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Objectives: Benign prostatic hyperplasia (BPH) is associated with the presence of local inflammatory infiltrate. In addition to many microbial factors involved in benign prostatic pathology, there are allot of studies, which certifies the presence of prostate viral genomes, including the Human Papilloma Virus (HPV). HPV's oncogenicity has been demonstrated in cervical cancer using in situ hybridization, and also was subsequently demonstrated in other malignancies. A large number of studies have stated the hypothesis of HPV involvement in benign prostatic pathology. The objective of this article is to review key publications in the literature that are addressed to this topic. Methods: Improving HPV detection techniques has allowed the emergence of several papers that have studied the involvement of this virus in prostate pathology. But to date, most works have addressed the appearance of neoplastic involvement of HPV in BPH remains underinvestigated. Conclusions: Until now the results of studies are contradictory, because of the harvesting method, processing and interpretation of data in the clinical context. Thus, a standardized diagnosis of HPV in the benign pathology of the prostate is currently difficult to achieve. Although the role of HPV in cervical cancer pathogenesis has been long time disregarded, it's involvement in the prostate pathology is becoming increasingly evident. [ABSTRACT FROM AUTHOR]

Objectives: Benign prostatic hyperplasia (BPH) is associated with the presence of local inflammatory infiltrate. In addition to many microbial factors involved in benign prostatic pathology, there are allot of studies, which certifies the presence of prostate viral genomes, including the Human Papilloma Virus (HPV). HPV's oncogenicity has been demonstrated in cervical cancer using in situ hybridization, and also was subsequently demonstrated in other malignancies. A large number of studies have stated the hypothesis of HPV involvement in benign prostatic pathology. The objective of this article is to review key publications in the literature that are addressed to this topic. Methods: Improving HPV detection techniques has allowed the emergence of several papers that have studied the involvement of this virus in prostate pathology. But to date, most works have addressed the appearance of neoplastic involvement of HPV in BPH remains underinvestigated. Conclusions: Until now the results of studies are contradictory, because of the harvesting method, processing and interpretation of data in the clinical context. Thus, a standardized diagnosis of HPV in the benign pathology of the prostate is currently difficult to achieve. Although the role of HPV in cervical cancer pathogenesis has been long time disregarded, it's involvement in the prostate pathology is becoming increasingly evident. [ABSTRACT FROM AUTHOR]

Introducere. Prolapsul genital este o patologie importantă a femeii adulte, ce nu trebuie neglijată, deseori influenţând în mod negativ calitatea vieţii pacientelor. Conform datelor din literatura de specialitate, se estimează că peste 50% din pacientele care prezintă mai mult de o naștere pe cale vaginală prezintă un grad de prolaps genital, însă doar 10-20% prezintă manifestări clinice. De-a lungul timpului, tratamentul chirurgical prin abord transvaginal minim invaziv utilizând meșe de polipropilenă și-a dovedit eficienţa, devenind stardardul de aur în managementul acestei patologii. Materiale și metodă. Pe o perioadă de trei ani, am efectuat 118 intervenţii prin abord transvaginal utilizând meșe de polipropilenă pentru prolaps genital. Pacientele supuse intervenţiilor chirurgicale au prezentat cel puţin cistocel de grad II cu simptomatologie supărătoare, iar 39 din cele 118 prezentau și prolaps genital posterior. Vârsta a variat între 51 și 78 de ani, 94 fiind la menopauză, 64 fiind active sexual, pacientele având, în medie, două nașteri. Gradul prolapsului a fost stabilit pe baza sistemului de cuantificare publicat de International Continence Society - Pelvic Organ Prolapse. Pentru prolapsul genital anterior am utilizat meșe de polipropilenă cu 4 braţe trecute transobturator, iar pentru prolapsul posterior am folosit meșe cu două braţe trecute prin ligamentul sacro-spinos. În 34 de cazuri din cele 118 am efectuat și cura chirurgicală a incontinenţei urinare de efort - TVT. Rezultate. Pacientele au fost evaluate postoperator la o lună, la 3, 6 și 12 luni, succesul anatomic fiind întâlnit în 94% din cazuri. Doar trei paciente au prezentat recidivă, acestea având preoperator prolaps de grad IV, cazuri pentru care ulterior s-au practicat histerectomie totală, conizaţie sau colpocleisis. Printre complicaţii, menţionăm: 11 cazuri de eroziune vaginală, 5 cazuri de expunere a meșei, 21 de cazuri cu disconfort pelvian cronic, 5 cazuri de incontinenţă urinară de efort ocultă și 8 cazuri cu dispareunie de novo. Intervenţiile au dus la o îmbunătăţire semnificativă a simptomatologiei și implicit la îmbunătăţirea calităţii vieţii. Concluzii. Cu toate că Food and Drug Administration (FDA) a emis de-a lungul timpului o serie de avertizări privind siguranţa acestor dispozitive medicale, rezultatele obţinute depășesc cu mult riscurile, făcând acest abord terapeutic standardul de aur în managementul prolapsului genital. [ABSTRACT FROM AUTHOR]

Epstein Barr virus was encoded by IARC as a Group I carcinogen and it has the ability to immortalize in vitro B cells as well as the epithelial carcinoma cells. Cytomegalovirus, a Herpesviridae family member can also immortalize various human cells in vitro, especially in the skin where it its presence was noticed. The oncogenic capacity of these two viruses was demonstrated rising to questions related to a possible involvement in neoplastic prostate pathology. We extensively searched and studied in the specialized literature data which refer to these two viruses and their presence in the prostate, looking for specific methods used to detect them in the prostate tissue. The presence of these two viruses in prostate is a verified fact. What raises questions is their role in various forms of prostatic neoplasia whether it is prostatic adenoma, PIN or prostatic adenocarcinoma. Their role as promoter and oncogenic modulator has already been proved. [ABSTRACT FROM AUTHOR]

Post-radical prostatectomy erectile dysfunction (post RP ED) is a major postoperative complication with a great impact on the quality of life of the patients. Until present, no proper algorithm or guideline based on the clinical trials has been established for the management of post RP ED. According to literature, it is better to initiate a penile rehabilitation program as soon as possible after surgery than doing nothing, in order to prevent and limit the postoperative local hypoxygenation and fibrosis. The results of numerous clinical trials regarding the effectiveness of the phosphodiesterase 5 inhibitors therapy on post RP ED have made them the gold standard treatment. Encouraging results have been achieved in studies with vacuum erectile devices, intraurethral suppositories with alprostadil and intracavernosal injections, but due to their side effects, especially in the cases of intracavernosal injections and intraurethral suppositories, their clinical use was limited therefore making them a second line option for the post RP ED treatment. What should not be forgotten is that penile implant prosthesis has proven very effective, numerous studies confirming high rates of satisfaction for both patients and partners. [ABSTRACT FROM AUTHOR]

Genital prolapse represents a frequent pathology in women associating various uro-gynecological complications. The known risk factors are multiple births, menopause and obesity. Material and methods: In a retrospective study we have analyzed 15 women with advanced genital prolapse (grade III and IV). They all underwent mesh surgical procedures, according to their pathology. For the anterior prolapse we have used a four arm polypropylene mesh and for the posterior prolapse a two arm mesh anchored to the sacrospinous ligament. Results: Operating time and hospitalization were brief and no major intraoperatory complications occurred. The patients were discharged 2 - 3 days after the procedure, being periodically evaluated. After three months, two relapses occurred and vaginal hysterectomy and colpocleisis was performed. Conclusions: Genital prolapse represents a serious health condition, with direct impact on the normal social life and activities of women. With this kind of procedures, the operating time has been shortened, anatomical and functional results were excellent and due to the experience of the surgeons, the complications were practically absent. Classical surgical techniques such as perineoraphy are now becoming obsolete. [ABSTRACT FROM AUTHOR]

Epstein Barr virus was encoded by IARC as a Group I carcinogen and it has the ability to immortalize in vitro B cells as well as the epithelial carcinoma cells. Cytomegalovirus, a Herpesviridae family member can also immortalize various human cells in vitro, especially in the skin where it its presence was noticed. The oncogenic capacity of these two viruses was demonstrated rising to questions related to a possible involvement in neoplastic prostate pathology. We extensively searched and studied in the specialized literature data which refer to these two viruses and their presence in the prostate, looking for specific methods used to detect them in the prostate tissue. The presence of these two viruses in prostate is a verified fact. What raises questions is their role in various forms of prostatic neoplasia whether it is prostatic adenoma, PIN or prostatic adenocarcinoma. Their role as promoter and oncogenic modulator has already been proved. [ABSTRACT FROM AUTHOR]

Background: Patients with stage 5 chronic kidney disease (CKD) begin chronic hemodialysis with variable diuresis levels correlated to a comparable low glomerular filtration rate. Residual diuresis influences long-term evolution of the hemodialyzed patient, modifying the prognosis even if optimal Kt/ V is achieved. Aim of the study: The present study emphasizes the main determining factors of diuresis in a cohort of stage 5 CKD subjects at the beginning of hemodialysis. Material and methods: 216 patients with stage 5 CKD starting chronic hemodialysis were included in the study, and were grouped according to their residual diuresis: group A (urine output ≤ 500 mL/ day); group B (urine output between 500-1200 mL/ day); group C (urine output ≥ 1200 mL/ day). Results: Glomerular etiology, cardiac systolic dysfunction, severe malnutrition, emergency dialysis initiation and lack of permanent vascular access were proved to be associated with significant low diuresis. Age, gender, estimated glomerular filtration rate (GFR) and the presence of systemic hypertension did not influence the amount of daily diuresis. Conclusions: In CKD stage 5 patients, residual diuresis presents large variations in conditions of comparable low GFR. Factors influencing residual diuresis may be distinct from those that influence residual GFR. [ABSTRACT FROM AUTHOR]

Background and aim: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide, with a prevalence of 20%-40% in Western populations. The purpose of this article is to review data related to lifestyle changes in patients with NAFLD. Method: We searched a public domain database (PubMed) with the following categories: disease (NAFLD, fatty liver, and non-alcoholic steatohepatitis [NASH]) and intervention (lifestyle intervention, diet, nutrition) with each possible combination through 25 September 2014, for relevant articles. Review of articles was restricted to those published in English. We selected the studies involving adult patients only. Conclusion: There is no consensus as to what diet or lifestyle approach is the best for NAFLD patients. However, patients with NAFLD may benefit from a moderate- to low-carbohydrate (40%-45% of total calories) diet, coupled with increased dietary MUFA and n-3 PUFAs, reduced SFAs. More CRT are needed to clarify the specific effects of different diets and dietary components on the health of NAFLD patients. [ABSTRACT FROM AUTHOR]

Introduction. The malignant disease's ability to metastasize remains one of the major obstacles when treating patients with cancer. The indication of metastasectomy is currently limited to patients undergoing treatment of the primary tumor. Resections for lung metastases of high selected patients with urogenital cancer present minimal risks and can prolong survival. Prognostic factors that determine which patients will benefit from surgery are still unclear. Material and results. This article presents a retrospective analysis of patients who underwent lung metastases resection between 2008 and 2013 in our clinic. Among 148 patients, 8 (5.41%) had lung metastases after urologic cancers (UC), 18 (12.16%) after genital cancers (GC), 13 (8.78%) after breast tumors and 109 (73.65%) had lung metastases from other type of tumors. The overall 6 months survival was 100% for UC, 94.44 for GC, 84.62% for BC and 87.16% for others. Discussion and conclusion. The criteria for surgery proved to have a positive predictive value and what should be considered are the following: prolonged disease-free interval (DFI), unilateral disease, the absence of systemic pathologies, oncological margins resecability and less than 3 radioimagistic detectable metastases. A negative prognosis was observed in those with primary tumor in the cervix, at least 3 metastases and a tumor larger than 3 cm. To determine how to select surgical candidates for pulmonary metastasectomy more precisely, further analysis of prognostic factors is evident and the need for a prospective, randomized, multicenter study is clear. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis or hydatid disease is an important public health issue, mainly in developing countries, due to its high prevalence. Echinococcus granulosus, a cyclophyllid cestode, the pathogenic parasite found in humans, their intermediate host in its way to the final host, the members of canidae family. The main sites of infection in humans are the liver and the lungs. There have been recorded Rare locations such as the heart, spleen, muscles or retroperitoneal have also been recorded. Case presentation: We present the case of a 29-year-old man, living in rural environment, who was admitted in our Clinic for a pelvic cystic tumor and intermittent ureterohydronephrosis. The blood work showed positive antibodies for Echinococcus granulosus. An urethrocystoscopy and the excision of the tumor were performed. Conclusions: Although rare, the involvement of the male genitourinary tract in cystic echinococcosis is possible and can pose important diagnostic challenges. [ABSTRACT FROM AUTHOR]

The urinary abnormalities are an important health problem. If they are not recognized in due time, they usually lead to the loss of the renal unit function. In many cases, the diagnosis is late and incidental. Case presentation. We present the case of Ml., a 74-year-old male admitted in our surgical unit with diffuse left lumbar pain, low urinary tract symptoms and slow increase in abdomen volume in the past 4 years. Computer tomography scan and ecography showed a large left lumbar cyst like mass with a dilated supernumerary ureter with ectopic ureteral orifice in the prostatic urethra and apparently normal anatomic inferior renal unit. The goal was the excision of the "cyst like" mass (superior left renal unit) but because of the anatomical particularities (extensive fibrosis and local topographical changes) total nephrectomy was performed. Conclusions. Given a normal contralateral kidney, the discovery of a urinary abnormality can be a real challenge, their evolution being a silent one. This type of disease can be suspected only with the development of clinical symptoms. The anatomic particularities (duplex kidney) together with the long evolution of the disease changed the local topography making the preservation of the inferior left renal unit a difficult, almost impossible task for the surgeon. [ABSTRACT FROM AUTHOR]

Aims. The aims of our study were to assess the prevalence of prostate tumors in patients with metabolic syndrome. Material and methods. Subjects were patients recruited from three medical centers in Bucharest, Romania. For this study we selected men over 45 years of age with metabolic syndrome. The anthropometric measurements included height, weight, waist circumference and hip circumference. We calculated the body mass index (BMI) and measured the blood pressure. Biochemical tests included fasting plasma glucose (FPG), HbA1c, total cholesterol (TC), TG, HDL-C, fasting plasma insulin (FPI), prostate-specific antigen (PSA) and free-PSA. The prostate gland volume was measured by transrectal ultrasound. The diagnosis of prostatic cancer was based on a positive finding of the histological examination obtained from 14-core biopsy. Results. There was a high prevalence of prostate tumors (benign and malignant) - 82.85% (n=343). Prostate cancer was diagnosed in 7.9% of patients (n=33) using DRE, PSA, free PSA/PSA ratio and TRUS. The prevalence of BHP was 74.9% (n=310). The results of the present study indicate that PSA detects a significant number of prostate tumors missed in DRE. The use of DRE, PSA and TRUS, in combination, provided the highest rate of detection of prostatic tumors in patients with metabolic syndrome without infectious diseases of the prostate. Conclusions. The prevalence of prostatic tumors, prostate cancer and benign prostatic hyperplasia in metabolic syndrome patients is high. Due to its increased prevalence, the BPH can be considered as a feature of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Genital prolapse represents a frequent pathology in women associating various uro-gynecological complications. The known risk factors are multiple births, menopause and obesity. Material and methods: In a retrospective study we have analyzed 15 women with advanced genital prolapse (grade III and IV). They all underwent mesh surgical procedures, according to their pathology. For the anterior prolapse we have used a four arm polypropylene mesh and for the posterior prolapse a two arm mesh anchored to the sacrospinous ligament. Results: Operating time and hospitalization were brief and no major intraoperatory complications occurred. The patients were discharged 2 - 3 days after the procedure, being periodically evaluated. After three months, two relapses occurred and vaginal hysterectomy and colpocleisis was performed. Conclusions: Genital prolapse represents a serious health condition, with direct impact on the normal social life and activities of women. With this kind of procedures, the operating time has been shortened, anatomical and functional results were excellent and due to the experience of the surgeons, the complications were practically absent. Classical surgical techniques such as perineoraphy are now becoming obsolete. [ABSTRACT FROM AUTHOR]