Chronic pelvic pain syndrome (CPPS) presents a diagnostic challenge due to its multifactorial nature, often involving urological, gynecological, and psychological components. This study focuses on the effectiveness of prophylactic phytotherapy in preventing CPPS recurrence, aiming to mitigate symptoms and psychosocial impact. The study includes 74 patients following a six-month treatment regimen with Graminex, Seronoa Repens, Curcuma Longa, and Acediboswellic ke-to-acetyl-11. Symptom assessment employs the IPSS and NIH-CPSI questionnaires, conducted at 3, 6, 8, 9, and 12 months. Patients exhibit significant improvements in IPSS scores, with maintenance of treatment impact observed at 3, 6, and 9 months. Interruption of therapy leads to symptom recurrence, but upon resumption, responses are more effective. The third group, under observation for three months, reports positive outcomes. Both IPSS and NIH-CPSI scores show a consistent impact on urinary symptoms and pelvic pain, indicating the therapy's effectiveness. The study demonstrates a concordance in the positive effects of phytotherapy across different age groups, emphasizing its efficacy in alleviating urinary symptoms and pelvic pain in CPPS patients. Symptom remission or improvement in quality of life is reported, with a notable tropism for symptom reduction in the cold season. Patient adherence to treatment is high, and even after treatment interruption, resumed therapy yields significant improvements. The observed benefits include the absence of pelvic pain, dysuria, and enhanced sexual competence, contributing to an overall improvement in the quality of life for patients with CPPS.
Background: The highlighting of possible risk factors for urinary colonization in patients with obstructive urolithiasis that needed double J catheters implanted to preserve renal function. Methods: We performed a descriptive, retrospective study, carried out in the Urology Department of the Bucharest Central Military Hospital, between January 2020 and January 2022 and included 168 patients with urolithiasis who required the insertion of double J catheters. We studied the bacteriological profile, using both urine and JJ catheter samples. Results: We obtained a double J catheter colonization rate of 32% (54 patients) and 29% of urinary colonization (49 patients). The rate of urinary colonization is higher in patients with colonized ureteral catheters regardless of sex, age, and associated comorbidities. At the same time, we noticed an increased rate of urinary colonization in patients associated with diabetes, hypertension, and chronic kidney disease. Conclusions: The prevalence of urinary colonization in patients with double J catheters was 29%. The colonization of the JJ catheters, as well as the association with chronic diseases, such as diabetes, hypertension, and CKD (Chronic Kidney Disease), show an increased risk of urinary colonization.
Urinary lithiasis is a common pathology in the modern era. Its significance lies in the possible complications that may arise as well as in its potential for recurrence. The treatment and prevention of recurrences of urinary lithiasis often require the intervention of several specialists: urologists, nephrologists, endocrinologists, nutritionists, biochemists, etc. In the last 20 years, the treatment strategy for urinary lithiasis has changed, with minimally invasive methods replacing laparoscopic or open surgery. These are effective and have rare complications. Whichever treatment method is chosen, it may be necessary to temporarily divert the upper urinary tract by inserting double J catheters for preventive, curative, or palliative purposes. Ureteral catheters have had to be improved over time to avoid two major incidents: their migration and colonization. Various materials were used, varying the shape, size, length, guide as well as approaches. The urinary infection-urolithiasis association is frequent, without always being able to specify the cause-effect relationship. The rate of urinary colonization appears to be influenced by the presence of stent colonization as well as the time since the implant. The association of chronic diseases or emergency insertion is associated with an increased risk of urinary colonization. Complications induced by the time of the double J catheter being implanted are rare, and minor and disappear with its removal. In the case of failure to insert a double J ureteral catheter, the alternative would be to perform an ultrasound-guided percutaneous nephrostomy. Double J ureteral catheter insertion is an effective minimally invasive option in the treatment of obstructive urolithiasis.
According to literature the primary retroperitoneal malignant pathology is rare, representing less than 0.5% of all malignancies. In spite of its low incidence, this pathology often proves challenging in terms of diagnosis and treatment. The most com¬mon retroperitoneal malignancy is represented by lymphoma that accounts for approximately 33 % of the retroperitoneal malignancies. Other frequent retroperitoneal tumors are sarcomas: leiomyosarcomas and malignant fibrous histiocytoma (in order of incidence). We have analyzed the existing data regarding the most common primary retroperitoneal tumors in order to realize a brief classification and their differential diagnosis considering their clinical, imagistic, histopathological and molecular characteristics. The technological developments that have been made over the years in terms of imaging investigations, as well as in biomelecular and cytogenetic studies have offered new possibilities for of assessing a retroperitoneal mass in order achieve more precise informations that can guide physicians to better distinguish between different types of retroperitoneal tumors and therefore their therapeutical protocol. liposarcomas,
Retroperitoneal tumors grow quietly and are generally large in size, more than half of them being larger than 20 cm at the time of diagnosis. They usually present several therapeutic challenges because of their rarity, relative late presentation and anatomical location, often in close relationship with several important structures in the retroperitoneal space. Due to intimate relationships with vital organs in retroperitoneum, extensive surgery with en bloc resection of the involved organ is often required, most frequently the kidneys, followed by colon, pancreas and spleen. Malignant tumors have a poor prognosis, the most significant factors regarding survival rates being delayed diagnosis, high histological grade, inoperability due to invasion into vital organs, and a positive surgical border.
Renal angiomyolipomas (AML) are the most common benign renal tumors. By containing an important amount of fat tissue they are easily identifiable on CT and MRI images, thus no biopsy should be needed for a diagnosis. However there is a small percentage of AMLs that have very little fat tissue and are very difficult to differentiate from renal cell carcinoma. Along fat tissue, they also contain smooth muscle and blood vessels. Renal AMLs can occur as a sporadic finding, or more frequently in association with tuberous sclerosis complex (TSC) or pulmonary lymphangioleiomyomatosis (LAM). These tumors are usually an incidental finding on imaging tools, but sometimes a serious presentation is rupture and hemorrhage, which can easily evolve to shock. Therapeutical management vary from active surveillance to surgical removal, and it needs to be individualized for every patient and according to the clinical presentation.
-
Systemic lupus erythematosus (SLE) is a complex autoimmune condition, which often evolves with severe complications. In SLE, autoantibodies appear, with systemic inflammation and multiple tissue destructions. SLE is the most common form of lupus and is considered more severe than other forms. SLE can affect many parts of the body, including the kidneys, heart, lungs, brain, blood, and skin. Symptoms vary among patients. SLE can follow an unpredictable pattern of remissions (symptoms improve) and flares (symptoms worsen). Renal involvement is one of the most severe complications in SLE patients. The process of depositing the immune complexes in the kidneys could lead to the appearance of lupus nephritis. If the treatment is early and treat-to-target, it can change the course of the renal disease.
Heart failure is the final stage of evolution of a large number of cardiovascular diseases and represents a health problem worldwide, due to increased prevalence of cardiovascular diseases. The patients with heart failure with preserved ejection fraction (HFpEF) represent about a half of the patients with heart failure and the prevalence of HFpEF is on the rise. HFpEF is mainly a disease of the elderly patients, who have numerous cardiovascular diseases – hypertension, myocardial ischaemia, atrial fibrillation, valvular disease, and also non-cardiovascular comorbidities, such as obesity, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, and obstructive sleep apnoea. HFpEF is more prevalent in women than in men, but women have a better prognosis than men. The pathophysiological changes that appear in HFpEF are: ventricular stiffening, cardiomyocite hypertrophy and hypercontractility, myocardial fibrosis and inflammation, which lead to abnormal diastolic function with delayed relaxation and inappropriate filling, in the presence of a normal systolic function of the left ventricle. The diagnosis of HFpEF is based on clinical, echocardiographic and biological criteria. In contrast to HFrEF, there is no effective treatment for HFpEF. The treatment of HFpEF includes diuretics for clinical improvement and treatment of comorbidities. The prognosis of patients with HFpEF is similar with those with HFrEF. Currently, the main objectives of the treatment in patients with HFpEF are to improve clinical status and decrease hospitalizations. Further studies are needed to establish an effective treatment to increase survival in these patients. Therefore, HFpEF continues to be a challenge for clinicians regarding the optimal therapy..
This study analyzes the satisfaction of the patients with radical prostatectomy according to the signs and symptoms included in the EORTC QLQ – C30 and EORTC QLQ – PR25 questionnaires, including their relation with the health state that influences the pre and postoperative life quality. Fifty patients with prostate cancer in a localized stage were studied and analyzed in a prospective manner and for a period of 12 months, before and 6 months after the radical prostatectomy. In choosing the patients, the common denominator was the use of the same postoperative plan and the lack of postoperative complications, as well as the lack of chronic diseases. Erectile dysfunction, urine incontinence were quite frequent after radical prostatectomy, while the urinary obstruction and the weak urinary stream were less frequent. In this regard, people noticed a significant decrease of life quality. Although the study addressed a small group of patients, the results are similar to those belonging to other clinical studies. Even if the aspect of life quality is more rarely taken into account, the questionnaires regarding the life quality are specific, useful and quite cheap in evaluating different therapies.
Radical prostatectomy is the gold standard treatment for patients with localized prostatic cancer, but often the pathological diagnosis reveals a locally advanced stage. The aim of this paper is to present the oncological follow-up after radical prostatectomy on a group of 42 patients, patients which have been diagnosed after surgery with a more aggressive stage, locally advanced PCa. Over a period of four years 136 patients have undergone radical prostatectomy. The pathological examination has established that 42 patients presented extracapsular invasion and/or lymph node invasion. 18 patients (pT3-4N0M0) have undergone radiotherapy alone and 24 patients (8 pN1 and 16 pT3-4N1M0) have received androgen deprivation therapy in association with radiotherapy. Over the next two years 15 patients presented biochemical recurrence. For these patients chemotherapy was initiated, but in two cases PSA increase has been observed during periodic evaluation. Although it is not uncommon that postoperatively the histopathological examination establishes a more aggressive disease stage than that established before surgery, radical prostatectomy remains the solution for the localized prostate cancer, solution that can be boosted by radiotherapy and/or androgen deprivation therapy.
