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Introduction and Objectives. The aim of this subject is to present the results of the initial experience with the minimal invasive percutaneous nephrolitoholapaxy (MIP) technique in the Urology Clinic from SCJU Arad. Materials and Methods. The Urology Clinic from SCJU Arad, reported 15 cases of renal and ureteral lithiasis who underwent MIP technique between November 2018 - February 2019. All patients signed the informed consent, blood and urine samples were collected preoperatively, in order to assess the biological status of patients. Stone size (largest diameter) was measured on x-ray, the strategy of intervention was planned by consulting the urographic or computed tomographic images, by case. Interventions were performed under spinal anesthesia and prophylactic antibiotics were administered to all patients preoperatively. An 16 Ch Storz nephroscope was used, lithotripsy being achieved with an 30 W Ho:YAG Auriga QI laser, finally a 14 Ch - balloon nephrostomy was inserted. Results. The mean age of patients was 48 years (range 24 - 72 years), the mean operative time was 47 minutes (range 35 - 59 minutes). Patients had a single stone, either located in the renal pelvis or in the middle and lower calyces. Particular cases: one case of horseshoe kidney, one case of surgical solitary kidney, one case of sepsis with patient under anticoagulant treatment, one case of pregnancy, one case of bilateral staghorn calculi with chronic renal disease and one case of stone located on the lumbar ureter. The mean stone size was 14 mm (range 8 mm - 20 mm), except the case of bilateral staghorn calculi (3.4 - 5 cm diameter, 80 minutes). The clinical and biological status of patients, analyzed postoperatively, showed no significant hemorrhage, one cases complicated with acute pyelonephritis, stone free rate was achieved in percent of 87.4%, nephrostomy ablation time between 24-48, mean hospitalization time 4 days, better tolerance and low pain for smaller nephrostomy tubes. Conclusions. MIP technique is a better alternative in the treatment of small and medium size renal stones. The postoperative complications are minimal, and the stone free rate is similar to classic percutaneous nephrolithotomy, also in selected cases and with surgeon's experience, MIP can exceed the contraindications, in order achieve maximal therapeutic results. [ABSTRACT FROM AUTHOR]

Introduction and Objectives. Prostate carcinoma (PCa) can be an evasive diagnosis, with unpredictable outcomes, when refering to prognosis. Histopathological diagnosis of PCa can be established by transrectal ultrasound-guided (TRUS) biopsy after an abnormal finding in digital rectal examination (DRE) or finding an increased value of total prostate specific antigen (PSAt) in the blood. The purpose of this study is to evaluate the correlation between standard complementary parameters like: age, PSAt, Gleason score, histological degree of chronic prostate inflamation, prostate volume and clinical tumoral stage - DRE, in order to predict cancer agressivnes at time of diagnosis. Materials and Methods. The study included 60 patients, who attended a urological consult (anamnestics, total PSA evaluation, DRE - digital rectal examination, abdominal ultrasound). After the examination, the patients with abnormal DRE and PSA level (> 4 ng/dl) underwent TRUS prostate biopsy. After histopatological diganosis of PCa, the patients were divided into groups according to age, PSAt, cancer agressivness, histological degree of chronic prostate inflamation, prostate volume, clinical (DRE) tumoral stage and furthermore, the groups were compared to each other for statistical analysis. Results. A positive biopsy result was found in all patients. The PSA level corresponded well with the diagnosis of prostate cancer. All prostate cancer patients enrolled in the study had serum PSA above 4 ng / mL, while the dominant number of patients had serum PSA> 10 ng / mL. The mean age of the patients was 68 years, the majority of them had an average prostate volume (40-70 cm3). Most of the patients had prostate cancer at the T3 clinical tumoral stage. Also, the majority of cases had a Gleason score 7. The highest percentage of patients had first degree of inflammation associated with the presence PCa. Nonparametric analysis using the Spearman ρ (rho) correlation coefficient, revealed weak but statistically significant associations between PSA and prostate volume, respectively between PSA and the degree of chronic inflammation. The clinical tumoral stage - DRE, showed a significant mean association with prostatic volume. Overall, a trend of increasing absolute value of PSAt with Gleason score, was observed (median test, p = 0.006). A significant increase in serum PSAt with histological degree of chronic inflammation (Median test, p ≤ 0.001). Furthermore, a general trend of prostate cancer severity was estimated, based on the total Gleason score, associated with the degree of chronic inflammation. Conclusions. The correlation between standard parameters: Age, PSAt, Gleason score, degree of chronic inflammation, ultrasound-determined prostate volume, and clinical tumor stage - DRE, improves PCa diagnosis and are valuable parameters for obtaining a prognostic factor at time of diagnosis. [ABSTRACT FROM AUTHOR]