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With the increase in the incidence of cancer worldwide and the aging of the population, prostate cancer remains a topic of debate in the world of urologists and beyond. In the last years several notable advances were made in the care of men with this disease. In our days, we have a great amount of information regarding cellular, molecular biology and also a series of innovative strategies driven by technological advances. Because in everyday practice there are socio-economic as well as age differences between European patients, we wanted to highlight if the European guidelines can be totally applied to elderly Romanian patients. [ABSTRACT FROM AUTHOR]

Introduction and Objectives. Ormond’s disease or the so called retroperitoneal fibrosis involves proliferation of fibrous tissue in the retroperitoneum. All retroperitoneal organs can and will be affected in time by this disease: kidneys, great vessels, ureters and so on. Symptoms vary from hypertension to hypotension, renal failure, chronic or acute back pain, deep vein thrombosis and many more. It is a rare disease with un unclear pathology owing its name to John Kelso Ormond who discovered it in 1984. PubMed and Scopus databases were used. “Ormond disease” and “retroperitoneal fibrosis” were the key words used, special care was given to new articles. Although in the past surgery was the mainstay treatment, nowadays glucocorticoid and immunosuppresing therapy seem to gain more and more ground. It is a serious disease which left untreated can lead to major health problems including dyalisis and/or renal transplantation. [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]

Introduction and Objectives. The neurogenic detrusor overactivity (NDO) represents the pathology in which the bladder detrusor overactivity can be caused by a series of neurological conditions. The burden of NDO is not all neglectable, impairing the patients' quality of life. Currently there is no optimal medical therapy to relieve all the neuro-urological symptoms available. even if antimuscarinic agents have been used for many years with good clinical and urodynamic response, there is still limited data for tailoring the perfect antimuscarinic treatment for individual patients with NDO. High doses or combination of anticholinergics are recommended for maximizing the outcome in neurological patients, still, the incidence of adverse events is the major factor for therapy discontinuation. For patients who abort anticholinergic drugs or for unresponsive patients or for patients unwilling to assume the side effects, other types of treatments should be regarded. In recent years, Onabotulinumtoxin A has emerged as the most effective minimally invasive treatment to reduce NDO, therefore an efficient treatment alternative. Materials and Methods. The aim of this prospective study performed on 15 patients was to assess the efficacy of botulinum toxin A intradetrusor injections for the treatment of NDO. Intradetrusor injections with Onabotulinumtoxin A 200 U were performed through a minimally invasive flexible cystoscopy technique, under general intravenous anesthesia. Urodynamic studies were performed at baseline and 3 months after injecting the botulinum toxin. Urodynamic parameters like reflex volume (RV), maximum cystometric capacity (MCC) and maximum detrusor pressure (MDP) were assessed. The number of incontinence episodes and the score of quality of life questionnaires were also analyzed at baseline and 3 months after the injection. Results. Mean age for the study group was 48,73 years old, most of the patients presented with spinal cord injury or multiple sclerosis. RV increased in most of the cases with an average of 49.26 ml (42.84%). MCC presented an overall average increase of 69.93 ml (57.32%). MDP showed an average decrease of 12.15 cm H2O, accounting for 22.93%. Incontinence episodes were reduced with 66.66% compared to baseline. On the Overactive Bladder Perception Score an average decrease of 0.73 (12.5%) was recorded, while on The VAS QoL an average decrease of 1.93 points (22.52%) was noted. No major adverse events were recorded. Conclusions. Botulinum toxin A intradetrusor injection can be a feasible minimally invasive treatment for patients with neurogenic detrusor overactivity not only for patients who are non-responsive or who fail to tolerate anticholinergic medication, with possible low rates of adverse events that lead to discontinuation. [ABSTRACT FROM AUTHOR]

Objective. To try and elucidate which is the best sampling anatomical site, if there is a corroborative aspect in using more sites and also the existence of clustering phenomenon. A systematic review of the literature was made including PUBMeD database. There were significant anatomic site disparities in the reporting of HPV (Human Papilloma Virus) prevalence. The pre-procedural and procedural methods vary, also the pathological analysis used (besides PCR - Polymerase Chain Reaction). Most of them identify the skin (penile or scrotum or perineum) as the highest prevalence zone followed by urethra and anal area. [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]

Introduction: Prostate cancer is a serious public health issue affecting more and more men. Using PSA and periodic urologic exams more and patients are diagnosed in an early stage and may benefit from a curative treatment. Retropubic radical prostatectomy, external beam radiation therapy and brachytherapy are the curative options. Materials and method: The experience of a single surgical team from Central Military Hospital representing 50 cases was analyzed in terms of PSA level at diagnose moment, preoperative and postoperative staging, preoperative and postoperative Gleason score, intraoperative complications and also precocious and late postoperative complications and oncologic outcomes. Besides those aspects, we have analysed surgery related parameters. Results: Favorable outcomes were obtained in most cases with mild to moderate intraoperative complications (blood loss), early postoperative complications (hematuria, urinary tract infection, lymph drainage) or late postoperative complications (erectile dysfunction and urinary incontinence). Conclusions: Radical prostatectomy remains the gold standard treatment for patient with localized prostate cancer and in some cases for local advanced prostate cancer. It provides good oncological outcome with manageable complications. [ABSTRACT FROM AUTHOR]

Introduction: Lack of sufficient prostatic tissue samples has traditionally hampered prostate cancer research. Existing initiatives aimed at creating high quality, well characterized fresh or formalin-fixed, paraffin embedded tissue banks are mainly based on radical prostatectomy specimens. Research projects based on "surplus" tissue slides resulting from prostate biopsies would be highly desirable but until very recently no histological technique proved practicable and/or cost-effective. Materials and Methods: A multiplex grooved matrix (Biopsy Chip) was used for aligning the specimens by the urologist who collected core biopsies with an ultrasound-guided biopsy gun from 30 consecutive patients suspected of prostate cancer. Haematoxylin-eosin staining was performed at four levels, 50 micrometers apart. For every level, four additional sections were saved for special stains. Congo Red, Toluidine Blue at pH 1.99, 2.5 and 3.2, Hucker-Twort Gram stain, Periodic Acid-Schiff and Tarpley's techniques were employed for selective staining of amyloid, mast cells, eosinophils, bacteria and mucosubstances, respectively. Aggregate length of cores on slides, sample distribution statistics, presence of corpora amylacea, bacteria, mast cells and eosinophils were examined by three independent observers. Results: The biopsies did not show curling during processing, remained properly oriented, and maintained intact tissue relationships even when the cores were fragmented. The aggregate length of the cores on slides was 130.6 ± 24.7 mm (mean ± SD, min: 79 mm, max: 170 mm). Serial sectioning was greatly facilitated by the matrix employed and at least 50% of the bioptic material was saved in the paraffin block. Reporting of the histopathological findings was made in a quantitative fashion, and spatial representations of the neoplastic tissue were recorded. Mast cells, eosinophils, Corpora Amylacea, intraluminal mucin, calculi and intracytoplasmatic granules were identified in areas adjacent to prostate cancer, a lot more frequently than in benign hyperplasia or in cancerous acini. Conclusions: The multiplex method of harvesting, processing and reporting of prostate biopsies is an easily applicable, cost-effective method, provides tumor location information and creates consistent duplicate arrays for analysis and research purposes. Unlike other methods, it can be used efficiently for parallel quantitative analysis of various biopsy samples. [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]

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]

Introduction: Over the last decades there has been an ascending trend towards minimally invasive techniques for managing PUJO (pelvi-ureteric junction obstruction). The aim of the present retrospective study is to report the initial experience and to assess the feasibility and safety of day case laparoscopic pyeloplasty. Material and Methods: Data on all patients who underwent day case laparoscopic pyeloplasty from October 2006 to October 2008 was collected. The inclusive criterion for this study was patients with PUJO who were planned for day case laparoscopic pyeloplasty. All patients followed a standard pathway of care for day case laparoscopic procedure. The diagnosis of PUJO was confirmed by diuretic renography (furosemide technetium-99m mercaptoacetyltriglycine renal scan) in all cases. To assess the functional result of the pyeloplasty and to have an objective measurement the renal scan was repeated between three and six months postoperatively. The success rate of DS and readmission rate were collected and evaluated. Results: During the study period there were 15 patients with PUJO planned for day case transperitoneal laparoscopic pyeloplasty. Age ranges from 11 to 68 years old. American Society of Anaesthesiology (ASA) was three in one case and 1 and 2 for the other patients. The patient with an ASA of three failed to be discharged. Three patients had medical co-morbidities: cardiac or respiratory. Fourteen patients have been successfully discharged and one patient failed discharge. No patient needed reassessment after discharge. Conclusion: Although the numbers in our series are too small to draw final conclusions, we think that patients, physicians and also hospitals could benefit if in selected cases the laparoscopic pyeloplasty is done as day-case surgery, without compromising the safety of the patient. [ABSTRACT FROM AUTHOR]

Benign prostatic hyperplasia (BPH) is a highly prevalent nonmalignant condition which occurs commonly in men over the age of 60. Botulinum toxin type A (BoNT-A) used selectively can be a therapeutic solution for those patients. This paper aims to update the knowledge referring to the effects of BoNT-A on the prostate. Intramuscular injection of BoNT-A induces inhibition of acethylcholine release at the neuromuscular junction and causes temporary chemodenervation with paralyzing effects and atrophy of striated muscle as well as the smooth muscle fiber. BoNT-A also causes inhibitory effects on the autonomic nervous system affecting the glandular tissue, action responsible for diffuse atrophy and apoptosis of nasal and prostate glands. BoNT-A injected at the prostatic level induced: increase of the urinary flow, decrease of the prostatic volume, of the residual volume, of the IPSS symptom score, as well as of PSA. The effects maintained for 6-12 months and no side effects were reported in any patient. BPH is an important issue of public health and any new treatment option is good news for the patient population as well as for the urological community. Although the clinical series demonstrates efficacy at 30 months more studies are necessary in order to identify the mechanisms by which BoNT-A affects the prostate, the ideal dose and the duration of effect. [ABSTRACT FROM AUTHOR]

Introduction. Horseshoe kidney is a rare pathology that could be found singular or in association with other malformations or sometimes with malignant disease. The risk to develop stone disease is higher in a horseshoe kidney then in a normal one. Renal carcinoid tumors, Rokitansky syndrome, ano rectal malformations and neural tube defects are just other frequent associated disease. As its name suggests horseshoe kidney is composed of two renal units fused in 95% of cases at the inferior pole and the rest at the upper pole. The isthmus may be vascularized, or not. Topographically the renal vasculature is highly respected for both renal units, the real problem of the isthmus is that it has an aberrant vessels arrangement, where without a viable approach imaging mean, the risks of bleeding is very high. Material and method. We are presenting a 52 year old patient, which has came to our clinic accusing diffuse pain at the left lumbar level without any complaints or symptoms that could require a routine check. We will focus on the peculiarities of surgical approach to this kind of disease and we will also make a discussion on the most frequent renal malformation. Conclusions. Horseshoe kidney is one of the most common congenital anomalies which represent a therapeutic challenge in terms of both minimally invasive and classic approach. The peculiarities of vascularity make it difficult to approach such a type of kidney for both extracorporeal lithotripsy as well as for open surgery. [ABSTRACT FROM AUTHOR]

Introduction: Cystic echinococcosis or hydatid disease is an important public health issue, mainly in developping countries, due to its high prevalence. Echinococcus granulosus, a cyclophyllid cestode, the pathogenic parasite finds in humans their intermediate host in its way to the final host, the members of canidae familly. Main sites of infection in humans are: the liver and the lungs. There have been recorded rare locations as: the heart; the spleen; muscles or retroperitoneal. Materials and method: We present the case of 29 years old man, living in rural environment, who was admitted to our Clinic for a pelvic cystic tumor and intermittent ureterohydronephrosis. Blood work showed positive antibodies for Echinococcus granulosus. We performed an urethrocystoscopy and the excision of the tumor. Conclusions: Although rare, the involvement of the male genitourinary tract in cystic echinococcosis is possible and can pose important diagnostic challenges. [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]

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]

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]

The COVID-19 pandemic has greatly affected lithiasis patients, which has led to an increase in the number of internal stents that have been installed. In this paper, two studies were carried out, a clinical study and a quantitative study. The aim of the first study was to evaluate the incidence and the prevalence of bacterial urinary colonization in patients with obstructive urolithiasis who needed internal stents implanted. In the second study, a multiple linear regression was created to identify the opinion of urologists regarding the importance of using digital technologies to improve the communication process. The result of the clinical study illustrates that the prevalence of urinary colonization in patients with internal stents carried out for obstructive urolithiasis was 35%, with this value being influenced by co-infection with COVID-19. The results of the quantitative study illustrated the fact that urologists are open to using new online technologies to facilitate communication with patients. The results have high importance for both doctors and patients, illustrating the main factors that have the ability to influence the communication process. The hospital managers should take into account the results obtained in this study when they choose to use certain online communication technologies with patients.

One of the most common types of cancer worldwide (9th most commonly diagnosed) is renal cell carcinoma (RCC). It is more common in developed countries and it usually develops in individuals between 60 and 70 years of age. The earlier the disease is identified, the lower the morbidity. Therefore molecular markers that exist in blood and urine may be used for earlier detection and diagnosis but also for the follow-up of the patient after treatment, whether surgical or oncological. The trend is to analyze the gene and protein expression as they constitute a source for new biomarkers. These markers are promising but in clinical practice regarding disease management, they are rarely used. Biological markers can be employed in many tumors because they can identify the prognostic value for individual treatment. However, markers for RCC are not validated, and their analysis is currently under investigation. Previous findings have demonstrated that the metastatic potential of RCC can be predicted using the biological features of the tumor cell. It is believed that the transformation from epithelial to mesenchymal phenotype gives the tumor cell the ability to metastasize. The purpose of this review was to identify the most valuable tumor markers that can be clinically used for the prognosis, treatment and follow-up of patients with renal tumors., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020, Spandidos Publications.)

Malignancy as an etiological factor involved in priapism pathogenesis is rare. Malignant priapism (MP) can arise as a result of penile tumor invasion, either from primary penile tumors or from metastatic penile tumors, or due to hematological malignancies. Non-urological penile metastases are associated with significant worse prognosis compared to urological penile metastases, the appearance of priapism in such cases affecting even more the prognosis and the survival of these patients. Patients diagnosed with hematological malignancies and priapism present significant higher survival rates compared to those who develop MP in the context of a non-hematological malignancy, this being related to the fact that hematological malignancies are more sensitive to chemo- and radiotherapy. Most malignant priapism cases are ischemic; therefore the management should be based on the initial steps of the IP therapeutic protocol. Considering the trigger factor that has led to the priapic event specific oncologic treatment can be added as well., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Radical prostatectomy is one of the most frequent therapeutic options used for the management of patients diagnosed with prostate cancer. Normal erectile function after radical prostatectomy is a great problem for numerous patients and a real challenge for urologists worldwide. The advancements that have been made over the years in terms of minimally invasive surgery, as well as in terms of surgical techniques, have reduced the incidence of erectile dysfunction, but even so, its rate remains high and the post-operative recovery of erectile function is a long and costly process. Phosphodiesterase 5 inhibitors have provided excellent results and have become the first-line treatment for these patients, followed by intracavernous injections with alprostadil. Several studies have underlined the impact of phosphodiesterase 5 inhibitors in terms of preventing the fibrotic changes that are responsible for the irreversible erectile dysfunction. The general opinion is that an erectile function recovery process should be started as soon as possible after surgery to prevent the negative effects of neuropraxia., (Copyright © 2020, Spandidos Publications.)

Penile carcinoma is a relatively frequent health issue in the developing countries such as Africa, Asia and South America, usually affecting men aged between 50 and 70 years. It is a highly treatable disease in its early stages, but has serious physical and psychological consequences. Usually, penile carcinoma is located in the penile glans, in approximately half the cases, with the most frequent histological type being squamous cell carcinoma with its microscopic subtypes. A large number of risk factors have been reported for this disease, having a multifactorial etiology, HPV infection being one of the most important factors involved in its appearance. Out of the HPV DNA positive genital cancers HPV-16 is the most frequently found type in men, followed by HPV-18. The evolution of penile cancer includes two independent carcinogenic pathways, related or unrelated to HPV infection. There is limited data available in literature regarding HPV-related neoplasia, as well as on the efficacy of vaccination in men, with studies still ongoing., (Copyright © 2020, Spandidos Publications.)

Botulinum toxin is a substance produced by Clostridium Botulinum and is responsible for human botulism. This substance is a poison, a neurotoxin, but used in limited quantities it can be a cure for some diseases. It is well connected to a large variety of medical applications. The mechanism of action relies on blocking the acetylcholine at the neuromuscular junction, which blocks the transmission of the nervous impulse with secondary flaccid paralysis. In urology, its role in idiopathic overactive bladder and neurogenic bladder is well known. We performed a thorough review using PubMed and other databases, revising the mechanisms of botulinum toxin action in urologic pathology, treatment procedures and other options. Botulinum toxin is a well-studied substance with a large number of applications in medicine. In urologic pathology, overactive bladder and neurogenic bladder are backed by robust studies that support the therapeutic role of this substance. The toxin has multiple effects, such as inhibition of the nerve growth factor, blocking the bladder sensory afferent pathway and apoptotic effect on the prostate tissue, by inhibiting the substance P, altering the nociceptive pathways. Interstitial cystitis and other rare pathologies show promising results, but further studies are needed. The role of botulinum toxin in benign prostatic hyperplasia is still not elucidated., (Copyright © 2020, Spandidos Publications.)

Recently developed short-pulsed laser sources garner high dose-rate beams such as energetic ions and electrons, x rays, and gamma rays. The biological effects of laser-generated ion beams observed in recent studies are different from those triggered by radiation generated using classical accelerators or sources, and this difference can be used to develop new strategies for cancer radiotherapy. High-power lasers can now deliver particles in doses of up to several Gy within nanoseconds. The fast interaction of laser-generated particles with cells alters cell viability via distinct molecular pathways compared to traditional, prolonged radiation exposure. The emerging consensus of recent literature is that the differences are due to the timescales on which reactive molecules are generated and persist, in various forms. Suitable molecular markers have to be adopted to monitor radiation effects, addressing relevant endogenous molecules that are accessible for investigation by noninvasive procedures and enable translation to clinical imaging. High sensitivity has to be attained for imaging molecular biomarkers in cells and in vivo to follow radiation-induced functional changes. Signal-enhanced MRI biomarkers enriched with stable magnetic nuclear isotopes can be used to monitor radiation effects, as demonstrated recently by the use of dynamic nuclear polarization (DNP) for biomolecular observations in vivo. In this context, nanoparticles can also be used as radiation enhancers or biomarker carriers. The radiobiology-relevant features of high dose-rate secondary radiation generated using high-power lasers and the importance of noninvasive biomarkers for real-time monitoring the biological effects of radiation early on during radiation pulse sequences are discussed., (© 2019 American Association of Physicists in Medicine.)