[Quality of life in incontinent men after implantation of an artificial urinary sphincter]. / Kvalita zivota u inkontinentních muzu po implantaci umelého sverace mocové trubice.

The authors implanted to a group of 10 patients incontinent after prostate surgery (on account of BPH and adenocarcinoma) an artificial AMS 800 sphincter. After a mean follow-up period of 29 months they evaluate based on a questionnaire the therapeutic effect and its influence on the patients quality of life as well as the adequacy of the approval procedure of indication on the part of the insurance company as it influences the quality of life. The effect of treatment and influence on quality of life is evaluated without exception very highly while the approval process is evaluated negatively. The authors draw attention to the risk of suicide in mentally otherwise sound subjects due to unsatisfactory solution of urinary incontinence. Correctly indicated treatment by an artificial sphincter can achieve very satisfactory results. The approval procedure must combine medical and rational aspects, it must be however revised, incl. the economic aspects of the system of health services.

Effectiveness of SWL for lower-pole caliceal nephrolithiasis: evaluation of 452 cases.

The authors report on the treatment of lower-pole caliceal nephrolithiasis with extracorporeal shockwave lithotripsy (SWL) using the Czech-made Medilit M-5 lithotripter. In 310 patients, they have performed 452 treatments and evaluated the results 3 months after the last session using plain radiographs and ultrasound examination. The effectiveness of treatment and the success rate of SWL decreased with increasing size of stones: with stones >20 mm, it declined to 30%. This poor success rate was attributable not only to the size of the concrement, but also to its location in a lower calix, which is unfavorable for the passage of fragments. For big lower-pole caliceal stones (>20 mm in the longest diameter), the authors recommend percutaneous nephrolithotomy as the primary management method, the effectiveness of which does not depend on the size of the stone. The success rate achieved in treating the lower-pole caliceal lithiasis using the Medilit M-5 machine was 61.3%, similar to that achieved with other lithotripters.

[Ureteroscopy--an alternative treatment in ureterolithiasis]. / Ureteroskopie--alternativa resení ureterolitiázy.

The authors evaluate the results of 315 ureteroscopies performed in 1991-1995 at the Urological Clinic in Brno Bohunice. 290 ureteroscopies were made on account of ureterolithiasis, diagnostic ureteroscopy was performed in 17 patients, in four instances extraction of a foreign body was involved and in four instances during ureteroscopy the stenosis of the ureter was severed. One-stage operations were successful in 226 patients (78%), in 42 patients (14%) after ureteroscopy ESWL had to be made. Ureteroscopy as a two-stage operation was performed in 12 patients (6%), five cases were resolved by open surgery because ureteroscopy failed. The authors evaluate early and late complications, none of which called for nephrectomy. The authors discuss the position of ureteroscopy in ureterolithiasis which is one of the most frequent indications.

[Effective treatment of nephrolithiasis of the lower calix using ESWL (evaluation of 452 procedures)]. / Efektivnost resení nefrolitiázy dolního kalichu metodou ESWL (zhodnocení 452 výkonu).

The authors present their results with the treatment of nephrolithiasis of the lower calix using the method of extracorporeal lithotripsy with the Czech apparatus Medilit M-5. In 310 patients they made 452 operations and checked the therapeutic results three months after the last session. For checking they used a native nephrogram and examination by ultrasound. With the increasing size of concrements the effectiveness declined and thus also the success of ESWL(in concrements above 20 mm in size it declined to 30%). This is not due only to the size of the concrement but also its site in the lower calix which is unfavourable for the elimination of fragments after ESWL. The authors recommend therefore in large concrements of the lower calix (more than 20 mm in the longitudinal axis) to select as the primary method percutaneous nephrolithotomy which is highly effective in this localization and is independent on the size of the concrement. The general success rate achieved in treatment of lithiasis of the lower renal calix with Medilit M-5 is 61.3% and is comparable with other lithotriptors.

[Implantation of inflatable penile prostheses as an effective alternative surgical treatment for erectile disorders]. / Implantace inflatabilní penilní protézy jako efektivní alternativa chirurgického resení poruch erekce.

The authors present an account of their own experience with results and complications of inflatable penile prostheses implanted in a group of 30 patients with organic erectile dysfunction. They discuss possible complications of this operation as well as the place of penile prostheses in the treatment of erectile dysfunction.

[Ureteroscopy in the treatment of ureterolithiasis]. / Ureteroskopie v lécbe ureterolitiázy.

After establishment of endourological methods at our University Urological Department we have treated 36 ureteral stones in 34 patients since January 91 until April 92. Through retrograde (23) and antegrade (13) access we have successfully treated almost all calculi with the exception of one (where we hadn't been able to pass through reimplanted ureteral orificium). We have introduced double J stent in 90% patients after procedure and discharged them 3 days postoperatively on average. We have had no serious complication. Ureteroscopy with stone disintegration possibility has enabled us almost to leave open surgery in those cases, lower morbidity and shorten time spent in the hospital significantly.