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Percutaneous nephrolithotomy (PCNL) is the gold standard treatment of large and staghorn kidney stones. Despite technological progress and improvement of PCNL technique, this procedure is associated with complications and in some cases remain a challenge for endourologists. According to the time, complications can be divided into intra- and postoperative. Intraoperative complications include bleeding, injury of the renal collecting system, visceral organs, pulmonary complications, thromboembolic disorders, extrarenal migration of the stone fragments and incorrect nephrostomy tube placement. Postoperative complications include infection and sepsis, bleeding, persistent urinary fistula, infundibular stenosis and death of the patient. The different recommendations that might be useful for the timely diagnosis of various complications in patients undergoing PCNL are provided in the review. Additionally, information on treatment algorithms is included.

The "gold standard" for the diagnosis and evaluation of urinary stones is native computed tomography, which allows determining stone localization and size of with high accuracy. However, this imaging technique has limited diagnostic usefulness in determining the stone chemical composition. The newly introduced method of dual-energy computed tomography, based on obtaining images at two different energy levels is highly effective in determining the composition of urinary stones. The review outlines the principles and methods of performing dual-energy computed tomography using various scanners. The authors analyze the results of using this method for diagnosing urolithiasis, determining the stone chemical composition and point out the limitations and difficulties encountered in its application.

Aim: To analyze the sub-segment of mHealth devoted to assessing of the risk of recurrent stone formation and metaphylaxis of stone formation. To design a smartphone application (app.) in Russian language for urolithiasis patients., Materials and Methods: Three working groups of urologists from three St. Petersburg clinics searched for downloadable medical applications relevant to the above requirements. After searching and analyzing existing medical applications, the most acceptable design and structure of our own application were identified., Results: The developed "Urolithiasis" application is available for free download in Russian language versions in App Store (Apple, Inc.) and Google Play (Android market, Google, Inc.). It features the following sections: 1) "Take the test" (personalized calculation of the risk of kidney stone recurrence and providing relevant recommendations using ROKS nomogram), 2) "Water" (with reminders to drink water and automatic logging of the water intake), 3) "Food" (Nutrition facts on the content of calcium, oxalate, purine, protein, citrate and calories in common foods), 4) "My doctor" (in the future this option will allow for on-line communication with a patients physician), 5) "Feedback" (if the patient does not find the desired product or has a question - this section is for him/her)., Conclusions: The smartphone application "Urolithiasis" in Russian may be recommended to patients with urolithiasis for improving the effectiveness of metaphylaxis.

We studied clinical characteristics of voiding disorders to improve treatment results in patients with Parkinson's disease (PD) in 64 PD patients (28 women and 36 men aged 45 to 76 years, mean age 62.5 +/- 9.4 years). Duration of PD was 8.0 +/- 3.4 years, history of voiding disorders--2.1 +/- 0.8 years. Hyperactive urinary bladder was the cause of voiding disorders in all the patients. The examinees have undergone physical examination, microscopic and cultural examination of the urine, ultrasound investigation of the kidneys, urinary bladder and prostate with determination of residual urine, urodynamic examination of the lower urinary tracts. All the patients were divided into four groups. Group 1 of 10 patients received antiparkinsonian therapy which corrected voiding disorders. Group 2 (n = 26) received tolterodin in a dose 4 mg/day, group 3 (n = 14) received oxibutinin in a dose 5 mg/day, group 4 (n = 14) were treated with trospium chloride in a dose 30 mg/day. Thus, initial correction of antiparkinsonian therapy was made in 64 patients, after this correction voiding disorders reduced in 10 patients and no further treatment was needed. Voiding disorders reduced in all 3 groups of patients given the drugs. Cystometric capacity of the bladder increased in all 4 groups from 155 (86-450) ml to 220 (105-530) ml, on the average, and unstable contractions of the urinary bladder decreased from 3.1 (1-8) to 1.6 (0-5). Quality of life in the examinees improved considerably. The data obtained evidence for M-cholino-blockers efficacy in PD patients with unstable detrusor after correction of antiparkinsonean therapy. Two-month course of tolterodin, oxibutinin and trospium chloride significantly reduced symptoms of urination disorders.