GOAL To evaluate risk factors of erective dysfunction (ED) and find out incidence in patients with newly diagnosed diabetes mellitus. MATERIAL AND METHODS All patients from Centre for Diabetes with newly diagnosed diabetes mellitus type 2 are involved in study. We have done interview using questionnaire-International Index of Erectile Function (IIEF)-5. Result of IIEF-5 less than 21 was used as bottom line for identification of patients with ED. RESULTS Newly diagnosed diabetes mellitus type 2 was a case in 243 patients from which 37% of them had ED. Comparing potent man with those with ED there are statistically significant difference according to smoking, duration of smoking, hypertension, body mass index and serum level of glycozated hemoglobin HbA1c. Using multivariate logistic regression model, age was identified as the most significant risk factor. CONCLUSION Patients with newly diagnosed diabetes mellitus have high prevalence of ED which can be related with other risk factors such as age of diabetes onset, hypertension, smoking and body mass index.

SUMMARY Objective: The aim of this study was to identified incidence of prostate cancer in patients and optimal required operative treatment. Patients and methods: The study was retrospective, clinical and manipulative, analytical and descriptive and covers the period from 01.01.2005 to 01.01.2007 with 4237 patients. For each patient, the data were analyzed from ambulance and hospital protocol at the Urology Clinic Sarajevo. Results: Of the 1986 patients with prostate operative treatment, there were 239 patients (12,03%) for 2005 year, and 2251 patients with prostate operative treatment, there were 281 patients (12,48%) for 2006 year. From 4237 patients, 520 patients undergone to prostate operative treatment or 12,27% patients. Conclusion: Every fourth patient with prostate disease, who was treated at the Urology Clinic of the University of Sarajevo, had prostate cancer. Patients aged between 70 and 79 years are usually operated patients. Number of palliative treated patients was 1.7 times greater than the number healed treated patients. The average age of treated patients in this study is higher than the same described in the literature.

Objective: The aim of this study is to demonstrate that the majority of patients with renal colic can be treated in an outpatient, conservative methods, and that does not require treatment in a tertiary health care. Patients and methods: The study was retrospective, clinical and manipulative, analytical and descriptive and covers the period from 01.01.2007 to 31.12. 2007 with 1829 patients of both sexes from 15 years upwards.For each patient, the data were analyzed from ambulance and hospital protocol on the Urology Clinic Sarajevo. Results: Of the 1829 patients with renal colic, 56% were men (1029/1829) and 44% were women (800/1829). The highest incidence is recorded in the population aged 35-55 years, where we recorded 817 colic or 44.66%. At the clinic for further treatment were admitted 163 patients or 8.91%. Conclusion: Renal colic usually occurs between the ages of 35-55 years. Men’s population gets 1.2 times more frequently than women and the right side is more common than the left. Most patients can be treated in outpatient clinics, conservative therapy, and a small number of cases requiring hospitalization.

Purpose: To evaluate efficacy and role of emergency extracorporeal shock wave lithotripsy in the treatment of symptomatic ureteral stones. Methods: Retrospective study which was conducted between July 2007 to July 2008 among 112 patients treated with urgent ESWL treatment of 803 patients treated with ESWL treatment at Urology Clinics of Clinical Center University of Sarajevo. Renal colic was diagnosed on a clinical basis, by ultrasound examination, and by plain x-ray of abdomen. The success rate of ESWL was defined by fragmentation and spontaneous elimination after ESWL treatment. Failed was defined as a need for auxiliary procedures. Results: Mean age of patients was 46,6 years (range 22-65). Male/female ratio was 78/34. Mean stone size was 7,90 mm. Fragmentation after a single session was complete in 62 patients, incomplete fragmentation in 29, and absent in 21 patients. Patients presenting with incomplete fragmentation underwent second (n=29) or even third session (n=17). Of the 21 patients where initial ESWL treatment had no impact on the stone, some underwent a second (n=16) or even a third session (n=11) without success. Of these patients, ureteroscopy was performed in 4 cases, three patients had spontaneous passage of the stones, and ureterolithotomy was performed for 4 patients with impacted stones. The DJ stent was placed for 4 patients due to fever and impossibility to manage the patients medically for the persistent pain. Conclusion: ESWL is a safe, effective, noninvasive method in the treatment of ureteral stones. Stone-free rate for stones in the upper and mid-ureter is above 80%. Stone size may be the main predictive factor for re-treatment. Even complete elimination of the stones is very hard to achieve after single ESWL session - real role of the ESWL treatment for the acute urinary obstruction is to provide ureteral canalization and recover renal function.

BACKGROUND Prostate specific antigen (PSA) has significance in diagnostics of the prostate cancer, establishing stage of the disease and follow up of results of the treatment with different methods. Increased PSA levels in serum is not characteristic only for persons who have prostate cancer but also of those with benign conditions, especially in range of 4.0 ng/mL to 10.0 ng/ml, where we see a lot of results superposition. Marker determination of free and total PSA-ratio FPSA/TPSA and total PSA and prostate volume--PSA density was introduced for improvement of the sensitivity of PSA. Purpose is to analyze demonstrators of the concentration of PSA and its fraction in patients with histologically confirmed and radically removed prostate cancer, and to establish its correlation with advancement and differentiation of the disease. WORK METHOD The investigation was done in 80 patients with histologically confirmed, prostate cancer clinical stage T1-2, NO, MO, initial PSA level of 2-10 ng/ml and performed radical prostatectomy. RESULTS Out of 80 patients, 6 of them (9%) had total serum PSA level within referral values (<4 ng/ml). There were 55 patients (68%) with values of ratio FPSA/TPSA from 0 to 0.15, 18 (23%) patients had values between 0.16-0.19 and 7 (9%) patients had values above 0.20 ratio FPSA/TPSA. Fifty patients (62%) had PSA density in values to 0, 15, and 30 patients (38%) had values above 0.15. According to completed multiple regression analysis values of PSA, ratio FPSA/TPSA and PSA density had no statistically significant correlation with extra-capsular invasion and lymphatic metastasis, which points out that as it is, they do not contribute to its prediction. CONCLUSION Significant number of patients with histologically proven and radically removed prostate cancer had serum PSA level within normal referral values. PSA density and ratio FPSA/TPSA can help in differentiating malignant from benign changes in prostate in PSA values to 10 ng/ml but not with absolute safety since significant number of patients with proven cancer had these parameters in level range characteristic for benign diseases.

Erectile dysfunctions represent the inability to achieve and/or maintain erection necessary for satisfactory sexual activity. During the past two decades from the disorder marked as impotence and perceived as a psychological problem, the concept evolved to erectile dysfunction, which is actually the result of multiple risk factors, organic and psychological, and manifested with inadequate penile erection. Etiology Erectile dysfunction is very often multifactorial, which makes it difficult to make a clear overview of causes of erectile dysfunction. Official classification of etiology factors is the following (1): a) organic; b) psychogenic; c) mixed (organic and psychogenic); d) unknown. We have evaluated erectile dysfunction as public health problem in Bosnia and Hertcegovina also ethiology,pathoge nesis,diagnosis and therapeutical solutions. Research includes a group of 90 patients, of whom 60 in experimental and 30 in control group. Group A consists of 30 patients with erectile dysfunction, who were treated with intracavernous injection prostaglandins.Group B consists of 30 patients with Erectile Dysfunction, who were treated using the system vasoactive substances–tbl Sildenafil citrate (Levitra). The control group consisted of 30 patients with erectile dysfunction with psychogenic etiology and was treated with Sildenafil citrate.Erectile dysfunction is important problem of public health and deserves support of basic sciences researchers.

hematology, immunology, cytology, etc) the and up delivery of The number of completed clinical-laboratory analysis in the shows high rate of growth that annually ranges from 10-17. the disorder of immune regulation which manifested by activation of T and B lymphocytes, production of antibodies, and the formation of immune complex causing to tissues. SLE is a time and to the doctors for more a while being a prototype of autoimmune disease. Kidney function loss is the most serious complication of SLE which represents a threat for long-term survival. Goal: The aim is to show the clinical and labora- tory parameters of lupus nephritis and principle of therapeutic protocol for the treatment of lupus nephritis using aggressive immunosuppressive therapy at the Institute of Nephrology of Clinical Center of the Sarajevo University by monitoring activity of disease. Patients and methods: Randomized retrospective study includes 14 patients with SLE and lupus nephritis that are treated at the Institute of Nephrology of Clinical Center University of Sarajevo in the period from the beginning of 2000 to 2003. Discussion: In our retrospective study, all patients were females with mean age of 34.5±13.5 years. Mean age at the beginning of SLE was 30.5±12.5 years. Most often clinical manifestations observed in patients with SLE are general ones (85.7%) - skeletal muscle (64.3%), skin (78.6%), hematologic (64.3), cardiac and pulmonal (42.9), neurologic (21.4%), thrombosis (35.7%), eye (14.3%) and abortion (7%). Conclusion: Females in reproductive age have SLE and lupus nephritis more frequently , which indicates that hormonal status (estrogen) has important role in illness pathogenesis. Most relevant parameters in evaluation of illness activity are the levels of complement components C3 and C4, level of antidsDNA, activity of urine sediment and proteinuria level. Aggressive immunosuppressive therapy that includes corticosteroids and cyclophosphamide, with control of side effects and its prevention, and duly treatment can lead to improvement of clinical symptoms and improvement of patient life. As long as new therapeutic modalities and more efficient treatment of autoimmune illnesses is not available, the greatest impact on mortality and morbidity can be achieved by monitoring late manifestations and treatment of extracranial manifestations that can lead to kidney function loss.

Urolithiasis is very common disease. Among different urinal system problems, calculosis is on the third place. Bilateral calculosis takes about 10-25%. Huge stones which fill the pyelon have sprayed shape like sea coral (staghorn calculus), they are also known as coral shaped stones. It is noticed that the result of treatment of coral shaped stones depends largely from the kidney stone volume. Making decision about best method of treatment is often very delicate and it is based on evaluation of all individual features of illness. Optimal treatment of the coral shaped lithiasis is still a controversial problem. In our paper we will present a case of complicated urolithiasis, and the treatment with staged solution for urolithiasis.

PURPOSE To present minimally invasive treatment of symptomatic renal cysts and compare treatment efficacy of single-session percutaneous aspiration and sclerotherapy using 96% alcohol versus prolonged percutaneous drainage without sclerosing agents in the treatment of symptomatic non-parasitic renal cysts. METHODS A retrospective-prospective study, was conducted between January 2005 and May 2008, among 68 patients (both sexes) that were diagnosed symptomatic non-parasitic renal cysts and treated in Urology Clinic, Clinical Center University of Sarajevo. RESULTS Initial average volume of cysts did not significantly differ between both groups while final average volume was significantly lower in group of patients treated by prolonged catheter drainage. During three months follow-up, 25 cysts (41%) completely disappeared and could not be detected by ultrasound exam, of which 16 cysts (53,3%) were in the examinees' group with prolonged catheter drainage and 9 cysts (30%) were in examinees' sclerotherapy group using alcohol as sclerosing agent (p=0,244). None of the completely disappeared cysts have had recurrence during follow- up period. Probability of disappearing of cysts was well correlated with volume of the cysts in both groups. Probability was less for the large cysts with initial volume higher than 500 ml. Probability of disappearing of cysts for the group of the prolonged drainage was p=0,0449. CONCLUSION Percutaneous treatment is the first choice treatment of symptomatic renal cysts. Percutaneous treatment of symptomatic cysts is both safe and effective whether we use prolonged catheter drainage or aspiration followed by instillation and 2-hr exposure to 96% alcohol.

The field of diagnostic radiology continues to evolve, particularly in refinements to crosssectional techniques. Imaging of the urinary tract, as a result, has become more precise, with new digital procedures offering a great selection of options, and new imaging algorithms being implemented. Ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) provide higher soft-tissue contrast resolution than conventional radiography, as well as multiplanar imaging capability, resulting in significant advances in almost all areas of uroradiology. While such advances have produced new algorithms to approach the diagnostic imaging evaluation, each particular case also depends greatly on the equipment and professional available. In summary, ever changing uroradiology remains indispensable in the diagnosis and treatment of patients with urologic disorders. We discuss the digital imaging techniques used in uroradiology, with summaries of the advantages and disadvantages of the various techniques, and will end with a discussion comparing different Doppler imaging methods.

INTRODUCTION: Erectile dysfunction (ED) is primarily vascular disease, which can be diagnosed with the Color Doppler ultrasonography, and using vasoactive medication (locally PgE1 and general Sildenafil citrate) this state can be treated. GOAL: To answer the question of which color Doppler technique used by urologist can reveal and evaluate treatment of the erectile dysfunction, and create clinically applicable diagnostic and treatment protocol for erectile dysfunction. RESEARCH METHOD: Testing of patients with erectile dysfunction is completed with color Doppler exam with application of pharmacology testing. Ultrasonic color Doppler is screening of blood flow in corpora cavernosa performed with linear probe of 3.5 Mhz and 7.5 MHz („Aloka“ 1700) with examination in flaccid phase of the penis and transversal scanning of the dorsal, cavernous arteries and corpus cavernosus. RESULTS AND DISCUSSION: Color- Doppler testing is performed on a group of 60 patients: 30 patients are treated with local application of Caverject in form of intracavernous injection (ICI) and 30 patients are tested with Sildenafil citrate. Also we had control group of 30 patients with psychological ED. Statistical tests pplied in the analysis of our results show significance in sensitivity in application of color Doppler diagnostic technology compared to classic ultrasonography urology technique and in diagnosis and therapy of the erectile disorders, especially of vascular genesis. This confirmed our work hypothesis of this research.

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.

UNLABELLED Renal colic represents the the collection of the acute symptoms which are characterized by very intensive and antagonizing pain, so, that withstanding, it calls for fast diagnosis and precise and speedy treatment. Intervention in renal colic cases has to be based on the knowledge on the origin of pain, renal damage suffered, and also has to protect the kidney from any damaged caused by the prolonged obstruction. MATERIAL AND METHODS This paper presents the results from prospective, analitical, comparative, ITT (intention to treat) study that has been carried out 200 ambulatory treated seperate patients with renal colic, divided into four groups, in the time period from year 2003 to 2005. In all these cases the the efficiency and the active time time of standard medications used with renal colic symptoms. RESULTS 2 grams of Metamizol i.v. and 75 mg of Diclofenac i.m. have shown equal efficiency in pain relief, which is 6 hours after the administration of therapy, while 50 mg of Butylscopolamin i.v. requires additional analgesic treatment (p < 0.05). The effect of Metamizol is a bit stronger 15 minutes after the application than the rest of the medications, but 30 minutes after the application the effects of Metamizol and Diclofenac are almost identical. Using meta analasys and EBM (Evidence Based Medicine) parameters in regard to the side effects, the made conclusion was that Diclofenac is the medication of choice for renal colic. Reserve medication is Metamizol, while Butylscopolamin causes negative side effects in 84% of the cases, and in 24% of the cases it causes cupping of the renal colic.