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The aim of the work is to analyze the scientific literature data on the principles and state of rational antibiotic therapy use according to factors for the development of inflammatory changes in the urinary tract with the identification of the latter in the complex therapy for urolithiasis, taking into account the peculiarities of contact laser lithotripsy. The article presents the results of analytical processing of professional publications on current principles of rational antibiotic therapy in the surgical treatment for urolithiasis, taking into account factors that may influence the development of inflammatory changes in the urinary tract. It has been revealed that there is currently no clear understanding about chances of developing infectious processes during the treatment for urolithiasis of various localization, as well as the advisability and duration of using antibiotics in the comprehensive treatment of the disease. At the same time, antibiotic overuse has resulted in phenomena of resistance, side effects, and a number of other complicating factors needed to be addressed. Conclusions. An analysis of present approaches to antibacterial therapy, considering its rationality at different treatment stages, has been conducted concluding that clear criteria and indicators for the use of drugs have not been specified, but these data serve only as recommendations and have not been thoroughly examined. Data on searching for a solution to problematic aspects are also provided.

The aim of the study was to analyse the microbial profile of the urinary tract infections (UTIs) due to urolithiases and to study susceptibility to antibiotics in its causative agents. The main method of the research was bacteriological. Antimicrobial susceptibility testing was conducted by serial microdilution assay in accordance with recommendations of the European committee on antimicrobial susceptibility testing (EUCAST). For present study 128 unique urine samples were collected from patients with UTIs associated with urolithiasis. Among all collected specimens, 78% (n=100) gave clinically signi­ficant growth. Among all examined participants, 88.9% of women (64/72) and 64.3% of men (36/56) had confirmed UTI; in the study, female/male ratio was 1.4 (χ2=9.76; p

The aim of the work is to analyze the scientific literature data on the principles and state of rational antibiotic therapy use according to factors for the development of inflammatory changes in the urinary tract with the identification of the latter in the complex therapy for urolithiasis, taking into account the peculiarities of contact laser lithotripsy. The article presents the results of analytical processing of professional publications on current principles of rational antibiotic therapy in the surgical treatment for urolithiasis, taking into account factors that may influence the development of inflammatory changes in the urinary tract. It has been revealed that there is currently no clear understanding about chances of developing infectious processes during the treatment for urolithiasis of various localization, as well as the advisability and duration of using antibiotics in the comprehensive treatment of the disease. At the same time, antibiotic overuse has resulted in phenomena of resistance, side effects, and a number of other complicating factors needed to be addressed. Conclusions. An analysis of present approaches to antibacterial therapy, considering its rationality at different treatment stages, has been conducted concluding that clear criteria and indicators for the use of drugs have not been specified, but these data serve only as recommendations and have not been thoroughly examined. Data on searching for a solution to problematic aspects are also provided. [ABSTRACT FROM AUTHOR]

Introduction: Kidney stones disease is a medical condition when hard deposites made of various minerals and substances form inside kidneys. It may lead to clinical symptoms as severe pain felt in the belly area or side of the back. Also it can radiate and reach testicles, groin area, labia. Other symptoms may include blood in the urine, abnormal color of urine, fever, nausea, vomiting. Because of growing incidence rate- adequate question is how can we protect ourselves from kidney stones development by changing habits. Aim of study: Fundamental aim of study is to demonstrate how daily, routine habits changes may have a huge impact on kidney stones development risk. State of knowledge: There are a lot of confirmed parameters and factors which can lead to kidney stones devolopment. Factors that increase risk of developing kidney stones include: dehydration, diet (meat intake, fruit/vegetables intake, sodium intake), family or personal history, obesity, digestive diseases and surgery, metabolic disorders, urinary track infections, anatomical abnormalities- obstruction of the kidney, calyceal diverticulum, horseshoe kidney, ureterocele. This group includes many modified factors, so lifetime risk of kidney stones depends also on our habits and way of life. Conclusion: There are many modified factors which may lead to this disease and because of that it is crucial to improve patients and whole society awareness about them. By appropriate daily habits changes we can significantly reduce risk of lifetime kidney stone disease development. It is important to know that concrete reports and analyses were made and they demonstrated scientifically proven correlations.

Urinary stone disease (USD) is a polyetiological urological disease caused by both exogenous and endogenous factors, including hereditary ones. It is characterized by the appearance of stones in the kidneys and urinary tract, and a tendency to relapse, often with a severe course. Almost 25 % of stones consist of uric acid (UA). The leading role in the pathogenesis of urate nephrolithiasis (UN) is played by disorders of purine metabolism, which are characterized by the development of hyperuricemia (HU) and hyperuricuria. The aim of the work is to review modern literary sources on the role of purine metabolism disorders in the etiopathogenesis of UN. Results. The development of UN depends on the constancy of the acidic urine pH, as well as on a decrease in diuresis, HU and hyperuricuria. UA is the final metabolite of purine metabolism and the main stone-forming substance in patients with UN. HU develops both due to uncompensated disorders of purine metabolism with a decrease in renal secretion and intestinal uricolysis (excretion pathway) and excessive intake of purine bases in the body and their increased synthesis in vivo (metabolic pathway). Citric acid, as one of the main metabolites of the tricarboxylic acid (TCA) cycle, is connected through the corresponding substrates to the formation of purines and the metabolite of amino acid metabolism, glutamine. TCA is connected to the cycles of urea, glyoxylate and purine bases through α-ketaglutaric acid. It is a substrate of citric acid, and it affects the synthesis of glutamate, which combines with ammonia to form glutamine, used in the cycle of purine synthesis. Conclusions. The role and diagnostic value of purine metabolism upsets, disorders of the TCA (citric acid), amino acid metabolism (glutamine), the activity of xanthine oxidase is a key enzyme in purine synthesis which passes through TCA with the participation of its metabolite α-ketaglutarate, have been established. TCA is bound to glutamine, rich in nitrogen, which is necessary for the synthesis of purine bases.

Asymptomatic hyperuricemia is associated with many somatic diseases, the onset and progression of chronic kidney disease (CKD), with an increase in cardiovascular and general mortality. Symptomatic hyperuricemia - gout and various variants of kidney damage, despite the availability of modern rheumatological, urological and nephrological guidelines, does not lose its relevance, as it is characterized by a severe course, significantly worsens the quality of life, increases cardiovascular risk and leads to disability. Hyperuricemia is a persistent increase in the concentration of uric acid (UA) in blood serum (above 360 μmol/l). The appointment of urate-lowering therapy (ULT) for gout is based on the Guidelines of the American College of Rheumatology (ACR, 2020), the European League Against Rheumatism (EULAR, 2016), the National Institute for Health and Care Excellence (NICE, 2022), in the case of urolithiasis - the Guidelines of the European Association of Urology (EAU, 2023) and the American Urological Association (AUA, 2019). Asymptomatic hyperuricemia, from the point of view of the evidence base, requires only the use of lifestyle modification measures. The Austrian Society of Rheumatology and Rehabilitation for patients with gout and hyperuricemia in 2022 proposed dietary and lifestyle recommendations, including sour cherries (Montmorency), which can lower UA levels. Combination of concentrated Montmorency tart cherry powder (1:50) and dry willow extract is an innovative strategy for the treatment of asymptomatic and symptomatic hyperuricemia, a natural hypouricemic agent with an antiinflammatory effect, which is prescribed as a complementary therapy for gout and hyperuricemia in: cardiovascular diseases, diabetes and metabolic syndrome, CKD, urolithiasis. The appointment of сombination of concentrated Montmorency tart cherry powder (1:50) and dry willow extract will contribute to the achievement of the target value of the UA level in the blood serum of patients with asymptomatic and symptomatic hyperuricemia, the initiation of reno- and cardioprotection, the reduction of the risk of gout attacks, and the achievement of a stable and long interrelapse period. [ABSTRACT FROM AUTHOR]

Percutaneous nephrolithotomy (PCNL) is a classic operation for the presence of large calculi in the kidneys. A channel size of 24-30 Fr is a standard surgical access incision. The smaller surgical access incisions (<18 Fr) were originally introduced in pediatrics, but are now increasingly used in the treatment of adults. Access to the renal cavity system in most clinics is performed under X-ray control, but the combination of this method with ultrasound control demonstrates a number of advantages over the mono-control method. The objective: to analyze the results of treatment of patients with kidney stones by the method of mini-percutaneous nephrolithotomy (mini-PCNL) under fluoroscopic and combined (ultrasound and fluoroscopic) control, to determine the optimal control method during puncture, dilatation and intraoperative assessment of Stone-free status. Materials and methods. For a realization of the research aim, a retrospective analysis of medical documentation was conducted on the basis of the "Institute of Urology named after Academician O. F. Vozianov of the National Academy of Medical Sciences of Ukraine". The study included 178 medical cards of patients from 18 to 72 years old with kidney stones, in which mini PCNL was performed under combined control in 95 cases (Group 1), and under fluoroscopic control (Group 2) in 83 cases. Clinically relevant parameters were studied, including the dynamics of postoperative serum creatinine and hemoglobin, blood loss, total operative time, duration of ionizing radiation, and duration of hospital stay. Postoperative complications that occurred in patients during their stay in the hospital were classified according to the Clavien-Dindo system. To assess the Stone-free state at the stage of discharge from the hospital, the patients were performed kidney ultrasound and general urography. The Student's t-test and the chi-square test were used to compare anthropometric indicators and clinical results associated with both methods of control in mini-PCNL. Statistical data analysis was performed using program STATISTICA 10 (StatSoft.Inc). Data were calculated as mean ± standard deviation or percentage with a significance level of p<0.05. Results. Groups of patients were identical by age, sex, anthropometric parameters, and characteristics of calculi. However, the average operation time for mini-PCNL under combined control was significantly shorter (96.2±23.0 vs. 127.4±33.1 min; p<0.05). The average duration of ionizing radiation was significantly shorter in the group with combined control (10.6±4.8 vs. 284.0±86.0 sec; p<0.05). Conclusions. Combined control offers a wider range of incision access to the renal cavity system and the creation of a safe percutaneous working channel in real-time mode. Mini-PCNL under combined control has comparable clinical results to intervention under fluoroscopic control with significantly lower indicators of the duration of the operation time and a reduction in the radiation time of the patient and the operating team. [ABSTRACT FROM AUTHOR]

Urinary stone disease (USD) is one of the most common urological diseases occurring mainly in people of working age. USD is associated with metabolic disorders, the causes of which include endogenous and exogenous factors. Metabolic syndrome (MS) is a “non-infectious epidemic” that manifests itself in diabetes, hypertension, atherosclerosis, and obesity. The bidirectionality of metabolic processes is an important factor of USD and MS. Aim. The paper aims at reviewing modern literary sources regarding the determination of pathogenetic links between the comorbidity of USD and MS. Results. Nephrolithiasis spreads and recurs simultaneously with obesity. A decrease in urine pH, which is the basis for the formation of urate stones, is associated with the presence of obesity, insulin resistance, and MS. Under such conditions, urine alkalinization is the main treatment for urolithiasis. The risk of stone formation increases when the body mass index is more than 30 kg/m2. Among patients with insulin resistance, nephrolithiasis is more severe, and kidney stones occur more often. The relationship between the hypertensive component of MS and USD has been established. Disorders of lipid metabolism have a negative prognosis, causing physicochemical aberrations in urine and the development of nephrolithiasis. Hyperuricemia is related to both the ability of insulin to reduce uric acid clearance in the proximal renal tubules and insulin resistance. The link between USD and chronic inflammation is based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids, which leads to the development of hyperoxaluria in patients with MS. Clinical studies show the formation of kidney stones in conditions of oxidative stress, an association between stone formation and the development of MS, coronary heart disease, arterial hypertension, which is the result of common pathogenetic characteristics. Conclusions. The comorbidity of USD and MS is a systemic disorder. Kidney stone formation is associated with a decrease in urine pH against the background of MS. Hyperuricemia is comorbid with insulin resistance, dyslipoproteinemia, arterial hypertension, and abdominal obesity. Systemic chronic inflammation, comorbid with obesity and USD, based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids. Oxidative stress has a common pathogenetic link between stone formation and insulin resistance, atherosclerosis, hypertension, and obesity.

The aim of the work is to study the peculiarities of the course of urate nephrolithiasis and urate nephrolithiasis comorbid with metabolic syndrome. Materials and methods. Clinical and laboratory data of 183 patients. The control group of patients with urate nephrolithiasis received traditional therapy. The patients of the main group with urate nephrolithiasis comorbid with metabolic syndrome took quertin and traditional therapy, as well as popular medical drugs that correct metabolic processes. Clinical laboratory, biochemical, ultrasound, radiological, radioisotope, immunoenzymatic, and physical-chemical methods were used. Results. The pain was more intense in patients with urate nephrolithiasis than in patients with urate nephrolithiasis comorbid with metabolic syndrome. Manifestations of the inflammatory process increased in patients with urate nephrolithiasis comorbid with metabolic syndrome, and concomitant diseases intensified the excretion of stone-forming compounds. Metaphylaxis with quertin against the background of commonly accepted drugs that correct metabolic processes had a positive effect on the course of urate nephrolithiasis comorbid with metabolic syndrome and contributed to the reduction of stone formation relapse. Conclusions. In-depth diagnosis of metabolic processes can help the doctor to correctly determine the differentiated tactics of examination and treatment, as well as to prevent possible complications in a timely manner.

Urolithiasis is a condition which is commonly encountered in practice, however retrograde migration of a calculus within the ureter has only recently been documented with few cases reported in the literature. We present the case of a 47-year-old woman presenting with symptomatic urolithiasis confirmed by CT who recovered from her symptoms only for it to be discovered that the calculus had undergone retrograde migration into the renal calyx on a follow up CT examination. We theorise that retrograde urolithiasis migration may be an innate safety mechanism that evolved to prevent complications and/or death from urolithiasis impaction by attempting to return a migrated lithiasis to the renal calyx.

Urinary stone disease (USD) is the most common and progressive disease of the urinary system, which is characterized by frequent exacerbations and a severe course. This is a complex disease caused by various causes, in which several biochemical processes are involved, occurring not only in the urinary system, but also in the whole organism. USD depends on geographical, climatic, ethnic, dietary and genetic factors. Over the past 20 years there has been an increase prevalence of this disease. The course of USD is characterized by the acute and chronic pyelonephritis and frequent recurrence, which leads to the development of renal failure, disability and fatal consequences. Calculus can form de novo anywhere in the urinary tract. The pathophysiology of USD differs depending on the place of stone formation and depends on endogenous and exogenous factors. Urinary tract stones are classified depending on etiology, location, size, number, frequency of occurrence, and radiopacity. The main symptoms of USD are pain of various nature; microscopic hematuria; dysuria, which most often indicates the presence of a stone in the urinary bladder or a low location in the ureters; discharge of crystals of urinary salts or concretions; increased body temperature. The diagnosis of USD is based on a carefully history taking and physical examination, which allows to determine the correct direction of diagnostic approach, which include laboratory and instrumental methods of diagnosis. Ultrasound diagnosis is used as the main method for visualization of calculi, but recently non-contrast-enhanced computed tomography has become the standard for the diagnosis of acute low back pain, replacing intravenous urography. The choice of treatment is based on many parameters, such as the number, size, morphology, shape, volume, mobility, hardness and location of the stones and is individualized for each patient. There are two main approaches: conservative treatment and surgic al one. Medicinal treatment of USD is used primarily to prevent the repeated formation of new stones or to increase those inclusions that are already present in the organs. Drug therapy is carried out with the aim of normalizing processes in the body, the failure of which leads to the development of pathology. However, conservative treatment has its limitations and is most often used as a symptomatic treatment. Open laparoscopic interventions are rarely used recently, minimally invasive methods are more popular: extracorporeal shock-wave lithotripsy; ureterorenoscopy; percutaneous nephrolithotomy. Taking into account the increase in the prevalence of USD in Ukraine and disability (the third place among the general spectrum of causes of disability in urological practice), the article analyzes and reviews modern approaches to classification, early and accurate diagnosis, and choosing a timely and correct method of treatment. [ABSTRACT FROM AUTHOR]

Urinary stone disease (USD) is associated with the formation of sand and calculi in the organs of the urinary system. This is a common chronic pathology, which is characterized by the frequent exacerbations and a severe course. Without timely treatment, USD threatens of the urinary tract blockage and intoxication of the organism. The article emphasizes the importance of carefully the treatment choose of patients with stones of the upper urinary tract and vascular and cardiac pathologies, because these nosologies have common etiological links and are related to age and sex. An analysis of methodological and scientific literature was carried out to study approaches to the treatment of patients with USD with comorbid vascular and cardiac pathologies. Various methods were used, namely: the search for methodological and scientific literature, in particular induction and deduction, comparison, classification, systematization, abstraction and specification, analysis of documentation. The analysis of approaches to the treatment of patients with stones of the upper urinary tract demonstrated that there are two main approaches to treatment - conservative therapy and surgical treatment. Due to a number of reasons, conservative medical treatment can be used only in some cases as the method of choice for the treatment of patients with USD. The use of extracorporeal shock wave lithotripsy (ESWL) for the destruction of stones in the kidneys and ureters significantly increases the effectiveness of treatment of the patients. However, in patients who were operated for cardiovascular pathology, in the case of complete withdrawal of anticoagulant therapy, even for a short period, the risk of complications increases. Therefore, before performing ESWL in such patients, it is recommended to reduce the anticoagulant dose or switch to low-molecular-weight heparins 3-4 days before the planned surgical intervention. During the treatment of patients with calculi of the upper urinary tract and vascular and cardiac pathologies, a careful choice of treatment and the involvement of related specialists are necessary. [ABSTRACT FROM AUTHOR]

The domestic cat has a predisposition to diseases of the genitourinary system. Among the diseases of the lower urinary tract in a domestic cat, the leading place belongs to cystitis. Among cats living in city apartments, compared with cats on free range, the diagnosis of idiopathic cystitis is 2.5 times more common . The lack of contact of the organism with the environment and threats has led to a decrease in the resistance of cats to stress. Prior to the publication of this article, there was no official information on the age and breed predisposition to idiopathic cystitis in domestic cats within the metropolis of Ukraine. We identified the following groups of pathologies: idiopathic cystitis, urolithiasis, bacterial cystitis and urethral plugs. 2 age groups of animals were formed - up to 6 and older than 6 years. The study involved domestic cats of 29 breeds. The study is retrospective and multicenter and it includes data obtained on the basis of outpatient journals of the network of Zoolux clinics from 09.10.2020 to 12.07.2021. A total of 384 clinical cases were used in the study, of which 44 were eliminated. Idiopathic cystitis was diagnosed in 256 animals (75.3%), of which males - 159 (62.1%) and females - 97 (37.9%). Domestic cats under 6 years of age (179 animals, 69.9%) most often suffered from idiopathic cystitis. Domestic cats of Eastern European breeds were the largest population among patients with idiopathic cystitis of cats of long- and short-haired breeds (138 animals, 53.9%).

Under the action of exogenous, androgenic, genetically determined factors, the metabolism of stone-forming salts of calcium, phosphorus, magnesium, oxalates, uric acid in the blood serum and their active excretion by the kidneys to the state of hypersaturation (oversaturation) is disturbed) urine is formed. When the level of crystallization inhibitors is disturbed, a saturated salt solution crystallizes with the formation of microliths. The formation of stones in the kidneys is possible only in the presence of «building material» - supersaturated saturated urine, therefore, hyperoxaluria is a pre-stone condition. Treatment measures should be aimed at correcting mineral metabolism in the body after establishing the type of hyperoxaluria using laboratory tests: salt transport, calcium load, dietary test - low-calcium diet, thiazide test and determination of the mineral composition of the removed (removed) stone. Genetically consequential conditions (10–15%) count about 30 varieties in which the main sign or symptom in the manifestation of the disease is urolithiasis. Unfortunately, congenital tubulopathies are not sufficiently studied, so the treatment is symptomatic, in some cases simultaneous kidney and liver transplantation options are possible. Clinically, 4 main forms of hypercrystalluria are distinguished: hypercalciuria, hyperoxaluria, hyperuricuria, phosphaturia and mixed forms of crystalluria. Acquired forms of hypercrystalluria, of which they are absorptive (type II intestinal hyperabsorption - absorptive hypercalciuria and absorptive hyperoxaluria), are of main clinical interest, which is characteristic of the course of calcium-oxalate urolithiasis. Metaphylaxis of calcium-oxalate urolithiasis is formed on the basis of these data. [ABSTRACT FROM AUTHOR]

Abstract Introduction and aim of the study: Urolithiasis is a disease involving the formation of deposits in the lumen of the urinary tract. The continued development of minimally invasive treatment methods allows for more effective treatment with greater operator comfort and less risk to the patient. It has been concluded that retrograde intrarenal surgery (RIRS) is superior to other therapeutic methods in many respects. The aim of this study is to review the available studies and publications and to identify potential complications following treatment of kidney and ureteral stones by RIRS, with a particular focus on infectious complications and their risk factors. Method and materials: We reviewed the literature available on PubMed and Google Scholar, using the words 'urolithiasis'; 'urolithiasis treatment'; 'retrograde intrarenal surgery'; 'infectious complications of retrograde intrarenal surgery'. Results: Among the risk factors associated with infectious complications after RIRS, long duration of surgery, recent positive urine culture, urinary tract infections or antibiotic use, purulent urine, urinary nitrites, obstructed access through the ureter, struvite stones, co-morbidities play a special role. Conclusions: Among the complications of surgical treatment of nephrolithiasis and ureteral stones by RIRS, infectious complications are of particular concern. In view of the knowledge of their risk factors, preventive measures should include limiting the duration of surgery, possible antibiotic therapy and considering the use of a larger diameter UAS. This is especially true for patients with abnormal urine results, struvite stones, a history of urinary tract infection or predisposing comorbidities. Key words: Urolithiasis; Kidney Calculi; Retrograde Intrarenal Surgery; Urolithiasis infection;

Background Double J stent (DJ) is widely used in urological practice in patients with renal stones. However, its application is related to the risk of incrustation. We present a case of severe calcification of forgotten DJ in a patient with previously undiagnosed hyperparathyroidism (HPT). Case presentation A 30-year-old female was admitted to the Urology Department with renal colic. An initial kidney, ureter, and bladder X-ray revealed a completely calcified DJ catheter placed twelve months earlier. Unfortunately, the patient did not show up for a follow-up visit, and stent removal was not performed. Due to the extent of the disease, the patient was qualified for multistage endoscopic treatment. Total treatment lasted six months and consisted of five urereroscopies and one hybrid procedure. Simultaneously, diagnostics of a metabolic cause of the advanced stone disease suggested primary hyperparathyroidism, confirmed during parathyroid scintigraphy. After urological treatment had been completed, parathyroidectomy was performed. During a further 7-year follow-up, only one episode of renal colic occurred within the first year after treatment. The patient is stone-free until the present day. Conclusions Stents are designed to last usually up to six months, but they should be removed as quickly as possible after finishing treatment. Also, other causes such as a metabolic or hormonal imbalance should be considered. In our patient combination of forgotten DJ and HPT was the reason for excessive stone formation. Selective removal of the parathyroid gland was effective in the presented patient, with no stone recurrence observed.

Urolithiasis is a disease which is characterized by the formation of stones in the urinary system and is one of the most actual problems in modern urology and medicine worldwide. Recently, there has been a steady spread of this disease. Urolithiasis ranks the second position in the structure of urological diseases in Ukraine, second only to infectious and inflammatory pathologies and accounts for 30-45 % of diseases of the genitourinary system. Urolithiasis is manifested by the appearance of stones in the urinary system (most often the kidneys). The most common type of kidney cancer (KC) is renal cell carcinoma. It accounts for about 97 % of all kidney tumors. With the increase in the number of patients with renal tumors and urolithiasis, there is a clear tendency to increase the number of patients with a combination of these two serious diseases. Unfortunately, the question of the relationship and interdependence between the development of urolithiasis and kidney tumor remains open today. The objective: to search, systematize and analyze scientific publications about the mechanisms of development and treatment of this combined pathology. Infection and chronic inflammation cause the development of urothelial proliferation and the emergence of malignant neoplasms. Inflammatory cells secrete cytokines and chemokines in response to a chronic recurrent infectious-inflammatory process that causes tumor cell growth and tumor progression. Special attention in the publications is paid to the role of endothelial dysfunction in the development of kidney tumors. The importance of vascular endothelial growth factor (VEGF) in the mechanism of neoangiogenesis of KC is demonstrated. Management of the patients with combined pathology of urolithiasis and KC involves the doctor’s choice of the optimal method. The analysis of literature publications demonstrates that today there are a number of issues devoted to the presence of KC and urolithiasis in one patient. These are the risks of such a combination, and the mechanisms of development, as well as determining the most rational and effective management in each case. All above mentioned cause the need for further study of the treatment of patients with urolithiasis and kidney tumor. [ABSTRACT FROM AUTHOR]

Urolithiasis is common condition affecting more than 10 % of well-developed country’s population. Formation of the stones may have few different causes. Stones can be classified by size, location, etiology, composition, and risk of recurrence. Evaluation of the stones should consist of imaging : X-Ray, CT, USG. When dealing with staghorn calculi PCN approach should be method of choice. This procedure is relatively safe and effective. In this paper we would like to present a case report of large and very hard complete staghorn calculi which was managed by the PCNL

Urolithiasis is a disease unit more common in adult patients. However in the pediatric population it is also animportant clinical problem due to high risk of recurrence in the patient’s life among others. Hyperkalciuria, hyperuricemia, hyperoxaluria and cystinuria secondary to metabolic disorders promote stone formation.The aim of this study is the presentation of a case of a girl with multiple congenital anomalies, bilateral staghornurolithiasis and bladder stones developing in the course of hypercalcemia.The patient was diagnosed with urolithiasis at the age of 2 months. The course of the disease in her case is characterized by extremely frequent recurrences and numerous urinary tract infections of various aetiology, includinghigh-resistant bacterial strains. These infections were often turbulent and required hospitalization. Due to the extentof urolithiasis, invasive treatment was necessary, both in the lower and upper urinary tract. Endoscopic techniques(transurethral cystolithotrypsy and ureterorenoscopy) were used in urinary bladder and ureter urolithiasis. Renaldeposits were removed by the use of open access surgery (pyelolithotomy with intrarenal lithotrypsy).Although the ongoing development technology and miniaturization of equipment have allowed and popularizedminimally invasive treatment of urolithiasis, some exceptional cases still require surgical treatment with open surgery.The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocolwas approved by the Local Ethics Committee (LEC) of all institutions. No conflict of interest was declared by the authors.

Introduction. Contemporarily urolithiasis is a serious problem in nephrology. This disease is conditioned by many factors, including climatic, geographical, ethnic and genetic. The most important ones, however, include diet and the composition of urine excreted. Urolithiasis can be symptomatic and asymptomatic. There are many methods of its treatment. The most commonly used methods are pharmacological and surgical ones, and modern treatment methods are also on their increase. Untreated urolithiasis can lead to many complications. Aim. The aim of the study was to determine the tasks of a nurse in the care of a patient with urolithiasis treated with percutaneous nephrolithotripsy. Methods and materials. The individual case method was used in the study, using the following research techniques: nursing interview, observation, measurement and documentation analysis. The research tools used for the study include the Individual Nursing Care Card, the Visual Analogue Scale - VAS, risk of postoperative nausea and vomiting- the Apfel score. Findings. Nine nursing diagnoses based on the patient's health issues were made during the study process. Conclusions. The nursing problems concerning the patient result from surgery and hospitalization.

Background. The study of the problem of urolithiasis in recent years has reached a qualitatively new level in connection with the use of a multidisciplinary approach and the principles of evidence-based medicine. In the domestic literature, there are isolated reports on the meaning and methods of correction of metabolic disorders in urolithiasis. There is still no consensus on the feasibility and effectiveness of preventive methods after the removal of stones. The purpose of the study: assessment of the effect of phytotherapy (Urolesan®) on the metabolic status and urine microbiota in patients with urolithiasis — calcium oxalate nephrolithiasis after shock wave lithotripsy. Materials and methods. In 50 patients with calcium oxalate nephrolithiasis aged 18 to 65 (middle age — 41.1 ± 1.6) years, the effect of Urolesan® on the metabolic status (the impact on urine pH, the level of oxalate, calcium, uric acid excretion, indicators of biochemical blood tests), features of urine microbiota and prevention of the recurrent formation of calculi were studied after shock-wave lithotripsy. Results. An analysis of the dynamics of urine pH, measured on days 2, 5, 10, 20, and 30 of treatment with Urolesan®, showed that the patients undergoing a follow-up examination had a gradual increase in urine pH from 5.80 ± 0.04 to 6.13 ± 0.04 on day 5 (p < 0.05) and up to 6.47 ± 0.04 — on day 30 (p < 0.05). The dynamics of oxalate and calcium urine excretion showed that after a month of treatment with Urolesan®, the daily excretion of oxalate decreased by 1.5 times, and calcium — by 1.2 times compared with baseline (p

Summary Aim: An attempt to assess the expression of the CLDN14 gene at the mRNA level in patients diagnosed with urolithiasis in relation to healthy persons constituting a comparative group. Material and methods: The material for examinations was peripheral blood from 23 patients, including 12 women and 11 men with diagnosed kidney stones disease and 6 donors (control group), including 2 women and 4 men who did not have kidney stones. Results and conclusions: The studies showed differences in the level of CLDN14 gene expression in both the examined and the comparative group. Key words: CLDN14, gene expression, urolithiasis

Kidney stone disease is one of the most common disorders and can be considered a disease systmetic. It occurs in about 5-20 % of all population. Due to the chemical composition of deposits there are several types of kidney stones including calcium oxalate, calcium phosphate, uric acid, magnesium-amonium, phosphate, cysteine. Nephrolithiasis is more common in men than in women. Kidney stones are formed as a result of the crystallization of minerals and their salts. The cause of stone formation in the kidneys also contributes some drugs (such as corticosteroids), hyperparathyroidism, osteoporosis, long-term treatment of peptic ulcer with alkalizing preparations, overdose of vitamin D and improper diet. The most important in treatment of renal colic is relieving pain. Sometimes it is enough to administer analgesics, but sometimes it is necessary to administer strong opioid drugs. Effective medical treatments including thiazide, potassium citrate, acetohydroxamic acid can prevent new stone formation in most patients.

Aim. To study clinical peculiarities of chronic obstructive pulmonary disease in patients with comorbid chronic pyelonephritis on the background of urolithiasis with oxaluria. Materials and methods. 60 patients were included into the study and divided into 3 groups. Study groups: I-st group - 18 patients with isolated course of chronic pyelonephritis (CP) and urolithiasis (U) of oxalic and mixed genesis, II-nd group - 19 patients with chronic obstructive pulmonary disease (COPD), study group III - 23 patients with COPD, CP and U of oxalic genesis. Additional control group consisted of 20 practically healthy individuals (PHI) of corresponding age and gender. Laboratory and clinical examination of the patients was conducted. Spectrophotometry with polarization of biologic material was performed. Statistical analysis was done in Primer of Biostatistics, Origin 8.0. Results. Systemic inflammation in patients with COPD and comorbid CP with oxaluria form the syndrome of mutual burdening. This fact was proved by inverse correlation between oxalate salts in sputum (15,5±1,0) mg/24h) and reduction of forced expiratory volume in 1 second (FEV1) in group III. This result was in 2,1 lower than in PHI (r = -0,53,р

The article analyzes characteristics of chemical composition and pharmacodynamics of phytotherapeutic agents (monopreparations and complexes), used in the treatment of kidney and urinary tract diseases. Analysis of main pharmacological effects of medicinal plants and their complexes was made, comparative characteristics of herbal remedies by indications for use in acute and chronic diseases of the kidneys and urinary tract (pyelonephritis, cystitis, urethritis, glomerulonephritis, nephrolithiasis) and edematous syndrome of various etiologies was carried out. Pharmacological characteristics of diuretic, nephroprotective and nephrolitholytic action of watermelon lyophilized powder according to its composition (flavonoids, macro- and micronutrients, vitamins and so on.) was analyzed. On the basis of data on a wide range of biological activity, sufficient clinical efficacy as adjuvant therapy drugs, as well as good tolerability of herbal remedies, appropriateness and prospects of search for new plant nephroprotective drugs was concluded.

The article analyzes characteristics of chemical composition and pharmacodynamics of phytotherapeutic agents (monopreparations and complexes), used in the treatment of kidney and urinary tract diseases. Analysis of main pharmacological effects of medicinal plants and their complexes was made, comparative characteristics of herbal remedies by indications for use in acute and chronic diseases of the kidneys and urinary tract (pyelonephritis, cystitis, urethritis, glomerulonephritis, nephrolithiasis) and edematous syndrome of various etiologies was carried out. Pharmacological characteristics of diuretic, nephroprotective and nephrolitholytic action of watermelon lyophilized powder according to its composition (flavonoids, macro- and micronutrients, vitamins and so on.) was analyzed. On the basis of data on a wide range of biological activity, sufficient clinical efficacy as adjuvant therapy drugs, as well as good tolerability of herbal remedies, appropriateness and prospects of search for new plant nephroprotective drugs was concluded.

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In order to determine the directions of urolithiasis prevention and metaphylaxis improvement there was conducted a retrospective epidemiological study of a rep­resentative sample of 443 patients (study group, 403 – without and 40 – with recurrences) and 203 patients with other, mainly acute urological pathology (control group). It was established that urolithiasis affects mainly people of the working age (75%). Prevalence of pathology increases with age (OR=3.93; 95% CI=1.64-9.44), as well as recurrences formation (2.44; 1.21-4.93) occurring in 10-20% of patients with urolithiasis older than 40 years. It was proved that social and economic burden of the disease increases with recurrent stone formation due to the increase of low well-being (3.43; 1.77-6.65), unemployment (2.26; 1.14-4.45) and disability (3.93; 1.64-9.44). Conclusion is drawn on the need of improving prevention, first of allmetaphylaxis, technologies, by sharing of responsibilities between urologists and family doctors.

In order to determine the directions of urolithiasis prevention and metaphylaxis improvement there was conducted a retrospective epidemiological study of a rep­resentative sample of 443 patients (study group, 403 – without and 40 – with recurrences) and 203 patients with other, mainly acute urological pathology (control group). It was established that urolithiasis affects mainly people of the working age (75%). Prevalence of pathology increases with age (OR=3.93; 95% CI=1.64-9.44), as well as recurrences formation (2.44; 1.21-4.93) occurring in 10-20% of patients with urolithiasis older than 40 years. It was proved that social and economic burden of the disease increases with recurrent stone formation due to the increase of low well-being (3.43; 1.77-6.65), unemployment (2.26; 1.14-4.45) and disability (3.93; 1.64-9.44). Conclusion is drawn on the need of improving prevention, first of all metaphylaxis, technologies, by sharing of responsibilities between urologists and family doctors.

Urolithiasis is considered a civilization disease. The prevalence is estimated at 5-20% of the population. There are many litogenesis risk factors such as hypercalciuria, hypophosphaturia, low urine pH or increased excretion of oxalates with urine - a condition called hyperoxaluria which is a major risk factor for renal stones. Oxalate urolithiasis can be caused by defects in oxalates metabolism, excessive intake in the diet or increased intestinal absorption of oxalates. The reason of hyperoxaluria might be a genetic defect (primary hyperoxaluria) or excessive consumption due to improper diet (secondary hyperoxaluria). Human intestinal flora plays an important role in oxalates metabolism. Described in the 1980s Oxalobacter formigenes, inhabiting the human gastrointestinal tract is known for contributing to decrease the excretion of oxalates with urine and consequently, reduce the risk of recurrence of kidney stones. Other known bacteria which have a beneficial effect on the metabolism of oxalates include Lactobacillus, Enterococcus faecalis, Providentia retgerri. These bacteria may be useful in the future treatment of calcium oxalate urolithiasis.

This review of contemporary publications analyzes the prevalence of combinations of bowel and renal diseases. Special attention is paid to the problem of correlation between bowel diseases and urolithiasis. We consider the possible pathogenic mechanisms of lesions, such as genetically determined violations of intestinal absorption and secretion, changes in the intestinal microbiota, systemic inflammatory response, water and electrolyte disturbances.

Herbal medicines provide their versatile complex influence on the course of the pathological process in the kidneys due to biologically active compounds. Specifically, they cause the direct impact on the concrements formation. The search of drugs which would contain high biological compounds of plant origin is an actual issue of modern pharmacology. The aim of investigation was to study the anti-inflammatory activity of the new combined drug of urolytolytic action, which includes the total plant extract and succinate buffer complex. Materials and methods: aseptic exudative inflammation was caused by subplantar introduction of 0,1 ml of 1% solution of λ-karahenin in the right hind paw of rats, the investigated drug was administered at doses 1, 2 and 4 ml/kg. The influence of the studied drug was evaluated in terms of swelling limbs volume. It is shown that the severity of antiexudative action of flarosukcinehad dose-dependent nature, increasing from dose of 1,0 ml/kg to 2,0 ml/kg (by 5,5%). Further dose increase to 4,0 ml/kg, was not defined by significant increase of activity. Anti-inflammatory activity of the drug ranged from 25 to 33%, which can be regarded as quite distinct, since in pharmacological study of anti-inflammatory drugs pharmacological activity level of at least 20%is significant.

Herbal medicines provide their versatile complex influence on the course of the pathological process in the kidneys due to biologically active compounds. Specifically, they cause the direct impact on the concrements formation. The search of drugs which would contain high biological compounds of plant origin is an actual issue of modern pharmacology. The aim of investigation was to study the anti-inflammatory activity of the new combined drug of urolytolytic action, which includes the total plant extract and succinate buffer complex. Materials and methods: aseptic exudative inflammation was caused by subplantar introduction of 0,1 ml of 1% solution of λ-karahenin in the right hind paw of rats, the investigated drug was administered at doses 1, 2 and 4 ml/kg. The influence of the studied drug was evaluated in terms of swelling limbs volume. It is shown that the severity of antiexudative action of flarosukcine had dose-dependent nature, increasing from dose of 1,0 ml/kg to 2,0 ml/kg (by 5,5%). Further dose increase to 4,0 ml/kg, was not defined by significant increase of activity. Anti-inflammatory activity of the drug ranged from 25 to 33%, which can be regarded as quite distinct, since in pharmacological study of anti-inflammatory drugs pharmacological activity level of at least 20% is significant.

Urolithiasis is a metabolic disease caused by various endogenous and (or) exogenous factors, often is hereditary and is defined by the stone presence in the urinary system. Antibacterial therapies, herbal medicine, dietary restrictions, mineral water are used in the complex treatment of patients with urolithiasis after removal of concrement by different methods. The search for new and improvement of already known methods of treatment of urolithiasis remains relevant to date. Along with the use of synthetic drugs the use of herbal remedies that have diuretic, antispasmodic, bacteriostatic and many other effects is appropriate. An extremely valuable feature of herbal products is their ability to enhance excretion of urea and other nitrogenous waste products of metabolism, which is especially important in cases of severe renal failure of different aetiology. Note, however, that the range of herbal medicines used for the treatment of urolithiasis with symptoms of azotaemia is rather limited. The aim of our study was to investigate the range of medicines used to treat urolithiasis presented in the domestic pharmaceutical market by different countries, as well as to determine whether the Ukrainian medicines are available in the domestic market. Materials and Methods The analysis of products’ range was performed according to the State Register of Medicines of Ukraine and АТС classification system. The object of the study was the medicinal products, which are used for treatment of urolithiasis. Results The products were analysed according to three АТС groups: products that inhibit uric acid synthesis; other urologicals; solvents of urinary concrement. The study has shown that 21 products are registered in Ukraine (June 2014). It has been established that the market is distributed almost equally between domestic and foreign manufacturers i.e. 8 foreign and 7 domestic manufacturers are present in the pharmaceutical market. The next stage of research was to identify the value of drugs. In the market of Ukraine manufacturers mainly offer the medicines of natural origin, which is 66.66%. For further study of this segment, the products were subject to analysis regarding their pharmaceutical form. The studies have revealed that in the pharmaceutical market of Ukraine the drugs are presented in the following pharmaceutical forms: tablets - 32%, capsules - 11 %, syrups - 16 %, drops - 17 %, gel, powders, granules and teas - 6 % of each. Thus, the most common dosage form is tablets. It is worth mentioning that to date, in the pharmaceutical market of Ukraine the main portfolio of the medicinal products in tablets is compiled by the medicinal products of foreign origin. The share of registered medicinal products in tablets manufactured by Ukrainian manufacturers versus imported medicines is 33.33 % to 66.66 %. However, only one domestic manufacturer present in the market produces the tablets of plant crude: knotweed extract powder, St. John's wort extract powder, horsetail extract dry, avisan. Conclusions The study of the market of medicinal products used for treatment of urolithiasis approved in Ukraine has been performed. It has been established that the pharmaceutical market of Ukraine presents 21 trade names of drugs used to treat urolithiasis. Preparations are analyzed depending on the origin and content of active components, presentation, type of dosage form. Based on the marketing analysis, it has been established that regardless of the general quantity of medicines of plant origin, in the study group the share of herbal medicines in tablets is insignificant (1 manufacturer). The feasibility of study regarding the development of products of plant origin in tablets for treatment of urolithiasis has been confirmed.

Patients with calcium-oxalate nephrolithiasis of the solitary kidney remaining after nephrectomy with calcium-oxalate nephrolithiasis and two functioning kidneys were examined. Biochemical blood tests were performed: creatinine, urea, parathyroid hormone (PTH), ionized calcium, phosphorus and 25-hydroxyvitamin D3 (vitamin D). The presence of vitamin D deficiency in patients with urolithiasis was analyzed, in particular in case of urolithiasis of the solitary kidney. It was revealed that the percentage of patients deficiency of vitamin D is significantly higher in groups of patients with nephrolithiasis, most of all among patients with a solitary kidney. Thus, it may indicate that vitamin D deficiency is a risk factor for the development of secondary hyperparathyroidism and the formation of calcium kidney stones, especially in individuals with a solitary kidney. [ABSTRACT FROM AUTHOR]

Aim. To analyze the dynamics of changes of urinary tract infections. Methods and results. A comparative analysis of the dynamics of microorganisms in the period from 2004 to 2014 has been done. Significant difference between the quantitative characteristics of gram-negative and gram-positive group infections among the 539 patients (including 275 of them in 2014) has not been found. At the same time it has been pointed out that in recent years the number of associations of microorganisms from 5,8% (2004) to 12% (2014) dramatically increased. Among the antibiotics that had an effective impact on the microorganisms mainly ampicillin, levomitsitin and some others have been mentioned. Conclusion. The ampicillin and levomitsitin can be used as broad-spectrum antibiotics before the final decision identifying antibiotic of purposeful action.

Introduction. Undoubtedly, technological progress, the "conquest" of civilization leads to a deterioration of the environmental situation. It affects the human body, causing a violation of homeostasis, due to disorders in it. The purpose of the work. In view of the above, the task was to study the peculiarities of the process of the use of minimally invasive techniques in patients with urolithiasis treated in the period from 2012 to 2017 in the urological department of the Truskavets City Hospital and in the private office of lithotripsy Ya.V. Feciak in the complex with the use of medical water "Naftusya" during treatment and in the early postoperative period as a means of metaphysics of recurrent stone formation and quicker rehabilitation of patients. Materials and methods of research. The treatment of 1757 patients with urolithiasis in the urological department of Truskavets city hospital and the private office of lithotripsy Ya.V. Fetsiak for the period of 2012 - 2017. The study included 681 patients with kidney stones, 1045 patients - with ureteric stones and 31 patients with urinary bladder specimens. 357 contact nephrolithotripsy, 491 contact ureterolithotripsy (CULT), 27 contact cystolithotripsy and 2074 extracorporeal shock-wave lithotripsy (ESWL) sessions were performed for these patients. Men were 946 (54%), women 811 (46%). The age of the patients ranged from 18 to 84 years. The size of the concretions localized in the ureter ranged from 0.6 cm to 3.4 cm and, as a rule, was 0.9-1.2 cm. The maximum size of the kidney stone was 9.5 cm, and the average size varied within 1 , 4-27cm. ESWL was performed on the Dornier Compact S machine. In the 882 patients, 2074 procedures were carried out for the ESWL, which was 2.35 procedures per patient. In the planned period, 71% of patients, 29% in urgent (at the height of the renal colic or within the next 30 hours) were treated. Results In the contingent of patients treated with ESWL, medical water "Naftusya" was used before the crushing session and exchange course for 2-3 weeks three times a day at a temperature of 17-20 degrees C in an amount of 10 ml per kilogram of weight per day. Patients, who used contact lithotripsy "Naftusya" were prescribed from the second day after the operation, that is, when in the postoperative period, complete peristalsis of the colon was restored. Doses were identical, as in patients with ESWL. Our long experience in treating patients with urolithiasis has shown recurrence of stone formation in 10-15% of patients with urolithiasis within five years of intervention. The latter is much lower compared to the literature without the use of water "Naftusya". Conclusions 1. ESWL - an effective out-patient method of removing concretions from the urinary tract. 2. Contact lithotripsy, along with ESWL - modern methods for the elimination of concretions from urinary tract with short bed day and minimization of surgical trauma. 3. Therapeutic water "Naftusya" - an effective means of metaphysics of urolithiasis. 4. Early postoperative rehabilitation of patients with urolithiasis is possible only on the territory of Truskavets. 5. The use of water "Naftusya" can significantly reduce the recurrence of stone formation in patients with urolithiasis, which makes this balneotherapy a "gold standard" in metaphilactics and early post-operative rehabilitation of patients with urolithiasis.

Hyperuricemia - a condition characterized by elevated relative to normal ranges, levels of uric acid in the blood. Among the diseases caused by hyperuricemia, most noteworthy are gout, urate nephropathy, and urolithiasis. The topic of this article is devoted to the comparative characteristics of drugs used to correct hyperuricemia. The main part of the article is an analysis of pharmacodynamics, efficacy, safety and expediency of using orotic acid agents.

Urolithiasis - disease, morphological substrate of which is the formation of stones in the urinary tract and related changes in the urinary tract. The disease is characterized by its prevalence and a variety of etiological and pathogenetic factors. The topic of this article is devoted to the comparative characteristics of drugs used in the treatment of this disease. The main part of the article is an analysis of pharmacodynamics, efficacy, safety and expediency of using citrate drugs.

The article analyzes characteristics of chemical composition and pharmacodynamics of phytotherapeutic agents (monopreparations and complexes), used in the treatment of kidney and urinary tract diseases. Analysis of main pharmacological effects of medicinal plants and their complexes was made, comparative characteristics of herbal remedies by indications for use in acute and chronic diseases of the kidneys and urinary tract (pyelonephritis, cystitis, urethritis, glomerulonephritis, nephrolithiasis) and edematous syndrome of various etiologies was carried out. Pharmacological characteristics of diuretic, nephroprotective and nephrolitholytic action of watermelon lyophilized powder according to its composition (flavonoids, macro- and micronutrients, vitamins and so on.) was analyzed. On the basis of data on a wide range of biological activity, sufficient clinical efficacy as adjuvant therapy drugs, as well as good tolerability of herbal remedies, appropriateness and prospects of search for new plant nephroprotective drugs was concluded. [ABSTRACT FROM AUTHOR]

Urolithiasis and osteoporosis are not only medical but also social problems. There are common pathogenetic mechanisms of these diseases, one of which is the occurrence of secondary hyperparathyroidism against hypocalcemia and vitamin D deficiency, leading to increased bone resorption and, consequently, violations of the structural and functional state of bone tissue, development of urolithiasis. The article gives clinical examples of various therapeutic approaches in patient depending on the degree of changes in bone mineral density, presense of risk and history of of fractures in combination with urolithiasis.

In the article the attention was paid to one of the most urgent problems of modern medicine — urolithiasis. One component of the pharmacotherapy of this disease is phytotherapy. This article provides an experience of use of combination therapy with Flavia® and Le Cran® in patients with urolithiasis with localization of the stone in the ureter. It is shown that in patients with ureteral stones up to 5 mm Flavia® and Le Cran® accelerates elimination of the stone, and also that the combination therapy of urolithiasis, complicated by infectious inflammatory process, with Flavia® and Le Cran® increases the effectiveness of antibiotics.