Rozhádané sestry a medicína

MUDr. Radkin Honzák, CSc.

Urol. praxi. 2024;25(1):3  

Urodynamics in patients prior to renal transplantation

MUDr. Pavel Navrátil, FEBU, MUDr. Ivo Novák, Ph.D., doc. MUDr. Jaroslav Pacovský, Ph.D., MUDr. Pavel Navrátil, CSc.

Urol. praxi. 2024;25(1):7-10 | DOI: 10.36290/uro.2024.010  

This article focuses on urodynamic evaluation (UDN) as a part of the pre-transplant assessment in a subset of patients preparing for kidney transplantation. In patients with end-stage renal disease, kidney transplantation is a preferred treatment method, offe­ring significant improvement in quality of life and reduction in morbidity and mortality compared to long-term dialysis. Functional evaluation of the urinary tract is an essential component of the pre-transplant examination, and in indicated cases, UDN provides a comprehensive assessment of lower urinary tract function. This work highlights the importance of UDN in identifying and treating pre-existing...

Nocturia

MUDr. Eva Burešová, Ph.D.

Urol. praxi. 2024;25(1):11-15 | DOI: 10.36290/uro.2024.011  

Nocturia is a lower urinary tract symptom that is found to be most annoying for patients. It is most often caused by nocturnal polyuria that can be well diagnosed based on an analysis of the patient's voiding diary. In case lifestyle measures fail to have a sufficient effect, it is treated with desmopressin. This treatment is safe, but in at-risk patients (older than 65 years) it can cause hyponatraemia. Therefore, it is necessary to monitor blood sodium levels both before treatment initiation and during its course.

Comination pharmacotherapy of lower urinary tract symptoms

MUDr. Marcela Fontana, Ph.D., FEBU

Urol. praxi. 2024;25(1):16-21 | DOI: 10.36290/uro.2024.012  

Pharmacotherapy represents an effective treatment for most patients with lower urinary tract symptoms (LUTS). However, initial monotherapy may not lead to sufficient impact on LUTS and thus improvement in quality of life. We have medications from different drug groups, which can be effectively combined to achieve the best possible treatment effect. This text offers an overview of current pharmacotherapy of LUTS with focus on combination therapy.

Current treatment options for chronic prostatitis/chronic pelvic pain syndrome in men

MUDr. Václav Řepa, MUDr. Ondřej Česák, MUDr. Vladimír Študent ml., Ph.D., FEBU

Urol. praxi. 2024;25(1):22-26 | DOI: 10.36290/uro.2024.013  

Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) is a disease that mainly affects younger middle-aged men. CP/CPPS is defined as pelvic pain lasting ≥3 months out of the previous 6 months without a clearly identifiable infectious or other organic cause. For the wide spectrum of symptoms of CP/CPPS, it is often necessary to choose a multimodal treatment approach, where both pharmacological and non-pharmacological treatment or a combination of them can be used. Targeting treatment is also complicated as the etiology of CP/CPPS is not yet completely understood. The presented work aims to provide a comprehensive overview of current knowledge,...

Nitrofurantoin in the treatment and prevention of urinary tract infections in adults and adolescents

MUDr. Michaela Matoušková

Urol. praxi. 2024;25(1):27-31 | DOI: 10.36290/uro.2024.014  

In the Czech Republic, several dosage forms of medicinal products containing nitrofurantoin have been used. Recently, a specific treatment programme under which nitrofurantoin was supplied to the Czech Republic in the microcrystalline anhydrous form was terminated. Nitrofurantoin is now available in macrocrystalline form. Its primary indication is a first choice in treatment of uncomplicated lower urinary tract infections (IDMC). It is also used in the prophylaxis of recurrent IDMC. The macrocrystalline form is characterized by better tolerability and bioavailability compared to the microcrystalline form. The recommended dosage given in the Summary...

Management of treatment-related adverse effects in renal cell carcinoma

MUDr. Martin Matějů, Ph.D., MUDr. Michal Zubaľ

Urol. praxi. 2024;25(1):32-37 | DOI: 10.36290/uro.2024.015  

The paradigm of treatment of metastatic clear cell renal carcinoma (mccRCC) has repeatedly undergone significant changes in recent decades - from treatment with cytokines, interleukin-2 and interferon-α to therapy with tyrosine kinase inhibitors (TKIs) or mammalian target of rapamycin (mTOR) inhibitors to combined regimens based on immune checkpoint inhibitors (ICI). The combinations of ICI+ICI or ICI+TKIs have been fully established in the first line of therapy of mRCC in the past decade, based on large phase III studies using sunitinib as a comparator. These include CheckMate214 (ipilimumab plus nivolumab), KEYNOTE 426 (pembrolizumab plus axitinib),...

Drug interactions of drugs used in urinary tract infections and dietary supplements

MUDr. Miroslava Ryšánková, MUDr. Marie Hurtová

Urol. praxi. 2024;25(1):38-41 | DOI: 10.36290/uro.2024.016  

Urinary tract infections are very common. It is usually an acute infection that most urological patients encounter at least once in their lifetime. Treatment of an acute episode is usually not difficult. Problem arises in case of recurrent inflammations that are not exception in urological practice. Their treatment is long-term, combining regimen measures with the use of dietary supplements, usually on herbal basis. It is supplemented with immunoprophylaxis or chemoprophylaxis. With these combinations possible drug interactions and contraindications need to be considered.

A rare case of high-flow priapism

MUDr. Veronika Lounová, MUDr. Igor Hartmann, Ph.D., doc. MUDr. Aleš Vidlář, Ph.D., FEBU

Urol. praxi. 2024;25(1):46-48 | DOI: 10.36290/uro.2024.018  

High-flow priapism, also referred as non-ischemic or arterial priapism, accounts for only about 5% of all priapism cases. Its most common cause is a blunt perineal or penile trauma. The trauma results in laceration of cavernous artery or its branches, leading to the formation of a fistula between artery and lacunar spaces of cavernosal bodies. Increased blood flow results in persistent erection. This type of priapism can also be treated conservatively, but optimal time interval for initiating active interventional treatment remains a subject of discussions.

Rare finding of primary adenocarcinoma of the urinary bladder

MUDr. Marko Ptašinský, MUDr. Tomáš Ostárek, FEBU, MUDr. Rostislav Kuldan, MUDr. Tomáš Blažek

Urol. praxi. 2024;25(1):49-51 | DOI: 10.36290/uro.2024.019  

Bladder adenocarcinoma is a rare histological finding. It occurs either as primary bladder adenocarcinoma, or as a secondary. In the case of secondary occurrence, adenocarcinoma of intestine, prostate, lungs and breast is the most common source. We describe a case of patient with primary adenocarcinoma of bladder.

Post-qualification education of nurses in urology

Bc. et Bc. Pavlína Potúčková, Mgr. Bc. Hana Novotná

Urol. praxi. 2024;25(1):53-54 | DOI: 10.36290/uro.2024.020  

In the Czech Republic, nurses have limited access to post-qualification training in urology compared to some foreign countries. These countries allow nurses to provide extensive care, including prescribing medications, which is not common in the Czech Republic. Studies highlight that expanding nurses' competencies in urology results in improved clinical outcomes and more efficient service delivery. However, barriers include inconsistency in the nurse role designation and the absence of a regulatory body in the Czech Republic. Support from the health care team and professional organizations is critical to the success of the development of this field.

Prescribing spa treatment by urologists: related legislation and practical modalities

MUDr. Kamil Belej, Ph.D., FEBU, MBA

Urol. praxi. 2024;25(1):42-45 | DOI: 10.36290/uro.2024.017  

Spa treatment has been with mankind for several millennia. At present, it is a separate branch of health care services, and even though it often cannot cure a particular disease, its beneficial effect on one's general health is very important and, in many aspects, irreplaceable. In urology, it is indicated in association with recovery after surgical procedures, as adjunctive treatment in patients with urolithiasis and inflammatory conditions, and as supportive treatment in cancer patients. In the Czech Republic, it is always at least partially reimbursed by health insurance after approval by the respective physician reviewer. In order for it to be...