Leiomyoma as a case of renal tumor.

Leiomyoma is a benign tumor originate from mesenchymal or connective tissue. Because of a low incidence, difficulties in differentiation from other renal tumors with imaging modalities, the definitive diagnosis of a leiomyoma is possible after examination of a specimen. We present a case of 79-years-old women with incidentally discovered renal tumor in CT scan. Because of the small size of a tumor, patient was informed about possibility of active surveillance. Partial nephrectomy was performed with a histopathologic diagnosis of renal leiomyoma. After 6 months of a follow-up, patient is found to be asymptomatic and free of disease.

Patients' quality of life after implantation of ZSI 375 artificial urinary sphincter due to stress urinary incontinence.

INTRODUCTION: The study aimed to evaluate the outcomes of artificial urinary sphincter ZSI 375 implantation for stress urinary incontinence, focusing on quality of life assessment (QoL). MATERIAL AND METHODS: The study had a prospective and non-randomized design. It was conducted in two urological centres in Poland. Between July 2013 and June 2019, artificial urinary sphincter ZSI 375 was implanted in 86 consecutive men with stress urinary incontinence. The follow up was completed in December 2019. The assessment of functional results was based on number of pads used and declared to have been used by patients. The quality of life was assessed on the basis of the ICIQ-SF questionnaire (International Consultation on Incontinence Questionnaire-Short Form), SF-36 questionnaire (Short Form 36 Health Survey Questionnaire) and the severity of pain by means of the NRS (numerical rating scale of pain intensity). RESULTS: The operations were performed in 86 patients aged 28 to 80 (median 69). With the median (SD; range) follow-up of 21 (20.2; 1-68) months, daily pad usage decreased significantly from ≥4 to 1.1 (±0.97 pads) per day. Seven (8.1%) patients achieved total continence, 60 (69.8%) social continence, 14 (16.3%) improvement and 5 (5.8%) failures (≥4 pads per day). 15 patients (17.5%) experienced complications after surgery. The study showed a significant improvement of QoL evaluated by ICIQ-UI SF and SF-36. CONCLUSIONS: Therapy with the use of ZSI 375 device is successfully applied in surgical management of moderate to severe male stress urinary incontinence. The life quality of patients assessed using questionnaires is at a high level.

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.

Four-year follow-up on a Zephyr Surgical Implants 375 artificial urinary sphincter for male urinary incontinence from one urological centre in Poland.

INTRODUCTION: The treatment of choice for patients who have iatrogenic urinary incontinence is the implantation of an artificial urinary sphincter. We performed a prospective study on the outcomes of men undergoing artificial urinary sphincter (AUS) implantation (ZSI 375; Zephyr Surgical Implants, Geneva, Switzerland). MATERIAL AND METHODS: Patients with moderate-to-severe stress incontinence urinary were included. The ZSI 375 device is a one-piece device with a cuff and a pump unit. Patients underwent a perineal incision for cuff insertion and an inguinal incision for the pump unit to be placed in the scrotum. Complications and number of pads used to manage incontinence were recorded. Perioperative complications were categorized according to the Clavien-Dindo classification. Pain connected with implantation of AUS was assessed with the visual analogue scale (VAS). RESULTS: Between July 2013 and June 2017, 50 patients underwent ZSI 375 device insertion in the Department of Urology and Urological Oncology in Pulawy, Poland. The follow-up stopped at the end of September 2017. The median (range) follow-up was 21.04 (1-50) months. No patient experienced bladder hyperactivity. Complications leading to a revision or permanent device removal arose in 12 patients (erosion = 9, infection = 0, mechanical failure = 3). Social continence (0 or 1 pad/day) was achieved in 29/50 patients (58%). An improvement (50% less pads/day) was achieved in 15/50 patients (30%). A failure was seen in 6/50 patients (12%). Perioperatively, all patients were classified as grade I in the Clavien-Dindo classification. Mean value of pain intensity in VAS was 0.82. CONCLUSIONS: The ZSI 375 device is safe, effective and the follow-up period was long enough to identify all potential complications.

Safety and Efficacy Outcomes of ZSI 475 Penile Prosthesis.

OBJECTIVE: The aim of this study was to demonstrate safety and efficacy of ZSI 475 hydraulic penile prosthesis three components. Preparation, procedure and functional results are similar to AMS 700 and Coloplast Titan. This study was conducted from September 2012 to December 2016. PATIENTS AND METHOD: From September 2012 to December 2016, 29 ZSI 475 hydraulic penile prostheses three components were implanted by six surgeons in 28 patients in five European centres. Mean age of patients was 60 years old (44-75). Standard peno-scrotal incision procedure was performed for the 28 patients. Erectile function was assessed by IIEF-5 self-administered questionnaire. RESULTS: Median follow-up was 35.11 months (8-47). Postoperative complications were limited to scrotal pump torsion that required a revision, an armed tubing breakage and a scrotal haematoma. At the end of follow-up, 100% of patients had a functional prosthesis and 92.86% were satisfied. CONCLUSIONS: Implantation, risks of complications, functional outcome and patient satisfaction with penile implant ZSI 475 are similar to standard hydraulic penile implants three components as AMS 700 and Coloplast Titan.

Current interventional management of male stress urinary incontinence following urological procedures.

INTRODUCTION: Despite improvements in surgical techniques and implementation of minimally invasive procedures, male stress urinary incontinence affects a substantial number of patients after prostatic surgery. In response to increasing demand of optimal treatment modality, new alternatives to artificial urinary sphincter have recently been introduced. This review summarises the therapeutic surgical options with their outcomes in management of postprostatectomy stress incontinence. MATERIAL AND METHODS: We performed a literature review by searching the PubMed, Web of Science and Embase databases for articles published from January 2000 until April 2015 based on clinical relevance. RESULTS: Artificial urinary sphincter is currently considered the "gold standard" treatment of male stress urinary incontinence. Although the new devices in this group have recently been investigated, the AMS 800 remains the only widely used implant. Male slings and adjustable continence devices, achieve the social continence rates up to 60%. Periurethral injections of bulking agents, have limited efficacy of male stress incontinence. Argus sling and ProACT are both associated with substantial explantation rates. Stem cell therapy is a promising option but still requires additional testing. CONCLUSIONS: The development of new alternatives to artificial urinary sphincter is constantly progressing. Although recently introduced minimally invasive treatment options have not yet surpassed the outcomes of the artificial urinary sphincter they should continue to be evaluated and compared against the gold standard.

[Urologic complications as a reason of recurrent urinary tract infections in patients after renal transplantation]. / Schorzenia urologiczne jako przyczyna nawrotowych zakazen dróg moczowych w odleglym okresie po przeszczepieniu nerki.

Urinary tract infections are the most frequent complications after renal transplantation. A retrospective study was conducted in patients treated after renal transplantation. We paid special attention to urinary tract infection connected with urologic complications and other urologic diseases.

A case of lichen planus of the penis mimicking leukoplakia lesions: a review of differential diagnosis.

We describe a case of a 50-year-old man with lesions localized in the region of urethral meatus and on the epithelium of the foreskin. The lesions were observed as the white spots with flat or somewhat depressed surface, locally similar to leukoplakia, lichen sclerosus atrophicus or cicatrix, without any subjective symptoms. Cystoscopy, micturition urography and biopsy were performed by urologist. The diagnosis of lichen planus Wilsoni was made based on the biopsy examination. We obtained great improvement of lesions through the applied local therapy