Vitamin D Status in Renal Transplant recipients is not Associated with Erectile Dysfunction.

Erectile dysfunction (ED) is a highly prevalent disorder among renal transplant recipients. Vitamin D deficiency (VDD) has been associated with several ED risk factors but only recently directly linked to ED. We conducted a study to investigate whether vitamin D serum levels were associated with the presence and severity of ED in 40 male patients that underwent deceased donor kidney transplantation (TX) from 2001 to 2013. Blood samples were collected on two seasonally distinct occasions and 25(OH)D concentration was assessed by radioimmunoassay. A 5-item version of the International Index of Erectile Function (IIEF-5) was used for ED evaluation and group stratification. We found comparable rates of ED (75%) and VDD (42.5%-62.5%) as in previously published studies. Serum levels of 25(OH)D did not differ between patients with and those without ED on both measurements (p=0.656 and p=0.914, respectively), or when comparing different ED severity groups. Duration of renal replacement therapy before TX and graft duration until analysis were longer in patients with ED (p=0.022 and p=0.05, respectively), but with the results being nonsignificant on logistic regression. In conclusion, we found no association of 25(OH)D concentration with the presence and severity of ED in renal transplant recipients. So far, there are no similar published data.

[Cystine urolithiasis: recommendations for diagnosis, treatment and recurrence prevention]. / Cistinska urolitijaza: preporuke za dijagnostiku, lijecenje i prevenciju recidiva.

Cystine lithiasis is a diagnostic and therapeutic challenge. This consensus document has outgrown of discussion of experts in nephrology and urology. It is our hope that this document will be of use for all physicians who are facing this disturbing type of urolithiasis. So far, in our national literature there have been no comprehensive documents dealing with this entity and we believe that not only nephrologists and urologists will benefit, but also specialists in internal medicine and general practitioners.

Trends in testicular germ cell cancer incidence in Eastern Croatia.

AIM: To investigate a possible association between radioactive and toxic elements contamination, mainly depleted uranium (DU) from the Chernobyl accident, Croatian War of Independence and Bosnian War and the increasing incidence of testicular germ cell cancers (TGCC) in the population of Eastern Croatia. METHODS: From 1969 to 2012, 258 testicular cancer (TC) patients were treated at the Department of Urology, University Hospital Centre Osijek. Incomplete data were found in 32 patients who were excluded from the analysis and 10 patients had non-TGCC TC. Seminoma and non-seminoma groups were included out of 216 TGCC patients. The patients were assigned to one of the time periods: 1969-1995 (distant prewar and war period) and 1996- 2012 (postwar period). RESULTS: In the postwar period 3.5 times higher incidence rate for non-seminomas (4.5 patients yearly vs. 1.3), seminomas (4.2 vs. 1.2) and TGCC overall (8.7 vs. 2.5) was found compared to the prewar period, with non-seminoma presenting in more advanced stage III (35.5% vs. 13.9%, p=0.013). CONCLUSION: Usage of depleted uranium in armed conflicts could lead to the development of TGCC after unknown time of latency. Exposure assessment is mandatory to determine a possible causative correlation between the depleted uranium exposure and testicular germ cell cancer.

[Clinical guidelines for diagnosing, treatment and monitoring patients with bladder cancer--Croatian Oncology Society and Croatian Urology Society, Croatian Medical Association]. / Klinicke upute za dijagnostiku, lijecenje i pracenje bolesnika oboljelih od raka mokracnog mjehura Hrvatskoga Onkolokog Drustva i Hrvatskoga Uroloskog Drustva Hrvatskoga Lijecnickog Zbora.

Urothelial cancer is the most common bladder cancer. Hematuria is the most common presenting symptom in patients with bladder cancer. The most common diagnostics of bladder cancer is performed by transurethral resection of bladder after which pathohistological diagnosis is set. It is necessary to determine whether the cancer penetrated in muscle layer (muscle-invasive cancer) or not (muscle-noninvasive cancer). Decision on therapeutic modality depends on the clinical stage of disease and on prognostic and risk factors. For muscle non-invasive bladder cancer transurethral resection is preferred with or without intravesical instillation of Bacillus Calmette-Guérin (BCG). For invasive cancer the method of choice is radical cystectomy. Radiotherapy is used in radical and palliative purposes. Metastatic disease is most frequently treated by chemotherapy metotrexate/vinblastine/doxorubicine/cisplatin (MVAC) or gemcitabine/cisplatin (GC). The purpose of this article is to present clinical recommendations to set standards of procedures and criteria in diagnostics, treatment and follow up of patients with bladder cancer in the Republic of Croatia.

ESWL treatment of urinary stones in children--the overview of 14 years of experience.

Extracorporeal shock wave lithotripsy (ESWL) treatment has been used at Department of Urology, University Hospital "Osijek", Croatia, since July 1988. Until December 2001 seven thousand and eight hundred patients underwent ESWL for urinary stones, 68 of them were children (0.87%). Sixty-eight children aged 4 to 15 years (average 10.14 years) underwent ESWL. They were treated for the total of 91 stones: 35 (38.46%) caliceal, 23 (25.27%) in pyelon, 7 (7.69%) in pyeloureteric segment and 14 (15.38%) ureteral. Staghorn calculi were found in 6 (6.59%) patients and multiple stones (four or more stones in the same kidney) in 6 (6.59%). There was total of 95 ESWL sessions performed in 68 patients (1.39 session per patient). Fifty-six patients (82.35%) without residual stones found at the control plain film and sonography of urinary tract were considered "stone free". Addition of 5 patients with clinically insignificant residual fragments (less than 4 mm) increases overall success rate to 89.70%. ESWL is a simple, safe and effective procedure in the management of urolithiasis in childhood. Clinical experience of our institution confirms ESWL as the first line treatment for kidney stones in the pediatric age patients.