Iimmunohistochemical study of cells proliferative activity by Ki-67 protein and localization of matrix metalloproteinase-9 (MMP-9) has been carried out at benign prostatic hyperplasia and adenocarcinoma of different gradations by the Gleason score. A significant decrease of the MMP-9 levels in the adenocarcinoma of different gradations have been found. A moderate positive correlation between the Gleason score and cell proliferation Ki-67 index (rs = 0.674) and a moderate negative correlation with the level of such score and expression of MMP-9 (rs = –0.660) were detected

Prostate cancer (PC) is one of the most burning problems of modern urologic oncology. Patients at its high risk are characterized by a more aggressive course of the disease and significantly lower tumor-specific and relapse-free survival rates. Hormone therapy and radiotherapy are one of the conventional treatments in patients with PC at high risk of progression. Nonetheless, more and more publications demonstrating the efficiency and safety of surgical therapy in this contingent of patients are recently appearing. This paper presents the results of surgical treat-ment in 499 patients with PC at high risk of progression, who have undergone radical prostatectomy with extended pelvic lymphadenectomy at the Department of Urologic Oncology, P.A. Herzen Moscow Oncology Research Institute.

Introduction. Endoscopic radical prostatectomy is a highly effective treatment for localized prostate cancer. Intrafascial prostate dissection ensures early recovery of urine continence function and erectile function. This article sums up our own experience of performing intrafascial endoscopic prostatectomy.

Materials and methods. 25 patients have undergone this procedure. 12 months after surgery 88.2 % of the patients were fully continent, 11.7 % had symptoms of minimal stress urinary incontinence. We encountered no cases of positive surgical margins and one case of bio-chemical recurrence of the disease.

Conclusion. Oncologically, intrafascial endoscopic radical prostatectomy is as effective as other modifications of radical prostatectomy and has the benefits of early recovery of urine continence function and erectile function.

Extraperitoneoscopic (endovideosurgical extraperitoneal) radical prostatectomy (ERPE) is one of the current surgical treatment procedures in patients with localized prostate cancer. Failure of vesicourethral anastomosis (VUA) and the development of its stricture are common surgi-cal complications. This investigation compares the efficiency and safety of different procedures to form VUA during ERPE: an interrupted suture (n = 24), a MVAC suture (n = 23), and a MVAC suture using self-locking suture material (n = 24). The performed comparative analysis of different procedures for forming VUA during ERPE may conclude that there are a number of advantages of the MVAC suture ap-plying the self-locking suture material. These advantages include less time taken to form VUA with the low frequency of complications, such as leakages occurring during control cystography or the development of delayed VUA strictures.

In this study the results of retrospective analysis of treatment of 311 patients in Samara Oncology Center in 2008–2011 with locally advanced prostate cancer are presented. According to the received treatment patients were divided into 3 groups: 103 underwent HIFU, 101 patients had a course of EBRT, 107 patients received only hormone therapy (HT). Overall survival in patients with locally advanced prostate cancer after HIFU therapy was 86.2 %, after EBRT and HT – 66.3% and 18.1 %, respectively. These data indicate a high clinical efficacy of ultrasound ablation.

Objective: to identify factors for the development of dysuria and its prevention in patients with prostate cancer (PC) after high-intensity focused ultrasound (HIFU) therapy.

Subjects and methods. In September 2008 to June 2013, the Clinic of Urology, S.M. Kirov Military Medical Academy, treated 98 patients, by performing HIFU sessions on an Ablatherm apparatus (EDAP, France). All the patients underwent transurethral resection of the prostate (TURP) to reduce the volume of the ablated tissue. The patients were divided into 2 groups: 1) 29 patients underwent TURP 3 days before HIFU therapy; 2) 69 did this 1 month before major surgery. Each group was divided into 2 subgroups: 1) after ultrasound ablation, a urethral catheter was inserted for 10 days; 2) epicystostoma was applied, followed by its overlapping on day 3 postablation and spontaneous urination. The postoperative incidence of dysuria was estimated from subjective (complaints, voiding diary, and Inter-national Prostate Symptom Score) and objective (uroflowmetry, small pelvic ultrasonography with determination of residual urine volume) criteria.

Results. In the patients who had undergone TURP one month before HIFU therapy, grades I–II urinary incontinence and urethral pros-tatic stricture occurred much less infrequently than in those who had undergone this maneuver 3 days prior to major surgery. Urinary in-continence and urethral prostatic stricture occurred 2-fold more frequently after TURP being carried out 3 days before HIFU therapy than after the urethral catheter being inserted. TURP performed one month before HIFU therapy showed no great difference in the incidence complications regardless of the type of bladder drainage.

Conclusion. The short interval between TURP and HIFU therapy for PC increases the risk of postoperative dysuric events. The optimal time to perform TURP prior to HIFU therapy is 1 month.

Routine measurement of prostate-specific antigen (PSA) levels has resulted in the increased number of prostate biopsies. The lower age-related reference values of PSA have in its turn led to the larger number of unnecessary prostate biopsies (to the hyperdiagnosis of clinically insignificant PC). Biopsy can presently identify prostate cancer (PC) in only 35 % of the patients with total PSA level of 4–10 ng/ml and PSA-negative PC in 20–25 %. The diagnostic potentialities of PSA as an independent marker have been obviously exhausted. The new PC oncomarkers described in the latest literature are certain to deserve meticulous attention and investigation. From a variety of oncomarkers, PCA3 is most promising biomarker. PCA3 versus total PSA or its other derivatives is the best predictor of PC during primary or repeated prostate biopsy. Some publications show that PCA3 may be used to schedule primary or repeated prostate biopsy, by constructing risk nomograms, in conjunction with other individu-al indicators of a patient’s examination, including those with other newest biomarkers for PC. The use of PCA3 in everyday practice may assist in increasing the specificity of PC diagnosis and in reducing the number of unnecessary prostate biopsies.

The paper deals with the differential diagnosis of kidney tumor and gastrointestinal stromal tumor. Preoperative diagnosis cannot always be made correctly, by applying even the most novel diagnostic methods. Nevertheless, the choice of treatment policy must be optimal.

The paper describes the technical characteristics of laparoscopic partial nephrectomy in patients with renal cell carcinoma. It has been ascertained that the authors’ two-layer wound closure technique during laparoscopic partial nephrectomy allows to perform complex renal resection (a total RENAL scale score up to 10) during long-term warm ischemia time that does not differ significantly (p = 0.09) in duration of simpler laparoscopic partial nephrectomy (without opening the pelvicalyceal system).

The paper gives the results of surgical treatment in patients with renal cancer, by applying its resection method developed at the Department of Urology, I.I. Mechnikov North-Western State Medical University. The proposed method was used to operate on 2 patients. In both cases, organ-sparing surgery was performed, as absolutely indicated. The postoperative follow-up revealed neither recurrent cancer nor signs of tumor dissemination; the function of the operated kidney was satisfactory. The proposed renal resection procedure can reduce the risk of complications observed during renal autotransplantation and minimize volemic, metabolic, and hypothermic disorders developing after use of other methods for long-term anti-ischemic defense of the organ during surgery.

Objective: to enhance the efficiency of combined treatment for non-muscle-invasive bladder cancer ((NMIBC) and to assess the results of its treatment using transurethral resection (TUR) as monotherapy and in combination with intravesical adjuvant chemotherapy (CT).

Subjects and methods. The results of treatment were analyzed in 59 patients with NMIBC. Twenty-two patients underwent TUR in Group 1; TUR and single intravesical injection of drugs were performed in 19 patients in Group 2; 18 patients had TUR and long-term intravesical CT.

Results and discussion. The recurrence rates were 59.1, 57.9, and 38.89 % in Groups 1, 2, and 3, respectively. Intravesical CT was found to appreciably affect the prevention of recurrence in the area of resection. The rate of this recurrence was 31.81, 26.32, and 5.56 % in Groups 1, 2, and 3, respectively.

 Conclusion. Adjuvant intravesical chemotherapy CT is an effective method to prevent recurrent bladder cancer.

Purpose. Assessment of predictors of cancer-specific survival (CSS) in patients at high risk of progression of muscle-invasive bladder cancer (MIBC) after radical cystectomy that have been included in a prospective, randomized study to assess efficacy of shortened course of adjuvant chemotherapy.

Material and methods. A total of 92 patients were included in the study. Prognostic significance of age, gender, recurrent status of urinary diversion, pT category and pN, the number of distant lymph nodes (LN), the degree of differentiation and the presence of metaplasia, the number of metastatic lesions of the LN and LN-density lesion on CSS were evaluated with Cox proportional hazard model.

Results. Factors significantly associated with the probability of death from bladder cancer were number of metastatic lymph nodes (hazard ratio (HR) 1.128; 95 % confidence interval (CI) 1.018–1.251; p = 0.022) and the density of LN involvement (HR 1.011; 95 % CI 1.001–1.022; p = 0.039).

The diagnosis of superficial papillary bladder tumors remains a serious problem and has 2 aspects: classificational and morphological ones. As of now, 2 classifications of superficial bladder tumors, the basis for which is different principles (the 1973 WHO and the 2004 WHO ones) are equally used. Pathologists and clinicians must know criteria for both classifications and understand their differences, advantages, and disadvantages. If they are unaware of the normal structure of the bladder and the specific features of work with transurethral resection material, they cannot adequately stage non-muscle-invasive tumors.