Monitoring of pathogen resistance profiles is necessary to guide empirical antibiotic therapy before culture and sensitivity results become available. The aim of this study was to describe current antibiotic resistance patterns of five most frequent causative uropathogens in a Department of Urology of a tertiary referral centre in Central Europe over a period of nine years. The Hospital Department of Clinical Microbiology database was used to extract data on all positive urine samples from inpatients in the Department of Urology between 2011 and 2019. Numbers of susceptible and resistant isolates per year were calculated for five most frequent uropathogens: Escherichia coli, Enterococcus spp., Klebsiella spp., Pseudomonas aeruginosa, and Proteus spp. Antimicrobial agents selected for the survey included: ampicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam; cefuroxime, cefotaxime, ceftazidime and cefepime; ciprofloxacin and ofloxacin; gentamicin and amikacin; ertapenem, meropenem and imipenem; trimethoprim-sulfamethoxazole (co-trimoxazole), nitrofurantoin, colistin, and vancomycin. High resistance rates of Gram-negative uropathogens were demonstrated to most common antimicrobials, with statistically significant increasing or decreasing trends in some cases. No carbapenem-resistant Enterobacteriaceae were isolated. Vancomycin-resistant Enterococcus spp. strains were rare in our population.

Mirabegron (50 mg) improved both urodynamic variables and patient-reported outcomes in patients with NDO. The treatment was tolerated well.

Sir, We report a case of a mixed epithelial and stromal tumor of the kidney with malignant transformation of its mesenchymal component. A 46-year-old woman was operated on for a computed tomography-proven solidified cyst in the upper pole of the left kidney. No tumorous metastatic dissemination was found during further clinical examination.The kidney contained a cystic tumor 7 cm in diameter bulging into the perirenal fat. The gray-brown wall of the cyst was 0.2-to 0.3-cm thick, the inner surface was smooth, covered by light and dark brown, hemorrhagic material. A flat, red-brown prominence measuring 4×3×1.5 cm, multilocular on a cut surface, protruded into the intracystic space. The margins of the tumor were sharply demarcated from the renal parenchyma but were indistinct on the side of perirenal fat. The hemorrhagic contents of the cyst, submitted separately in a total volume of about 200 ml, were characteristic of blood clots, seemingly free of tumorous material. The renal parenchyma outside the tumor area, renal pelvis and ureter were unremarkable.The tumor showed a histological structure of a benign multilocular cyst containing cysts and septa, which comprised occasional small tubular structures. Septa were formed by fibrous stroma with uneven cellularity focally displaying ovarian stroma-like features (Fig. 1) and immunohistochemically showing positivity of vimentin, smooth muscle actin, muscle actin and desmin. Ultrastructurally, the bland-looking cells surrounded by external lamina and connected by primitive attachment sites were set in the background of collagenous matrix. They contained numerous organelles, including copious cisternae of the rough and smooth endoplasmic reticulum, intermediate filaments and Golgi complex. Numerous patches of microfilaments were focally present in the cytoplasm of the benign stromal cells. The tubules and cysts were lined with a single layer of epithelial cells, mostly showing a hobnail appearance, oxyphilic, periodic acid-Schiff base (PAS)-negative cytoplasm and large, irregular nuclei. PAS-positive material was present in some lumina. Immunohistochemically, the cells were cytokeratin and epithelial membrane antigen (EMA) positive. No heterologous tissue, renal blastema cells or poorly differentiated epithelial structures were found.

This study demonstrated that even mild urinary leakage significantly reduces the QoL, while subsequent increase in the degree of incontinence has only minimal additional effect. There was no linear correlation between incontinence severity and QoL.