scholarly journals Percutaneous antegrade ureterolithotripsy for proximal ureteral stones: overview own experience use

2021 ◽  
Vol 9 (2) ◽  
pp. 92-99
Author(s):  
S. V. Popov ◽  
R. G. Guseinov ◽  
N. K. Gadjiev ◽  
A. V. Davydov ◽  
V. M. Obidnyak ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Statistical Significance ◽  
Main Group ◽  
Ureteral Stones ◽  
Control Group ◽  
Renal Ultrasound ◽  
Biochemical Tests ◽  
Extracorporeal Shock Wave

Introduction. Currently, a large number of techniques are used in the treatment of patients with ureteral stones: extracorporeal shock-wave lithotripsy (ESWL), retrograde ureterolithotripsy (RULT), laparoscopic and retro-peritoneoscopic ureterolithotomy.Purpose of the study. To evaluate the possibilities and effectiveness of percutaneous antegrade ureterolithotripsy in the treatment of patients with proximal ureteral stones in comparison with transurethral contact ureterolithotripsy.Materials and methods. Twenty-eight patients with urolithiasis were treated, who underwent percutaneous antegrade ureterolithotripsy (PAULT) and 27 patients of the control group, who underwent RULT. All patients included in the study underwent a standard preoperative examination: complete blood count and urine analysis, bacteriological urine culture, biochemical tests, and X-ray research methods. Plain urography, renal ultrasound, computed tomography were used as imaging methods. The OLYMPUS URF-V3 8.4 Ch (Olympus Europa SE & Co. KG., Germany) video uretero-renoscope was used for PAULT in patients of the main group; lithotripsy was performed using thulium laser. The results of the study were subjected to statistical processing in order to determine the statistical significance of the differences between the data obtained. Quantitative variables were described using the arithmetic mean (M) and standard deviation (5). Qualitative variables were estimated by absolute and relative frequencies (percentages). The data were considered reliable at p values < 0.05.Results. The average time of surgical intervention in patients of the main group from the moment of placement of the ureteral catheter was 47 ± 12 min, with access without preliminary renal catheterization: 28 ± 4 min. Average time of surgical intervention in patients of the control group: 42.0 ± 10.7 minutes. The presented data indicate a significant (p < 0.05) greater cases' number of complete stone removal among patients of the main group compared with patients in the control group (74.0%).Conclusion. PAULT is preferred among choice treatment methods for patients with proximal ureteral large stones, for whom RULT and ESWL cannot be performed with a high level of “stone-free” rate and a minimum number of complications.

Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

2018 ◽  
pp. 39-42
Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Paranasal Sinuses ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Sodium Hyaluronate ◽  
Main Group ◽  
Control Group ◽  
Nasal Breathing ◽  
Minimal Invasiveness

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.

scholarly journals IMPROVING THE RESULTS OF TREATMENT OF PATIENTS WITH URETERAL CONCREMENTS AFTER CONTACT URETEROLITHOTRIPSY

2017 ◽  
Vol 4 (2) ◽  
pp. 8-12
Author(s):  
R. M. Solh ◽  
M. I. Andrukhin ◽  
O. V. Makarov ◽  
V. V. Fedchenkov
Keyword(s):  
Laser Therapy ◽  
Postoperative Period ◽  
Acute Pyelonephritis ◽  
Main Group ◽  
Ureteral Stones ◽  
Control Group ◽  
Results Of Treatment ◽  
Group 6 ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.

scholarly journals Determining the risk factors for xerostomia in dental out-patients

2015 ◽  
Vol 96 (2) ◽  
pp. 174-177
Author(s):  
K V Komarova ◽  
N N Ratkina ◽  
V K Polenichkin ◽  
E P Karmanov
Keyword(s):  
Risk Factors ◽  
Musculoskeletal Diseases ◽  
Statistical Significance ◽  
Main Group ◽  
Control Group ◽  
Endocrine Disorders ◽  
Chi Square ◽  
Chi Square Test ◽  
Period Duration ◽  
Group 1

Aim. To determine the risk factors for xerostomia.Methods. The study included 137 patients aged 25 to 60 years (61 males, 76 females), the main group consisted of 40 patients with xerostomia (11 males, 29 females), with a median age of 44.5 years (38; 49.5). The control group included 97 patients without xerostomia (50 males, 47 females), median age - 42 years (36; 49). The questionnaire by V.V. Afanas’ev (1993) was used to collect the complaints, anamnesis and to determine the risk factors for xerostomia. Qualitative indicators are listed as absolute numbers and shares (%). In assessing the statistical significance of qualitative indicators differences, contingency tables with subsequent Pearson chi-square test were used.Results. Among the patients of the main group, 19 (47.5%) took medications decreasing the salivation, with intake period duration ranging from 1 to 4 months. When questioned, patients with xerostomia reported statistically significant increase in the rates of cardiovascular disorders (15 patients, 37.5%), gastrointestinal tract diseases (11 patients, 27.5%), endocrine diseases (10 patients, 25%), musculoskeletal diseases (9 patients, 22.5%). The combination of three or more positive answers on V.V. Afanas’ev questionnaire questions was revealed in 12 (30%) patients of the main group, which was significantly higher compared to the control group (1 patient, 1.03%).Conclusion. The most typical reasons for developing xerostomia were the following: taking medications decreasing the salivation, presence of cardiovascular, gastrointestinal, musculoskeletal and endocrine disorders. Three or more positive answers on V.V. Afanas’ev questionnaire questions increase the probability of detecting xerostomia in a respondent.

scholarly journals Assessment of Urinary Kidney Injury Molecule-1 as an Indicator of Early Renal Insult in Children with Cystic Fibrosis

2020 ◽  
Vol 8 (B) ◽  
pp. 262-267
Author(s):  
Walaa Shahin ◽  
Ahmed Bader ◽  
Rawdah Ahmed ◽  
Mona Alattar ◽  
Mona Alfalaki ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Urine Analysis ◽  
Kidney Injury ◽  
Fractional Excretion ◽  
Control Group ◽  
Renal Ultrasound ◽  
Fractional Excretion Of Sodium ◽  
Beta 2 ◽  
Renal Tubular ◽  
Kidney Injury Molecule 1

BACKGROUND: The risk of acute kidney injury in cystic fibrosis (CF) patients is due to renal tubular affection by CFTR gene. AIM: Our study aimed at early detection of renal impairment in CF patients, to enable careful monitoring and adjustment of nephrotoxic medications. METHODS: Fifty patients with CF were enrolled in our study; they were age- and sex-matched to 40 healthy control children. All subjects were screened by urine analysis, measurements of kidney function tests, fractional excretion of sodium, β2-microglobulin (beta-2-M) excretion, and renal ultrasound examination. Urinary kidney injury molecule-1 (KIM-1) was assayed using ELISA technique. RESULTS: Both urinary beta-2-M and KIM-1 concentrations were significantly higher in CF patients compared to the control group (p < 0.001). The duration of the disease was significantly positively correlated with the urinary beta-2-M and KIM-1 levels (r = 0.6 and 0.7, respectively; p < 0.01). CONCLUSIONS: Our results showed that urinary KIM-1 can be considered as a sensitive early indicator of acute renal injury.

scholarly journals The effectiveness of kinesio taping in edema-reducing treatment for fractures of the lower jaw

2021 ◽  
Vol 102 (2) ◽  
pp. 243-248
Author(s):  
D K Gasimzade ◽  
F V Takhavieva ◽  
S S Ksembaev ◽  
O A Ivanov
Keyword(s):  
Statistical Significance ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Mandibular Fractures ◽  
Kinesio Taping ◽  
Lower Jaw ◽  
Measured Length ◽  
Miniplate Osteosynthesis ◽  
Angle Fractures

Aim. To assess the effect of Kinesio taping on edema reduction among the patients with fractures of the mandible (lower jaw) in the early postsurgical period of osteosynthesis. Methods. Patients with unilateral mandibular angle fractures with displacement of fragments (49 men at the age of 1850 years), divided into 2 groups: the main group 26 patients (with the inclusion of Kinesio taping in the complex of treatment) and the control group 23 patients (the traditional complex of treatment). All patients underwent splinting of the jaw and miniplate osteosynthesis. Kinesio tapes were applied the next day after surgery to the skin above and below the surgical wound. Three out of five standard landmarks were used to measure edema on the 1st and 5th days after osteosynthesis. Data were analyzed by using descriptive statistics and Student's test. In all cases, the level of statistical significance was 5% (p 0.05). Results. On the day after osteosynthesis, the patients of the main group showed a statistically significant (р 0.003) increase in the measured length for all three landmarks compared with the intact side due to pronounced postoperative edema. On the 5th day after the inclusion of Kinesio taping in the complex of treatment, there was a reduction in edema the indicators of the fractured and intact sides did not differ significantly from each other (р 0.05). In patients of the comparison group, the decrease in the parameters of postoperative edema on the 5th day of observation was negligible and insignificant in all measurements (р 0.05). Conclusion. The results indicate the effectiveness of using Kinesio taping for mandibular fractures in the early postoperative period of osteosynthesis, which makes it possible to achieve a significant reduction in postoperative edema; Kinesio taping is a promising, easy-to-perform method that can be used to reduce inflammatory edema in fractures of the mandible.

scholarly journals Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

2018 ◽  
Vol 85 (7) ◽  
pp. 27-29
Author(s):  
V. P. Аndriushchenko ◽  
D. V. Аndriushchenko ◽  
Yu. S. Lysiuk
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Control Group ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Second Stage ◽  
Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

Efficacy of Tamsulosin with Extracorporeal Shock Wave Lithotripsy for Passage of Renal and Ureteral Calculi

2008 ◽  
Vol 42 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Ryan L Losek ◽  
Laurie S Mauro
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stone ◽  
Data Extraction ◽  
Renal Stones ◽  
Ureteral Stones ◽  
Control Group ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave

Objective: To review the evidence for the safety and efficacy of adjunctive tamsulosin in enhancing the efficacy of renal and ureteral stone clearance when used with extracorporeal shock wave lithotripsy (ESWL). Data Sources: A search of MEDLINE (1950-January 2008), PubMed (1950-January 2008), and the Iowa Drug Information System (1966-January 2008) was performed using the search terms tamsulosin and extracorporeal shock wave lithotripsy. MeSH headings included lithotripsy and adrenergic α-antagonists. Additional references were found by searching bibliographic references of resulting citations. Study Selection and Data Extraction: All studies utilizing tamsulosin therapy after a single session of ESWL or after the development of steinstrasse, an accumulation of stone fragments that obstructs the ureter, were included. Data Synthesis: To date, 5 prospective studies have evaluated the efficacy of tamsulosin combined with ESWL in enhancing the passage of renal and ureteral stones. in one trial, 12-week renal stone clearance was 60% in the control group compared with 78.5% in the tamsulosin group (p = 0.037). Among trials that evaluated overall ureteral stone clearance, efficacy rates were 33.3-79.3% in the control groups compared with 66.6-96.6% in the tamsulosin groups. Reports of pain and supplemental analgesic dosing were consistently lower with tamsulosin, but data on the incidence of subsequent retreatment with ESWL or ureteroscopy was rarely reported. Adjunctive tamsulosin particularly enhanced the passage of renal stones 10-24 millimeters in diameter. Overall, tamsulosin was well tolerated. Conclusions: Overall, evidence suggests that adjunctive tamsulosin therapy combined with ESWL is safe and effective in enhancing stone clearance in patients with renal stones 10-24 millimeters in diameter. Evidence regarding ureteral stone clearance is inconclusive, although adjunctive tamsulosin has been reported to reduce painful episodes. Larger prospective trials evaluating different dosages and stone locations, as well as the ability of tamsulosin to reduce repeat ESWL or more invasive methods such as ureteroscopy should be performed.

scholarly journals Can Tumor Necrosis Factor-α and Interleukin-6 Be Used as Prognostic Markers of Infection following Ureteroscopic Lithotripsy?

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Athanasios Bantis ◽  
Georgios Tsakaldimis ◽  
Athanasios Zissimopoulos ◽  
Stilianos Giannakopoulos ◽  
Christos Kalaitzis ◽  
...  
Keyword(s):  
Prognostic Markers ◽  
Surgical Intervention ◽  
Infectious Complications ◽  
Ureteral Stones ◽  
Control Group ◽  
Serum Samples ◽  
Ureteroscopic Lithotripsy ◽  
Postoperative Fever ◽  
Factor Α ◽  
Necrosis Factor

Introduction. Ureteroscopic lithotripsy (URS) although highly effective for the treatment of ureteral stones is associated with certain complications, the more common of which are postoperative fever and infection. In the present study we aimed to evaluate the levels of serum cytokines in patients undergoing ureteroscopic lithotripsy and investigate any possible correlation between levels of cytokines and infectious complications after URS. Materials and Methods. Thirty patients (19 males, 11 females), with a mean age of 47 (range: 26–68) that underwent URS lithotripsy for ureteral stones, and 10 healthy volunteers serving as the control group were enrolled in this study. Serum samples for TNF-α and IL-6 were obtained before surgical intervention and after 1, 24, and 48 hours and 2 , 24, and 48 hours, respectively. The preoperative and postoperative levels were compared and correlated with the possible complications after URS. Results. Serum TNF-α levels were statistically significant, increased 1 hour (P=0.0083) and 48 hours (P<0.001) after operation. IL-6 levels were found statistically significant, elevated after 2 and 24 hours from the URS (P<0.001). In 2 patients we observed postoperative fever (>38.5°C). These two patients had high preoperative values of TNF-α and IL-6 ( 30 and 50 pg/mL, resp.) and these values increased postoperatively. Conclusion. High preoperative levels of serum TNF-α and IL-6 may indicate a predisposition for postoperative inflammation and infection following URS lithotripsy.

scholarly journals Associations of SNP rs_7927894 of FLG gene and TARC/CCL17 with atopic dermatitis in children

2021 ◽  
pp. 12-18
Author(s):  
V.O. Dityatkovsky ◽  
◽  
O.E. Abaturov ◽  
N.V. Naumenko ◽  
O.O. Alifirenko ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Statistical Significance ◽  
Venous Blood ◽  
Clinical Signs ◽  
Main Group ◽  
Control Group ◽  
Serum Concentrations ◽  
Control Groups ◽  
And Control ◽  
Severity Degree

One of the main genetic factors of the development of atopic dermatitis (AD) in children are single nucleotide polymorphisms (SNP) of the filagrin gene (FLG), particularly rs_7927894 FLG. One of the mostly studied and promising AD marker chemokines (CK) is the thymusE and activation regulated chemokine (TARC/CCL17). Purpose – to detect the associations and role of different variants of SNP rs_7927894 FLG gene and TARC/CCL17 in children suffering different AD clinical proE files (CP) – isolated or combined with comorbid atopic disorders (AtD). Materials and methods. The main group comprised 39 patients aged 3 to 18 years, suffering the isolated AD or combined with comorbid AtD. The control group comprised 47 patients aged 3 to 18 years, suffering the pathology of gastrointestinal tract without clinical signs of atopy. All the patients of the main and control groups had undergone detection of the genotype variants of SNP rs_7927894 FLG gene by real-time polymerase chain reaction and detection of TARC/CCL17 serum concentrations in venous blood. The cutEoff value of statistical significance was set as p<0.05. Results. The incidence and association of genotype variants C/C, C/T and T/T SNP rs_7927894 FLG gene in patients of cohorts of the studied groups were detected as follows: C/T rs_7927894 FLG was significantly the most common in the general main group (56.4%, p<0.05), within the cohort of CP AD isolated (61.1%, p<0.05) and CP of AD combined with comorbid AtD (52.4%, p<0.05). There were detected the associations of studied SNP with AD: C/T rs_7927894 FLG is significantly directly associated with AD (r=0.291, p<0.05), C/C rs_7927894 FLG has a reverse association with a trend to significance (r=-0.194, p=0.07). Mean serum concentrations of TARC/CCL17 did not differ significantly among patients cohorts of the main and control groups, respectively: general main group — 615.8 pg/ml, main with a CP AD isolated — 651.3 pg/ml, main with a CP of AD combined with comorbid AtD — 585.4 pg/ml, control — 608.4 pg/ml (p>0.05). Associations of serum TARC/CCL17 concentrations were determined as follows: elevation trending to significance within increasing AD severity degree (r=0.290, p=0.07) and significant elevation within the AD exhacerbation period (r=0.426, p<0.05). No significant association of TARC/CCL17 as to AD patients compared to the control group was detected in our study (r=-0.027, p>0.05). Conclusions. The genotype heterozygote variant C/T rs_7927894 FLG is significantly the most common and associated with all AD CP in children — isolated and combined with comorbid AtD. Variant C/C rs_7927894 of FLG gene is significantly reversely associated with AD in children. Serum concentrations of TARC/CCL17 did not reveal any significant differences between the AD patients and nonEatopic ones. However, they significantly elevate within AD exacerbation phase and trending to significance within AD severity degree increase in children. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: atopic dermatitis, children, associations, polymorphism, filaggrin, thymus- and activation regulated chemokine.

scholarly journals Combined (citrate and herbal) drug uriklar in extracorporeal shock wave lithotripsy and metaphylaxis of urolithiasis

2018 ◽  
Vol 8 (1) ◽  
pp. 19-25
Author(s):  
Aleksandr Yu Shestaev ◽  
Vladimir V Protoshchak ◽  
Mikhail V Paronnikov ◽  
Artyem O Kiselev
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Main Group ◽  
Urinary Stones ◽  
Control Group ◽  
Total Efficiency ◽  
Herbal Drug ◽  
Extracorporeal Shock Wave

The aim of the study was to study the clinical efficiency and safety of the drug uriklar in extracorporeal shock wave lithotripsy (ESWL) and early metaphylaxis of urolithiasis. Materials and methods. 45 patients were included in the prospective study. The patients were divided into two groups. The main group consisted of 25 patients, they received uriklar 1 capsule three times a day for one month before and three after ESWL. The control group included 20 patients who underwent ESWL only. Uriklar is combined drug with citrate and herbal components. Results. The total efficiency of ESWL was 92% in I group versus 75% in control group. Among the patients of the main group, the frequency of renal colic after ESWL was 24% (6 patients), while in the control group colic occurred in 9 patients (45%). The severity of pain syndrome was of 5.12 ± 2.1 in I group and of 7.48 ± 2.2 and in II group (p < 0.05). Uriklar in the first group of patients increased the pH of urine and the excretion of citrate significantly and decreased excretion of uric acid. After 3 months, the vast majority of patients (n = 24, 96%) of the main group underwent curing of the urinary tract, and daily diuresis remained at 2.3 ± 0.3 l/day. Conclusions. The uriklar taking increases the fragmentation of urinary stones and the elimination of the resulting fragments from the urinary tract, promotes the normalization of metabolic disorders, and effectively eliminates infectious-inflammatory complications of urolithiasis. It is also well-tolerated and has no side effects. (For citation: Shestaev AYu, Protoshchak VV, Paronnikov MV, Kiselev AO. Combined (citrate and herbal) drug uriklar in extracorporeal shock wave lithotripsy and metaphylaxis of urolithiasis. Urologicheskie vedomosti. 2018;8(1):19-25. doi: 10.17816/uroved8119-25).

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