Our clinical trial included until now, 22 patients in whom new generation urethral stent named Allium, were inserted due to bladder outlet obstruction caused in 7 patients (pt) with benign prostate hyperplasia, in 13 pt with bulbar urethral stricture of different ethiology and in 2 pt with prostate cancer. Allium prostatic stents, designed by Daniel Yachia differs in some crucial characteristics from previously used stents: they are covered for the first time in urethra stenting history, without relatively low radiation force and because of that nonirritative. The indications, contraindications and preliminary results in this study are discussed concerning the patients with cancer of the prostate.

Detailed preoperative evaluation is essential in prevention of perioperative complications. As thorough anamnesis, physical examination and standard laboratory investigation do not contribute much in prediction of perioperative complications and outcome, and detection of tumor markers is also insufficient in means of prognosis, some molecular marker have emerged lately as prognostic markers in surgery. Recent data on pathophysiological processes stress response, derangements of hemostasis, in sepsis or in thromboembolism as well as in malignancy, indicate that presence or elevation of some molecular markers of fibrinolysis can indicate possibility of perioperative complications and even predict outcome. As it is evident that neoplastic cells enhance thrombin and other procoagulant production, detection of degree of activation of coagulation and fibrinolysis can contribute in prediction of treatment outcome in patients with bladder carcinoma scheduled for radical surgical procedures.

The current referential literature describes over 40 surgical techniques of continent urinary derivations. A variation of ureterosigmoidostomy, published by Hadzi Djokic et al. (1996) is a combination of the original Mainz pouch II (sigma rectum pouch) technique (Fish & Hohenfellner, 1991) and modified ureterointestinal anastomosis as described by Camey & LeDuc (1979) with a few new details described by the author himself. In the period 1994-2006, the total of 236 patients were treated by this method. Radical cystectomy in cases of multifocal transitional cell carcinoma of the bladder was the most common indication for this method (91,5%). In the course of follow-up (mean duration 24 months) the quality of life (QL) of these patients was evaluated by physical characteristics, mental status, social aspects and comparative evaluation of quality of life with ileal conduit which is still considered the "gold standard" for urinary derivations. A very good quality of life in all studied dimensions (3/4) patients) suggests the fact that this form of continent urinary derivation provides the patients with the fair quality of life and confirms justifiability of this surgical procedure under certain indications.

Radical prostatectomy is one of most common treatment options currently recommended for clinically localized prostate cancer. Evaluation of intraoperative and postoperative complications is important in evaluation of relative morbidity of this treatment option. Furthermore, investigation of complications of surgical treatment in correlation with not only surgical technique, but comorbidity, ASA stage and anesthetic technique enables improvements in complete perioperative treatment and decrease of incidence of complications resulting from the procedure. Improvement of anesthetic techniques and use of new anesthetic agents contributes to better outcome of surgical treatment. For radical surgery, combined epidural analgesia and general anesthesia reduces postoperative complications and mortality. Benefits can be conferred most likely by altered coagulation activation in surgery, increased blood flow, reduction of operative stress response. Modalities for reduction of intraoperative blood loss during radical prostatectomy are normovolemic haemodilution, preoperative donation of blood for autologus transfusion and use of erythropoietin for increasing red cell mass.

The absence of basal cell layer of prostatic acini containing high-molecular cytokeratin, which is immunohistochemically detected by monoclonal antibody 34betaE12, is an essential diagnostic characteristic of prostatic cancer. The absence of immunohistochemical reaction in 3 or more pseudoglandular structures of prostatic tissue indicates malignant process. The percentage of immunohistochemically completely negative glandular structures was determined by semiquantitative measurement in tissue specimens obtained by TRUS biopsy of the prostate, and it was correlated with serum PSA concentration and Gleason score. The increase of percentage of glandular prostatic formations completely negative to high-molecular cytokeratin detected by 34betaE12 led to simultaneous rise of mean value of Gleason prostatic cancer score (p < 0.001) as well as the average serum PSA concentration in subjects (p < 0.05).