Pediatric patients suffering from valve bladder syndrome (VBS) are at risk of developing chronic kidney disease (CKD) and renal failure in later life. Therefore, it is of vital importance to determine the risk factors and the best possible strategies for diagnosis and treatment in patients with VBS that would minimize the risk of developing CKD. In this review we have presented the current knowledge of CKD risk factors in patients with posterior urethal value (PUV). We have also discussed possible recommendations for prenatal diagnostics procedures to be undertaken in patients with PUV, postnatal monitoring and therapeutic strategies that could reduce the risk of developing CKD in this population. Although in most cases there are no clear guidelines for appropriate clinical actions that can be undertaken in patients with PUV to minimize the risk of kidney failure, we have tried to present concise and accurate advice for physicians taking care of patients with PUV.

Background. According to the Polish National Cancer Registry, bladder cancer is the 4 th most common cancer in the male population (7.0%), while prostate cancer takes 2 nd place (14.0%). In the case of both cancer types, prognoses are precarious and depend on many factors, such as the size of the primary tumor, infiltration of regional lymph nodes, histological grade and occurrence of distant metastases. Objectives. The objective of this work is to verify the coincidence of prostate cancer and bladder cancer in patients who underwent radical cystoprostatectomy in Wroclaw Medical University, Department of Urology and Oncological Urology, as well as to indicate factors that may influence the peri-and post-operative course. Material and Methods. We have retrospectively reviewed patients who underwent radical cystoprostatectomy for muscular-invasive bladder cancer between 2009 and 2014, which comprised of 116 male patients. We managed to establish telephone and personal contact with the patients. Results. Seventeen of the 116 patients were diagnosed with coincidental prostate cancer in post-operative histological examination (14.6%). This result is lower than in other series of cystoprostatectomy cases (range 23-68%). The mean age of patient was 68.9 years and the median was 69.5 years. Factors influencing the peri-and post-operative periods were not statistically significant. Conclusions. Serum PSA level and DRE should be performed more often on patients prepared for radical cystoprostatectomy. An accurate pre-operative assessment of cancer infiltration is required for both types of tumors. Complete resection of prostate prevents residual neoplasm infiltration. It is important to take into account the possibility of primary prostate tumor occurrence in patients qualified for radical cystectomy. The post-operative supervision should be focused not only on bladder carcinoma but on the prostate carcinoma, too (Adv Clin Exp Med 2015, 24, 4, 657-662).

Introduction: The standard treatment method of muscle-invasive bladder cancer is radical cystectomy. This complex procedure consists of removing the urinary bladder with distal ureters and regional lymph nodes. Additionally, the prostate with seminal vesicles in men and uterus with ovaries in women should be excised. Therefore, this demanding oncological surgery is associated with a high occurrence of complications. The aim of this study was to assess the complications after radical cystectomy and identify the factors associated with severe complications and high mortality rate. Materials/Methods: We retrospectively analyzed medical data of 213 patients who underwent a radical cystectomy. Preoperative risk factors were assessed based on American Society of Anesthesiologists classification (ASA) and the Charlson Comorbidity Index (CCI). Clavien-Dindo classification was also included in our analysis. We investigated various factors associated with 30-day and 90-day mortality. Results: Complications after surgery were reported in 38% (n = 81) of patients in the studied group. Excluding perioperative high fever, the complication rate was 18%. The following complications were observed in 30-day postoperative period: wound infection (n = 6), wound dehiscence (n = 4), mechanical bowel obstruction (n = 3), hemorrhage (n = 2), cardiological (n = 8), stroke (n = 3). Observed 30-day mortality was 2.3% (n = 5), while 90-day mortality was 8.9% (n = 19). The mortality rate was associated with the stage of cancer and the type of urinary diversion. Conclusions: Radical cystectomy is a complex and traumatic urological surgery. It is associated with a significant complication rate and mortality, and it negatively affects quality of life. Therefore, all known risk factors should be thoroughly assessed preoperatively to select optimal treatment. Furthermore, the patient should be carefully informed about the risks associated with the surgery.

Glucocorticoids are widely used as anti-inflammatory, antiproliferative and immunosuppressive agents in many diseases. Their use is often long-term, which is associated with the risk of adverse effects from various systems. In this paper, we pay particular attention to the effects of steroid therapy on cardiovascular diseases as long-term steroid therapy increases the risk of cardiovascular death. The risk of complications depends on the dose and therapy duration. Complications may also occur when steroids are used locally. According to literature data, glucocorticoids may contribute to the development of hypertension, myocardial ischaemia, heart failure and, according to some studies, stroke. The use of steroid therapy can lead to the development of disorders that are part of the metabolic syndrome. The pathogenesis includes the effects of glucocorticoids on the renin-angiotensin-aldosterone system, the autonomic system, stimulation of the mineralocorticoid receptor, and effects on the synthesis of factors regulating the width of blood vessels. Other disorders that may develop in the course of this therapy include osteoporosis, myopathy, electrolyte and metabolic disorders. However, it is difficult to determine to what extent the complications are caused by the therapy itself and to what extent by the treated disease. It is also worth noting about the negative impact of anabolic steroids, the use of which is usually not a part of therapy.

Background. Bladder cancer is one of the most common cancers in Europe and is mostly found in men. Cystectomy is the treatment for invasive tumors that infiltrate the muscle of the bladder. This procedure is associated with a large number of complications. Eligibility for surgical treatment is important, because surgery may shorten the patient's life. The main prognostic factor is the severity of the disease, but less specific factors can be very helpful in selecting the form of treatment.Objectives. To identify and analyze factors affecting significantly the survival in patients undergoing radical cystectomy (RC). Material and methods.A retrospective analysis of a group of 129 patients treated at the