[Urinary tract dysfunction in spinal cord injury patients]. / Uroloska disfunkcija u osoba s ozljedom kraljeznicne mozdine.

Spinal cord injury (SCI) results with paralysis but also with micturition dysfunction; therefore rehabilitation management and long-term follow-up include lower urinary tract care in order to prevent upper urinary tract pathology and complications. That comprises timely and standardized neurological and urological diagnostics and eliminatory techniques with intermittent catheterisation in majority of patients. Urological diagnostics include blood and urine tests, urine culture, ultrasound and X-ray of urinary tract, and cystometry to assess dynamic properties of neurogenic bladder. It has been proven that incomplete SCI patients have neurogenic bladder with similar findings as patients with complete injuries, i.e. cystometric capacities are reduced while intravesical pressures are increased, which endanger upper urinary tract. Furthermore, it has been shown that there is no difference of these findings between particular levels of injury: cervical, thoracic, thoracic-lumbar and lumbar, so these risks are similar in every group. Conclusively, it is necessary to conduct urinary tract diagnostics in SCI patients for sake of the quality and quantity of patients' lives.

Prostate specific antigen density can help avoid unnecessary prostate biopsies at prostate specific antigen range of 4-10 ng/ml.

Elevated level of prostatic specific antigen (PSA) is an established parameter to help determine the need to perform prostate biopsy. The aim of the present study was to determine whether PSA density (PSAD) could better predict pathologic finding of 12-core prostate biopsy in men with PSA 4-10 ng/mL than PSA alone. Transrectal ultrasound guided biopsy was performed in 125 men with PSA within this range. The rate of cancer detection was 24%. Study results showed a significant difference in PSAD between the two patient groups with negative and positive biopsy findings (P=0.002), while difference in the measured PSA levels was not significant (P=0.091). Study results suggested that PSAD could serve as an additional parameter in predicting negative outcome of prostate biopsy, with a cut-off value of 0.15 ng/mL/mL within PSA range of 4-10 ng/mL (sensitivity 86.7% and negative predictive value 91.5%).