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Urogenital fistulas are common complication of obstetric and gynecological surgery; the most common are vesicovaginal fistulas. Vesicouterine fistulas are rare, which explains the difficulties in diagnosis and treatment. The literature review and own clinical case presented in article. A 43-years-old female patient was consulted with complaint of urinary leakage from vagina, which appeared 1 month after the cesarean section and vesicouterine fistula has been diagnosed. Successful laparoscopic treatment of vesicouterine fistula was performed at the Avicenna Medical Center after 3 months. The urethral catheter was removed 7 days after surgery. At control examination after 1, 3 and 6 months, ultrasound examination of the pelvic organs confirmed the consistency of the scar on the uterus. Urination remained free and painless, the patient did not notice urine leakage. This clinical observation shows the possibility of treating a vesicouterine fistula with a laparoscopic approach with a good result and the possibility of early rehabilitation.

Urinary fistulas complicating treatment of pelvic tumors are the clinical diagnostic problem that needs research and decision. The top-priority radiological method for diagnostic urinary fistulas is computed tomography. About application magnetic resonance imaging (MRI) is less well knows. The possibilities MRI to diagnostic of urinary fistulas are illustrated in the article; we discuss the limitation of method requiring additional use of other radiological methods. A literature search on the topic of research was carried out on the databases PubMed and eLIBRARY.

Urological complications after kidney transplantation is still now one of the main reasons of worsening operation results. Most surgeons pay a lot of attention to the urinary fistulae. At verifiable urinary fistulae the next tactics significantly depends on the presence of urinary stent. Subject of the work: to study the effectiveness of implantation as for double J-stents at kidney transplantation for prophylaxis of urinary fistulae. Materials and methods. The analyzed results of kidney transplantation among 66 patients from 2012 to 2016. There were 37 (56.1 %) men, the average age of patients was 33.4±12.4 years. All the patients on early after surgical period were done the monitoring of clinic-biological indexes, ultrasonic examination with scanning of renal allograft. As for the aim of the work all the patients were divided into two groups: The main group included 35 (53 %) recipients with kidney allografts, everyone of them was set uretero-bladder anastomosis on the double J-stent during the period from 11.2013 to 06.2016. The average age of patients was 32.6±9.2 years, there were 17 (48.6 %) men, 18 women (51.4 %). Controlling group involved 31 (47 %) patients. During the period from 01.2012 to 10.2013 at kidney transplantation urinary stents were not used among the patients. The average age of recipients was 34.3±15.3 years, there were 20 (64.5 %) men, 11 women (35.5 %). Results. According to the analysis of our clinic material the implantation of J-stent at kidney transplantation for prophylaxis of urinary fistulae is reliably (p0.05) with the infection of urinary tracks with the presence of urinary stent. Conclusions. Implantation of J-stent is effective and safe method of surgical prophylaxis of urinary fistulae and it can be routinely applied at kidney transplantation.

Introduction: Retrograde intrarenal surgery (RIRS) is being actively implemented in the treatment of renal stones and other diseases. If necessary, RIRS can be combined with percutaneous procedures., Aim: To study the results of RIRS in patients with nephrolithiasis and various renal disorders., Materials and Methods: A total of 106 patients who undergone RIRS were included in the study. There were 66 men (63.4%) and 40 women (36.6%). Mean age was 46.8+/-15.6 years. The indication for RIRS in 84 (79.2%) patients was renal stones. Calculus in calyceal diverticulum were diagnosed in 6 (5.7%), encrusted stents in 8 (7.7%), urinary fistulas after partial nephrectomy in 5 (4.7%), pelvis tumors in 2 (1.9%), pelvis perforation after marsupialization of parapelvic cyst in 1 (0.9%) patient, respectively. Simultaneous retro- and antegrade procedures were performed in 27 (25.5%) cases. In those with nephrolithiasis and encrusted stents, lithotripsy was done with the removal of stone fragments. Two patients underwent endoscopic resection of the pelvis tumor. In six patients, the neck of the diverticulum was incised after lithotripsy, while in five cases retrograde endoscopically controlled percutaneous treatment urinary fistulae was performed. In one case, laser fulguration of the pelvis defect with stenting was done., Results: RIRS was effective in 72 (85.7%) of 84 patients with renal stones. The operation time was 70.8+/-10.2 minutes. In 12 (14.3%) cases with residual fragments, extracorporeal shock-wave lithotripsy (n=7) and repeated RIRS (n=5) were performed. The efficiency of RIRS after two sessions was 91.7%. Complications were observed in 11 (10.4%) patients. With encrusted stents, the operation time was 95.0+/-16.5 min. After laser fragmentation of encrustations in the lower part of the stent, percutaneous lithotripsy was performed with antegrade removal of its upper half. The time for RIRS in those with diverticula was 60.0+/-8.5 min, the average stone size was 8 mm (from 6 to 10 mm). In all cases lithotripsy with mucosal fulguration was successfully done. The procedures for urinary fistulae were also effective (operation time was 45.0 +/- 20.5 minutes) and there were no complications., Conclusion: RIRS is a safe and effective treatment for patients with nephrolithiasis and other kidney disorders. Modern flexible ureteroscopes allows to examine the collecting system and to perform lithotripsy and removal of stone fragments.