Objectives: To determine the optimal medication for the treatment of renal colic using evidence based medicine (EBM) parameters (RR, ARR, NNT, NNH, ARI, RRI). Sample and Methodology: During 2010, an ITT study was conducted on 400 outpatients of the Sarajevo University Clinical Center Urology Clinic in order to investigate renal colic pain relief drugs. Each group consisting of 100 patients was administered either Metamizol amp. i.v., or Diclofenac amp. i.m., or Butylscopolamine amp. i.v., while 100 patients belonged to the placebo group that was given distilled water (aqua redestilata). All patients completed visual analogue pain scale (VAPS) from 0 to 10 prior to and after the treatment. Results: Using EBM parameters Diclofenac Na and Metamizol were shown to be the most efficient in the treatment of renal colic. In these two groups, relative risk (RR) was 21 and 8,5% respectively; Absolute Risk Reduction (ARR) was 74 and 86% respectively, and Number Needed to Treat (NNT) was 1 for both groups, while chi-squared (X2) test has shown that there is no statistically significant difference between these two drugs when it comes to their effect. In the Butylscopolamine group, RR was 81; ARR 18%, while NNT was 5. With respect to side effects, only in his group it was shown that Relative Risk Increase (RRI) was 84, ARI 83%, while Number Needed to Harm (NNH) was 2. Conclusion: The most optimal medication for the treatment of renal colic according to EBM parameters is Diclofenac Na, followed by Metamizol. Butylscopolamine is not recommended for the treatment of renal colic.

Anatrophic nephrolithotomy (ANL) in the selected cases represents the method of choice in the treatment of staghorn calculi. We evaluated postoperative outcome of patients subjected to standard ANL that received 10 mg of Verapamil immediately before declamping renal artery, due to prevention of reperfusion injury. From 2002 to 2005, 18 nephrolithotomies were performed on 15 patients, in the Urology Clinic, University of Sarajevo Clinics Centre. Preoperative evaluation included intravenous urography and radionuclide renal scans which had been repeated 6 months after the operations. 10 males and 5 females were operated with mean age of 45 years. Urography and renal scans showed severe calyceal distortion and infundibular stenosis in 83% cases, complicated with ureteropelvic junction obstruction in 55% cases. Chronic kidney failure was present in 60% patients. Mean operative time was 150 minutes, with mean cold ischemia time of 61 minutes and mean blood loss of 300ml. There were five minor postoperative complications. Residual small calculi were found in 3 patients. Kidney function was stabilized in the patients suffering from chronic kidney failure, which was proved by radio nuclide imaging. ANL improved by using calcium channel blockers as a protective factor for reperfusion injury proved to be a good treatment choice with a low level of complications and noticeable stabilization and improvement of kidneys function.

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.

Primary retroperitoneal mucinous cystadenocarcinoma is very rare disease. It is very similar to cystadenocarcinoma ovary. Histogenesis of this tumour still remains unknown. In our case report tumour was noticed in left retroperitoneum during routine ultrasound check of stomach in female patient 43 years old. CT studies of kidney, retroperitoneum and pelvis, irigography studies and gynecological examination was done additionally.