Umělá inteligence – příležitost, nebo hrozba?

doc. MUDr. Ondřej Volný, Ph.D.

Urol. praxi. 2025;26(4):179

Urodynamics in neurogenic disorders of the lower urinary tract

MUDr. Lucie Bartáková, MUDr. Pavel Drlík, Ph.D.

Urol. praxi. 2025;26(4):183-187 | DOI: 10.36290/uro.2025.084

The role of urodynamic examination is irreplaceable in patients with suspected neurogenic aetiology of bladder dysfunction. Many disorders and especially situations that are risky for patients in the long term cannot be distinguished without urodynamic examination. The most important is the detection of high-pressure bladder, which is not physiological and, over time, damages not only the lower but also the upper urinary tract. Moreover, in some patients it can be completely asymptomatic.

Nitrofurantoin in the treatment and prophylaxis of lower urinary tract infections - current recommendations

MUDr. Marcela Fontana, Ph.D., FEBU, MUDr. Michaela Matoušková

Urol. praxi. 2025;26(4):188-193 | DOI: 10.36290/uro.2025.085

Urinary tract infections represent one of the most common bacterial diseases, predo­minantly affecting women. In recent years, the growing trend of antibiotic resistance has significantly influenced the management of infections, including those of the urogenital tract. This highlights the critical need for rational antibiotic prescribing, with an emphasis on the use of narrow-spectrum agents that maintain a favorable resistance profile. Due to its ability to achieve high urinary concentrations, low preva­lence of resistant strains, and minimal impact on intestinal microflora, nitrofurantoin remains a cornerstone in the treatment and prophylaxis of...

Current prostate cancer diagnostics

MUDr. Jiří Stejskal, Ph.D., FEBU

Urol. praxi. 2025;26(4):196-200 | DOI: 10.36290/uro.2025.086

This review article presents current recommendations for prostate cancer detection, while considering local specifics. It discus­ses the topics of initiating diagnostics, prostate cancer screening, the use of imaging methods, and indications and techniques of prostate biopsy. The article is based on the latest guidelines of the European Association of Urology.

Artificial sphincters in managing severe incontinence in men

MUDr. Kateřina Fojtíková

Urol. praxi. 2025;26(4):201-203 | DOI: 10.36290/uro.2025.087

The article deals with the management of severe urinary incontinence in men when conservative approaches fail to work. It focuses on implantation of an artificial urethral sphincter as one of the most effective options that, despite its invasive nature, results in significant improvement in the quality of life of patients. The text discusses the main causes of incontinence, such as those linked to prostate surgery, and explains how both traditional and modern types of sphincters work. Also included is an overview of contraindications and possible complications associated with sphincter implantation. The aim of the article is to highlight the need for...

Upper tract urothelial carcinomas

MUDr. Michaela Šafářová, FEBU, MUDr. Šárka Kudláčková, Ph.D.

Urol. praxi. 2025;26(4):204-208 | DOI: 10.36290/uro.2025.088

Urothelial carcinoma is the second most frequently diagnosed malignity in urology. However, upper tract urothelial carcinomas (UTUC) account only for 5-10% of diagnosed urothelial carcinomas. The diasease is twice more frequent in men than women. Main risk factors include smoking and consumption of aristolochic acid. The most frequent symptom is macroscopic haematurie, which may be absent in up to 20 % of patients. According to the EAU Guidelines (2025) it is neccessary to stage the pacient according to the TNM classification and assess if it is either low or high risk localised disease or metastatic disease. The therapy of each stage is very different...

Genetic and molecular factors in the development of bladder cancer - a geneticist's view

MUDr. Klára Nováková, Ph.D., doc. MUDr. Lenka Foretová, Ph.D.

Urol. praxi. 2025;26(4):210-215 | DOI: 10.36290/uro.2025.089

Bladder cancer development is influenced by a combination of genetic and molecular factors that affect cellular processes such as growth, division, and DNA repair. These factors may play a role in tumor initiation and progression. Key genetic and molecular factors associated with this disease include mutations in tumor suppressor genes (e. g. TP53, RB1, CDKN2A), oncogenes (e. g. FGFR3, HRAS, ERBB2, PIK3CA), microsatellite instability (MSI), aberrant protein expression (PD-L1), epigenetic changes (e. g. CDKN2A gene methylation) and chromosomal changes of the loss of heterozygosity type. It turns out that individual genetic...

The impact of chronic diseases on male sexual function

MUDr. David Čapka, doc. MUDr. Robert Grill, Ph.D.

Urol. praxi. 2025;26(4):226-230 | DOI: 10.36290/uro.2025.092

Chronic diseases can have a significant impact on male sexual function in several ways. Sexual dysfunction can be the first symptom of some chronic diseases. Treatment can vary depending on the cause and may include lifestyle changes or modifications, medication, or surgery. There is a clear need to prospectively collect data and information on all aspects of men's health, including cardiovascular disease (CVD) screening protocols and assessing the impact of primary and secondary prevention strategies. Overall, several studies have shown that lifestyle modifications, including physical activity, especially aerobic exercise, weight loss including bariatric...

Antibiotics and drug interactions in urology

PharmDr. Aleš Šorf, Ph.D., PharmDr. Petr Domecký, Ph.D.

Urol. praxi. 2025;26(4):220-225 | DOI: 10.36290/uro.2025.091

Urinary tract infections represent the second most common group of bacterial infections in the general population, and their diagnostic and therapeutic management requires careful consideration of multiple factors. Key determinants include the location and severity of the infection, the risk of recurrence, and local epidemiological data on anti­biotic resistance. Antibiotics from different classes vary in their pharmacokinetic and pharmacodynamic profiles, which influence their potential to cause clinically significant drug interactions. These interactions can substantially impact treatment outcomes, either by leading to therapeutic failure or by increasing...

Rational approach to the treatment and prevention of lower urinary tract infections in women

MUDr. Marcela Fontana, Ph.D., FEBU, MUDr. Michaela Matoušková

Urol. praxi. 2025;26(4):217-219 | DOI: 10.36290/uro.2025.090

Acute cystitis is the most common form of urinary tract infection (UTI), commonly treated by physicians across various specialties. The latest guidelines of the European Association of Urology introduce a new classification of UTIs into localized and syste­mic, replacing the previsous division into complicated and uncomplicated UTIs. They also emphasize the importance of antimicrobial stewardship and rational antibiotic use, considering potential adverse effects, the risc of insreasing bacterial resistance, and disruption of the patient's natural microbiome. The following text summarizes current recommendations regarding the treatment and prevention...

Cystolithiasis formation caused by a forgotten intrauterine contraceptive device

MUDr. Michaela Motolová, Ph.D., FEBU

Urol. praxi. 2025;26(4):231-234 | DOI: 10.36290/uro.2025.093

Cystolithiasis in women is a rare diagnosis. Its etiology is associated with the pre­sence of foreign material (mostly stitches) in the bladder - most often iatrogenic in connection with gynecological interventions or urinary outflow insufficiency due to a neurogenic disorder, but also with changes in the architecture of pelvic floor - a higher grade cystocele (1, 2). This case report aims to highlight the not often discussed issue of neglected and migrating intrauterine devices (IUD) from the urologist's point of view. It also reflects the proper multidisciplinary management of a critical condition of a geriatric patient with obstructive pyonephrosis...

The significance of the systematic component in MR/TRUS fusion biopsy for prostate diagnosis: a retrospective study

MUDr. Přemysl Grubský ml., MUDr. Libor Pochobradský, Mgr. David Brebera, MUDr. Daniela Tomčová

Urol. praxi. 2025;26(4):235-238 | DOI: 10.36290/uro.2025.094

Worldwide, prostate cancer is among the most significant malignancies in the male population. It is a serious health issue that requires ongoing improvements of diagnostic methods and treatment strategies. Effective and accurate diagnosis, especially of clinically significant prostate cancers, plays a key role in the entire management of this disease, treatment planning and improving both patient the quality of life and survival of patients. This article presents our experiences with the fusion biopsy program and its potential use in clinical practice. The primary aim of this retrospective study was to determine whether it is necessary to perform systematic...