of the Urosling type manufactured by the Lintex company (Russia), correction of cystocele II-III degree was carried out using the patient's own tissues in the anterior colporrhaphy operation.
Results. The results of interventions in 25 patients who underwent a simultaneous correction of cystocele and SUI were evaluated by cystocele reduction and continence control. One patient had relapse of cystocele and SUI 3 months after the operation due to the non-compliance with the doctor’s recommendations. The patient did not limit her physical activity. There was no cystocele recurrence in 24 patients 10-15 months after the operation. At 10 to 15 months after surgery, 22 out of 25 women had no signs of SUI. At 6 to 7 months after surgery, a slight leakage of urine caused by a strong cough was observed in 2 patients.
Conclusions. The results of the performed 25 simultaneous surgical corrections of cystocele in the concomitant SUI give the tangible prospects for the applied method of surgical treatment of these pathologies. 

Urolithiasis is a multifactorial metabolic disease caused by the interaction of genetic and environmental factors. Today, the study of urolithiasis is a hot topic due to the steady increase in both incidence and prevalence, as well as the high recurrence rate of this disease. In urolithiasis, the majority of concrements are forming on the base of calcium salts. The study of the molecular and genetic aspects of hypercalciuria is a promising way to improve urolithiasis control. Claudins are the proteins of renal epithelium tight junctions that play an important role in the calcium reabsorption in kidney.
In this review, we describe actual worldwide data on the epigenetic regulation of kidney claudins activity via small noncoding RNAs and the perspectives of using “claudins – microRNA” system components for the urolithiasis targeted pharmacotherapy. The article contains information on the segment-specific expression of claudins in nephrons, claudinopathies associated with impaired calcium metabolism in the kidneys, tight junctions as dynamic equilibrium systems, microRNA biogenesis and principles of action, various therapeutic strategies using microRNAs. 

Computer-assisted ejaculate analysis (CASA) is one of the ways to assess morphokinetic parameters of spermatozoa and is intended to simplify manual assessment of ejaculate by a specialist. CASA is characterized by high objectivity and representativeness of the study, a large number of investigated parameters, high study speed, automatic data capturing, short staff training time, and possibility of sperm hyperactivation assessment. To date, a number of problems remain in the use of this technique, such as dependence on hardware and software, the need for internal quality control and the possibility of false-positive or false-negative results. However, with the development of technology there are plans to overcome these difficulties. In the future, the transition from calculating changes in the position of the sperm cell head to the evaluation of the flagellar wave is expected, which will help to avoid errors, and better characterize the kinetic characteristics of the cells. Possible development of CASA could be new ways of using the technique, such as evaluation of the number of antisperm antibodies, determination of DNA fragmentation level, improving the quality of sperm selection for intracytoplasmic sperm injection (ICSI) program.

Objective is to analyze the prevalence, clinical manifestations, diagnostic features and outcomes of incrusting cystitis and pyelitis (IC and IP, respectively) in patients with kidney transplantation according to the literature.
Material and methods. Russian and foreign literature in Russian and English was searched in Medline/PubMed, RSCI/Elibrary, CyberLeninka, Google Scholar databases. The analysis included journal articles, literature reviews, original studies, and clinical cases. Materials from conference proceedings, abstracts, dissertations, textbooks, and training manuals were not considered. Since IC and IP are rare conditions, the search covered the works published from 1992 to 2022.
Conclusions. Renal transplant recipients should be considered a high-risk group for the development of an incrusting urinary tract infection due to Corynebacterium urealyticum. The outcome of these diseases is difficult to predict, so the diagnosis of IC and IP should be made as soon as possible. Untimely or inadequate treatment in patients who underwent kidney transplantation is highly likely to result in graft loss. 

All modern methods of nuclear medicine used in assessing the state of the urinary system in children are presented in the article. With an emphasis on clinical interpretation, the main points of dynamic and static nephroscintigraphy scanning, radionuclide direct and indirect cystography, as well as hybrid SPECT study are described the purpose of each study, the tasks to be solved during the study, the features of clinical evaluation. It is indicated that the full planning of research technologies, taking into account the anatomical and functional state of the kidneys and the urinary tract is the key to successful diagnostic and determination of the way of treatment. In particular, the authors present diagnostic technologies developed and implemented by them in practice over the past 10 years, such as direct radionuclide cystography and SPECT with dynamic nephroscintigraphy. This work, on the one hand, will allow doctors of clinical practice, pediatric urologists-andrologists, nephrologists, urologists to get more information about the methods of radionuclide diagnostics, and on the other hand, it will be useful for nuclear medicine specialists in understanding clinical tasks.