Osteoporosis is one of the epidemics in modern aging societies. Epidemiological studies indicate that many patients with osteoporosis are also characterized by diminished glomerular filtration rate (GFR), which indicates various degrees of chronic kidney disease (CKD). On the other hand, the status of osteoporosis in the classification of mineral and bone disorders in CKD has not been well defined. In the present paper, we review the epidemiology of osteoporosis in the context of kidney failure, discuss tools used to diagnose osteoporosis in patients with CKD, present data on fracture risk in patients with kidney diseases, and describe the relationship between metabolic bone diseases and the development of vascular calcification. We also present current treatments in osteoporosis with special attention to the outcomes of these treatments in patients with low GFR.

Introduction Currently, polypropylene materials are used widely for the treatment of various urogynecologic disorders. This type of treatment can be complicated, although rarely, with erosions of the polypropylene implants into the bladder or the urethra. There is no established treatment for such complications. We present our experience in transvesical laparoendoscopic single-site surgery (T-LESS) removal of eroded materials, and a review of the literature in this field. Materials and methods From June 2015 to May 2017 eight females, with an average age of 66.5 years (range 55–80 years), were referred to our Center because of the erosion of polypropylene material in the bladder, after anti-incontinence or pelvic organ prolapse treatment. Patients were diagnosed with ultrasound and cystoscopy. Seven bladder erosions and one bladder and urethral penetration were found. Patients were qualified for removal with the T-LESS approach. The Tri-Port + disposable set and standard laparoscopic instruments were used. The eroded materials were dissected and cut away, and the defects of the bladder wall were closed with barbed sutures. The peri-operative efficacy and safety of the method were assessed, and the patients were scheduled for follow-up visits at 6 weeks and every 3 months thereafter. The patients were offered a cystoscopic exam during the 7–10 month period after the operation. Results The procedures were completed successfully in all patients. No blood loss or complications were observed. The mean operative time was 54.5 min, and the average hospital stay was 30 h. During a follow-up at 11 months, all patients were cured, except for one who presented urethral erosion. Conclusions The T-LESS technique for removal of eroded meshes is a safe and effective method. The precise access to the bladder minimizes morbidity, and suturing the bladder wall defects may reduce the risk of recurrence.

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Abdominal surgery on patients with significant body malformation is often a challenge for an operative team. Particularly, when patient presents lesions suspected for malignancy but benign disease cannot be excluded. In the reported case the patient suffered from cerebral palsy and had extreme spinal distortion with significant displacement of internal organs. Solid renal mass was detected incidentally, but because of body deformation the biopsy to asses pathological status could not be performed. The decision to perform surgery was made and the patient underwent successful laparoscopic partial nephrectomy. Pathology examination of the specimen revealed renal cell carcinoma grade 2.

IntroductionJan Janowicz was born in 1893 in Giełuta. After arriving in Olsztyn in 1945, he began the process of establishing a surgical department in Olsztyn. In a short time, he set up hospital wards and outpatient clinics, which provided surgical care to the inhabitants of Olsztyn and Olsztyn voivodeship. Due to the lack of specialist staff, he was simultaneously the head of department at three hospitals in Olsztyn. On his initiative and under his supervision, independent departments of orthopedics, pediatric surgery, urology, and thoracic surgery were established. Jan Janowicz, as a pioneer in Olsztyn’s surgery and the founder of new departments, became the most important and most distinguished surgeon in the post-war history of medicine of Warmia and Mazury.AimThe aim of the study is to present the biography of Jan Janowicz, the pioneer and most distinguished surgeon of Olsztyn and the Warmian-Masurian voivodeship.Material and methodsThe study is based on the available literature as well as the authors’ own research.Results and discussionWe present a biography of Jan Janowicz, a pioneer of Olsztyn’s medicine.ConclusionsDoctor Janowicz, who came to Olsztyn in 1945, was a pioneer and the first person to organize surgical care in what is now the Warmian-Masurian Voivodeship. His activities led to the establishment of independent departments of pediatric surgery, orthopedics, urology, and thoracic surgery.