Urology for Practice, 2012, issue 6

Editorial

Strach z výsledků vyšetření aneb Čeho a proč se vlastně bojíme?

Mgr. Roman Pešek

Urol. praxi, 2012; 13(6): 231

Review articles

Health-economics of intravesical therapy in bladder cancer

MUDr.Jana Skoupá

Urol. praxi, 2012; 13(6): 236-237

Health-economics is one of the processes during the complex health-technology assessment. It supports rational resource allocation in times of financial scarcity. Even in the Czech republic health-economic evaluations are receiving more attention from payers and decision makers. The incidence of bladder cancer (BC) is increasing, requiring higher proportions of financial resources to be allocated to costly treatment. In non-muscle invasive forms, intravesical instillation of chemotherapy and/or BCG vaccine has shown advantages in terms of time to recurrence. The publication calculates costs for intravesical treatment in relation to progression-free-year...

Herbal drugs for the treatment of symptoms of benign prostatic hyperplasia

prof.MUDr.RNDr.Luboslav Stárka, DrSc., PharmDr.Lucie Sosvorová, Mgr.Petra Mikšátková

Urol. praxi, 2012; 13(6): 239-244

A revival of interest in phytotherapeutic agents for the treatment of benign prostate hyperplasia and prostate carcinoma, both in Europe and North America, can be ascribed to an intensive propagation and to an easy access to these drugs and especially to a the patients’ dissatisfaction with the adverse effects of the medical alternatives. There exists a handful of herbal drugs with various types of mechnisms of action. One of the most frequently prescribed and studied such agents is Serenoa repens extract. Those, which are available on the inland market are breifly characterised here.

Possibilities of using biological therapy in patients with glomerular disease

doc.MUDr.Romana Ryšavá, CSc.

Urol. praxi, 2012; 13(6): 246-252

Recently, there have been increasing numbers of patients with kidney disease who fail to respond to standard treatment or relapse following its termination. The use of biological drugs, products of protein nature most commonly prepared by fusion of proteins of various origin (animal or human antibodies), is a possible solution for these patients. Intravenous human immunoglobulins that, by binding autoantibodies, result in the control of the immune process can be considered to be the earliest form of biological therapy. They are particularly used in patients with a severe course of SLE or ANCA-associated vasculitides. Currently, a wide range...

Sexual and reproductive medicine in practice

Ethical aspects of assisted reproduction

Bc.Ilona Haasová

Urol. praxi, 2012; 13(6): 254-258

The first part of this work deals with the ethical aspects concerning assisted reproduction: the moral embryo state, genetic material donation, the matter of “spared” embryo, cryopreservation, stem cells research, surrogate motherhood, multi-purposed motherhood reduction, surgical procedures conducted with micromanipulator technology, sex selection and fertile age – 49. The second part deals with the ethical problems, especially, with the psychological demandingness concerning the whole process of assisted reproduction. In conclusion the religious opinions and the ethical code of juridical aspects are presented.

At a glance

Gonorrhoea - currently and in survey (part 1)

MUDr.Jana Zímová, Mgr.Pavlína Zímová, MUDr.Pavel Zíma

Urol. praxi, 2012; 13(6): 260-263

Gonorrhoea is one of the most common sexually transmitted diseases (STD) and belongs among „classical STD“. Primary affects the columnar epithelium of urogenital tract with possible blood dissemination. The source of the disease is gram-negative, non-motile, non-spore forming diplococci from group Neisseriacae, species Neisseria, subspecies Neisseria (N.) gonorrhoeae. The incubation period ranges from 1 to 14 days, but majority of gonorrhoea symptoms develops whithin 2 to 5 days. Diagnostics is based on clinical picture, microscopy and culture. In the first part of the article we closely describe definition, etiology, pathogenesis,...

Case report

Intravesical instillation of propiverine in the treatment of neurogenic bladder dysfunction

MUDr.Zdeněk Dítě, FEAPU, doc.MUDr.Radim Kočvara, CSc., FEAPU

Urol. praxi, 2012; 13(6): 264-266

Pediatric neuropathic bladder dysfunction can cause not only urinary incontinence, but irreversible renal damage as well. Majority of patiens suffer from a congenital neural tube defect. Many affected children can be successfully treated with clean intermittent catheterisation and anticholinergic medication. Patients frequently experience severe side effects or insufficient suppression of detrusor overactivity. Intravesical instillation of propiverine hydrochloride or oxybutynin chloride offer an effective alternative. We review our experience with administration, safety and efficacy of intravesical propiverine.

Embolization of internal iliac artery branches as management of uncontrollable

MUDr.Marek Tůma, MUDr.Lubomír Hyršl, MUDr.Radoslava Ouhrabková, CSc.

Urol. praxi, 2012; 13(6): 267-268

bleeding in inoperable bladder cancer Bladder cancer is the second leading malignancy in urology. It occurs in all age groups, being most prevalent at about 60 years of age. A number of patients with inoperable metastatic bladder cancer suffer from local symptoms where, in addition to dysuria and pollakisuria, bleeding is a major therapeutic challenge. Without proper and effective treatment, it may lead to significant deterioration in the patient’s general condition and, in the terminal stage, to death. In this report, we describe a case of a patient with massive uncontrollable bleeding in metastatic bladder cancer which was managed...

Histological structure of metastases in the region of the retroperitoneum

MUDr.Miroslav Louda, Ph.D., MUDr.Jaroslav Pacovský, Ph.D., MUDr.Ivo Novák, Ph.D., MUDr.Vladimír Giblo, MUDr.Petr Hušek, MUDr.Petr Kutílek, Ph.D., MUDr.Marie Hurtová, MUDr.Miroslav Podhola, Ph.D., doc.MUDr.Jiří Páral, Ph.D., doc.MUDr.Miloš Broďák, Ph.D.

Urol. praxi, 2012; 13(6): 269-270

The aim of this study was to analyze the incidence of metastatic deposits in the retroperitoneal space operated on at the Urological Clinic, University Hospital and Charles University in Hradec Kralove in the years 1998–2011. Retrospectively, we analyze 17 cases of metastases and histopathological origin. In 16 (94 %) cases it was the first operation, tumor metastasis, once (6 %), then the second recurrence of primary renal cell carcinoma. Surgery for retroperitoneal metastases in the same period accounted for 4.6 % of all procedures performed in this field. Were found three sources of metastases from tumors into the retroperitoneum,...