Introduction The optimal management of distal ureteral stones remains a matter of debate since current guidelines favor ureteroscopy over extracorporeal shock wave lithotripsy (ESWL). We aimed to evaluate the efficiency of ESWL for distal ureteral stones and to identify factors that affect treatment outcomes. Materials and methods The retrospective study included records of 115 patients with distal ureteral stones, 5 mm to 18 mm in size, undergoing 223 ESWL sessions as an outpatient procedure. Early fragmentation and three-month follow-up stone-free rate (SFR) was assessed through radiographic imaging. Treatment was successful if there were no residual fragments or they were ≤4 mm, three months after the last session. Results The mean ±standard deviation (range) stone size was 9.68 ±3.10 (5.00-18.0) mm. The mean body mass index (BMI) was 24.3 ±2.67 (18.4-29.8) kg/m² with a significant correlation between BMI and stone size (r2 =0.324, p <0.001). Patients underwent ESWL an average of 1.7 ±1.36 times (1-5), while 68 patients (59.1%) became stone-free after one session. The overall SFR was 82.6%; for patients with stone sizes ≤10 mm and >10 mm, it was 99% and 9.4%, respectively. Cumulative SFR after the second session was 77%. In 20 (17%) patients the treatment was a failure. Complications occurred in 10.4%, while auxiliary procedures were needed in 8.7% of cases, both significantly affected by the stone size (p <0.001). The efficiency quotient (EQ) was 0.76. Treatment outcome was significantly different depending on stone size, BMI, number of sessions, complications, and auxiliary procedures (p <0.001, p =0.022, p <0.001, p <0.001, p <0.001, respectively). Univariate regression analysis identified stone size and BMI as significant predictors of treatment outcome (odds ratio (OR) 3.84, 95% confidence interval (CI): 2.31-8.97, p =0.001, and OR 1.25, 95% CI: 1.04-1.54, p =0.024, respectively). Conclusions Extracorporeal shock wave lithotripsy continues to be a safe and effective option for managing simple calculi in distal ureters with a diameter of ≤10 mm. The stone size and BMI remain significant predictors of treatment outcome.

Introduction: Non-muscle-invasive bladder cancer (NMIBC) is usually effectively treated with transurethral resection (TUR), most often followed by intravesical instillation of bacillus Calmette-Guérin (BCG) or intravesical chemotherapy. Although the precise mechanism of BCG immunotherapy is still unclear, a local immune response is presumed. However, a number of severe side effects and complications are related to intravesical immunotherapy. AIM: Aim of this report is to present rare case of the renal granulomatous disease in a patient previously treated with intravesical instillation of BCG immunotherapy, following TURBT. In addition, we performed review of previously reported cases of renal granulomas following intravesical BCG immunotherapy. Case report: A 79-year-old man was presented to Urology Clinic due to clinically verified tumor of the urinary bladder. After transurethral resection of bladder tumor, histopathological analysis revealed the diagnosis of papillary urothelial high-grade pT1 carcinoma. Intravesical BCG immunotherapy was initiated, according to protocol currently used in our institution. Upon completion of therapy with BCG, we re-examined the patient and, using ultrasound, found a change in the right kidney, resembling moth bites not seen on CT scan before TURBT. Additionally, CT-guided core-needle biopsy of the affected kidney was performed, and the specimen was sent for histopathological analysis, which revealed chronic necrotizing granulomatous inflammation. Antituberculotic therapy was initiated for 6 months. Upon completion of antituberculotic therapy, control CT-scan was performed at follow-up, indicating regression of changes on the right kidney. Conclusion: This case report emphasizes the importance of consistent implementation of follow-up protocol and the identification of lesions during the asymptomatic period and enables the proper treatment of the disease. To reduce the incidence of adverse effects of BCG treatment for bladder tumors, an individualized approach is needed.

Introduction: Cancer of the prostate (PCa) is the second most common cancer-related cause of death among men and the most common non-cutaneous malignancy in Western countries. Numerous papers have been published on the topic of various aspects of this disease; however, rather little has been written on the diagnostic and prognostic value of the prostate cancer obtained from needle biopsy. Aim: To examine the utility of Pixel Prostate software in determining the volume and topographic distribution cancer of the prostate (PCa), and to analyze it with other variables that are characteristic for PCa. Methods: retrospectively, 75 patients data and postoperative prostate specimens were analyzed, after determining topographic distribution and cancer volume (PCa), using PixelProstate software. Results: Mean VPCa was 6.99 cm3 (0.14-29.7; median 4.51), and mean percentage cancer volume relative to prostate volume (%VPCa) was 16% (0.1-67.2%; median 13%). 71% of the patients had T2 stage, while the rest had T3 stage. Apex involvement was present in 65% of the patients, while central zone involvement and extraprostatic extension were present in 23.5% and 22.7% of the patients, respectively. Preoperative Gleason score undergrading was present in 27 (36%) patients, while bilateral PCa finding was increased from 51% to 87%, postoperatively. The most discriminant variable according to the prediction of %VPCa>10% had preoperative bilateral needle biopsy findings, with AUC of 0.75 (<.001), with sensitivity and specificity of 84% and 70%, respectively; (+LR 2,8; PPV of 74%; NPV of 82%). %VPCa showed good correlation with prostate specific antigen (PSA) and PSA-density. Conclusion: A possibility of precise spatial orientation and volume characterization of the PCa by PixelProstate software was shown. Simultaneously, with time, a clinician, experienced by PP software feedback, gets better insight for the planning of future prostate biopsy, as an important factor in clinical decision making.

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.

Objectives : chronic nonbacterial prostatitis/chronic pelvic pain syndrome has a high incidence rate and is usually accompanied by many psychological problems. The objective of this paper was to assess the quality of life in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome. Methods : The study included 90 patients diagnosed with chronic nonbacterial prostatitis/chronic pelvic pain syndrome. The quality of life was studied using the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). Results : 54 (60%) patients reported sexual potency problems, 66 (73.3%) found that their disease received insufficient medical attention, 93.9% reported a large number of symptom-related problems affecting the performance of daily activities, all patients were thinking about the disease symptoms, and 77.7 % reported that they would be unsatisfied if told that they would spend the rest of their lives with the symptoms experienced over the last week. Conclusion : Chronic nonbacterial prostatitis/chronic pelvic pain syndrome causes sexual potency problems and significantly impairs patients’ quality of life. In addition, the respondents believe that their condition is not treated with sufficient medical attention. Keywords : quality of life, chronic nonbacterial prostatitis/ chronic pelvic pain syndrome, sexual potency

Power quality is one of the important challenges for the smart distribution grids. It is not possible to know the state of power quality in the network without appropriate measurements or monitoring. As an answer to need for power quality monitoring in smart distribution grids, this paper further develops the Integrated Power Quality Monitoring System (IPQMS). IPQMS integrates power quality data from all the measurement devices available in the smart distribution grids: power quality monitors, portable power quality analyzers, smart meters, protection relays, fault locators etc. Smart meters are the key sensors in smart distribution grids and should be used as indicators of power quality disturbances in IPQMS. The complementary use of power quality monitors and smart meters in IPQMS should enable the analysis of the propagation of power quality disturbances throughout the distribution network. Current state-of-the-art smart meters have certain capabilities regarding the monitoring of some power quality parameters. The necessary upgrades to the state-of-the-art smart meters regarding their power quality monitoring capabilities are discussed in this paper in the context of their role in IPQMS. This paper elaborates in detail one new concept of operation and process algorithms for IPQMS, with special emphasis on smart meters. This paper also presents experimental results of integrated power quality monitoring using power quality monitors, state-of-the-art smart meters and protection relays. The presented experimental results prove that with integrated power quality monitoring, distribution system operators can get a complete information about power quality in their networks.

This paper presents a framework for determining the price of power and energy at each node in distribution network as well as the price of energy losses in their elements. The proposed framework is based on the concept of the radial structure network and gives one approach to solving the pricing problem that is based on purchase price of power and energy at the network supply point. In this way it is possible to determine the economic value of energy losses whether in the network as a whole or in particular voltage levels. The model has been successfully tested and results from test studies are reported.

This paper presents application of component criticality importance measures in phase of preparation and design of power plants. These measures provide a numerical rank to determine which components are more important for power plant reliability improvement or more critical for power plant failure. Identifying critical components for power plant reliability provides an important input for decision-making and guidance throughout the development project. The study on several schematic design options of conventional thermal power plant show that the importance measures can be used as an effective tool to assess component criticality in the project phase of new production capacities.

In many countries, renewable energy technologies receive increasing attention. Several countries have set ambitious targets for integrating renewable energy sources into their power systems. A special place occupy wind power plants (WPP) and photovoltaic power plants (PVPP), characterized by variable output power in relatively short time intervals. These variations represent a challenge for managing and development planning of certain power systems. Appropriate measures in reduction of output power variation ranges can be achieved by geographical dispersion of these generating units. In this paper, quantitative effect analyses of geographical dispersion on requirements for balancing power has been done. Simulations and calculations have been performed using real, measured data on wind and solar energy potential. The research includes WPP and PVPP and has been extended to certain hybrid power system (HPS) configurations. Comparative analyses of integrating significant power in the considered generating facilities at one location and its wider spatial distribution showed significant decrease in balancing power requirements for even more than 60% in the case of geographical dispersion. Calculations carried out pointed also to a certain complementarity between WPP and PVPP in HPS configurations.