IntroductionAcute epididymo-orchitis (AEO) is an acute inflammatory disease of the epididymis and ipsilateral testis. Treatment should be started immediately after diagnosis and includes antibiotics, analgesics, and, if necessary, surgery.Materials and methodsAfter AEO diagnosis, patients were treated conservatively with analgesics and antibiotics. If no clinical improvement was observed within the first 48-72 hours of conservative treatment, patients underwent surgery. Depending on examination results, 254 patients (pts.) were divided into three groups: 1) with palpable differences between the epididymis and testis (E/T+), and without neither hydrocele, local softening (malacia), nor abscess of the epididymis or testis; 2) with E/T+, absence of malacia, presence of hydrocele, and none, one, or a few small abscesses within the epididymis/testis and 3) without palpatory differentiation between the epididymis and testis, with or without malacia, with hydrocele, and none, one, or more abscesses of any size. We analyzed the clinical outcomes in each group.ResultsAll of patients from the first group were successfully treated with antibiotics. In the second group, conservative treatment was effective in 70 pts. (85.4% of this group), but the other 12 pts. (14.6%) did not show clinical improvement and underwent organ-sparing surgery. The majority of patients from the third group did not demonstrate an objective response to antibacterial treatment during the first 48-72 hours and, therefore, underwent surgery. Based on examination results and clinical outcomes we developed a classification system for AEO, which divides AEO into three stages and recommends an approach to its treatment.ConclusionsOur classification is able to systematize treatment approaches in patients with AEO.

IntroductionIt is impossible to imagine a modern socially–active man who does not use mobile devices and/or computers with Wi–Fi function. The effect of mobile phone radiation on male fertility is the subject of recent interest and investigations. The aim of this study was to investigate the direct in vitro influence of mobile phone radiation on sperm DNA fragmentation and motility parameters in healthy subjects with normozoospermia.Material and methods32 healthy men with normal semen parameters were selected for the study. Each sperm sample was divided into two equal portions (A and B). Portions A of all involved men were placed for 5 hours in a thermostat, and portions B were placed into a second thermostat for the same period of time, where a mobile phone in standby/talk mode was placed. After 5 hours of incubation the sperm samples from both thermostats were re–evaluated regarding basic motility parameters. The presence of DNA fragmentation in both A and B portions of each sample was determined each hour using a standard sperm chromatin dispersion test.ResultsThe number of spermatozoa with progressive movement in the group, influenced by electromagnetic radiation, is statistically lower than the number of spermatozoa with progressive movement in the group under no effect of the mobile phone. The number of non–progressive movement spermatozoa was significantly higher in the group, which was influenced by cell phone radiation. The DNA fragmentation was also significantly higher in this group.ConclusionsA correlation exists between mobile phone radiation exposure, DNA–fragmentation level and decreased sperm motility.

IntroductionRenal cell carcinoma (RCC) is a widespread oncourological disease with a tendency towards a slow increase of incidence. In the recent decade, there has been development of numerous effective drugs targeted at different molecules that play a dominant role in RCC carcinogenesis. Understanding of RCC carcinogenesis confirms the key role of angiogenesis in maintaining the viability of renal tumours and their metastases.Material and methodsWe aimed to systemize numerous medicines, used to inhibit the angiogenesis in patients with advanced RCC according to their targets, and to analyze their efficacy.ResultsThere are roughly four main mechanisms of action of the targeted drugs:Blockade of circulating extracellular VEGF molecules.The selective blockade of tyrosine kinase receptors’ domains.The simultaneous blockage of the tyrosine kinase receptors’ domains and intracellular tyrosine kinases.The blockade of mammalian target of rapamycin (mTOR) which is responsible for support of vital functions of cancer cells. In addition to FDA officially approved drugs, numerous experimental agents have been synthesized, which are currently on initial stages of clinical studies in RCC treatment.ConclusionsThe results of the currently used targeted drugs demonstrate perspectives of metastatic RCC conservative treatment, that are able to prolong cancer–specific survival in previously doomed patients for up to 29 months. The development of schedules for sequential treatment or combination targeted therapy remains a current challenge. The quality of life is an important factor that influences remedy choice. The advantages and disadvantages of neoadjuvant and adjuvant targeted therapy are currently being intensively discussed.

Priapism is a persistent erection without sexual stimulation that cannot be relieved by orgasm. Its etiology includes the impaired mechanism of detumescence caused by the abundant release of neurotransmitters, venules obstruction, impairment of the intrinsic mechanism of detumescence, or prolonged relaxation of the intracavernous smooth muscles. Treatment of priapism is conservative, pharmacological, or surgical. Efficient treatment options include the intracavernous vasoconstrictor injections or surgical shunting. Alternative treatment options include the intracavernous methylene blue injections or selective penile arterial embolization. Between 2001 and 2009, we treated 10 patients with priapism at our clinic. According to our data, priapism as a complication after intracavernous administration of prostaglandin E1 occurs in 2.7% of patients, after additional administration of prostaglandin E1 and phentolamine – in 5.0% patients, after administration of papaverine – in 8.3% patients. The obtained results allow recommendation of prostaglandin E1 as a medication of choice among the vasoactive substances for intracavernous use due to high efficacy and low side effects. Initially all cases of priapism must be treated pharmaceutically, but can be converted to surgery as needed. Unilateral transcaputal puncture of the cavernous body (shunting after Winter) in our patients with ischemic priapism allowed to achieve detumescence in 100% of cases without subsequent recurrence and to restore erectile function in 30% of patients.

Background: The aim of this study was to investigate the effect of the herbal medicine Canephron®N, particularly regarding its ability to prevent recurrences of cystitis, associated with E.Coli in women of child-bearing age. Methods: Ninety patients were randomised into two treatment groups. Both, the test group (n = 45) and the control group (n = 45), received an antibacterial therapy (fluoroquinolones) for 7 days determined by urine culture. Furthermore, in both groups general recommendations on preventing cystitis were made (sufficient liquid consumption, avoidance of hypothermia etc.). The test group received an additional Canephron®N therapy for 3 months (2 tablets, three times a day). Control examinations were conducted on day 7 and after 3, 6 and 12 months; or immediately in the case of a recurrent episode. The following cystitis symptoms were recorded at each time point: pain in the bladder, burning and stinging during urination, urinary urgency and frequent urination in small amounts. The criteria for defining a recurrent episode of cystitis were rebound lower urinary tract infection symptoms with pyuria and positive bacteriological urine culture. Results: Canephron®N in addition to fluoroquinolones helps to reduce cystitis symptoms after 7 days better compared to treatment with fluoroquinolones only, as well as pyuria after 3, 6 and 12 months and urine levels of E. coli at 3 and 12 months. The frequency rate of recurrent episodes of cystitis was in the test group always lower than in the control group with a statistically significant difference at 6 months (8.9% vs. 17.8%) and at 12 months (15.5% vs. 35.5%). At 12 months, the mean score of the LUTI Symptom Severity Index was 6 (p ≤ 0.05) in the control patients and 3 (p ≤ 0.05) in the test patients. This may indicate that the relapses were less severe in the test group. Conclusion: Treatment with the herbal medicine Canephron®N is a novel treatment method of alleviating the symptoms of cystitis and especially for reducing the rate of recurrent cystitis episodes.