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D. Junuzović, B. Kulovac, Damir Aganović, Alden Prcić, M. Babić, S. Bajramović

Haemangiopericytoma is an uncommon tumour of vascular origin. We report a case of one of the rarer sites of this tumour in man: pelvic paravesical site. We report case of 47 years old man with pelvic hemangiopericytoma and discuss imaging studies and pathohystological findings. Although modern imaging techniques have provided useful information concerning the hypervascular and clearly demarcated appearance of this tumour which displaces but does not invade adjacent organs, its diagnosis can only be established by histology. Its degree of malignancy and its invasive potential are unclear. The risk of local recurrence and metastases in more than one half of cases justifies wide surgical excision, possibly combined with adjuvant radiotherapy, and long-term follow-up. That is to say, that hemangiopericytoma malignum pelvis is the very rare sites of this tumour and till now it is not reported in Bosnia and Herzegovina.

D. Junuzović, B. Kulovac, Alden Prcić, Damir Aganović, S. Bajramović

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.

D. Junuzović, B. Kulovac, Alden Prcić, Damir Aganović, S. Bajramović

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.

Damir Aganović, Alden Prcić, D. Junuzović, B. Kulovac

OBJECTIVE to compare predictive value of urodynamic parameters (level of obstruction and stop-flow test) to post prostatectomy outcome. SAMPLE AND METHODOLOGY 30 patients elected for prostatectomy based to the patient's symptoms, radiological signs of benign prostate enlargement and signs of the retention of urine. All patients underwent complete UDM-uroflowmetry, cystometry and pressure/flow studies, after fulfilling International Prostatic Symptom Score (I-PSS). Three months after operations patients were submit same tests. Schafer nomogram was used for determination of grade of obstruction as well as grade of detrusor contractility, and stop flow test is performed to calculate maximal estimated flow (Qmaxest). RESULTS 7 (23, 5%) patients were out of obstruction before the operation coupled with detrusor under activity. Postoperatively group symptoms reduction, reduction of post void residual (PVR) urine and increase of Qmax was noticed. Incidence of detrusor hyperactivity is reduced. As a measure of absolute postoperative success for the individual patient, I-PSS <7 with Qmax >15 ml/sec is taken. By this way, urodynamic measurement have shown sensitivity of 75%, specificity of 91%, PPV of 75% and post-test probability of 78% for prediction of excellent postoperative outcome for the patients with strong detrusor who were in the obstruction preoperatively, while stop-flow test with Qmaxest >35ml/sec showed lower predictive value of postoperative success (sensitivity of 89%, specificity of 62%, PPV of 50% and post-test probability of 50%). CONCLUSION Preoperatively obstructed patients with preserved detrusor contraction according to Schafer nomogram will experience much better outcome, while stop-flow test is not powerful indicator of postoperative favorable outcome.

A. Novo, I. Masic, S. Toromanovic, N. Loncarević, D. Junuzović, J. Dizdarević

Medical documentation is a very important part of the medical documentalistics and is occupies a large part of daily work of medical staff working in Primary Health Care. Paper documentation is going to be replaced by electronic cards in Bosnia and Herzegovina and a new Health Care System is under development, based on an Electronic Family Registration Card. Developed countries proceeded from the manual and semiautomatic method of medical data processing to the new method of entering, storage, transferring, searching and protecting data, using electronic equipment. Currently, many European countries have developed a Medical Card Based Electronic Information System. Three types of electronic card are currently in use: a Hybrid Card, a Smart Card and a Laser Card. The dilemma is which card should be used as a data carrier. The Electronic Family Registration Cared is a question of strategic interest for B&H, but also a great investment. We should avoid the errors of other countries that have been developing card-based system. In this article we present all mentioned cards and compare advantages and disadvantages of different technologies.

D. Junuzović, S. Mehmedbasić

The inability of a male to attain and maintain an erection sufficient to allow vaginal penetration is called erectile dysfunction. It is a part of general male sexual dysfunction called impotence, which also includes libidinal, orgasmic and ejaculatory dysfunction. Erectile dysfunction affects millions of men and although it may not mean a total loss of sexual satisfaction, it often creates a mental stress that affects the man's quality of life. Knowledge of erectile dysfunction has increased remarkably over the past decade. Nowadays, about 50-85% of erectile dysfunction patients can be shown to have a somatic cause by modern methods of examination. Erectile dysfunction may also occur as a result of specific illness or medical treatment, and it is often multifactorial in etiology. Erectile dysfunction increases with age.

D. Junuzović, S. Mehmedbasić, Damir Aganović, F. Smajlović

Erectile dysfunction (ED)--the consistent or recurrent inability of a man to attain and/or maintain, a penile erection sufficient for sexual performance--is a common health condition among men that is largely untreated. It is estimated that some degree of ED affects more than one half of all men over the age of 40--152 million men worldwide. That is a big problem, that needs appropriate treatment. After diagnostic evaluation of the patient, doctor decides what is the best treatment option for the patient, following his health condition. Choice of treatment options: physio-sexual therapy, oral drug therapy, topical drug therapy, transurethral drug therapy, intracavernosal therapy, hormonal treatment, vacuum devices and surgery. Nowadays the most important contemporary treatments of ED are peroral sildenafil and intracavernosal pharmacotherapy using vasoactive medicines. However, these drugs are not suitable to every patient. More noninvasive methods to treat ED, such as oral medication or locally applicable preparations are needed.

D. Junuzović, S. Mehmedbasić, F. Smajlović

UNLABELLED Color-Doppler sonography (CDS) of the cavernosal arteries has received considerable attention since its description in 1985 by Lue et al. Color and Spectral Doppler analysis, provides a useful noninvasive means of evaluating both morphologic and hemodynamic penile abnormalities. CDS is the best method in diagnostic evaluation of patients with erectile dysfunction. It assesses the integrity of the arterial supply to the penis and provides some useful information on the veno-occlusive mechanism. Because the arterial diameter and flow rate change during the different phases of erection CDS is performed after pharmacostimulation with vasoactive agents. Purpose of this study is diagnostic evaluation patients with erectile dysfunction. PATIENTS AND METHOD We studied 60 patients suspected for vasculogenic ED, and 30 patients suspected for psyhogenic ED, assessing the morphodynamic features of cavernosal arteries by Color-Doppler sonography and their response to contravaernosal injection of prostaglandin E1 (PgE1) and oral dose of Sildenafil citrate. Morphodynamic parameters evaluated by color Doppler sonography included: peak systolic velocity, endodiastolic velocity, inner arterial diameter, index and acceleration of penile blood flow. Patients were divided in the groups: A group (A1--10 patients < 35 years of age, A2--20 patients > 35 years of age) underwent pharmacotest with ICI PgE1; B group (B1--8 patients < 35 years of age, B2--22 patients 35 years age) were tested with oral dose of Sildenafil citrate and C group--30 patients who were also tested with the same drug. CONCLUSION The CDS may be used to evaluate the hemodynamic parameters of the erectile dysfunction. Arterial insufficiency is suspected with poor blood flow, while veno-occlusive dysfunction is inferred in the face of adequate blood flow and poor erectile response.

T. Guzina, M. Babić, A. Alagic, N. Šuvaković, M. Malinovic, M. Hiroć, D. Junuzović, N. Kariklić et al.

From October 1988 through December 1990, we treated 1221 male and 784 female patients aged 2 to 84 years for urolithiasis using the Dornier MPL-9000 lithotripter. Stones were located in calices or the renal pelvis in 34% of cases each, in the ureter in 17%, and in the bladder in 0.8%. Twelve per cent of the stones were branched renal calculi. The mean volume of the stones was 16 cm3 for branched calculi, 8 cm3 for renal pelvic calculi, 1.8 cm3 for caliceal calculi, 1.5 cm3 for ureteral calculi, and 19 cm3 for vesical calculi. In the 35% of patients who had stone volumes larger than 5 cm3, a ureteral stent was introduced before treatment. The kilovoltage was adjusted according to the size and location of the calculi. The average number of shock waves was 2150. It was necessary to re-treat 35% of the patients, with some having as many as 10 sessions, and the total number of sessions in the series was 3380. However, it proved possible to fragment 94% of the stones, with 80% of the patients being stone free a...

S. Alibegovic´-Grbic´, D. Junuzović, N. Gáborcík, V. Krajčovič, M. Zimková

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