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Smjernice se odnose na klasifikaciju, dijagnostiku i liječenje sindroma prostatitisa.

Correlation of Gleason grade in preoperative prostate biopsy and prostatectomy specimens.

Panonian-Balkan endemic uropathy (PBEU) has recently been defined as a single rural household environmental disease of the entire urinary tract due to common living conditions and nourishment, with imprecisely defined, but usually long latency. Seemingly various clinical manifestations, including chronic renal failure due to endemic tubulointerstitial nephropathy, renal cell carcinoma (RCC) and urotheliomas of all localities, observed with significantly higher frequency in the affected population, represent a complex, however, one unique nosological entity which can be found in one single patient. This conclusion is based on results of previous research by Croatian and foreign investigators, as well as our own recent research. The starting point of our investigation of the endemic occurrence of RCC, as the integral part of the clinical picture of PBEU, was an epidemiological reappraisal of the five essential previously published studies from Croatia and Serbia, covering the period from 1951 to 1990. Our aim was to assess whether RCC occurs with considerably higher frequency in the endemic area or not. Due to insufficient statistical analysis of their results none of the authors of previous reports observed a definite correlation between RCC and endemic nephropathy. In our comparison of RCC frequency in endemic vs. non-endemic areas we used the chi-square test. Statistical analysis of raw data from insufficiently analyzed tables disclosed highly significant frequency of RCC occurrence in the endemic area. Because of omissions in statistical analysis authors of previous studies failed to recognize this phenomenon. We conclude that RCC, although unrecognized, has occurred with significantly high frequency in endemic areas of Croatia and Serbia since the very beginning of the research on PBEU in 1951 until these days. This conclusion has prompted us to continue our research on epidemiological and clinical characteristics of endemic RCC in the endangered area. This epidemiological reappraisal revealed the extent of one of numerous gaps in comprehension of the complex problem of PBEU.

The 11-year prospective epidemiological study has encompassed 58 cases of upper urinary tract urothelioma, including 21 solitary tumors of renal pelvis, 9 solitary ureteral tumors and 28 multifocal tumors. An analysis of sex, age and residential distribution of patients was carried out as well as their occupation, frequency and distribution of symptoms, test results, tumor locality, "staging", histopathological characteristics and tumor relapses, frequency of simultaneous primary cancer, surgical approach and techniques, intraoperative and postoperative complications, as well as postoperative death rate. The aim of the study is to estabtish the basic clinical and epidemiological parameters important for the assessment of ; the relationship between this disease and risk factors, the clinical picture of the disease, the applicability of diagnostic procedures, the pathological characteristics of the disease and surgical treatment results. This comprehensive procedure is necessary for reassessment of this seldom and in many ways distinctive casuistry, which is particularly important for our national pathology. The participation of patients from the focuses of endemic uropathy amounting to 34.5% and of rural residents amounting to 31.0% indicates the epidemiological distinction of observed group of patients. Poor and frequently unrecognized symptomathology, high relapse rate accompanied by neglecting of recurrent hematuria as well as of constantly positive urinary citology, inadequate surgical results with the postoperative death rate of 15.5% and low 5-year survival rate, call for revision of the recent clinical approach to the upper urinary tract urothelioma.