PARP inhibitors in treating metastatic castration-resistant prostate cancerReview articles

MUDr. Igor Richter, Ph.D., doc. MUDr. Josef Dvořák, Ph.D., MUDr. Vladimír Šámal, Ph.D., MUDr. Jiří Bartoš, MBA, MUDr. Sofya Al-Samsam

Urol. praxi. 2023;24(3):126-130 | DOI: 10.36290/uro.2023.058  

Several different types of systemic therapy are available for the treatment of metastatic castration-resistant prostate cancer. The more lines of therapy are used, the more patients' lives can be prolonged. However, despite receiving treatment, patients gradually develop disease progression. Therefore, other treatment modalities are being sought that would prolong the survival of patients with metastatic castration-resistant prostate cancer. PARP (poly(ADP-ribose)polymerase) inhibitors have been shown to be effective in these patients both in monotherapy and in combination with ARTA therapy. The most recent data have been available for the olaparib...

Poděkování českým lékařůmEditorial

MgA. Olga Menzelová Kelymanová

Urol. praxi. 2023;24(2):55  

Treatment of superficial wounds, ulcerations and leions on male genitaliaFor nurses

Mgr. Markéta Koutná, Ph.D.

Urol. praxi. 2023;24(2):110-114 | DOI: 10.36290/uro.2023.049  

This paper focuses on superficial wounds and ulcerations of male genitalia, which often arise as a result of decompesation of the patien'ts health state in the conditions of intensive care. It presents possible care and treatment using moist wound healing method with selected therapeutic dressings. The artical can not include all available dressings. The author is aware of the fact, that local treatment can also be carried out using magistraliter preparation by a specialist in the field of a dermatology. The aim of the paper is to present care and treatment procedures that can be carried out in common conditions in hospital, outpatient as well as at...

Primary bladder amyloidosis as a cause of macroscopic hematuriaCase report

MUDr. Tomáš Ostárek, MUDr. Slavomír Vachata, doc. MUDr. Jaroslav Pacovský, Ph.D.

Urol. praxi. 2023;24(2):107-109 | DOI: 10.36290/uro.2023.048  

Amyloidosis is benign metabolic disorder characterised by extracellular deposition of abnormal proteins in various organs of the body. Primary bladder amyloidosis is a rare urological disease. We present case of a 67-year-old woman with clinical, radiological and endoscopic symptoms of bladder carcinoma.

Urologic complications after kidney transplantationFrom the boundary of urology

MUDr. Silvie Rajnochová Bloudíčková, Ph.D., DBA

Urol. praxi. 2023;24(2):103-106 | DOI: 10.36290/uro.2023.047  

Urologic complications with the incidence of 1-10% significantly contribute to morbidity and mortality in kidney transplant recipients. Individualized pretransplant evaluation and posttransplant follow-up reduce the occurance of urologic complications. A multidisciplinary approach, early diagnosis and therapy improve prognosis and outcome of kidney transplant.

A new diagnostic algorithm in primary diagnosis of prostate cancerAt a glance

MUDr. Šárka Kudláčková, Ph.D.

Urol. praxi. 2023;24(2):100-102 | DOI: 10.36290/uro.2023.046  

Prostate biopsy still remains an essential step to confirm the diagnosis of prostate cancer . In connection with the new studies and the resulting recommendations a diagnostic algorithm was compiled on the basis of which further examinations are indicated. It is about simplifying the decision-making process, which over time with the addition of other diagnostic modalities (e. g. MRI) has become somewhat confusing even for clinical urologists. The aim of this work is to provide simplified guide to implementation of guidelines EAU, when prostate biopsy is indicated (1).

Urodynamics - when and what type od examinationAt a glance

MUDr. Roman Sobotka, FEBU

Urol. praxi. 2023;24(2):90-99 | DOI: 10.36290/uro.2023.045  

Urodynamics (UDN) is a functional examination of lower urinary tract, i. e. the bladder and the subvesical area (sphincter and prostate), the evaluation is carried out based on measured and calculated pressure values and urine flow. Urodynamic examination consists of non-invasive measurement of urine flow (uroflowmetry) and invasive methods - examination of the filling phase (filling cystometry) and micturition phase (micturition cystometry or PQ study). The indication to invasive urodynamic examination should be preceded by a non-invasive examination, especially a patient history, functional examination of the S2-S4 reflexes, questionnaires and a...

Drug interactions of medications used in the therapy of erectile dysfunction with dietary supplementsDrug interactions

PharmDr. Josef Suchopár, Mgr. Štěpán Suchopár, MUDr. Michal Prokeš

Urol. praxi. 2023;24(2):84-88  

Herbal products, or food supplements made from them, can lead to drug interactions as well as drugs. However, manufacturers of such food supplements do not point out possible drug interactions. Phosphodiesterase type 5 (iPDE5) inhibitors are widely used drugs, the common feature of which is degradation by the CYP3A4 and CYP3A5 pathways. Inhibitors and inducers of these cytochrome P-450 isoenzymes cause drug interactions of varying severity, and only for some of them is it possible to find a recommended management in the SPC. The aim of the article is to provide basic information about herbal products with the potential to influence pharmacokinetics...

Medical assessment service in relation to urologyGood advice from practice

MUDr. Petr Jiřík

Urol. praxi. 2023;24(2):80-83 | DOI: 10.36290/uro.2023.044  

The main duty of a health assessment doctor at the District Social Security Administration (OSSZ) is to assess the health status of the client in the sector of sickness and pension insurance, i. e., in the insurance scheme. A health assessment doctor at the OSSZ can also assess the health status of the client for the purpose of providing benefits in the non-insurance scheme, with the contracting authority being the employment office and the client applying therein. This includes care allowance, where the degree of dependency (degrees I to IV) is assessed, as well as disability card and special aid allowance.

Testosterone deficiency in adulthood, diagnosis and possibilities of therapeutic substitutionSexual and reproductive medicine in practice

doc. MUDr. Taťána Šrámková, CSc.

Urol. praxi. 2023;24(2):72-79 | DOI: 10.36290/uro.2023.043  

Late-onset hypogonadism in adulthood represents a significant health problem because, based on the association of low testosterone levels with diabetes, cardiovascular disease and osteoporosis, it leads to reduced length and quality of life. Hypogonadal men die earlier than men with a sufficient supply of androgens, and cardiovascular disease and diabetes contribute significantly to this. The diagnosis of testosterone deficiency requires the presence of clinical manifestations and laboratory confirmation of its abnormal level. If the diagnosis is confirmed, lifestyle modification and injectable, oral or transdermal substitutions are recommended. The...

Recent advances in microsurgical treatment of varicocele and microTESESexual and reproductive medicine in practice

MUDr. Vladimír Kubíček, CSc.

Urol. praxi. 2023;24(2):68-71 | DOI: 10.36290/uro.2023.042  

The article deals with the recent developments in microsurgical techniques for microscopic varicocele surgery and microdissection testicular sperm extraction (microTESE). In varicocele surgery, recent developments have led to intraoperative microvascular Doppler diagnosis, three-dimensional magnification, and clipless ligation of the spermatic veins with preservation of the spermatic arteries. In microTESE, the benefits include preoperative triplex microvascular Doppler diagnosis, hydrodissection of testicular tubules and high magnification of the tubules in vivo with possible micrometry of the tubules, selection of tubule collection sites with a greater...

Hyaluronic acid - use in practical urologyReview articles

MUDr. Hana Musilová

Urol. praxi. 2023;24(2):64-67 | DOI: 10.36290/uro.2023.041  

Hyaluronic acid is a polysaccharide with various utlization. In urology, hyaluronic acid found its place in many uses. It is applied in prevention of recurrence of lower urinary tract infections, treatment of post-radiation cystitis or in therapy of primary bladder pain syndrome. It is also used in andrology or pediatric urology.

Intravesical thermochemotherapy - indication, patient preparation and practical aspects of administrationReview articles

doc. MUDr. Michal Fedorko, Ph.D., FEBU, MUDr. Alena Sorokač Kubolková, MUDr. Jakub Papirek, MUDr. Vítězslav Vít

Urol. praxi. 2023;24(2):58-63 | DOI: 10.36290/uro.2023.040  

Device-assisted intravesical chemotherapy aims to increase the efficacy of intravesical chemotherapy in the treatment of non-muscle-invasive bladder cancer. Currently, its use is limited to cases where radical cystectomy cannot be performed after failure (or intolerance or unavailability) of intravesical immunotherapy with BCG vaccine, either because of poor performance status of the patient or because of refusal of surgery. In the Czech Republic, two methods of this treatment based on the use of thermal energy are available. The article provides summary of both these methods with an emphasis on practical aspects of their use.

Špatná zpráva; možné reakce pacienta a jejich zvládání (2. část)Editorial

MUDr. Radkin Honzák, CSc.

Urol. praxi. 2023;24(1):3  

Synchronous tumor duplicity of prostate and rectum carcinomaCase report

MUDr. Pavel Škrobánek

Urol. praxi. 2023;24(1):48-50 | DOI: 10.36290/uro.2023.020  

Prostate cancer is one of the most common malignancies in men in the Czech Republic. Similarly, we can talk about rectal cancer, the incidence of which in the Czech Republic is at the forefront of international comparison, so it is not such a rarity when there is a simultaneous (synchronous) occurrence of both malignancies in one patient. The problem of this topic remains mainly the absence of standardized procedures or guidelines of professional societies, stemming from the insufficient sample of the specific population, which would be the basis for clinical studies. The close anatomical relationship between the two structures carries a number of...

Renal cell carcinoma in the testicleCase report

MUDr. Veronika Lounová, MUDr. Igor Hartmann, Ph.D., MUDr. Hana Študentová, Ph.D.

Urol. praxi. 2023;24(1):45-47 | DOI: 10.36290/uro.2023.019  

Renal cell carcinoma predominantly metastasizes through haematogenous spread. It has been shown experimentally that clear-cell renal cell carcinoma can bypass the primary sites of metastasis formation and establish metastases directly at atypical sites. Testicular metastases are generally very rare, accounting for less than 1% of all testicular tumours. A metastasis may occasionally mimic a primary testicular tumour. A rare case is reported of clear-cell renal cell carcinoma in the testicle, the primary origin of which can only be debated of.

HematuriaAt a glance

MUDr. Marcela Čechová, FEBU, MUDr. Michaela Matoušková

Urol. praxi. 2023;24(1):42-44 | DOI: 10.36290/uro.2023.018  

Hematuria is defined as presence of red blood cells in urine. It represents a common symptom in urological pracice which can be a sign of serious disease of urgenital tracat. Adequate attention to the diagnostic of hematuria should always be given.

Urolithiasis - metabolic disorders and conservative treatmentAt a glance

MUDr. Kateřina Vlachová

Urol. praxi. 2023;24(1):37-41 | DOI: 10.36290/uro.2023.017  

Urolithiasis with increasing incidence and prevalence is one of the diseases of civilization. High number of relapses initiated the improvement of lithiasis removal techniques, while emphasizing the importance of preventive and conservative treatment procedures. Metabolic examination can reveal the cause of urolithiasis in up to 97% of patients. We try to causally set up a possible conservative treatment. The patient's compliance with long-term treatment remains questionable.

Prophylaxis of thromboembolic complications in urologyFrom the boundary of urology

doc. MUDr. Jana Hirmerová, Ph.D.

Urol. praxi. 2023;24(1):31-36 | DOI: 10.36290/uro.2023.016  

Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE is associated with substantial morbidity and mortality. Surgery significantly increases the risk of VTE. In thromboprophylaxis, two methods may be used - pharmacologic prophylaxis (usually low-molecular-weight heparin, LMWH) and mechanical methods (compression stockings and intermittent pneumatic compression). Mechanical methods represent an alternative for the patients with high bleeding risk or may be used in combination with LMWH to intensify the prophylaxis in those with high thromboembolic risk. Urologic surgeries may differ in thrombotic risk and...

Consequences of covid-19 as seen by an andrologistSexual and reproductive medicine in practice

MUDr. Jan Novák, FEBU, FECSM, MUDr. Libor Zámečník, Ph.D., FEBU, FECSM, MBA

Urol. praxi. 2023;24(1):28-30 | DOI: 10.36290/uro.2023.015  

For almost 3 years, we have all been direct participants of covid-19 pandemics. The disease, albeit primarily affects respiratory system, may have a negative impact on many other organ systems including reproductive tract. The authors present an overview of possible complications of SARS-CoV-2 virus infection as seen by an andrologist.

Autosomal dominant polycystic kidney disease from urological point of viewReview articles

MUDr. Pavel Navrátil, FEBU, MUDr. Jiří Špaček, MUDr. Michal Balík, doc. MUDr. Jaroslav Pacovský, Ph.D., MUDr. Pavel Navrátil, CSc.

Urol. praxi. 2023;24(1):21-27 | DOI: 10.36290/uro.2023.014  

Autosomal dominant polycystic kidney disease is a genetic disease that leads to chronic renal failure in about half of patients. It is a multisystem disease with a predominance of kidney affection and significantly worsening the patient's health. Causal therapy is not known. Renal complications include urinary tract infections, nephrolithiasis, hematuria, cyst bleeding and others. Treatment in chronic renal failure includes renal replacement therapy - hemodialysis/peritoneal dialysis and kidney transplantation. Indication, timing and technique of nephrectomy of native polycystic kidneys remains controversial. It is necessary to proceed individually,...

Management of the metastatic renal cancerReview articles

doc. MUDr. Jaroslav Pacovský, Ph.D.

Urol. praxi. 2023;24(1):17-20 | DOI: 10.36290/uro.2023.013  

Metastatic renal cancer is serious disease with serious prognosis. The management covers surgery od primary tumor, eventually on metastasis. Lymphadenectomy has no therapeutical impact; it is useful for staging only. Monoclonal antibody, tyrosinkinase inhibitors, mammalian targets of rapamycin (mTOR) and cytokines can be used for oncological management. The complex therapy needs multidisciplinary cooperation and well-informed patient.

D-mannose in preventing recurrent urinary tract infectionsReview articles

MUDr. Eva Burešová, Ph.D.

Urol. praxi. 2023;24(1):14-16 | DOI: 10.36290/uro.2023.012  

Urinary tract infections (UTIs) are frequent diseases, particularly in women. Acute simple cystitis poses no serious medical problem. However, a recurrent UTI, defined as the occurrence of two UTIs in six months, or three UTIs per year, decreases the quality of life of patients and leads to repeated antibiotic use. Daily routine measures and long-term prophylaxis with low-dose antibiotics or their targeted use in at-risk situations, e. g., prior to sexual intercourse or during hormonal changes, are recommended as methods of preventing recurrent UTIs. With long-term antibiotic use, patients may experience unpleasant adverse effects of this treatment...

Urinary incontinence - medication versus surgeryReview articles

MUDr. Miroslava Ryšánková, MUDr. Marie Hurtová

Urol. praxi. 2023;24(1):6-13 | DOI: 10.36290/uro.2023.011  

Urinary incontinence is a growing problem in current urological medicine. It affects the patient in his socioeconomic and emotional life, burdening the environment especially economically. The authors of the article have set themselves the goal of summarizing the current possibilities of its treatment, especially by medication and surgery. It is important to determine the type of incontinence for self-treatment. The most common type of incontinence in both genders is stress and urgency incontinence. Other types are represented to a lesser extent and sometimes stand outside the current official recommendations of professional societies. The treatment...

Pharmacotherapy of nocturnal enuresis in childrenFrom the boundary of urology

PharmDr. Nikola Karasová, Ph.D.

Urol. praxi. 2022;23(4):180-187  

Nocturnal enuresis in children is classified as intermittent involuntary leakage of urine in a child older than 5 years. Most often it is a failure to wake up when the bladder is full. It may also be increased urine production due to insufficient nocturnal secretion of antidiuretic hormone. If bedwetting starts to occur due to psychological stress, it is a secondary enuresis. The nocturnal enuresis is a significant social handicap for the child and successful treatment leads to an increase in self-esteem and can prevent psychological problems. A comprehensive diagnosis is essential to rule out the possibility that it is a symptom of another disease....

Sdělování špatné zprávy (1. část)Editorial

MUDr. Radkin Honzák, CSc.

Urol. praxi. 2022;23(4):159  

Hematuria caused by the internal illiac artery aneurysm with secondary arterio-vesical fistulaCase report

MUDr. Nicolette Zavillová, MUDr. Marek Krolupper

Urol. praxi. 2022;23(4):204-206 | DOI: 10.36290/uro.2022.054  

As well as in other departments of medicine, also in urology, we treat much older patients with more frequent comorbidities. Many of our patients have a history of reconstructive procedures on the vascular system. We encountered a complication in a patient after angiosurgery, which included closing a large aneurysm of the internal iliac artery by coiling. In this case study, a fistula between the vascular bulge and the bladder developed after filling the aneurysm with coiling and the hematuria was presented. However, the source of hematuria was not the fistula from the already filled bulge, but the bleeding of the vessels of the bladder mucosa due...

Zinner syndrome: case reportCase report

MUDr. Jana Laubová, MUDr. David Škvára

Urol. praxi. 2022;23(4):201-203 | DOI: 10.36290/uro.2022.053  

Zinner syndrome is a rare congenital anomaly of Wolffian duct consisting of unilateral renal agenesis, ipsilateral seminal vesicle cysts and ejaculatory duct obstruction. The diagnosis is usually established at the age of increased sexual activity (adults, adolescents). Patients with this diagnosis have fertility problems as a result of ejaculatory duct obstruction. We present a case of a boy followed in our department since birth for right renal multicystic dysplasia diagnosed prenatally. At the age of 20 months a resorption of dysplastic kidney was detected and the boy was followed as a patients with a solitary kidney. At the age of 15 years a retrovesical...

Penile fracture associated with urethral injuryCase report

MUDr. Marika Nesvadbová, MUDr. Igor Hartmann, Ph.D.

Urol. praxi. 2022;23(4):199-200 | DOI: 10.36290/uro.2022.052  

Penile fracture with associated urethral injury is a rare acute condition in urology. The diagnosis is mainly based on medical history, physical examination, retrograde urethrography (in the case of suspected urethral injury), and/or magnetic resonance imaging (MRI). When penile fracture with urethral injury has been demonstrated or if there is diagnostic doubt, surgical revision with suture of the tunica albuginea and urethra is indicated. Conservative treatment is not recommended because of the risk of complications (erectile dysfunction, penile curvature, urethral stricture).

Complication of a transvesical prostatectomyCase report

MUDr. Markéta Římská, MUDr. Jakub Pavelka, FEBU, MUDr. Roman Staněk

Urol. praxi. 2022;23(4):196-198 | DOI: 10.36290/uro.2022.051  

The study presents the case of a 66-year-old patient who was followed up in the urology clinic for a long time and who was indicated for surgical treatment of benign prostatic hyperplasia. Considering the size of the prostate, which was 72 grams, the decision was made in consultation with the patient to perform transvesical prostatectomy. On the second postoperative day, Redon drains were removed from the subcutaneous tissue and prevesical space. At the same time, an unsuccessful attempt was made to remove the suprapubic cystostomy catheter. During the patient's hospitalization, several attempts have been made to remove the catheter with no success....