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Kidney stone disease (KSD) is a complex disease. Besides the high risk of recurrence, its association with systemic disorders contributes to the burden of disease. Sufficient water intake is crucial for prevention of KSD, however, the mineral content of water might influence stone formation, bone health and cardiovascular (CVD) risk. This study aims to analyse the variations in mineral content of bottled drinking water worldwide to evaluate the differences and describes the possible impact on nephrological and urological diseases. The information regarding mineral composition (mg/L) on calcium, bicarbonate, magnesium, sodium and sulphates was read from the ingredients label on water bottles by visiting the supermarket or consulting the online shop. The bottled waters in two main supermarkets in 21 countries were included. The evaluation shows that on a global level the mineral composition of bottled drinkable water varies enormously. Median bicarbonate levels varied by factors of 12.6 and 57.3 for still and sparkling water, respectively. Median calcium levels varied by factors of 18.7 and 7.4 for still and sparkling water, respectively. As the mineral content of bottled drinking water varies enormously worldwide and mineral intake through water might influence stone formation, bone health and CVD risk, urologists and nephrologists should counsel their patients on an individual level regarding water intake.

Objective To develop an easy-to-use side-specific tool for the prediction of prostate cancer extracapsular extension (ECE) using clinical, biopsy, and MRI parameters. Materials and methods Retrospective analysis of patients who underwent radical prostatectomy preceded by staging multiparametric MRI of the prostate was performed. Multivariate logistic regression analysis was used to choose independent predictors of ECE. Continuous variables were transformed to categorical ones by choosing threshold values using spline knots or testing thresholds used in previously described models. Internal validation of the rule was carried out as well as validation of other algorithms on our group was performed. Results In the analyzed period of time, 88 out of 164 patients who underwent radical prostatectomy met inclusion criteria. ECE was evidenced at radical prostatectomy in 41 patients (46.6%) and in 53 lobes (30.1%). In the multivariate analysis PSA, total percentage of cancerous tissue in cores (%PCa) and maximum tumour diameter (MTD) of Likert 3–5 lesions on MRI were independent predictors of ECE. The following rule for predicting side-specific ECE was proposed: %PCa ≥ 15% OR MTD ≥ 15 mm OR PSA ≥ 20 ng/mL. Internal validation of the algorithm revealed safe lower confidence limits for sensitivity and NPV, proving that model offers accurate risk grouping that can be safely used in decision-making. Conclusion The rule developed in this study makes ECE prediction fast, intuitive, and side-specific. However, until validated externally it should be used with caution.

IntroductionLong-term outcomes of patients treated for invasive bladder cancer in Poland are poorly documented in the literature. Impact of various clinical parameters on their survival is even less well studied. Radical cystectomy is a major surgery, so the patients’ condition can be equally important as cancer stage. The aim of the study was to assess 5-year overall survival (OS) after cystectomy and impact of comorbidity on OS in a single Polish academic centre.Material and methodsClinical data of all patients who underwent cystectomy in years 2004-2006 for urothelial cancer were retrospectively reviewed. Survival status was determined at least 5 years after surgery. Pathological variables, comorbidities, surgery delay and complications were evaluated as potential predictors of OS. Kaplan-Meier estimates of the survival function as well as Cox proportional hazards models were utilized.ResultsThirty-day, 1-year and 5-year OS for 63 patients was 98.4%, 58.7% and 31.7%, respectively. None of the investigated parameters were significantly related to five-year OS. However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor. Five-year OS in 16 patients with pT1-2 and without diabetes and without post-operative complications was higher than in the remaining 47 patients (56% vs. 23%; P = 0.02).ConclusionsFive-year OS in our group was lower than in most published international series but concordant with a previous Polish report. Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.

IntroductionResults of urodynamic studies performed in female patients are often difficult to interpret. The objective of the study was to develop a nomogram that would help in diagnosing functional bladder outlet obstruction (BOO) in neurologically intact women with any kind of lower urinary tract symptoms.Material and methodsFrom the urodynamic database adult women were chosen with maximal flow rate (Qmax) ≤ 12 ml/s in a pressure-flow study. Four criteria were used to identify a group of patients suspected of BOO: thickened bladder wall, presence of bladder diverticula, subjective improvement on α-blockers and improvement of voiding symptoms on any form of treatment. The line separating high and low pressure zones on the pressure-flow chart was established according to the position of patients who met at least one of them.ResultsSixty-seven patientswere investigated. Twenty-one women met at least one of the specified criteria. They had significantly higher voiding pressures (p det(Qmax) 35 cm H2O vs. 16.5 cm H2O; p = 0.002). A new nomogram with one separating line (p det(Qmax) = 1.5 × Q max+ 10) was proposed. The difference in the distribution of women fulfilling the criteria between high pressure zone and low pressure zone was highly significant (19/35 vs. 2/32; p < 0.0001). Sensitivity, specificity, positive and negative predictive values of our nomogram in identifying patients suspected of BOO was 90.5%, 65.2%, 54.3% and 94% respectively.ConclusionsThe new nomogram can be considered a screening test which efficiently excludes obstruction among women with low Q max in a pressure-flow study.