The review deals with one of the pressing andrological issues – gynecomastia, its etiology and pathogenesis. Based on the current epidemiological and experimental data, most common etiological factors of gynecomastia were investigated. A multiple-valued role of various causes of gynecomastia in several age-groups was revealed. Literature data show that gynecomastia may be a manifestation of various diseases: endocrine, genetic, systematic. As well as that, gynecomastia may occur in patients with oncological diseases. However, gynecomastia can be an iatrogenic complication. Currently, we continue to make insights to the problem of gynecomastia in order to be able to classify its etiological factors and determine its basic pathogenesis pathways.

The article describes modern methods of examination, preoperative preparation and surgical treatment of infertility in men with non-mosaic form of Klinefelter syndrome (SK) by microdissection method of testicular sperm retrieval. Men with SK responsive to hormonal therapy with aromatase inhibitors and human chorionic gonadotropin (НCG), have a greater chance of a favourable outcome of infertility treatment. Testicular volume, testosterone levels and test results with НCG are important prognostic factors in this group of patients. We present a clinical case of treatment of infertility in men with SK by microTESE (microdissection testicular sperm extraction).

General and private questions of clinical endocrinology and pathophysiology of vitamin D disorders at men are considered in the literary review. The general part of the review is devoted the analysis not numerous while epidemiological and the clinical-experimental researches showing an important role of vitamin D deficiency as a factor of deterioration of modern men health from the point of view of increase at them cardiovascular and oncological risks, and also indicators of the general death rate. High frequency of vitamin D deficiency both in the world, and in population of the Russian men is shown. Laboratory criteria of various kinds of vitamin D disorders are resulted. Inflammatory and tumoral prostate diseases which are the most often meeting in andrological practice are considered as a private examples of a role of vitamin D and its disorders at men. Considering their high prevalence, as well as prevalence of vitamin D deficiency, in man’s population and a close connection with system hormonal-metabolic disorders (obesity, insulin resistance, androgen deficiency), it is possible to assume additional negative influence of vitamin D deficiency to initiation, clinical current and progressing both system disorders of hormonal-metabolic homeostasis, and prostate diseases too. The further development of vitamin D endocrinology within the limits of andrology can lead in the long term to working out new rational pharmacotherapeutical options for pathogenetic management of a prostate pathology.

Nearly one in 5 couples are thought to be infertile or subfertile. Worldwide sperm counts are declining. Environmental factors, lifestyle changes and dietary status may negatively impact spermatogenesis, most cases of male factor infertility and low sperm counts are idiopathic. The common denominator appears to be increases in oxidative stress and abnormalities of metabolic function. This may be localized primarily in immature sperm cells and white blood cells. The large content of phospholipid bound polyunsaturated fatty acids in the sperm membrane makes it more susceptible to peroxidative damage. Breakdown or disturbance of the membrane leads to functional impairment of sperm cell. This process leads to sperm dysfunction, abnormal parameters on semen analysis, DNA fragmentation and functional disorders affecting sperm penetration and oocyte interaction. Remarkably, studies have shown that antioxidants and other related micronutrients can reduce oxidative stress and thereby enhance sperm function. An optimized sperm supplement should be recommended in all cases of male subfertility as well as unexplained infertility.

In a critical review of the literature highlights issues cardiological safety of testosterone therapy in men with cardiovascular diseases, based on research evidence over the past 25 years, as well as a detailed analysis of a number of recent publications, was summoned by the ambiguous attitude of experts and researchers in connection with them demonstrated high frequency of adverse cardiological outcomes in men on the background of androgen replacement therapy. Most modern randomized studies have proven a link between low testosterone levels and the poor state of the cardiovascular system in older men, so early detection and proper correction of hypogonadism in them can be regarded as an effective preventive and therapeutic cardioprotective option. Results improperly designed studies that have low probative due to errors in design and statistical treatment of the material and, more recently published, it should be, no matter what, to actively explore and analyze in order to not only criticize, but also to learn from them scientific practical use to a more correct understanding of the problem as a whole. The authors present their views on this issue and try to uncover the possible causes of the mixed results of recent publications on cardiological safety of testosterone drugs, a high degree of which they themselves have no doubt.

Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.

Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.

Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 %) patients. Supernumerary renal arteries and veins observed in 5 (4.9 %) patients; retroaortic left renal vein type I and II – in 3 (3.0 %) patients. Double vena cava inferior detected in 1 (1.0 %) patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.

Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %), the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

The article describes a novel technique of performing transurethral cystolithotripsy in gas (carbon dioxide) medium, and the results of its first usage in 30 patients with bladder stones, compared to transurethral cystolithotripsy in conventional liquid medium in 30 patients. Data analysis shows that the rate of stone destruction in gas media was 1.47 times higher in small (less than 10 g) stones and 2.3 times higher in large (more than 10 g) stones as compared to surgeries conducted in liquid media. Also, we concluded that our proposed technique is safe and has advantages when compared to conventional surgery in liquid media. This is absence of increased stone mobility, better visualization during surgery and higher economic efficacy (5 times on average).

Method of choice for surgical treatment of vasculogenic erectile dysfunction (ED) is the genesis of arteriovenous falloprosthetics. In the initial stages of the disease, young men, dissatisfied inhibitor therapy 5-phosphodiesterase and/or intracavernous injections do not agree to such a view of his proposed lecheniya. Authors give the results we operated 26 patients 25–48 year old (mean age 34.3± 7.4) with vasculogenic ED. Of these, 23 patients with venoocclusive ED, 3 patients had arterial insufficiency of the corpora cavernosa. Of these 3 patients, 2 were haemodynamic and clinical features with arteriovenous ED step subcompensation. Maximum period of observation data up was 23 months. Overall clinical compensation of these patients and subsequent sexual rehabilitation was evaluated as satisfactory: the total value of transactions amounted to international index of erectile function 9–13 (10.5 ± 3.6), after surgery 14–25 (21.3 ± 4.2) (p = 0.001). Use this innovative technology allows you to make a sexual rehabilitation most of these patients and avoid falloprosthetics.

Buserelin is one of the first synthetic gonadotropin-releasing hormone agonists. The R.M. Fronshtein Clinic of Urology, I.M. Sechenov First Moscow State Medical University, has experience in using Buserelin depot in 32 patients with metastatic prostate cancer. The results of using Buserelin depot for 12 months are described. There was a significant reduction in prostate-specific antigen levels in the entire group.

Twenty-seven (84.4 %) patients could achieve tumor stabilization. Twenty (62.5 %) of the 32 patients treated with Buserelin depot at the Clinic of Urology showed decreased residual urine; 9 (28.1%) had no changes and 3 (9.4 %) displayed increased residual urine. The administration of the drug caused significant bone pain relief in 76.5 % of the cases.

All the Buserelin depot-treated patients satisfactorily tolerated the given treatment. There was either concomitant disease progression or treatment discontinuation in none of the cases. Thus, Buserelin depot proved to be an effective drug with a good safety profile.

The article studies the influence of a complex of acetyl-L-carnitine and L-carnitine fumarate in combination therapy qualitative and quantitative indicators of sperm in men with various forms pathospermia. The study has shown that such improved performance as morphology, motility and concentration. It turned out that the treatment of complex drugs carnitine series allows you to have a spouse patients natural pregnancyin 29.57 % of cases, which does not exclude the use of drugs containing acetyl-L-carnitine and L-carnitine fumarate in preparing men to assisted reproductive technologies programs.

During thoracodorsal flap phalloplasty, recovered contractility of the muscular base of the neophallus may lead to its shortening that impedes introjection.

To eliminate deformity and shortening of the neophallus, the authors propose the procedure of corset plasty of its muscle, which differs in that the alloplastic material – esfil mesh endoprosthesis, is used as a corset instead of fascia latum of the hip. The proposed procedure reduces surgical trauma, improves the functional characteristics of the neophallus, and accelerates sexual rehabilitation.

The work is based on a study of prostate stones obtained by transurethral resection of the prostate in 5 patients with benign prostatic hyperplasia in combination with chronic calculous prostatitis. Stones have been investigated by scanning electron microscopy and X-ray microstructural analysis, as well as a comparative study of bacteriological swabs from the surface of the stones after ultrasonic treatment of stone and without it. Pretreatment ultrasound prostate stones before sowing on nutrient medium swabs improves bacteriological diagnosis, which may be due to the dispersion of biofilms and exit vegetative forms of bacteria from it. This feature can serve as ultrasound theoretical justification for its use to improve the efficiency of diagnosis of various forms of prostatitis.