Chronic nonbacterial prostatitis/chronic pelvic pain syndrome is unsatisfactorily defined and insufficiently studied illness. Also, the treatment success is questionable and therefore, this illness is a therapeutical problem for urologists--which medications are the best choice in treating this uncomfortable condition? This paper presents results of prospective, open, analytical, comparative study that was performed on 90 patients with diagnosed chronic nonbacterial prostatitis/chronic pelvic pain syndrome. Patients were divided into three groups and were treated with two medications ciprofloxacin (C), doxazosin (D) and combination of ciprofloxacin + doxazosin (C+D). The effects were measured using symptom questionnaire for prostate illnesses of the National Institute for Health - USA (NIH-CPSI). During the basic evaluation, sum ranging from 0 to 43 was calculated for each patient. This number is called total sum NIH-CPSI (National Institutes of Health Chronic Prostatitis Symptom Index) of the questionnaire, which generates the questions from 1 to 9. The most significant change occurred in C+D group where the total sum changed from 18-38 in the beginning to 5-31 at the end of the treatment (55,1% (p<0,001)). Significant changes were also found in D group where the change was 46, 4% (p<0,001). At the end of the treatment no significant change was registered in C group (p<0,005): p<0,001--significance threshold. Combination of ciprofloxacin + doxazosin proved to be the best choice for treatment.

The IPP higher than 10 mm as a non-invasive predictor of infravesical obstruction shows good correlations with clinical and urodynamic parameters, while the specificity and PPV against obstruction are significant. Despite a good correlation with IPP, the BWT is only a modest indicator of obstruction.

Aim: To determine the discriminatory power of penile urethral compression-release index (PCRI), clinical prostate score (CLIPS) and bladder outlet obstruction index 2 (BOON2) for the detection of bladder outlet obstruction (BOO), and the associated bladder abnormality in patients with benign prostatic enlargement (BPE). Material and methods: In study was included of 135 patients with proven BPE underwent urodynamic measurement (UDM) and PCR maneuver. PCR Index was calculated following the formula: (Qs-Qss)/Qss x 100(%). CLIPS score was calculated based on non-invasive variables (prostate volume, maximal urinary flow, residual urine and voided volume), while BOON2 was calculated using the formula intravesical prostate protrusion (IPP)-3 x Qmax-0.2 x mean voided volume. UDM results were plotted on Schaefer and URA nomograms. Results: A comparative analysis was made using ROC curves. The area under the curve (AUC) for PCRI is 0.85 (PTP 91.3%), while AUC for CLIPS and BOON2 is 0.8 (PTP 77.6%) and 0.82 (PTP 74.5%), respectively. PCRI with the cut-off point of 96% clearly distinguishes obstructed patients with normocontractile detrusor and the presence of detrusor overactivity (DO), versus those unobstructed. CLIPS (>10) shows good BOO prediction, but without the possibility of distinguishing between detrusor contractility grade and the occurrence of DO. BOON2 has shown that impaired contractility has influence on this number in obstructed patients. Conclusion: PCRI is a very good noninvasive urodynamic test for a group-wise detection of BOO in patients with BPE and associated bladder co-morbidities; it is therefore superior in comparison with to CLIPS or BOON2.

Paper goal is to determine complications after urgent surgical treatment of patient with penile fractures, by using circumferential-degloving technique (degloving penile skin to root of penis). In period between 1998-2006 year, 23 patients have been treated as urgent cases with clinically proven penis fracture, age between 18 and 35. Patients were treated in 3 medical centers in Bosnia and Herzegovina(Sarajevo, Tuzla and Zenica). All 23 (100%) patients were injured during sexual intercourse. In the case of 20 (86,9%) patients partial rupture of corpus cavernosum was verified. Two (8,6%) patients had a complete rupture of urethra and it was primary sutured. In 22 cases (95,6%) spontaneous erection appeared, and in the case of 2 (8,6%) patients penile curvature was verified. Urgent surgical treatment is the best therapy choice, which enables preservation of erection in great number of cases in patients with penile fracture.

A im: Establish the main differences in the prostate volume, prostate specific antigen density (PSAD), number of biopsy samples in patients with primarily or rebiopsy detected prostate cancer. Materials and methods: In the 2007-2009 period, at the KCUS Urology Clinic, there were 379 TRUS guided prostate biopsies in 323 patients with known prostate volume. The total of 56 patients (17.3%) underwent the first rebiopsy, primarily due to precancerous lesions. The mean prostate volume, ranges of prostate size, PSAT, PSAD and the number of biopsy samples were analysed retrospectively, and the main characteristics in patients with primarily and rebiopsy diagnosed Pca were evaluated as well. Results: The first biopsy cancer detection rate was 29.6% (112/379). The rebiopsy detection rate was 30.3%. There was no statistically significant difference in the prostate volume and the number of biopsy samples among the total number of patients with prostate cancer against the group with benign (suspected) findings. There was a higher Pca detection rate in patients with the prostate volume <40 cm3 and 40-60 cm3, against the group with the prostate volume >60 cm3. PSAD was significantly higher in patients with PCa (0.24 vs. 0.18; p=0.013). The total of 27.2% of the patients with negative biopsy findings and 48% of the patients with diagnosed Pca had PSAD >0.15. PSAD showed sensitivity and specificity in prostate cancer detection of 50% and 75%, with PPV of 48%. Furthermore, the patients with PSAD >0.15 had a higher Gleason score versus the patients with PSAD <0.15 (6.7 ± 2.4 vs. 5.9 ± 1.7; p <0.003). A comparison of the main characteristics in patients with primarily and rebiopsy detected prostate cancer gave a statistically significant difference only in the number of biopsy samples (10.9 vs. 14.1, p <.0000). Conclusion: Patients with a smaller prostate volume, lower PSAD and a higher number of biopsy samples in rebiopsy have a higher chance of prostate cancer detection. PSAD carries a higher specificity in rebiopsy decision, and a higher PSAD is related to a higher Gleason score.