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The diagnosis and treatment of 120 patients with urolithiasis were made. The following examinations were made: the study of immune status and lipid peroxidation, detection of selective proteinuria, leukocyte migration inhibition reaction with autoantigens obtained from the tissues of the renopelvic segment providing additional information about renal parenchyma and immune system. The patients were divided into two groups: 70 patients of the study group received pre-, intra- and postoperative preventive pharmacotherapy, while 50 patients of the control group received standard therapy. It is shown that preventive measures in the patients of the study group aimed at raising resistance of the kidney to the shock wave and prevention of infectious-inflammatory process evidence for necessity of the above measures not only before extracorporeal shock wave lithotripsy, but also in intra- and postoperative periods.

Overall 62 patients coral calculi underwent percutaneous nephrolithotripsy and distant shock-wave lithotripsy (DSWL). Percutaneous nephrolithotripsy as monotherapy was effective at 47 (75.8%) patients. At 15 (24.2%) patients the residual calculi were fragmented with DSWL. Obtained positive results permit to recommend percutaneous nephrolithotripsy both as monotherapy and in combination with DSWL for the treatment of patients with coral nephrolithiasis.

The study enrolled 506 males 20 to 50 years of age (mead age 30.8 +/- 0.5 years) with chronic prostatitis (CP). Group 1 consisted of 332 (65 +/- 4.1) patients with CP caused by lateral urogenital infection (LUGI) due to chlamydias, ureaplasmas, mycoplasmas, gardnerellas, herpes virus type 2. Group 2 comprised 174 patients free of LUGI. T-cell and humoral immunity parameters were assessed by T-lymphocytes CD3, T-helpers CD4, T-suppressors CD8, CD4/CD8, natural killer cells CD16 using indirect immunofluorescence. Phagocytic activity of T-lymphocytes was estimated with latex as the antigen. An etiological factor was ureaplasmas, chlamydias and others in 170 (51.2 +/- 5.4%) and 155 (46.7 +/- 5.4%) patients, respectively. Mixed infection was diagnosed in 94 (28.3 +/- 4.8%) patients. Secondary immune and interferon deficiencies were detected in 155 (30.6%) patients of both groups. The patients received etiological (antimicrobial) and pathogenetic (immunological) therapy. The highest effect was obtained in prostatitis caused by mono-LUGI. Pain and pollakiuria attenuated, the copulative function improved. The conclusion is made that CP, especially secondary to LUGI, should be treated by combination of etiotropic with immunotropic methods.

The trial included 144 patients aged from 24 to 46 years with secretory infertility in the presence of chronic prostatitis of 2 to 13 year duration. The study group consisted of 96 patients who received conventional treatment in combination with physical factors provided by the unit APK-ELM-01 Andro-Gin. The control group consisted of 48 patients on conventional treatment alone. The results were processed mathematically and statistically. The patients were examined before, 2 weeks, 1 and 6 months after the treatment. Positive response was greater in the study group: better parameters of prostatic secretion, spermogram. Normalization of all the parameters occurred in 95 and 80% patients of the study and control groups, respectively. Thus, Andro-Gin is effective for treatment of chronic prostatitis with secretory infertility.

Effects of plasmapheresis and hemosorption on efficacy of the treatment of autoimmune male infertility (AMI) were studied in 289 AMI males with oligoasthenozoospermia aged 19 to 37 years. The males were divided into three groups by the levels of antisperm antibodies (ASAB) in the blood and ejaculate. The study was made of cellular and humoral immunity, intensity of protein and lipid free radical oxidation and antioxidant defense. Patients of group 1 with high ASAB in the blood but low in ejaculate received a course of plasmapheresis. Patients of group 2 with high ASAB both in the blood and ejaculate were subjected to hemosorption and plasmapheresis in one contour. Group 3 patients with high ASAB in ejaculate but low in the blood received efferent therapy only after medication and photomodification of the blood. The treatment reduced elevated levels of ASAB in the blood and ejaculate, normalized free radical oxidation, cellular and humoral immunity, antioxidant defense. This resulted in improvement of spermogram parameters, efficacy of assisted reproductive technologies, higher probability of natural pregnancy in the patients' wives.

A multivitamin complex Vitamax was given to 65 patients with chronic prostatitis who retained sexual disorders after basic treatment. Mean age of the men was 41 +/- 10 years (25-67 years). The efficacy of the drug was assessed by the data obtained with Male Copulative Function questionnaire. All the patients were found to have mixed sexual dysfunction. Vitamax was taken in a dose 2 capsules a day before a morning meal, a total of 30 capsules a course. After the treatment all the patients improved their copulative function. Thus, Vitamax is an effective drug in sexual dysfunctions related to chronic prostatitis, the efficacy being higher in young men. Side effects were absent.

The antichlamydial action of wilprafen was studied in patients suffering from urogenital chlamydial prostatitis complicated by infertility. An individual approach to etiotropic and pathogenetic therapy with wilprafen alone and in combination with vobenzim introduced by the authors in men with chlamydial prostatitis complicated by infertility produced a high curative effect.

We used the drug avelox, a new fluoroquinolone of the fourth generation, in therapy of urogenital infections (caused by chlamydia, mycoplasma, ureaplasma) in men. The test group consisted of 45 men with urethritis, urethroprostatitis given avelox in a single dose of 400 mg/day for 10 days. 18 control patients with urethritis took ofloxacin in a dose of 200 mg twice a day for 10 days. Examination for infection eradication was made 2 weeks and 2 months after the end of the treatment. Eradication of chlamydial infection was achieved in 18 (94.73%) patients, mycoplasma (ones in 23 (80%), ureaplasma--in 29 (86%) patients. Thus, clinical efficiency of avelox may be characterized as very good in chlamydial infection, good in ureaplasma and mycoplasma infections. Side effects occurred only in 5 patients who had short-term transient gastrointestinal disorder. Compared to ofloxacin, avelox is more effective and less toxic.

156 women operated on for genital endometriosis received treatment for infection of the upper urinary tracts diagnosed by ultrasound. The treatment was conducted only in case of normal urodynamics achieved by drainage (on demand) and comprised antibacterial therapy, efferent hemocorrection, intravascular laser irradiation of blood, hyperbaric oxigenation. A response was obtained in 98% patients.

Fifty-nine male patients with urogenital infections were treated by wilprafen (josamycin). The results evidence for high efficiency of the drug in patients with urogenital inflammations and recommend it for wide use.

To specify the implication of the genetic factors in formal genesis of urolithiasis, the pattern of stone formation was investigated in 206 probands with urolithiasis hereditary loading versus 324 patients rejecting family history of this disease. Distribution of the disease forms was considered in correlation with mineral metabolism derangement and hereditary loading in the proband. It was found that severe urolithiasis occurs more frequently in the groups with phosphorus-calcium urolithiasis. These groups also included many families with the disease history. Numerous cases of urolithiasis of hyperparathyroidism etiology suggest endocrine disorders involvement in urolithiasis onset. Clarification of hereditary loading and its distribution in the families of urolithiasis patients allows a purposeful control of the families members to render them prophylactic aid.

Phosphorus metabolic disturbances play a great role in the occurrence of urolithiasis. This study covered 150 patients with urolithiasis to establish correlations between the frequency of histocompatibility antigens and the increase in blood and urinary phosphorus levels. The HLA antigens were identified by the routine microlymphocytotoxic method involving a histotyping serum panel. The ABO antigens and rhesus were determined by the agglutination method by using reference sera. The study revealed specific distribution of histocompatibility antigens in urolithiasis patients with disturbed phosphorus metabolism. Hyperphosphatemia correlated with the higher frequency of HLA-B35 (chi 2 = 9.89) and E/E system rhesus (chi 2 = 8.63); hyperphosphaturia showed a negative association with the HLA-A28 antigens (chi 2 = 9.7), as well as with E/e (chi 2 = 14.69) and e/e (chi 2 = 39.36) and a positive association with HLA-B13 (chi 2 = 5.98) and B35 (chi 2 = 36.58). The highest relative risk for hyperphosphatemia associated with the B27 and B35 antigens was observed with genetic predisposition, being 3.63 and 7.13, respectively. B12- and B35-positive individuals were at higher risk for hyperphosphaturia up to 11.25. There were significant differences in antigen frequency, and sex, genetic predisposition to urolithiasis, association of phosphorus metabolic disturbances with other metabolic disorders, and their effects of parathyroid lesions, etc. The findings reveal the immunogenetically induced risk for the occurrence and development of urolithiasis with disturbed phosphorus metabolism to make goal-oriented prophylactic measures.

The examination of 217 males suffering from diabetes mellitus revealed copulative dysfunction in 111 (51.1%) of them. The investigation of sex, gonadotropic hormones, testicular reserves, sexual constitution and sexual formula was carried out in 22-55-year-old males with sexual dysfunction and healthy controls. It was an erectile phase of the sexual cycle that suffered most frequently. Reduced libido was observed in 19% of the patients. All the diabetes examined showed constitutional predisposition to impaired potency. The patients had high serum concentrations of prolactin, lutropin and dihydroepiandrosterone in low testosterone and insignificantly elevated follitropin and estradiol. There was also low gonadal resistance to choriogonin stimulation. These findings and literature data lead to the conclusion that insulin insufficiency entailing hyperglycemia brings about a rise in prolactin and dihydroepiandrosterone levels which may reduce the sensitivity of the receptors and lutropin in the testes and inhibit testosterone secretion. This is confirmed by inactive gonadal response to stimulation of chorionic gonadotropin. Spermatogenic disorders observed in 25% of the patients were associated with sexual affections and local structural changes (hypotrophy) of the testes.

Associations between sterility in varicocele and HLA antigens have been studied. The results show increased incidence of antigens B13 and B22 in sterile males with varicocele. Specific distribution of HLA antigens, their relations with varicocele were characterized. The findings can be of use in identification of risk groups among varicocele patients.