Nowadays, urinary incontinence in women is not only a medical but also a serious social and hygienic problem. A variety of methods are used to eliminate this pathology, including surgical treatment. In the Russian Federation, 30,000 female patients per 1 million female population require surgical correction of urinary incontinence (Krasnopolsky V.I. et al., 1997). The anatomical and functional condition of the lower urinary tract, pelvic diaphragm and the degree of genital prolapse influence the choice of surgical technique. In cases of minimal prolapse of the bladder neck with a significant degree of urinary incontinence, suprapubic suspension surgeries are performed.

The goal is to increase the effectiveness of surgical uterine extirpation for cervical and corpus abnormalities combined with vaginal wall prolapse and relative urinary incontinence.

Aim: The recurrent course of chronic lower urinary tract infections in more than 10% of women is caused by variants of the external urethral opening, such as vaginal ectopy and hypermobility. This creates conditions for retrograde infection of the urethra during sexual intercourse. The aim of the study was to improve the treatment outcomes of women with recurrent lower urinary tract infection with vaginal ectopia or external urethral hypermobility.

Introduction and aims of the study. Urinary trauma in women remains the most serious complication in obstetric and gynecological practice. Unfortunately, such patients often remain without specialized care and suffer from total urinary incontinence.

Aim: To substantiate pathogenetically the choice of surgical correction method for genital prolapse complicated by urinary incontinence.

By minimally invasive methods of surgical treatment we mean benefits performed under endoscopic, transvaginal or percutaneous access without extensive opening of the skin, aponeurosis, and abdominal cavity. The development of minimally invasive surgery is currently the most promising trend in all fields of medicine, gynecology in particular. The advantages of minimally invasive technologies manifest themselves most fully at surgeries in hard-to-reach for traditional surgery areas, such as the cervical space of the small pelvis and the urethrovesical segment area. This fact together with high frequency of genital prolapse and dissatisfaction with the results of earlier proposed methods of treatment determined our interest in this problem.

Stress urinary incontinence in women is an urgent problem of modern urogynecology. About 40% of the female population of Russia suffer from this disease. New methods of their surgical treatment are being actively searched for. In recent years, the search for new methods of stress urinary incontinence treatment has been based on the necessity to objectify the results of treatment. It is important to monitor the results of surgery immediately, contact with the patient during the procedure is necessary.

Aim of the study: Optimization of preoperative preparation, surgical treatment and rehabilitation of patients with prolapse and prolapse of the vaginal and uterine walls.

The aim of the present study was to perform a clinical and physiological evaluation of the efficacy of different methods of surgical treatment of patients with genital prolapse and prolapse accompanied by the treatment of urinary incontinence with tension.

Genital malformations account for 4% of all congenital anomalies. Absence of the vagina occurs with a frequency of 1 per, 4-5 thousand newborns. The problem of vaginal formation in congenital aplasia has long attracted the attention of many specialists.

Currently, one of the important and understudied issues in urogynecology is the problem of stress urinary incontinence in women of childbearing age. In the USA, more than 15 million people suffer from urinary incontinence, a disease more common than diabetes mellitus (Neil M., 1999). In the Russian Federation, symptoms of urinary incontinence have been identified in 38.6% of women (I.V. Ryapolova, L.Y. Litvinenko, 1998).

One of the common urological diseases is tension urinary incontinence. Its treatment has not only medical but also social importance. Tension urinary incontinence is one of the diseases that not only cause physical suffering to women, but often lead to their social isolation. Tension urinary incontinence predominantly affects women who have undergone a pathological delivery, during which the muscles of the pelvic floor, perineum and genitourinary diaphragm are torn.

Aim: Analysis of cystometry results in women with complaints of urinary incontinence in order to determine its cause.

Aim of the study: Analysis of the results of different types of surgical treatment for stress urinary incontinence combined with urgent syndrome.

Aim: To optimize the diagnosis, prevention, and treatment of genital prolapse and urinary incontinence.

We examined 89 patients with vaginal wall prolapse and urinary incontinence before and after surgical treatment. The course of the postoperative period was uncomplicated (sanogenetic) in all women. The mean age of the women was 55.5±10.6 years, body weight was 71.4±1.2 kg, and height was 162.0±0.53 cm.

Aim: In some patients with urinary disorders the clinical picture and symptoms are determined by fluctuations of the maximum intraurethral pressure or urethral instability, which dictates the necessity of measuring pressure at its maximum point during a combined urodynamic study during urethral profilometry. The aim of the study was to investigate the clinical significance of maximal intraurethral pressure fluctuations in women.

Women suffer from tension urinary incontinence at different ages, but mainly from 40 to 50 years, the frequency of this syndrome ranges from 5% to 30% in the structure of general gynecological pathology.

The validity of loop surgery for tension urinary incontinence in women using both the body's own tissues and various synthetic materials is generally recognized. However, currently known techniques do not always satisfy physicians. For example, when a skin loop is used, a scar remains after the flap is formed, which is certainly a negative moment for patients. When synthetic materials are used, there is a high risk of erosion of the loop bed and long-term infection in the surgical area.

One of the possible causes of urinary incontinence (UI) may be a lesion of the pudendal nerve innervating the transverse striated muscle of the external urethral sphincter. In this case the most adequate method to assess the state of sphincters and pelvic floor muscles, to reveal the presence of denervation and degree of reinnervation in these muscles is needle electromyography (EMG), which is based on the study of motor units of muscles by analyzing their potentials recorded with concentric needle electrodes.

The aim is to increase the effectiveness of surgical correction of stress urinary incontinence in women with vaginal wall prolapse by using a pathogenetically justified combined treatment method consisting of anterior colporrhaphy with urogenital diaphragm muscle plasty, fixation of the bladder neck to the rectus abdominis muscles and aponeurosis using three caproneal ligatures, posterior colporrhaphy, perineolevatoroplasty.

216 women with stress, imperative and mixed forms of urinary incontinence were examined. Priority was given to anamnesis, physical examination, summary evaluation of urinary diary and traditional microbiological information.

Urodynamic studies are widely used in patients with various urinary disorders. However, the standard urodynamic study performed within 30-50 minutes often does not allow for evidence-based assessment of the accumulation and evacuation phases, which leads to various diagnostic errors.
The aim of this paper is to acquaint the readers with the results of examination of women suffering from various forms of dysuria using urodynamic monitoring.

Imperative urinary disorders are one of the most common medical problems. The main clinical symptoms of imperative urinary disorders are: frequent urination, imperative urge to urinate and imperative urinary incontinence. The pathogenesis of this pathology is currently not fully understood. Urodynamic examination in these patients usually reveals signs of detrusor instability (involuntary detrusor contractions during the filling phase), or urethral instability (fluctuations of maximum urethral pressure).

The final link in the pathology responsible for involuntary urine loss during physical exertion is a disturbance of the mechanism of adequate transmission of the impulse of increased intra-abdominal pressure to the urethra and bladder. The conditions leading to the occurrence of transmissive disorders are decreased resistance of the urethra and its upper half leaving the zone of hydraulic protection.

120 continent women with vaginal and uterine wall prolapse without urethrocele were examined. Urodynamic examination was performed in the lithotomic position using a "barrier". The first group (n=75) included patients with isolated cystocele and the second group (n=45) with cystocele and uterine prolapse. 

We studied some etiological and pathogenetic factors of tension urinary incontinence (TUI) in 132 female patients. The cause of the disease in 78 (59.5%) of them was fast or prolonged labor, heavy physical work; trauma in 26 (19.7%) and hormonal disorders in 19 (14.3%) patients. All the patients were subjected to a comprehensive examination that included cytological examination of vaginal smears with determination of the caryopycnotic index, cystourethroscopy, retrograde cystourethrography, and urodynamic studies.

The number of women suffering from stress urinary incontinence and requiring specialized treatment remains very high. Meanwhile, it is often possible to judge the presence and severity of the pathological process only by indirect data of examination, palpation, instrumental methods of examination.

The aim of the study: to determine the effectiveness of different types of therapy for urinary dysfunction in menopausal women.

Sexuality is an important topic for women recently entering postmenopausal age. The satisfaction derived from a healthy sex life is an important contribution to maintaining quality of life in menopause.

According to recent epidemiological studies, more than 50% of postmenopausal women suffer from urogenital symptoms, the frequency of which increases with age. Atrophic changes in the mucous membranes of the urogenital tract are caused by the loss of trophic function of estrogen, which leads to cessation of proliferative processes in mucous membranes, their thinning, increase in pH of the vaginal contents, dominance in the microbiocenosis of aerobic and anaerobic opportunistic pathogenic microflora.

Considering that the increased frequency of urogenital disorders in women in the menopausal period is caused by the development of marked atrophic changes in the vaginal and urethra mucosa on the background of estrogen deficiency, the presence of numerous contraindications to the use of pharmacological estrogenic drugs, we studied the possibilities of tissue therapy in the correction of urogenital disorders.

To study the possibility of using flow cytofluorometry (FC) of cervico-vaginal smears to objectify urogenital disorders (UGD) in women after surgical removal of ovaries, we examined 111 patients of reproductive age (25-35 years) who underwent surgical castration and had clinical manifestations of urogenital estrogen deficiency syndrome of different severity. All women were simultaneously examined: cervico-vaginal smears by triple-parametric FC method (GOI-92 cytometer, St. Petersburg) and traditional microscopic examination of vaginal smears.

The aim of the study was to investigate the state of vaginal microecology in postmenopausal women and to evaluate the microbiological efficacy of HRT for vaginal atrophy (VA).

Vesicovaginal fistulas are a complicated problem in urology due to their frequent recurrence.
Aim. To study five-year experience in the treatment of patients with vesicovaginal fistulas.

The problem of surgical treatment of vesicovaginal fistulas after gynecological surgeries is still a rather difficult task and does not always lead to successful results.
The aim of the present study was to improve the results of surgical treatment of patients with vesicovaginal fistulas after gynecological surgeries.

The main goal of the diagnostic process for various diseases is to obtain comprehensive information, allowing you to choose the best treatment option. Taking into account the necessity to assess the anatomical relations of the damaged urogenital organs and the results of plastic surgery for vaginal-vaginal fistulas, we used modern methods of radiological and ultrasound diagnostics in our work. 

Data on the dynamics of sexual function recovery in patients who underwent successful fistuloplasty were obtained by questionnaire survey. We interviewed 123 women with an average age of 41.6 years. Sexual function was restored in 71 (57.7%) patients without a history of hysterectomy 4.8 months after fistuloplasty. In 52 (42.3%) women who had undergone uterine extirpation, sexual function recovered only by 8 months after fistuloplasty.

In modern urogynecology, urogenital fistulas remain an urgent problem. From 1994 to 2000, 25 patients with vaginal fistulas were under our observation. Fistulas after gynecological operations were observed in 20 patients, after obstetric operations in 3 patients, after medical abortions in 2 patients. The period of existence of fistulas ranged from 4 months to 20 years. Fistuloplasty for recurrent fistulas was performed in 3 patients. The age of the operated patients ranged from 18 to 65 years.

Currently, one of the serious problems in urogynecology remains the problem of vaginal and vaginal fistula treatment. Up to 85% of fistulas develop after gynecological surgeries. Direct damage to the bladder wall during surgical treatment is the main cause of bladder-vaginal fistula formation. On the other hand, impaired blood supply to the bladder wall is believed to play a role in the genesis of fistula development.

Aim: Restoration of the continuity of the urinary tract and urination.
The treatment of patients with vesicovaginal fistulas is one of the most complex and topical areas of urogynecology. Causes of bladder-vaginal fistulas: a small incision of the abdominal wall during gynecological operations, festering of the operating wound, stitching of the bladder and vaginal walls, intensive bleeding during surgery with clips on the vessels, the bladder wall and tumor decay.

One of the most complicated problems of modern urogynecology is the damage of the urinary system organs. The high prevalence of instrumental interventions, the expansion of indications for operative delivery on the one hand, and the increased volume and number of radical operations performed by gynecologists are objective prerequisites for the occurrence of urinary system injuries.

The literature data indicate that the main causes of lower ureteral injuries are traumatic surgical interventions on the pelvic organs, in women more often on the genitals.
The aim of the present report is to analyze the treatment results of postoperative ureteric injuries.

The aim of this report is to acquaint the readers with the peculiarities of ureteric and bladder trauma after laparoscopic interventions, their diagnosis and treatment.

The aim of the study was to choose a rational treatment tactics for intraoperative injuries of the pelvic ureter in women diagnosed in the postoperative period.

In modern conditions, the operation of caesarean section in the lower segment has become one of the leading methods of operative delivery, and the frequency of its use, according to some authors, reaches 12-15%. The procedure is performed both in term pregnancies and to terminate pregnancy in the second trimester (small caesarean section). One of the complications of the postoperative period is uterine suture separation, requiring relaparotomy and uterine extirpation.

Obstetric traumas of the pelvic floor, perineum and urogenital diaphragm are the most frequent complications of childbirth and, according to domestic and foreign authors, account for 10.3-39%. Vaginal and perineal tears are the consequence of many causes depending on the mother and fetus, but, as a rule, they are the companions of pathological childbirth.

Aim of the study: To determine the frequency of detection of various genital infectious pathologies in women with insulin-dependent diabetes mellitus.

Bacterial vaginosis is the most common form of dysbiotic disorders of the vaginal microecology during pregnancy. Treatment of bacterial vaginosis requires awareness of the etiology and pathogenesis of this disease and strict individualization in the choice of methods and means.

In order to study the capabilities of modern research methods in the diagnosis of inflammatory diseases of the kidneys, we presented our experience in diagnosing the stages and forms of pyelonephritis using ultrasound, CT, thermal imaging in 106 patients with suspected purulent process in the kidney.