Введение. Сегодня растворение уратных камней, согласно клиническим рекомендациям, является основным методом их лечения. Помимо достаточно дорогой двухэнергетической компьютерной томо-графии (КТ), других методов неинвазивного определения состава камня не существует.Цель исследования. Создать инструмент прогнозирования уратного нефролитиаза, тем самым улучшить отбор пациентов, подходящих для литолитической терапии.Материалы и методы. Ретроспективно проанализированы результаты обследования 189 пациен-тов с мочекаменной болезнью. Первую группу составили 59 пациентов с уратными камнями, вторую -130 пациентов с камнями иного состава. Сравнивали следующие параметры: клинические характери-стики, результаты 24-часового анализа мочи, данные КТ.Результаты. Из изученных параметров наивысшую статистическую значимость в определении со-става камня имели: масса тела, индекс массы тела, рН мочи и плотность камня полученная по данным КТ (p<0.01). Произведение рН мочи и плотности камня, названное «Урат-индексом», имело неболь-шую площадь под кривой (AUC 0.96), что позволило с более высокой точностью диагностировать урат-ный нефролитиаз.Заключение. Предложенный показатель «Урат-Индекс» прост в получении, является эффективным инструментом прогнозирования уратного состава камня и способствует лучшему отбору пациентов для литолитической терапии.Ключевые слова: мочекаменная болезнь; уратный нефролитиаз; мочекислый нефролитиаз; урат-индекс Background. Nowadays dissolution of uric acid kidney stones is the first line treatment according to existing clinical guidelines. Besides dual-energy CT, which is costly, there is no non-invasive tool to predict uric acid stone composition.Aim. To develop a new tool for uric acid stones prediction which will improve patient selection for oral stone dissolution therapy.Materials and methods. We retrospectively analyzed treatment results of 189 patients which were distributed to two groups: with pure uric acid stones -59 patients and with other composition -130 patients. Demographic data, results of 24 hour urine analysis and CT scans were analyzed.Results. Among above mentioned parameters the following had the highest significance: body mass, body mass index, urine pH and stone density in Hounsfield Units (p<0.01). Product of multiplication of urine pH and CT-stone density called «Urate index» yielded highest AUC (0.96) which permitted with high accuracy diagnose uric acid stones.Conclusion. «Urate-index» is simple to obtain and has high predictive value which might help choosing target population for kidney stone dissolution.

Improvement of patients` knowledge about their disease is an important part of management of chronic diseases. One of the effective methods to increase the level of medical education of the population is to hold regular meetings with patients within the framework of «schools for patients». Urolithiasis is one of the most common urological diseases (3.5‒9.6% of the population). In addition to its high prevalence, Urolithiasis has a high recurrence rate (50‒75% over 5‒10 years). The most common prostate diseases are prostatitis, benign hyperplasia, and cancer. These diseases have a chronic course and require а long-term observation. Treatment of urolithiasis and prostatic diseases is one of the priority fields for the urology department of the Pavlov First St. Petersburg State Medical University. In addition to surgical treatment, the specialists of urology department take measures aimed at prevention of recurrence and complications of these diseases. Schools for patients with urolithiasis and prostate diseases are held every 3 months. The topics for discussion are chosen by the patients themselves. In addition to reports, patients undergo ultrasound of the kidneys, bladder and prostate, as well as consultations. Participation in schools of patients creates a conscious attitude to their disease, increases adherence to treatment and improves the prognosis of the disease. The distribution of such programs corresponds to the modern concept of preventive medicine and increases the efficiency of providing medical care to the population.

There are patients suffered prostate cancer and diagnosed with stone disease in urological centres. These cases represent non-standard issue of choosing the optimal surgical treatment. Currently clinical recommendations haven’t described the particular answer for this answer yet. There is also lack of information published in literature foсused on the issue.Aim of the study was to determine the optimal choice of surgical treatment for patients diagnosed with stone disease and prostate cancer.Materials and methods: Retrospective study of patients diagnosed with prostate cancer and stone disease for the period from 2006 to 2019 was performed. Among 2047 in-patient cases of prostate cancer 71 patients with stone disease were included.Results: 49 of 71 (69%) patients diagnosed with stone disease had indications for surgical treatment at the moment of hospitalisation. Stages of prostate cancer in this group were T1-T2 (91,7%) and T3(8,3%). 25 patients (51%) had kidney stone disease, 23 patients (47%) – ureter stone disease and only 1 patient – kidney and ureter stone disease. 37 patients (75%) presented complains related to stone disease, other cases (25%) were asymptomatic. Surgical treatment of stone disease primarily was performed in the majority of cases (72,2%). Surgical treatment of prostate cancer subsequently included radical prostatectomy in most cases 7 (86,1%). Simultaneous surgical treatment of both diseases haven’t performed in this study.Conclusion: The main factors influencing the decision making of optimal surgical treatment for this group of patients were clinical presentation and group of prostate cancer risk.

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