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An analysis of the Doppler-graphic results was made in transrectal ultrasound in 98 patients. Prostate cancer was detected in 44 cases. Priority zones for bioptic injection were determined. There were high probabilities of adenocarcinoma detection. The index of systolic speed of blood flow is significant for diagnostics.

Given study was aimed to research a role of kinetic performance of PSA in selection of the patients for conduction 11C-choline PET/CT in order to reveal local recurrences in patient with prostate cancer after radiation therapy (RT) and radical prostatectomy (RP). The study included 185 patients with histologically distinctive prostate cancer and biochemical signs of tumor recurrence after RP (61 patients) or RT (124 patients). All the patients were examined using 11C-choline PET/CT in order to detect local relapses. Calculation of growth rate of the PSA level and PSA doubling time were made. According to results of 11C-choline PET/CT, recurrences of prostate cancer were detected in 124 out of 185 (65%). There were 22 patients out of 61 (36%) after RP and there were 102 patients out of 124 (82%) after RT. It was stated a correlation between PSA rates, growth rate of PSA level and presence or absence of relapse according to PET/CT results. PSA level and growth rate of PSA were indicated as the most significant predictive signs, which could influence on the selection of the patients for conduction of 11C-choline PET/CT in relation to detection of local recurrence after RT and RP.

The authors showed the result of complication treatment of lower urinary tracts in 128 patients with localized prostate cancer. The patients underwent radical prostatectomy. Urinary discomforts included enuresis, urinary incontinence in postoperative period. Abnormalities of urine outflow due to urethral stricture were revealed in 6 (4,6%) patients by the 6 month after operation. These complications required surgical treatment. Urinary incontinence was noted in 20 (15,6%) patients in this period. It was stressful urinary incontinence in 16 (12,6%) and urgent - in 4 (3%). Patents with stressful urinary difficulty were advised to use the conservative treatment (pelvic floor muscle training and electrostimulation), but in case of inefficiency - surgical treatment.

According to the results of epidemiological studies of prevalence of erectile dysfunction in the Russian Federation, the search for the determinants of risk of its development was performed. It was found that the leading risk factors for the development of erectile dysfunction, in descending order of statistical significance, include the amount of accumulation of points according to the IPSS score, arterial hypertension, L(IPSS) quality of life index, age, diabetes, and overweight and obesity.

With the aim of evaluation of prevalence of erectile dysfunction (ED) and other violations of the sexual function of men in the Russian Federation, anonymous questionnaire survey of 1400 men was performed. The study involved seven centers located in the most densely populated regions of the country. 1225 questionnaires were analyzed. It was found that ED symptoms were present in 1101 (89.9%) respondents. Age-related symptoms (by AMS questionnaire) were detected in 554 (45.2%) patients, most of whom were aged 45-59 years. The importance of active detection of ED in men, as it can be one of manifestation of a more serious disease, was demonstrated.

A total of 76 patients with chronic abacterial prostatitis (CAP) in combination with erectile dysfunction were divided into two groups. Clinical symptoms of CAP and severity of erectile dysfunction were the same in both groups. Patients of the study group (n = 36) received pathogenetic treatment (vitaprost plus physiotherapy) and impase. The control group (n = 40) received vitaprost and physiotherapy. The results of the treatment showed that impase addition to combined treatment of CAP patients with erectile dysfunction significantly improves erectile function: 80.6% patients given impase raised their score by International Index of Erectile Function Scale to normal (26 points and higher). Impase efficacy increased with prolongation of the treatment from 4 to 12 weeks.

Our study of efficacy of Prolit-septo phytotherapy following extracorporeal shock-wave lithotripsy (ESWLT) in patients with nephrolithiasis has demonstrated that Prolit-septo noticeably reduces the time of evacuation from the urinary tract of the destructed stone fragments as well as renal colic incidence and renal inflammation exacerbation.

Prostatic surgery is often accompanied with increased intra- and postoperative bleeding which is caused, among other reasons, by enhancement of general and local fibrinolysis due to mechanical impact on prostatic tissue in operation. We proposed to inhibit enhanced fibrinolysis with preparation of tranexamic acid tranexam and tried it in 53 patients with prostatic adenoma undergoing transurethral prostatic resection (TUR). The comparison of bleeding severity in surgery with and without tranexam administration before, in and early after prostatic TUR showed that tranexam significantly lowers blood loss.

An experience with using contact laser lithotripsy is presented in treatment of such actual disease as cholelithiasis. This kind of modern minimally traumatic lithotripsy used in 73 patients has shown it to be effective independent of localization of the calculi: both in the urinary bladder and the kidney and ureter.

Pharmacotherapy of prostatic adenoma is based in present-day practice primarily on two basic groups of medicines--inhibitors of 5alpha-reductase and blockers of alphal-adrenoreceptors. Our trial included 98 patients with prostatic adenoma aged 59-79 years given combined treatment with finasteride (inhibitor of 5alpha-reductase) made in Hungary (prosteride, Gedeon Richter) and an uroselective blocker of alpha1-adrenoreceptors sonisin (Gedeon Richter, Hungary). Prosteride was given for 12 months, sonisine--for the first 6 months of combined treatment. Positive results were achieved in 97 (99%) of 98 patients. After 12-month combined treatment symptoms of the disease reduced by IPSS from 17.9 +/- 1.8 to 3.9 +/- 0.9 points, Qmax rose from 8.8 +/- 0.3 to 14.6 +/- 0.3, residual urine volume diminished from 91.7 +/- 8.5 to 31.7 +/- 4.4, the size of the prostate reduced from 72.4 +/- 2.9 to 50.6 +/- 3.7, quality of life improved 2-fold. Combined administration of finasteride (prosteride) and alpha1-adrenoblocker tamsulosine (sonisine) meet three principles of pharmacotherapy of prostatic adenoma: prevents progression of the disease and surgical treatment, relieves symptoms and improves quality of life.

Symptoms severity was assessed in 533 patients with urinary bladder overactivity (mean age 56.4 +/- 0.6 years). All the patients kept urination diary for 3 days, some patients filled in KHQ questionnaire to find out quality of life, were examined urodynamically. Overactive bladder (OAB) symptoms were studied in 52 patients before and after 12 weeks of solifenacin treatment in a dose 5 mg/day. The statistical analysis identified three degrees of OAB symptoms. The severity was calculated according to the formula in points (S): S = 2 x number of urinations for 3 days + number of urges for 3 days + 1*(*--in the presence of urgent urine incontinence). In 62 points and less the diagnosis was "mild severity" of the symptoms (degree 1), in 63-80 points--"moderate severity" (degree 2), in 80 points and more--"great severity" (degree 3). Of 533 patients, 119 (22.3%) had symptoms of degree 1, 148 (27.8%)--of degree 2, 266 (49.9%)--of degree 3. The patients with more severe disease had more distinct changes in urodynamic indices and worse quality of life. Solifenacin treatment reduced severity of the symptoms in most patients treated. Before solifenacin administration degrees 1, 2 and 3 of the symptoms severity were detected in 12 (23.1%), 13 (25.0%) and 27 (51.9%) patients, respectively. After treatment--in 26 (50.0%), 16 (30.8%) and 6 (11.5%) patients, respectively. OAB symptoms were absent in 4 (7.7%) patients. Thus, it is shown that the proposed system of the system assessment reflects severity of OAB clinical symptoms, the degree of urodynamic disorders and deterioration of quality of life. This classification system can be used for follow-up assessment of OAB symptoms in the treatment process. It is simple and perspective for wide application.

Finasteride effect before transurethral resection (TUR) of the prostatic gland was studied in 88 patients with prostatic adenoma (PA). Forty seven patients received prosteride (Gedeon Richter), forty one patients - proscar (MSD) in a dose 5 mg/day for 3 months. Finasteride reduced blood flow in prostatic tissue, density of the vascular plexus, epithelium/stroma coefficient from 1.26 to 0.84. This decreased intraoperative blood loss, postoperative hematuria, TUR duration, postoperative rehabilitation, number of early and late TUR complications.

Efficacy and tolerance of a novel antimuscarinic drug solifenacin succinate (vesicar) were studied in 55 patients with hyperactive urinary bladder (HUB). All the patients were divided into two groups: 27 patients of group 1 received solifenacin in a dose 5 mg/day, 28 patients of group 2--in a dose 10 mg/day. The 3-month treatment has improved symptoms of the HUB compared to the initial level: a daily number of vesical tenesmus reduced in patients of groups 1 and 2 by 47 and 51%, respectively; a number of episodes of urgent urine incontinence by 53 and 65%, voiding--by 24 and 26%, respectively. Most symptom incidence reduction (by 2/3) occurred within the first month of therapy. Tolerance to 5 and 10 mg/day solifenacine was satisfactory. The most frequent side effect was xerostomia (18.5 and 28.5%, respectively). The results of the study show that solifenacine in doses 5 and 10 mg/day is effective and safe drug for therapy of patients with hyperactive urinary bladder.

We studied efficacy of repeated courses of prostatilen in suppositories with dimexide in prostatic adenoma patients with normal micturition. Rectal suppositories contain 30 mg prostatilen and 90 mg dimexide. The course consisted of 15 suppositories. The treatment reduced clinical symptoms of infravesical obstruction, residual urine volume in administration of prostatilen in 15-day courses each 3 months. This suggests possibility of suppository prostatilen use not only as an alternative for expensive drugs but also in combination with them in treatment of initial prostatic adenoma.

Forty three patients with unsatisfactory outcomes of surgical treatment of benign prostatic hyperplasia (BPH) were examined urodynamically. Thirty five patients complained of daily and nocturnal pollakiuria, incomplete evacuation of urine from the bladder, imperative voiding. Eight patients had postoperative enuresis. Seventeen control patients had satisfactory surgical results. The urodynamic findings showed that postoperative dysuria was caused by detrusor pathology: detrusor hyperactivity (n = 27, 62.8%), contractile hypoactivity (n = 4, 9.3%), infravesical obstruction (n = 4, 9.3%). Diuresis patients had low maximal cystometric capacity of the urinary bladder, detrusor hyperactivity was diagnosed in 5 (62.6%) patients. Enuresis patients had also very low indices of urethral profilometry characterizing function of the sphincter. The urodynamic examination detected true stress urine incontinence in 3 enuresis patients due to sphincter impairment. Five patients had enuresis of mixed nature. Thus, urodynamic examination of patients with unsatisfactory results of surgery determined cause of dysuria. Accurate diagnosis of characteristics and causes of lower urinary tracts dysfunction decides choice of adequate therapeutic policy.

To improve reliability of the diagnosis of infravesical obstruction (IVO) in patients with benign prostatic hyperplasia (BPH), we examined 80 BPH patients (mean age 58.2 +/- 2.1 years). The examination included evaluation of complaints by IPSS, ultrasound investigation with determination of prostatic size and residual urine, and urodynamic tests: uroflowmetry, miction cystometry. We came to the conclusion that symptoms of BPH, size of the gland, amount of residual urine and maximal volumetric miction velocity not always evidence for IVO. To raise reliability of IVO diagnosis we propose the following formula: D1 = 0.818 x S(max) +0.0006 x S(min) +0.215 x Q(max) - 0.478 x Q(aver), where D1 is a discriminant function; S(max) is a maximal linear size of the prostate; S(min) is a minimal linear size of the prostate; Q(max) is maximal volumetric flow rate; Q(aver) is mean volumetric flow rate. If D1 > or = 2.85, IVO is definite. If D1 < or = 2.85, IVO absence is more probable. Thus, the proposed formula provides more reliable diagnosis of IVO in BPH patients than assessment of clinical indices.

We studied efficacy of a new cytomedine drug--vitaprost--in 98 patients with chronic abacterial prostatitis. Vitaprost was found to relieve symptoms of the disease, improved blood flow in the prostate, normalized blood rheology and immunological indices, increased mobility of spermatozoa in ejaculate.

The authors review the experience with prostatilen treatment gained in the urological clinic of the St-Petersburg State Medical University and analyze treatment outcomes for 96 patients with benign prostatic hyperplasia (BPH) aged from 51 to 89 years. Prostatilen proved its efficacy in relieving manifestations of infravesical obstruction in BPH, therefore, prostatilen administration in the treatment of patients with initial or moderate subjective and objective symptoms is justified. Dimexide suppositoria containing 30 mg of prostatilen are preferable.

A clinical data was studied for 117 males without complaints for copulative disorders admitted to urological clinic electively for benign prostatic hyperplasia (BPH)--44 (37.6%), urolithiasis--25 (21.4%), external genital diseases--17 (14.5%), renal cyst and hydronephrosis--16 (13.7%), renal and vesical tumors--15 (12.8%). Mean age of the patients was 56.2 +/- 16.1 years. The patients filled in IPSS and IIEF questionnaires. Mean score set (+/-SD) for IIEF and IPSS was 35 +/- 23 and 12 +/- 10, respectively. The majority of the patients (n = 61) were not sexually active. Erectile dysfunction (ED) was detected in 23 (19.7%) patients: mild and moderate in 19 (16.2%) and 4 (3.4%), respectively). 24 (73%) patients with normal erectile function, 10 (44%) patients with ED and the majority (n = 37) of sexually inactive men were satisfied with their sexual activity. Those males who needed improvement of sexual life quality had higher (p < 0.05) parameters of erectile function and sexual satisfaction. Age of the patients (R2 = 33.1; p < 0.0001) and IPSS index (p < 0.015) were leading indices in determining condition of the copulative function. IIEF correlated with tumors of the kidney or urinary bladder (p < 0.004) and benign prostatic hyperplasia (p < 0.015). Erectile dysfunction in men with urological diseases was closely related with age and severity of lower urinary tract symptoms. Other sexual disorders may be due both to general causes and urological diseases.

Prostatilen was used in 1115 patients with chronic pyelonephritis and prostatitis. It is shown that prostatilen has a corrective effect on hemocoagulation and immunity disorders, restores microcirculation, suppresses inflammation in the kidney and prostate. Thus, prostatilen is a pathogenetically sound drug for treatment in urogenital inflammation while in chronic prostatitis it can be used as a basic therapy.

Ejaculate and blood serum from 40 patients with chronic prostatitis were studied immunologically, IgG, IgA, sIgA, IgM concentrations in ejaculate may be greatly influenced by multicomponent composition of ejaculate. This means that it is impossible to diagnose chronic prostatitis only by changes of immunoglobulin concentrations in ejaculate. Data on IgA, sIgA concentrations plus on leukocyte count in ejaculate give more information for precise diagnosis of chronic prostatitis.

A long-term proskar (finasterid, MSD) treatment was given to 428 patients with benign prostatic hyperplasia (BPH). The response was achieved in 93.8-95.8% patients. The duration of the course should be at least 12 months. Side effects were rare: libido, erection, ejaculate volume diminished in 5.1, 5.6 and 4.2% patients, respectively. 20 patients were operated on after proskar therapy. Such pretreatment reduced glandular prostatic tissue.

Measurements were made of interleukine-8 (IL-8) levels in ejaculate, prostatic secretion, blood serum of 60 patients with latent chronic prostatitis (CP). These levels were higher in CP patients than in healthy subjects. A rise in concentrations of IL-8 in prostatic secretion and ejaculate correlates with other inflammation markers. This may indicate the degree of CP activity. No relationship between IL-8 levels in ejaculate and prostatic secretion, and large dispersion of this marker allow using this criterion for diagnosis in combination with other indices of local immunity.

Products of cell receptor (R-proteins) catabolic lysis were measured in ejaculate of 121 patients with chronic prostatitis and 15 healthy males. R-protein levels were higher in the patients (U = 172.5; p = 0.047). When immunological indices of the ejaculate (IgA, sIgA, IgG, IgM, interleukin-8) were measured, it was found that in patients with chronic prostatitis there is a positive correlation between concentration of interleukin-8 and content of R-proteins (r = 0.43; p = 0.028). Positive correlation also exists between R-protein content and prostate volume (r = 0.24; p = 0.034) while negative one--between R-proteins concentration and size of the hypoechogenic sites in the prostate (r = -0.25; p = 0.039), between R-proteins in the ejaculate and serum level of fibrinogen B (r = -0.25; p = 0.021). It is inferred that elevation of ejaculate R-protein level occurs in alteration of the prostate. The test for R-proteins in ejaculate can be helpful in detection of early stages of chronic prostatitis.

Application of 5-aminolauvulin acid (ALA) fluorescence allows to detect not only exophytic tumors of the bladder but also flat, small tumors-satellites and preneoplastic changes of the bladder. 175 biopsies were performed in 53 patients with suspected superficial tumor of the bladder. 3 hours before surgery all the patients were intravesically instilled 50 ml 3% ALA solution. Cystoscopy employed white and blue light. Visual registration of exophytic masses and red fluorescence of the suspected sites was registered and consequently compared to the histological findings. 96 of 100 sites with malignancy/dysplasia showed red fluorescence. In 13% patients cancer and mucosal dysplasia were detected only under the blue light and were missed by standard cystoscopy. Residual red fluorescence of the resection margins was observed in 41% patients after TUR. Sensitivity of ALA-fluorescent detection reached 96%, specificity 52%. ALA-induced fluorescent diagnosis is more effective than standard cystoscopy. It is most effective in diagnosis of dysplasias, carcinoma in situ, flat, small, multiple superficial tumors of the bladder during primary TUR.

Combined treatment including alpha-1a-adrenoreceptor blocker tamsulosine was given to 92 patients with chronic prostatitis having marked urination disorders (IPSS score 12.1 +/- 2.4). The response was achieved in 98.9% of cases. There was attenuation of the urination symptoms, speeding up of the maximal urine flow, decreased amount of the residual urine. It is recommended to add alpha-1-adrenoreceptors to combined treatment of chronic prostatitis patients with urination disorders.

The action of prostatilen on contractile activity of smooth muscles of isolated line slices of urine bladder of Wistar rats (myography) and arterial vessels of cat kidneys (resistography) was studied. On the basis of clinical cases effectiveness of prostatilen was analysed as a treatment restorting urine bladder function in acute reflex urinary retention after operations in the area of rectal sphincter, as well as in treatment of patients with chronic prostatitis. It is shown, that prostatilen produces contractile action on smooth muscles of renal blood vessels in cats and urine bladder walls in rats and it raises contractile activity of smooth muscles of human urine bladder. The results of experimental and clinical investigations make it possible to recommend the application of this bioregulating preparation for treatment and prophylaxis of disturbances in urination.

The authors have performed urodynamic investigations pressure-flow in 39 males (mean age 57.9 +/- 1.8 years) to detect infravesical obstruction. Interpretation of the findings rested upon Abrams-Griffits index (AGI) derived by the formula AGI = PdetQmax - 2xQmax, where Qmax is the maximal speed of urine flow and PdetQmax is detrusor pressure when the maximal urine flow is reached. Definite conclusion on the presence or absence of infravesical obstruction was feasible for 21(53.8%) of 39 examinees, was not possible for 18(46.2%) patients. Statistical processing yielded non-linear relationship between PdetQmax and Qmax (cubic parabola) requiring correction for AGI (coefficient K calculated according to the formula K = 58.7 - 0.00554x(Qmax)3). This correction for nonlinearity K allowed classification of 11 out of 18 patients who were initially indefinite. By standard AGI technique, the uncertainty zone made up 46.2% while correction for nonlinearity reduced this zone to 18.0% (p < 0.008). Thus, the account for nonlinearity of the relationship between PdetQmax and Qmax may contribute to a rise in diagnostic value of urodynamic investigations.

Patients with benign prostatic hyperplasia (BPH) received proscar (finasteride) in daily dose 5 mg for: at least 6 months (n = 206, 20.4%), 12 months (n = 513, 50.9%), 24 months (n = 164, 16.3%), 3-4 years (n = 125, 12.4%). Because the size of the prostatic gland reduced significantly (by 22%) only after one year of proscar treatment, the duration of this treatment should be continued for at least 12 months, in some patients as long as the whole life. The duration of the treatment should be decided for each individual patient. The improvement after the proscar treatment was observed in 95% of the patients treated for benign prostatic hyperplasia.

88 patients with benign prostatic hyperplasia (BPH) were given the inhibitor of 5 alpha-reductase proscar (finasteride, Merck and Co. Inc., USA) for 12-14 months and uroselective blocker of alpha-adrenoreceptors alfuzosin (dalfas, Synthelabo Group, France) for 4-5 months. The patients were examined before the combined treatment and on the treatment month 1, 3, 6 and 12. The proscar plus alfuzosin combination produced a response after 2-3-week treatment due to alpha-blocker Further, the effect was enhanced by the action of inhibitor of 5 alpha-reductase. Combination of alfuzosin with proscar meets three principal requirements demanded of BPH chemotherapy: improves urination, inhibits the growth of adenomatous tissue, diminishes the size of the enlarged prostate.

Prostatilen (5 mg/day i.m. for 5 days) was given to 46 patients with chronic pyelonephritis in the latent inflammation phase. The treatment resulted in relief of clinical symptoms, positive trend in laboratory indices characterizing activity of renal inflammation, albumin-globulin ratio. There was a decrease in leukocyturia, bacteriuria, ESR, blood fibrinogen and ceruloplasmin levels. Prostatilen reduced hypercoagulation and enhanced fibrinolytic activity of blood. The immunograms showed prostatilen-induced correction of immunity: T-lymphocyte count and functional activity increased, proportion of T-cell subpopulations returned to normal, metabolic activity of phagocyte oxygen-dependent substances became more intensive. The ability of prostatilen to initiate normalization of hemocoagulation and immunity is thought to be an essential factor of its therapeutic efficacy in chronic pyelonephritis.

Prostatilen effects on hemostasis were studied in 120 intact and 240 chronic prostatitis rats, 34 patients with chronic prostatitis. Intact rats responded to prostatilen by inhibition of platelet-vascular and coagulation hemostatic mechanisms and activation of fibrinolysis. Experimental chronic prostatitis in rats induced hemostatic shifts to hypercoagulation. These parameters returned to normal after 5- and 10-day course of prostatilen administration. A single prostatilen dose was unable to produce the above action. As to patients with chronic prostatitis, there were also prostatilen-induced platelet-vascular hemostatic normalization and fibrinolysis activation. Hemocoagulation was affected in a less degree. Prostatilen effects were unrelated to the disease stage. Normalization of hemostasis seems to be one of the factors of prostatilen therapeutic efficacy in chronic prostatitis. This peptide is found effective as a pathogenetic treatment of chronic prostatitis.

Bladder tumors morphological and treatment efficacy data obtained on 246 relevant patients over 60 years of age support the benefit of surgery in combined treatment of bladder cancer in elderly patients in spite of difficulties caused by concomitant diseases and defective adaptation. High-grade poorly differentiated cancer of the bladder causing more frequent recurrences and metastases occur in patients over 60 two times less often than in younger patients. Transurethral electroresection of the bladder with removal of the tumor followed by intravesical immunoprophylaxis of the recurrences is thought a radical treatment for elderly patients with bladder cancer stage T1 and T2. At stage T3 cystectomy is preferable. Positioning of the ureters into the straight ileocecal angle provides the best results in urine derivation after cystectomy. Transurethral electroresection is optimal in the treatment of elderly patients with bladder cancer stage T1-T2 and prostatic adenoma. Indications to transurethral adenomectomy in the presence of bladder cancer must be maximally extended as adenomatous nodes provoke infravesical obstruction and speed up the recurrence of bladder cancer.

Experimental verification of prostatilen prophylactics of changes in the urogenital organs consequent to g-loads was the idea of the work. The experiment was performed with 37 mongrel white male rats weighing 200-250 g who were exposed to the head-pelvis g-loads (+Gl) at 10 units. Behavior reactions of the rats were assessed with the "open field" technique immediately after centrifugation; weighing coefficients of the urogenital organs (the organ/body mass relation) were determined, and histological and morphometric analyses of prostate, testis and kidney were made. A significant moderating effect of prophylactic prostatilen on the stress-reactions in animals was first revealed; prostatilen was also found to speed up adaptation. This was concluded from normalization of the hemodynamics, a decrease in venous plethora and epithelial dystrophy, absence of basophilia in conjunctive tissue of the urogenital organs. Distention and overfilling of acini by secret and the number of epithelial acinus hulled into the lumen were markedly less in prostate. Spermatogenesis in testis was normalized, too. The histological profile of kidney approached the norm. Results of the experiment showed that prostatilen is a promising preparation from the standpoint of moderation of stress-reactions and counteraction of disorders in the urogenital organs caused by g-loads.

The purpose of the present study was to examine the effects of the animal renal peptide complex renaline obtained via acid extraction on the cause of acute pyelonephritis in the experiment. Renaline was found to be highly effective in treating experimental acute pyelonephritis in rats. This is manifested as improved changes in the parameters of leukocytosis, leukocyturia, rectal temperatures, and bacteriuria along with the regression of abnormal changes and the reduction in renal mass differences, as compared to the similar parameters in untreated animals. The findings indicate that the clinical use of renaline in the combined therapy for acute pyelonephritis.

Immunological examination (T- and B-cell immunity, metabolic activity of phagocytes) was conducted in 10 patients with primary and 21 patients with secondary chronic pyelonephritis in the phase of latent inflammation resistant to conventional antibacterial therapy versus 12 patients free of this disease. It was found that immunoreactivity in the above patients was compromised as shown by quantitative and qualitative deficiency of T-cell immunity (a fall in the absolute number of CD3+, absolute and relative content of CD2+DR+, changed proportion of T-lymphocyte subpopulations, low activity of oxygen-dependent anti-infection systems of phagocytes). B-system immunity did not much change for the worse. In primary chronic pyelonephritis immunoreactivity was affected more seriously.

Under analysis were results of operative treatment of 291 patients aged from 7 to 76 years with traumas and strictures of the urethra at the period from 1970 to 1990. Totally 325 operations have been performed. The primary suture of the urethra was successfully used in 8 of 36 patients with trauma of the urethra. Tunneling of the urethra for its strictures which was widely used in the clinic up to 1980 gave 46.2% of recurrences during the first 3 months after operation. It required the surgical methods to be changed. During the recent 11 years 161 operative interventions have been performed: 103 (64.0%) resections of the urethra, 45 (28.0%) internal optical urethrotomies and transurethral resections (TUR) of scarry tissues, 7 (4.3%) epidermoplasties of the urethra and 6 (3.7%) tunnelings of the urethra. The amount of recurrences dropped up to 13.7%. The primary suture of the urethra is necessary for penetrating ruptures of the urethra if the patient's state allowed. Resection of the urethra must be the operation of choice in patients with strictures and obliteration of the urethra. The endoscopic methods of treatment (urethrotomy and TUR) are indicated for short strictures and scarry deformity of the posterior urethra after operations on the prostate. The epidermoplasty is expedient for lengthy strictures.