Introduction. Urolithiasis is one of the most common pathologies in modern urology. This disease is registered in 10% of the population and is manifested by an annual increase. Despite all the effectiveness and safety of Ho:YAG, in recent years, the thulium laser has attracted more and more interest. At the moment, in the modern literature there is not enough information about thulium and holmium ureterolithotripsy. The aim of this study is to compare the effectiveness of thulium and holmium ureterolithotripsy. Material and Methods. Since from October 2018 to October 2019 in City Centre Endoscopic Urology and New Technologies Clinical Hospital of St. Luke; St. Petersburg, 420 patients underwent contact ureterolithotripsy with using of thulium (group Б) or holmium (group А) lasers for calculi localized in the ureter. Results. Patients in group B had an advantage in terms of such indicators as the time of surgery, the time of lithotripsy in the Dusting and Fragmentation modes for ureteral calculi of any localization compared with group A. The SFR level in the two groups was relatively identical. Patients in group B had a lower rate of retropulsion during lithotripsy compared to patients in group A. And also in group B there was no migration of calculus into the renal cavity system. Conclusion. Our data indicate the same level of stone free rate when using both thulium and holmium lasers in the dusting and fragmentation modes. However, there is a higher efficiency during ureterolithotripsy using a thulium laser compared to ureterolithotripsy using a holmium laser, regardless of the lithotripsy mode.

Extrauterine leiomyoma is a rare benign tumor, originating from smooth muscle cells, most often localized in the uterus. Extrauterine localization of leiomyoma is extremely rare. The presence of a neoplasm near the urethra always poses a challenge for differential diagnosis. Variety of pathologies sharing similar clinical findings requires further diagnostic testing and doctor alertness. We present the clinical case of urethral leiomyoma in a female patient aged 42 years complaining of frequent urination and vulval mass. The patient underwent neoplasm removal with further histologic examination revealing urethral leiomyoma. The article features the diagnosis and treatment of this rare pathology.

Луки», г. Санкт-Петербург, 3 Волгоградский медицинский научный центр, лаборатория моделирования патологии, 4 Волгоградский государственный медицинский университет, кафедра медицины катастроф В данной статье приводятся обобщенные и статистические данные о влиянии трансуретральной хирургии при доброкачественной гиперплазмии предстательной железы на эректильную функцию. Анализируются вопросы этиопа-тогененза, отражается динамика колебаний эректильной функции после трансуретральных вмешательств.Ключевые слова: эректильная дисфункция, доброкачественная гиперплазия предстательной железы, трансуретральная хирургия ДГПЖ, ретроградная эякуляция. Key words: erectile dysfunction, benign prostatic hyperplasia, transurethral surgery for BPH, retrograde ejaculation.Доброкачественная гиперплазия предстательной железы -это наиболее распространенное доброкаче-ственное заболевание мочеполовой системы у муж-чин в возрасте от 50 до 80 лет. До 50 % мужчин к 60-летнему возрасту не удовлетворены качеством моче-испускания, предъявляют жалобы на нарушения половой жизни. Хирургическое лечение доброкаче-ственной гиперплазии предстательной железы (ДГПЖ) является одним из основных способов [8]. В настоя-щее время у больных с ДГПЖ применяется целый ряд трансуретральных хирургических методик [4]. Лиди-рующую позицию занимают: моно-и биполярная ре-зекции, лазерная (гольмиевая или тулиевая) энуклеа-ции, различные методы вапоризации [15]. Ранее пока-зано, что у пациентов, перенесших трансуретральные вмешательства, в 4-40 % случаев развиваются рас-стройства эрекции той или иной степени выраженнос-ти. Поскольку многие мужчины пожилого возраста, составляющие большинство среди больных, подвер-гающихся трансуретральным эндоскопическим вме-шательствам, вкладывают в понятие улучшения ка-чества жизни не только улучшение качества мочеис-пускания, но и качества сексуальной жизни, столь высокий процент послеоперационной эректильной дис-функции требует пристального внимания врачей и ис-следователей к этой проблеме [3]. ЦЕЛЬ РАБОТЫОпределить влияние различных трансуретральных методов лечения ДГПЖ на эректильную функцию.

Prostate cancer (PCa) is in second place in oncological morbidity in males and is the fifth leading cause of death among the world's population. According to current world statistics, over the past 20 years there has been an increase in primary morbidity, as well as mortality from PCa. The key to diagnosing PCa is a prostate biopsy. Nevertheless, a systemic biopsy under transrectal ultrasound control is the subject of discussion and debate in oncourology, as it has significant drawbacks that affect the qualitative result of the diagnosis of PCa. Given the importance of adequate and staged PCa, various methods of targeted biopsy under magnetic resonance control have been proposed.This review will examine the main features and significance of targeted prostate biopsy, as well as the role of magnetic resonance imaging in the early diagnosis of PCa. The method of targeted biopsy of the prostate gland can improve the detection of PCa in relation to clinically significant forms. In addition, this method is extremely promising and requires further study to further improve the quality of early diagnosis of PCa, especially when selecting patients for radical surgical treatment.

Introduction. Urolithiasis refers to one of the most common diseases of the genitourinary system, which the urologist meets in his daily practice. When a stone is located in the ureter, surgical intervention is often required to restore the passage of urine and prevent the development of obstructive pyelonephritis. Currently, the holmium or thule laser ureterolithotripsy is condidered the «gold standard» of surgical treatment of ureteral calculi. The thermal effect on the ureteral wall when using a laser may be one of the reasons for the postoperative ureteral strictures development. The aim of our study is to compare in vitro thermal effects of these types of laser on the ureter wall by evaluating the change in the temperature of the irrigation fluid when they are used. Materials and methods. A tube with a diameter of 5 mm, which imitated the ureter, was placed in an aqueous medium with a temperature of 36°C. A temperature sensor (HI 98509 Checktemp 1) was installed in its lumen, at a 3 mm distance from the laser fiber. The time when the irrigation fluid reaches a temperature of 43°C, as well as its temperature at a pulse duration of 3 seconds at an irrigation rate of 25 and 50 ml/sec in the dusting and fragmentation modes, were recorded. Results and discussion. It was found that when using a thulium laser, regardless of the flow rate of the irrigation fluid, an increase in its temperature to 43°C is achieved for a longer time. Also, a lower temperature of the irrigation fluid with a pulse duration of 3 second is recorded using thulium laser. The obtained data allow us to assume that the use of a thulium laser is accompanied by a lower thermal effect on the ureter wall. Conclusion. In this study, we found that when using a thulium laser (Fiberlase U2) in the fragmentation and sputtering modes, a slower increase in the temperature of the irrigation liquid is observed than when using a holmium laser (Lumenis VersaPulse 100W), regardless of the irrigation speed. At a 3 second pulse , a lower temperature of the irrigation fluid was recorded during the use of the thulium laser.