Epidemiology of urogenital injuries in the Regional Specialist Hospital in Puławy in years 2007 -2018

Introduction Trauma is defined as damage to cells, tissues and organs caused by external factors acting on them. According to WHO data, trauma caused 4.8 millions of deaths in 2016. Urogenital trauma occurs in 10% of all the injuries in the human population. Aim of the study The aim of this study was to characterize the patients treated for injuries in Urology Department in Regional Hospital in Poland and compare the results with the data from literature. Material and methods The study involved patients hospitalized in Regional Specialist Hospital in Puławy, Poland from 2007 to 2018. The survey was based at analysis of medical documentation. The collected data has been subjected to statistical analysis. 66 patients were included in the study group. Their average age was 43.25 years. Results The absolute majority of patients were men – 81.81% (n=54), women – 18.18% (n=12). The average age for males was 42.27 and for the females – 44.25. Most frequent trauma in our study was the renal trauma 36.36% (n=24). 47.06% of this injuries were associated with MVA's. The second most frequent group was a genital trauma - 21 patients (31,81%). 81.81 % of them required surgical treatment. Another group constituted 10.6 % (n=7) were the patients treated for bladder injury. Penis was injured in 6.06% (n=4), 75% of patients required a surgery. Urether has been injured only in 4.55%. Conclusions Kidney is the most frequent organ of genitourinary tract, affected by trauma, particularly during MVA's. Victims are usually treated conservatively. External genitalia injuries, especially male, are also very frequent. Mostly patients need a rapid surgical intervention but appropriate treatment allows the patient to recover completely without any lasting disabilit

Rare case of the complex congenital upper urinary tract and heart malformation

Wady wrodzone układu moczowego stanowią jedne z najczęściej występujących anomalii rozwojowych. Szczególne miejsce wśród nich zajmują wady złożone. Autorzy opisują rzadki przypadek wrodzonej złożonej wady górnych dróg moczowych z towarzyszącą wadą serca.Congenital malformations of the urinary tract are among the most frequently occurring development anomalies. Complex defects take up a particular place among them. The authors describe a rare case of congenital complex urinary tract malformation with accompanying heart defect

Renal adenomatosis

Adenomatosis is a rare lesion of unknown etiology, defined as multiple (usually 5 or more) adenomas in one kidney. A case of renal adenomatosis in a 68-year-old woman treated previously for urolithiasis, who underwent nephrectomy because of the nonfunctional left kidney is reported. Apart from multiple adenomas, numerous hyperplastic lesions involving single tubules were present in the resected kidney. Both adenomas and hyperplastic lesions exhibited the expression of alpha-methylacyl-coenzyme A racemase (AMACR). Renal adenomatosis is worth special attention, since renal papillary adenomas are suggested as precursor lesions of papillary renal cell carcinoma that show similar AMACR expression

Preliminary outcomes of the European multicentre experience with the ZSI 375 artificial urinary sphincter for treatment of stress urinary incontinence in men

Introduction The ZSI 375 is a new artificial urinary sphincter utilised in men suffering from stress urinary incontinence (SUI). We present the first European multicentre study on the effectiveness of ZSI 375. Material and methods This study was conducted in a retrospective, non-randomized format in centres across Europe. Between May 2009 and December 2014, ZSI 375 was fitted in 109 SUI patients following radical prostatectomy, transurethral resection of prostate (TURP), rectal surgery and high intensity focused ultrasound (HIFU). Patients with history of pelvic radiotherapy or previous surgical treatment for incontinence or stricture were excluded from the series. Follow-up was completed by December 2016. The key outcome measures included overall improvement and complication rates. Results A total of 109 patients in 10 European centres were recruited and had the ZSI 375 device implanted. The average patient age was 72 years old. The indication for the majority of patients was incontinence following radical prostatectomy (100/109 patients, 91.74%). On average, patients were incontinent for 48.6 months prior to treatment. All patients used ≥4 pads daily at baseline and thus were classified as suffering from ‘severe incontinence’. The average follow-up until the final visit was 43 months. The pad usage decreased to 0.84 on average by the last visit. There were no reported cases of device infection. A total of 9 patients had urethral cuff erosion (8.25%),which was the most common complication in this series. A further 3 men (2.75%) experienced mechanical failure requiring subsequent device reimplantation. The implantation of the ZSI 375 device was considered successful in 92.66% of patients. Conclusions The ZSI 375 is an effective surgical treatment option in men with severe stress urinary incontinence. © 2019, Polish Urological Association. All rights reserved