Sdělování špatné zprávy (1. část)

MUDr. Radkin Honzák, CSc.

Urol. praxi. 2022;23(4):159  

Clean intermittent catheterization

MUDr. Eva Burešová, Ph.D.

Urol. praxi. 2022;23(4):161-165 | DOI: 10.36290/uro.2022.045  

Clean intermittent catheterization is the method of choice in patients with bladder-emptying dysfunction. The insertion of an indwelling urinary catheter is another option. The present paper describes the principle of intermittent catheterization and its indications; it also deals with possible complications and their rates in comparison with an indwelling urinary catheter.

Treatment of stress urinary incontinence in men after prostate surgery

doc. MUDr. Jozef Marenčák, PhD.

Urol. praxi. 2022;23(4):166-173 | DOI: 10.36290/uro.2022.046  

Male stress urinary incontinence (SUI) is common complication after radical surgery for prostate cancer. Patient´s individual features should be well kept in mind, with the aim of better assessing the individual risk of SUI. Therapy of post-prostatectomy SUI (PPSUI) can be difficult. If conservative management fails, surgical options can be used. Several surgical procedures are currently available to treat PPSUI. Out of these, artificial urinary sphincter (AUS) showed the longest record of safety and efficacy for patients with moderate to severe SUI. Male slings are an alternative approach for men with mild to moderate SUI. Other less popular options,...

Infectious complications after kidney transplantation

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

Urol. praxi. 2022;23(4):174-179 | DOI: 10.36290/uro.2022.047  

Infections are the main complications of kidney transplantation with the crucial impact on graft and patient surival. Infectious complications arise as a result of a relationship between patogen exposure, state of immune system, level of immunosuppressive therapy and patient's comorbities. Prevention, diagnosis and adequate therapeutical approach play the key role for amelioration of transplant outcomes.

Pharmacotherapy of nocturnal enuresis in children

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....

Treatment of erectile dysfunction using linear shock wave

doc. MUDr. Taťána Šrámková, CSc.

Urol. praxi. 2022;23(4):188-191 | DOI: 10.36290/uro.2022.049  

A non-pharmacological method of treating erectile dysfunction uses the linear application of a low-intensity shock wave. This method of treatment is mainly indicated for patients with mild and moderate vasculogenic erectile dysfunction. The rate of patients reporting satisfactory improvement is between 40-80%. Study results show that low intensity shock wave therapy could improve erectile function even in patients with severe erectile dysfunction who are either unresponsive or insufficiently responsive to oral phosphodiesterase type 5 inhibitors, thereby reducing the immediate need for more invasive treatment. The effect of treatment appears to be...

Complication of a transvesical prostatectomy

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....

Penile fracture associated with urethral injury

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).

Zinner syndrome: case 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...

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

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...

Pharmacology support of bladder urothelium function restoration

PharmDr. Bc. Hana Kotolová, Ph.D.

Urol. praxi. 2022;23(4):192-195 | DOI: 10.36290/uro.2022.050  

Incidence of urinary tract infections in clinical practice is hight. Urinary tract infections represent together with respirátory infections the most common inflammatory disease. In terms of currant situation og antibiotic resistence also antibiotic resistance also nonantibiotic strategyes of treatment are recommended. One option is to use complex effect of hyaluronic acid, chondroitinsulfate, quercetin and curcumin on support of bladder urothelium function restoration.