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BACKGROUND: The progress made in reconstructive urethral surgery over the past 20 years has shown the effectiveness of one-stage repair of anterior urethral strictures. Nevertheless, multi-stage urethroplasty retains its primary role in the treatment of patients with the most complex urethral narrowing and obliterations. AIM: To evaluate the immediate and long-term surgical results of multi-stage urethroplasty for penile and bulbar urethral strictures. MATERIALS AND METHODS: The study included 110 men aged 1884 years who underwent multi-stage urethroplasty for the anterior urethral structures in 20102019. The techniques of buccal and skin augmentation or urethral replacement plastics were applied. Before surgery, all patients underwent a standard urological examination. Early surgical complications were evaluated from medical records. Late surgical complications were determined according to examinations that included symptomatic assessment with specialized questionnaires, laboratory tests of serum and urine, physical examination, uroflowmetry, and retrograde urethrography and ureteroscopy (if urinary disorders were detected). The median follow-up was 5 years and 2 months. RESULTS: Early surgical complications were detected in 27 (24.5%) patients. Surgical interventions to resolve them were required in 7 (31.8%) cases: urethrocutaneous fistulas (5), acute urinary retention (1), scrotal hematoma (1). Late surgical complications were detected in 33 (30.0%) patients, including 29 (26.7%) cases of recurrent urethral strictures. All late complications cases were classified as Clavien-Dindo IIIb, and a total of 49 additional operations were performed to eliminate them. The primary success rate for multi-stage urethroplasty was 67.3 % with a median follow-up of 62 months. Only 73 (66.4%) completed all stages of the planned surgery. Urethral integrity throughout its entire length was restored in 67 (60.9%) cases, spontaneous urination in 106 (96.4%) cases. CONCLUSIONS: Multi-stage surgery for anterior urethral strictures is associated with relatively high risks of surgical complications at each stage of treatment. The probability of surgical revision of complications can reach 31.8%. Patients should be informed about the risks of developing surgical complications and the potential for more than two surgeries to achieve treatment goals when planning multi-stage urethroplasty.

Introduction. Any sexual dysfunction or complications associated with urethral stricture reconstruction can negatively affect quality of life and patient satisfaction with treatment results, even if the operation is considered 'successful' and urethral patency is restored. According to the literature data, the frequency of erectile dysfunction detected after urethroplasty varies from 0 to 40%. However, most publications are focused on the study of sexual disorders caused bulbar urethral reconstruction and one-stage surgical techniques. Purpose of the study. To evaluate sexual function in patients undergoing multi-stage urethroplasty. Materials and methods. The study included 73 men aged 18–84 years who underwent multi-stage urethroplasty for the anterior urethral structures in 2010–2019. Penile strictures were present in 39 (53.4%) patients, bulbar strictures in 7 (9.6%), penile bulbar strictures in 15 (20.5%) and multifocal strictures in 12 (16.4%) cases. The length of the strictures was 7.27 ± 3.26 (2–18) cm. The effect of staged urethral surgery on sexual function was studied using the IIEF-5, MSHQ-EjD, and MSHQ-InS questionnaires. The mean time from surgery to evaluation of sexual function was 67.8 ± 32.3 (14–134) months. Wilcoxon signed rank test, Mann-Whitney U test, and Kruskal-Wallis H test were used to test for differences in preoperative and postoperative values. Differences were considered significant at p < 0.05. Results. There were no significant changes in the initial indicators of the IIEF-5 questionnaire compared to the postoperative ones (19.67 ± 3.45 (5 – 25) vs 21.73 ± 2.47 (6 – 24) points; the mean difference was (Δ) 2.1, 95% confidence interval (95% CI) 16.1 – 20.2, p = 0.468). The total score of the MSHQ-EjD questionnaire increased from 14.67 ± 3.33 (1 – 28) to 25.41 ± 5.65 (1 – 34) points, the mean difference (Δ) was 10.8, 95% confidence interval (95% CI) – 15.4 – 18.9 (p < 0.001). Similar improvements were observed in the analysis of preoperative and postoperative scores of the MSHQ-InS questionnaire (17.31 ± 4.67 (5 – 30) vs. 24.61 ± 4.13 (8 – 30) points; Δ = 7.2; 95% CI: 15.4 – 18.8, p = 0.036). Conclusions. Patients who underwent multi-stage urethroplasty have minimal changes in erectile function and significant improvements in ejaculatory function, as well as the expressiveness of sexual satisfaction.

Introduction. Currently, the most common method of treating extended urethral strictures is augmentation urethroplasty using oral mucosa grafts. Analysis of the long-term outcomes of this surgery type shows a high incidence of relapses and complications.Purpose of the study. To improve the outcomes of augmentation urethroplasty, in particular the dorsal inlay (Asopa) technique, in patients with extended spongy urethral strictures by minimizing the risk of recurrent strictures.Materials and methods. The study is based on an analysis of the surgery in 90 patients (aged 18-72 years) with extended spongy urethral strictures. Seventy patients (group I) underwent dorsal inlay augmentation urethroplasty according to the Asopa technique, and 20 patients (group II) — according to the author's modified technique. Statistical data analysis was carried out using the SPSS ver.26 software (SPSS Inc. Chicago, IL, USA).Results. A comparative analysis of the course of the early postoperative period showed a lower number of complications in group II patients compared to group I — 20.0% versus 34.3%, respectively. The recurrent strictures were registered for groups I and II in 18.8% and 5.6% of cases 6 months after surgery, respectively. The recurrent urethral narrowing was most often localized in the area of distal anastomosis between the buccal graft and the native urethra in patients from both groups.Conclusion. The modified dorsal inlay augmentation urethroplasty technique developed and implemented in clinical practice by increasing the internal urethral lumen in the areas of proximal and distal anastomosis between the buccal graft and the native spongy urethral body allows minimizing the risks of recurrent urethral narrowing after augmentation urethroplasty.

Scientific and technological progress, the processes of globalization and internationalization have had a great influence on the development of the economy and related financial instruments, and financial technologies. To describe the model of economic behavior of individuals, the term “joint consumption economy” is widely used, which is based on the joint (collective) use of goods or services that are transferred for temporary use on a reimbursable or free basis. The analysis of information sources by the authors showed that, simultaneously with the term “sharing economy”, other concepts are used depending on the author’s point of view of the researcher and his belonging to the corresponding scientific school. The economy of joint consumption, as a model of the economy, is not new, however, in the context of the penetration of modern information and communication technologies into all spheres of the life of modern society, it received a new impetus for development and changed the structure of the relationship between consumers of goods (services) by reducing the transactional ones that arise in these processes costs, minimizing costs, reducing the number of intermediaries, increasing the number of online trading platforms and simplification of the process of providing consumers with temporary use of goods (services). The online services used in the sharing economy provide consumers with the opportunity to make more efficient, mobile and affordable the use of the resources at their disposal. To single out the volume of the economy of joint consumption among the general indicators of the national (world) economy due to the lack of a unified approach to its determination. For the effective development of the joint consumption economy, the development of the relevant regulatory legal acts is necessary, because for all its advantages there are mutual risks associated with the dishonesty of the parties involved in fulfilling their obligations.

In the study the adapted production process of one-axis tense-resistive sensors screen printed on different polymer substrates such as films, porous, fibrous materials with various composition and structure is described. Both commercially available and special processed functional materials with elongation up to 250% were used as the substrates. Various conductive printing compositions containing silver, graphite and carbon nanotubes were tested as the active grid lines base. The sensors volt-ampere responses were obtained at the both high (up to 20%) and low (up to 5%) elongations. The sensors work mechanism as well as the results of grid configuration effect on the sensor activity are shown.

Аннотация В статье анализируется структура физической подготовленности юных каратистов. Выявлены структурные связи между физической подготовленностью и соревновательной деятельностью. Установлено, что показатели скоростных качеств имеют более высокие корреляционные связи с параметрами соревновательной деятельности. Полученные данные могут быть использованы в учебно-тренировочном процессе в спортивных единоборствах. Ключевые слова: карате, спорт, соревновательная деятельность, технико-тактические действия, физические качества.

This chapter aims to show the linguistic means used in Mari verbal charms to denote those events, actions and processes which are either impossible or inevitable. The notions of impossibility (improbability) and inevitability are expressed with the help of folklore hyperboles and metaphoric similes. But their usage is of a distinct character, which reveals the intuitive folk understanding of several concepts also found in contemporary probability theory.