outlet obstruction caused by prostate cancer

New generation urethral stents in treatment bladde

/STRU^NI RAD UDK 616.65-006.04-097:577.112 The significance of TPSA, free to total PSA ratio and PSA density in prostate carcinoma diagnostics

Prostate-specific antigen (PSA) is the one of the most valuable tumor markers for the early detection and management of prostate carcinoma, but not an ideal one because of poor specificity in the case of prostatic hypertrophy and other benign conditions. In order to overcome this drawback some other parameters as is free to total ratio (F/T) PSA and PSA density (PSAD) are introduced. It has been investigated in 60 patients, 18 of them are proved to be found prostate cancer and other 42 were identified as benign prostatic hyperplasia. Patients with CaP had TPSA median of 11.4 ng/ml and the others with benign prostatic hyperplasia (BPH) had 6.9 ng/ml. In these two groups there was statistical significant difference (p 0.01). By receiver operating characteristics curve (ROC) estimated cutoff for TPSA was 4.0 ng/ml with 95 % sensitivity, 30 % specificity and area covered by ROC was in amount of 0.76. Median F/T ratio for patients with prostate cancer was 0.10, and for benign prostatic hyperplasia patients it was 0.25.For these values there is also statistical difference (p). Using ROC cutoff for F/T PSA was determined at the value of 0.18 with sensitivity 95%, specificity 80 % and area under the curve (AUC) 0.93. Median for PSAD in the group with CaP was 0.38 and in the BPH group was 0.16. There was statistical significance within those two groups. In conclusion F/T PSA, PSAD and TPSA are valuable tumor markers in distinguishing patients with CaP ant those without with modestly raised TPSA. Also F/T PSA showed up as better marker than TPSA and PSAD in investigated group of patients. Key words: prostate carcinoma, benign prostatic hyperplasia, prostate specific antigen, PSA density, free to total PSA ratio rezim

/STRU^NI RAD UDK 616.6-006.04-089.843-073 Results of application of orthotopic urine diversion

Introduction: Prolonged survival of patients undergoing radical cystectomy due to the infiltrative carcinoma of the urinary bladder has increased the need for development of the orthotopic bladder enabling preservation of the upper urinar

kidney parenchimal and collecting tract neoplasia

Border line cases and diagnostic doubts in definitio

Bilateral renal cell carcinoma with bilateral synchronous adrenal gland metastases – a case report

The authors reported a case of a 52-year-old patient with bilateral synchronous renal cell carcinoma synchronously disseminated in adrenal glands is presented. The patient underwent surgical treatment: radical nephrectomy on the right side, bilateral adrenectomie on the right and partial nephrectomy on the left side. Five years after surgery, patient is in complete remissio

/STRU^NI RAD UDK 616.65-005.04-089.5 Anesthesia for radical prostatectomy

Radical prostatectomy is one of most common treatment options currently recommended for clinically localized prostate cancer. Evaluation of intraoperative and postoperative complications is important in evaluation of relative morbidity of this treatment option. Furthermore, investigation of complications of surgical treatment in correlation with not only surgical technique, but comorbidity, ASA stage and anesthetic technique enables improvements in complete perioperative treatment and decrease of incidence of complications resulting from the procedure. Improvement of anesthetic techniques and use of new anesthetic agents contributes to better outcome of surgical treatment. For radical surgery, combined epidural analgesia and general anesthesia reduces postoperative complications and mortality. Benefits can be conferred most likely by altered coagulation activation in surgery, increased blood flow, reduction of operative stress response. Modalities for reduction of intraoperative blood loss during radical prostatectomy are normovolemic haemodilution, preoperative donation of blood for autologus transfusion and use of erythropoietin for increasing red cell mass. Key words: prostate cancer, radical retropubic prostatectomy, anesthesia rezim