Synyshyn Y. Substination and development of tactics to treat patients with ureteral calculi complicated by acute pyelonephritis

The dissertation was designed to elevate the efficacy in treating the patients with ureteral calculi who were found to have acute pyelonephritis (AP), through differential extracorporeal shock wave lithotripsy (ESWL) in clinical practice on the base of urological departments in regional clinical departments in the regional clinical hospitals. There was proved an absence of clinically considerable changes in urinary microflora after separation of pathogens out of renal and ureteral calculi after their fragmentation.To objectively evaluate the effective restoration of urinary passage from kidney through ureter bloked with calculus, the ultrasound-monitoring of the perimeter of renal cavity system was performed, and the terms of its performance after urgent ESWL were determined.An absence of clinically considerable traumatic ESWL effect on kidney, ureter and adjacent tissue in patients with nephroureterolithiasis and ureterolitiasis complicated with acute pyelonephritis was proved by means of monitoring the blood serum of C-reactive protein.There was scientifically substantiated the possibility to apply an urgent ESWL in patient with ureteral calculi complicated with acute serous pyelonephritis, as an alternative method to restorean urinary passage from the blocked kidney, that allows to reconsider and to widen the indications to ESWL as a whole