[FEATURES OF CLINICAL COURSE AND MORPHOMETRIC PARAMETERS OF BENIGN PROSTATIC HYPERPLASIA IN MEN WITH METABOLIC SYNDROME AND ANDROGEN DEFICIENCY].

The study was aimed to the evaluation of the effect of the components of the metabolic syndrome (obesity, insulin resistance (IR)) and androgen deficiency on the clinical course of lower urinary tract symptoms against the background of benign prostatic hyperplasia (LUTS/BPH) and nocturia, as well as on some of the parameters of BPH (prostate volume, residual urine volume, total prostate-specific antigen (PSA) blood level). The comprehensive survey of 160 men with LUTS/BPH (mean age 56.7 ± 3.3 years) was performed; based on the results of survey, three comparison groups were formed: Group 1 (n = 70)--patients with isolated obesity; Group 2 (n = 36)--patients with obesity and insulin resistance; and Group 3 (n = 54)--patients with obesity, insulin resistance and androgen deficiency. The control group consisted of 30 patients with LUTS/BPH without these metabolic and hormonal disorders. In patients with LUTS/BPH and obesity, higher frequency of nocturia compared with the control group was revealed (63.7% vs 23.3%; P < 0.05), as well as the relationship between the waist circumference and free testosterone level (n = 160; r = -0.322; P = 0.005) and waist circumference and total prostate volume (n = 160; r = 0.121; P = 0.005). In patients of Group 2, significant positive correlation between waist circumference and blood insulin level was identified (n = 36; r = 0.461; P = 0.005). Patients with obesity, insulin resistance and androgen deficiency had the highest average prostate volume and residual urine volume compared with those of other groups (P < 0.05). Thus, obesity, insulin resistance, androgen deficiency are associated pathological conditions, greatly aggravating the clinical course of LUTS/BPH due to adverse impact on the BPH parameters, acting both together and separately. The most severe LUTS/BPH were associated with the presence of all three of the above systemic disorders.

[Diseases of solitary kidney: the history and evolution of scientific issues].

The lecture is devoted to one of the most important problems of modern urology, which has a long scientific history--the diseases of solitary kidney after nephrectomy. Fundamental theory of solitary kidney was laid in the early XX century, during which it was significantly enriched by fundamental provisions preserving their practical significance in the present time. In the domestic literature of the last decade, however, the problem of diseases of solitary kidney is undeservedly forgotten and slightly developed. At the same time, recent data suggest a certain theoretical and practical conflict in this section of urology: on the one hand, the incidence of diseases of solitary kidney in the last 50 years has increased by at least a 2 times; on the other--an effective conservative treatments of diseases of solitary kidney at different stages of kidney failure have not yet implemented in clinical practice, except hemodialysis and renal transplantation used in the terminal stages of chronic renal failure. Methods of primary and secondary prevention of diseases of solitary kidney are not developed at all. The history and evolution of problems of diseases of solitary kidney is a good example of fact that despite available data and accumulation of new scientific evidence of the close relationship between local and systemic factors in the pathogenesis of these diseases, their new rethinking in the framework of interdisciplinary interactions for the optimization of methods of clinical management of this specific group of patients as well as for the development of new effective methods for early diagnosis, treatment and prevention are required.