Já, my, medicína a umělá inteligence

MUDr. Radkin Honzák, CSc.

Urol. praxi. 2023;24(3):119  

PARP inhibitors in treating metastatic castration-resistant prostate cancer

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...

Problematics of solving lithiasis and strictures of the ureter

MUDr. Jan Pulcer, MBA

Urol. praxi. 2023;24(3):131-133 | DOI: 10.36290/uro.2023.059  

Urolithiasis is a globally widespread disease of the urinary system affecting all age groups. In the last few decades, the prevalence of urolithiasis has been increasing worldwide and represents a serious medical but also a socioeconomic problem. Due to technological developments during the last two decades, ureteroscopic lithotripsy become a common method of treatment for upper urinary tract stones worldwide. It is a very effective and minimally invasive method. However, during an endoscopic procedure, injury to the ureter can occur which results in decreased peristalsis at the site of the insult, stimulation of ureteral hypertrophy, and initiation...

Current perspective on transurethral enucleation procedures on prostate in benign prostatic hyperplasia

MUDr. Vladimír Valter, MUDr. Miroslav Krhovský

Urol. praxi. 2023;24(3):134-139 | DOI: 10.36290/uro.2023.060  

As one of the most common urological diagnosis of aging men, benign prostatic hyperplasia (BPH) affects almost 80% of males over 70. Despite dramatic progress in technological and surgical treatment options, it is still considered as feared diagnosis among patients. Majority of aging men choose conservative, pharmacological treatment which in many cases is unable to permanently solve the lower urinary tract symptoms (LUTS) and in many cases ends up with permanent catheterization of those unfortunate ones who missed a surgery while having a suitable performance status. For the past 70 years transurethral resection of the prostate (TURP) has been considered...

Immunotherapy in kidney tumours

MUDr. Andrea Ondrušková, doc. MUDr. Hana Študentová, Ph.D.

Urol. praxi. 2023;24(3):140-145 | DOI: 10.36290/uro.2023.061  

Malignant kidney tumours are a frequent malignancy, with the Czech Republic having the highest rates of incidence in Europe. Treatment options for this disease have advanced greatly in recent years. Both advances in modern surgical methods and treatment with tyrosine kinase inhibitors (TKIs) have significantly contributed to the decreasing morbidity rates and improved survival rates. Major progress has been achieved with the inclusion of immunotherapy in the treatment regimens for this disease. This article deals with immunotherapy alone, combined immunotherapy, as well as the combination of immunotherapy with TKIs.

Treatment of urothelial carcinoma bladder cancer

MUDr. Jana Katolická, Ph.D., MUDr. Lucia Tomková

Urol. praxi. 2023;24(3):146-150  

Treatment of non-muscle-invasive bladder cancer (NMIBC) should follow a risk-stratified approach with transurethral resection (TUR) and intravesical chemotherapy (ChT) or Bacillus Calmette-Guérin vaccine (BCG) in intermediate- and high-risk patients. The use of cisplatin-based neoadjuvant chemotherapy for bladder cancer is supported. Cisplatin-containing combination ChT is standard in advanced or metastatic patients fit enough to tolerate cisplatin. Carboplatin-based ChT is recommended in patients unfit for cisplatin. Pembrolizumab or atezolizumab are alternative choices for patients who are PD-L1-positive and not eligible for cisplatin-based ChT....

Cardiovascular safety of testosterone replacement therapy

MUDr. David Čapka

Urol. praxi. 2023;24(3):180-183 | DOI: 10.36290/uro.2023.070  

This paper comments on a study that evaluates the risk of long-term cardiovascular events in men with hypogonadism undergoing testosterone replacement therapy. In a multicenter, randomized, double-blind, placebo-controlled noninferiority study, the authors included men aged 45 to 80 years who had a high risk of cardiovascular disease or had previously experienced it. Patients reported symptoms of hypogonadism, which were laboratory confirmed (fasting serum testosterone levels were < 300 ng/dl (10.4 nmol/L) based on two reliable measurements). Randomization was conducted in a 1 : 1 ratio for daily use of transdermal 1.62% testosterone gel (n = 2...

Antibiotic allergies

MUDr. Lenka Sedláčková

Urol. praxi. 2023;24(3):168-173 | DOI: 10.36290/uro.2023.067  

Antibiotic allergies represent a growing issue in the current medicine. They limit treatment options, and not always justifiably. The majority of cases is labelled as having penicillin allergy. However, penicillin allergy is up to ten times overdiagnosed. The true allergy confirmation is based on detailed analysis of the course of the adverse event, skin tests, and, selectively, laboratory and provocation tests. This paper offers a review of clinical manifestations and a basic orientation in diagnosis and management of antibiotic allergies.

Sexual dysfunctions among people living with HIV

MUDr. Ivo Procházka, CSc.

Urol. praxi. 2023;24(3):151-153 | DOI: 10.36290/uro.2023.063  

HIV infection is currently a chronic disease that in case of early diagnosis and treatment should not significantly alter health state of people living with HIV. Effective antiretroviral treatment considerably decreases also infectiousness. Prolongation and improvement of their life results in more commorbidities including sexual dysfunctions. Persisting negative problem of life with HIV is also a widespread stigma.

Haemospermia - a sign, or a disease?

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

Urol. praxi. 2023;24(3):154-156 | DOI: 10.36290/uro.2023.064  

Althought haemospermia is in most cases a benign sign with autolimiting course, it causes concerns in not only patients themselves, but their partners as well. The authors present an overview of possible causes with recommended diagnostic workup and possible therapeutic measures.

Male hypogonadism - summary according to EAU guidelines

MUDr. Aleš Horák

Urol. praxi. 2023;24(3):157-164 | DOI: 10.36290/uro.2023.065  

The author provides information about the diagnostics of male hypogonadism and testosterone replacement therapy - including the latest recommendations for the patients treatment and monitoring according to the European Association of Urology (EAU).

Treatment of chronic pain

MUDr. Marek Hakl, Ph.D.

Urol. praxi. 2023;24(3):165-167 | DOI: 10.36290/uro.2023.066  

Chronic pain is a serious socioeconomic issue. Its treatment requires a multidisciplinary approach. However, pharmacotherapy is the mainstay of treatment of chronic pain. The strategy of pharmacological treatment is based on the three-step analgesic ladder. Step 1 consists of non-opioid analgesics; if ineffective, these can be combined with weak opioids in Step 2 and/or strong opioids in Step 3. If necessary, strong opioid medication can be gradually discontinued.

Renomedullary interstitial cell tumor: a finding of an unusual size

MUDr. Marek Jurok, MUDr. Kamil Belej, Ph.D., FEBU, MBA, MUDr. František Chmelík, FEBU, MUDr. Petr Hrabal

Urol. praxi. 2023;24(3):174-176 | DOI: 10.36290/uro.2023.068  

Renomedullary interstitial cell tumor represents a relatively common benign renal tumor mostly with small size. This case report describes an incidental finding of renomedullary tumor of 2.5 cm with appearance of complicated cyst on CT examination. The article also summarises characteristic features and differential diagnostics of renomedullary tumor in common imaging methods and histopathological examination.

Metastatic/multicentric renal epithelioid angiomyolipoma - clinical case report

MUDr. Ondřej Cempírek, MUDr. Tomáš Málek, MUDr. Roman Boháč

Urol. praxi. 2023;24(3):177-179 | DOI: 10.36290/uro.2023.069  

Renal epithelioid angiomyolipoma (ReAML) is a rare subtype of angiomyolipoma. It is a benign kidney disease, in which cases of aggressive behavior and malignancy have been reported. These tumors represent 8% of operated kidney angiomyolipomas. Diagnosis is based on histological findings. The aim of this text is to review the information on this issue, the histological picture and the case report of a 42-year-old woman operated at our department who was found to have multicentric or metastatic involvement of the retroperitoneal lymph node.

An informed patient recovers better

Mgr. Bc. Hana Novotná

Urol. praxi. 2023;24(3):185-186 | DOI: 10.36290/uro.2023.071  

When educating and informing patients, it is necessary to think about the clarity of the given information, taking into account that a large part of population has low health literacy and it may be difficult to understand more specialized information. European Association of Urology (EAU) is creating a website with factually correct and well understandable information, which is currently becoming available also to Czech patients. The possibilities for their use are very wide and offer Czech health professionals and patients a very effective tool for improving information and thus the course of treatment.