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A case of renal arteriovenous fistula between the main renal artery and interlobar vein diagnosed 25 years after percutaneous renal biopsy was presented. A 62-year-old female was referred to a urologist with dilatation of the left renal pyelocalyceal system diagnosed after abdominal ultrasonography, while intravenous urography did not confirm that finding. Historically, she underwent renal biopsy 25 years ago without any complication. Her hypertension was well controlled during the last 10 years, although three antihypertensive drugs with occasional additional diuretics were necessary during the last 6 months. Color Duplex Ultrasonography, arteriography and Multi-Slice Computed Tomography revealed the presence of renal arteriovenous fistula between the main renal artery and interlobar vein, as well as severe dilatation of all interlobar veins, renal, ovarian and adrenal vein on the left side. Urological and vascular surgeons operated to ligate the fistula and preserve the kidney. However, it was not possible to reach the fistula inside the kidney and nephrectomy was performed.

The post-transcriptional messenger RNA (mRNA) decay and turnover rate of the template-independent poly(A) tail, localized at the 3'-untranslated region (3'UTR) of mRNA, have been documented among subtle mechanisms of uncontrolled cancer tissue growth. The activity of Poly(A) deadenylase and the expression pattern of RNASEL have been examined. A total of 138 prostate tissue specimens from 46 PC patients (cancer specimens, corresponding adjacent surgically healthy tissues, and in their normal counterparts, at least 2 cm from carcinoma) were used. For the stratification prediction of healthy tissue transition into malignant phenotype, the enzyme activity of tumor-adjacent tissue was considered in relation to the presence of microfocal carcinoma. More than a four-times increase in specific enzyme activity (U/L g.prot) was registered in PC on account of both the dissociation of its inhibitor and genome reprogramming. The obtained ROC curve and Youden index showed that Poly(A) deadenylase identified PC with a sensitivity of 93.5% and a specificity of 94.6%. The RNASEL expression profile was raised significantly in PC, but the sensitivity was 40.5% and specificity was 86.9%. A significantly negative correlation between PC and control tissue counterparts with a higher expression pattern in lymphocyte-infiltrated samples were reported. In conclusion, significantly upregulated Poly(A) deadenylase activity may be a checkpoint for the transition of precancerous lesion to malignancy, while RNASEL may predict chronic inflammation.

Background/aim: Retroperitoneal fibrosis (RPF) repre sents a chronic pathological process characterized by fibro sis which entraps and compresses the ureters and the grea blood vessels in the retroperitoneal space. A specific form of RPF is idiopathic RPF, an uncommon collagen vasculaj disease of unclear etiology. The series of 15 patients whicl underwent open surgical repair due to idiopathic RPF is presented herein., Methods: From 1989 to 2012, 11 male and 4 female patients underwent surgery due to primar RPF. The ureters were entrapped unilaterally (7 patients), or bilaterally (8 patients). Major symptoms included low bacl pain due to hydronephrosis (9 patients), uremia (4 patients) and urinary tract infection (2 patients). The diagnosis was based on intravenous urography (IVU), retrograde uretero pyelography and computed tomography (CT)., Results: Surgical procedures included intraperitoneal ureteral dis placement (8 patients) and ureteral wrapping with omental flap (6 patients). One patient underwent bilateral uretera stenotic segments resection and oblique ureterography, followed by wrapping with omental flap. Pathological examination confirmed primary RPF in all patients. The meat operative time was 3.5 h (range 2.5-4.5 h). The average in trahospital stay was 21 days (range 16-26 days). The meat follow up was 32 months (6-46 months). During the follow up, 12 patients had improvement on IVU., Conclusion: Early recognition of signs and symptoms of RPF is of the utmost importance for the outcome. Surgical procedures including ureteral wrapping with omental flap, or intraperi toneal ureteral displacement, usually represent definitive treatment.

Introduction: Triple renal pelvis is an extremely rare variation of the renal collecting system. To the authors' knowledge, bilateral triple renal pelvis has not yet been described in the literature., Case Report: A 55-year-old man was hospitalized due to papillary bladder cancer, detected on ultrasonography. As incidental finding, intravenous urography revealed bilateral triple renal pelvis. Six weeks after transurethral resection of the bladder tumor (TURB) the patient was admitted again, for the second TURB. Computed to mography-urography confirmed the presence of bilateral triple renal pelvis., Conclusion: The unique case of bilateral triple renal pelvis was presented as an extremely rare variation of the renal collecting system.

Introduction: Some cases of secondary adenocarcinoma developing in the replaced bowel segment of urinary diversions have been reported so far. Secondary adenocarcinoma develops 20 years after surgery in about 0.5% of those in whom an ileal segment is used. There have been several reports in the literature describing extensions of transitional cell carcinoma (TCC) from the distal urether into an ileal conduit. Histology of loop tumor in 50% was TCC. The site of tumors in the majority of cases is the area at the uretheral orifices or the stoma., Case Report: We presented a rare case of transitional cell carcinoma in an orthotopic ileal neobladder 12 years after radical cystoprostatectomy and ileal neobladder with the substitution by the procedure Camey II. A 65-year-old man with high-grade urothelial carcinoma of neobladder underwent partial resection of neobladder and right nephroureterectomy. Pathological analysis revealed high-grade urothelial carcinoma to the ileal neobladder (G II, Stage T2b). The patient died of laryngeal cancer a year after the surgery., Conclusion: Surgery of tumors in orthotopic neobladders is possible if diagnosed in time. In the presented case surgery resulted only in a decrease in the capacity of the neobladder without having an effect on the continence itself.

Introduction: Pelvic fractures represent approximately 3% of all skeletal injuries. About 15% of patients with pelvic fractures have associated bladder or urethral injuries. The most common causes of pelvic fracture are motor vehicle accidents, motorcycle crashes, motor vehicles striking pedestrians, and falls., Material and Methods: Retrospective study included the patients treated in the Emergency Center, Clinical Center of Serbia, Belgrade, between 2000 and 2009. Of 7445 patients, there were 894 injuries of the urinary tract and 376 pelvic fractures; 55 patients with pelvic fractures (14.6%) had bladder or urethral injuries. There were 31 patients with bladder injuries, 22 patients with urethral injuries, and two patients with associated injuries of the posterior urethra and the bladder neck., Results: The bladder injuries were treated by surgical exploration, cystostomy, suture of the bladder lesions and urethral catheterization. Urethral injuries were treated by primary cystostomy and urethral reconstruction and catheterization in 18 patients (82%), while cystofix-cystostomy was performed in four patients (18%)., Discussion: Genitourinary injuries increase overall mortality in patients with pelvic fracture, compared with traumas without associated GU injuries. These patients require multidisciplinary approach, preferably in tertiary institutions.

Introduction: The majority of diverticular bladder tumors (DBT) are urothelial. Due to the lack of the muscular layer in the diverticulum, the progression of these tumors is easier than in the bladder wall., Case Report: The case of invasive DBT with painless hematuria is presented. The patient was treated with diverticulectomy., Conclusion: Unifocal Stage-T3 DBTs can be successfully treated with diverticulectomy.

Introduction: Congenital renal arteriovenous fistulas (AVF) are rare, especially if they are associated with other developmental renal anomalies., Case Outline: A 34-year-old female was hospitalized due to total painless hematuria and bladder tamponade. Excretory urography revealed a horseshoe kidney with normal morphology of pyelocaliceal system and ureters. Aortography and selective renovasography detected a cluster-like vascular formation with multiple arteriovenous fistulas (AVF). Due to a large AVF gauge and poor flow of the efferent vein to the inferior vena cava, a surgical procedure of two renal artery segmentary branches ligation and division was performed. During the operative procedure, the presence of multiple superficial renal hemangiomas was detected., Conclusion: Although selective arterial embolization represents the preferable treatment option, conventional surgery remains favorable alternative in selected cases with large and complex AVF.

Introduction: The dissolution of urinary stones could be performed in the patients with urinary obstruction caused by phosphate, or uric acid stones, through the percutaneous nephrostomy (PCN)., Case Report: A 27-year-old woman with complete obstruction of the solitary left kidney due to uric acid stones is presented. The woman was admitted in emergency unit due to anuria. Five days after PCN, irrigation with 1.6% sodium bicarbonate solution was initiated. Due to complete ureteral obstruction, the "Y" extension with the valve was connected to PCN and to the urinary bag, which enabled the patient to perform intermittent self-irrigation. After 12 days of irrigation, all the stones dissolute and ceased., Conclusion: In the era of ESWL, PCNL and ureterorenoscopy, PCN-dissolution of urinary stones is rare procedure. However, this minimally invasive procedure could be successfully performed in selected cases.

Kidney transplantation is a treatment of choice for patient with end stage renal disease. Chronic renal failure is characterized with weak cellular and humoral immunity. In our paper we present our experience with presence of malignancy in renal transplant patients. Urology clinic in Belgrade transplanted 411 patients over the period of 16 years. Living donor transplantation was performed for 272 and cadaveric kidney transplant for 139 patients. In the postoperative follow up, malignancies were diagnosed in 7 of the transplanted patients. Three patients developed basal cell skin carcinoma, one was diagnosed with adenocarcinoma of the transplanted kidney, one developed transitional cell carcinoma of the bladder and testicular tumors were diagnosed in two patients. Postoperative immunosuppressive therapy usually double or triple when patients are in the immunological high risk group. Incidence of malignancy according to big health centers is around 1 in every 1000 transplanted patients. It is also noted the rise of incidence of malignancies in transplanted patient in over 50%.

Introduction: Ileal conduit (IC) is the standard urinary diversion following radical cystectomy. The formation of stone in the IC is one of the relatively common late complications of the procedure., Case Report: The case of 69-year-old man who developed 10-cm large stone in the IC, six years after cystectomy is presented., Conclusion: The majority of patients with the stone in IC can be treated with minimally invasive techniques, like manual extraction, or endoscopic procedures.

Aims: To present the rare case of transitional cell carcinoma of the renal pelvic in the region of endemic nephropathy., Patient Report: A 64-year old man with gigantic urothelial carcinoma in renal pelvis and ureter. Patient underwent right nephrectomy. Hystopathological analysis after right nephrectomy revealed urothelial transitional cell carcinoma, grade III-IV with infiltration of right ureter. After one month, because of the hystopatological findings, patient underwent ureterectomy on the right side., Results: Two years after surgery there are no signs of primary disease or metastasis and the cystoscopy findings are normal., Conclusion: Despite the poor prognosis, two years after surgery patient is without signs of primary disease or metastasis.

Objective: To estimate the value of urinary prostate specific antigen (uPSA) determination in the monitoring of prostate cancer (PCa) patients., Material and Methods: From January 2001 to December 2011, uPSA was determined in 397 patients. There were 265 patients with benign prostate, 19 with prostatitis and 113 with prostate cancer. Radical retropubic prostatectomy (RRP) was performed at 65 patients, while 48 patients had PCa received antiandrogen therapy., Results: Average uPSA value in the patients with benign prostate hyperplasia (BPH) was 190.8 +/- 184.2 ng/mL. Average uPSA in the patients with PCa was 287.5 +/- 303.4 ng/ml and it was not significantly different from BPH group. The average uPSA in the prostatitis group was 113.1 +/- 148.5 ng/mL, and 16.4 +/- 36.7 ng/mL in the post RRP group. During antiandrogen therapy, uPSA and PSA correlated significantly (r = 0.49)., Conclusion: The uPSA level reflects the response of normal prostatic and urethral secretory cells on total androgen activity. The uPSA level cannot distinguish the cases with BPH and cases with PCa. In addition, in the patients after RRP, uPSA reflects local urethral PSA production and has no role in the diagnosis of PCa recurrence. However, uPSA is better indicator of androgen suppression than testosterone (T), as it reflects the effect of suppression of all androgens, not only T.

The aim of this paper is to point out the significance of the rare urinary system anomaly such as horseshoe kidney. Tumors of the horseshoe kidney are rarely described as single cases in literature. Bilateral tumors of the horseshoe kidney can present a health and therapeutically challenge. In this paper we have analyzed characteristics of the horse shoe kidney tumors and their diagnostics. Primary means of the horseshoe kidney tumors treatment are surgical with different techniques depending on the size, presentation of the tumor and other indications. The review of the available literature is also included.

We present a rare case of 24 years old male who was diagnosed with simultaneous testicular tumor with pelvic ectopy and ipsilateral hematovesicula seminalis. Hemospermia was the only presented symptom. Patient underwent surgery and removal of the testicular tumor and right vesiculectomy were performed. Histopathological analysis revealed seminoma of the right testis and dilated right vesicula seminalis filled with hemorrhagic fluid and sings of chronic inflammation. Postoperatively irradiation of the abdomen was performed using standard protocol. Ten years after surgery there was no signs of decease recurrence.

Unlabelled: We have analyzed oncological and functional results of the patients who underwent radical retropubic prostatectomy for treatment of localized prostate cancer., Material and Methods: In the period of 4 years, from 2007. to 2011. on two analyzed urological departments there have been 32 patients who underwent surgical treatment for treatment of localized prostate carcinoma. All of the patients underwent radical retropubic prostatectomy. Patient age was in range from 57 to 70 years of age, with average value of 63 years of age. Gleason score values were: GS 8--2 patients, GS 7--6 patients, GS 6--10 patients, GS 5--9 patients, GS 3--4 patients GS 10--1 patient. Duration of the surgery was in the range of 55 to 95 minutes with the average blood loss between 220 and 640 ml. Fifty percent of the patients did not required blood transfusion., Results: After radical retropubic prostatectomy all patients are continent. Average urinary catheter removal time was 12 days after surgery. Postoperative surgical wound healing was prolonged for 4 patients. One patient had stenosis of urethrovesical anastomosis with was resolved with urethral dilatation. Control PSA values for 29 patients tree months after surgery was under 0, 2 ng/ml. Three patients were diagnosed with local tumor recurrence who underwent radiotherapy and latter on with hormonal therapy protocol. All patients are alive., Conclusion: Results of surgical treatment of localized prostate carcinoma have shown that the radical retropubic prostatectomy is the safe method for treatment of the localized prostate cancer, with good oncological response and small amount of postoperative complications.

Objectives: We review the functional and oncoloic outcomes of radical cystectomy and orthotog pic ileal bladder substitution with serous lined extramural ureteral reimplantation., Material and Methods: From 1985 to 2009 a total of 125 male patients (mean age 62.5 years, range 37 to 74) underwent orhotopic ileal bladder substitute at the urological Clinic in Belgrade. Of these, 8 patients underwent modified technique with serous lined extramural ureteral reimplantation. The median follow-up (available for 88 patients) period was 30 (2-72) months., Results: Perioperative lethality was nil. Modified operative technique was associated with low postoperative complication rates and without ureteric implantation site stenosis, reflux or deteriorization of renal function. All patients had satisfied day and night continence rates., Conclusion: The serous-lined extramural ureteral reimplantation is an attractive technique regarding its safety, versality and functional outcome. It is especially favorable for reimplantation to ureters of various calibers as well as dilated ureters.

Introduction: Serum prostate specific antigen (PSA) concentration in localized prostate cancer (PCa) patients depends of numerous factors related to tumor, prostate and the patient. Tumor factors include tumor volume, localization, growth rate and aggressiveness. Prostate factors include prostate volume, the activity of dihydrotestosterone (DHT) and PSA synthesis. Host factors include androgenic status and total blood volume., Objective: to discuss all the possible factors that influence on serum PSA levels in localized PCa patients. To present the mathematical model that predicts serum PSA concentration in localized PCa patients., Methods: Mathematical model is based on the hypothesis that tumor-related PSA molecules are released from the epithelial prostatic cells around the tumor, so called "Destruction Zone" around the tumor (DZ). The amount of PSA is dependent of DZ volume. Moreover, DZ volume depends on tumor volume, tumor localization in the prostate and tumor growth rate., Results: The study offers the wide spectrum of PSA values, dependent on tumor, prostate and patient characteristics. These values are comparable with the empirical results in the literature, especially if tumor-volume doubling time of three years is entered into the calculations., Conclusion: Although with some limitations, this mathematical model can explain the great variety of PSA serum concentrations in PCa patients.

Objective: To examine the possible reasons for great varieties in urethral prostate specific antigen (urPSA) levels, in patients after radical prostatectomy (RP)., Materials and Methods: In 46 patients with pros-tate cancer, PSA, urPSA, total testosterone, body-mass index (BMI) and the stage of androgenic alopecia (AGA) were determined. Forty-five patients underwent retropubic RP, while one underwent cystoprostatectomy with orthotopic bladder construction, due to bladder cancer., Results: Average patients age prior to surgery plus or minus standard deviation was 65.2 +/- 5.8 years. Average urPSA was 20.9 +/- 47.5 ng/ml (0.05 to 212 ng/ml, median 2.24 ng/ml). With urethral PSA cut-off of 2.0 ng/ml, two groups were formed: A (urPSA < 2.0 ng/ml) and B (urPSA = 2.0 ng/ml). Patients in the group A had significantly lower average AGA score, than the patients from the group B (2.4 +/- 1.3 vs. 4.4 +/- 2.2, p = 0.0003). In addition, patients from the group A had significantly lower pos-toperative PSA (0.07+0.08 ng/ml vs. 0.14 +/- 0.06 ng/ml, p = 0.0014)., Conclusions: The patients with higher urPSA have higher AGA scores and higher postoperative PSA. This phenomenon is probably the consequence of higher local dihydrotestosterone activity in the scalp and PSA-secreting urethral glands.

Objective: to present relatively uncommon surgical procedure for the treatment of localized prostate cancer., Material and Methods: Six patients with localized prostate cancer (PCa) underwent perineal radical prostatectomy (PRP) from 2006 to 2010. The average age was 65 +/- 5.2 years. The average preoperative PSA was 7.8 +/- 1.3 ng/ml. Two patients had pT2b stage, while four had pT2c stage. Gleason score ranged from 4-7., Results: All patients had negative surgical margins. Average operative time was 109 +/- 20 minutes and average blood loss was 525 +/- 180 ml. The urethral catheter was removed after 12 days in all patients except one, who required prolonged catheterization due to urinary fistula. All patients were continent after three months. Average postoperative PSA was 0.07 +/- 0.03 ng/ml., Conclusion: Perineal radical prostatectomy is valuable surgical procedure that provides good oncological results as well as urinary and sexual function.

Objective: To present the rare case of testicular hemangioma., Case Report: A 45-year-old clerk presented with painless swelling in the left testicle, which he noticed one month ago. Inguinal orchidectomy on the left side was performed and pathological report proved cavernous hemangioma., Conclusion: Hemangioma of the testis is very rare clinical condition. Clinical appearance and diagnostic exams are usually not sufficient for the diagnosis. Sometimes, hyperechoic lesion with increased vascularity can be seen on Doppler ultrasonography.

Objectives: To estimate the ratio between urinary prostate specific antigen (uPSA) and tumor volume after prostate biopsy., Methods: From 2000 to July 2008, uPSA concentration was determined in 60 patients with clinically organ-confined prostate cancer (PCa). All patients underwent six-area transrectal ultrasound (TRUS)--guided biopsy, with at least 12 biopsy cores. Single pathologist determined tumor grade (G), Gleason score (GS), the percentage of tumor infiltration (% TI) and the percentage of positive cores (% PC) in all biopsy cores. Additionally, relative tumor-biopsy volume (RTV) was calculated by multiplying % PC, % TI and prostate ultrasound-derived volume (Vol). Forty-one patients underwent retropubic radical prostatectomy (RRP), while 19 patients underwent radiation therapy., Results: Average uPSA was 308.6 +/- 311.9 ng/ml (range 0.06-988 ng/ml), average PSA was 9.7 +/- 5.5 ng/ml (range 1.2-24.3 ng/ml), tumor grade 1.7 +/- 0.8, Gleason score 5.2 +/- 1.3, the percentage of tumor infiltration 27.6 +/- 21.8%, and the percentage of positive cores, 52.2 +/- 30.7%. Average RTV was 6.3 +/- 8.4 ml (0.29-56 ml). All patients were divided in two groups: I, with RTV 4 ml and II, with RTV = 4 ml. The patients with RTV 4 ml had lower G (1.4 +/- 0.6 vs. 2.1 +/- 0.8, p = 0.0002), lower GS (4.5 +/- 1 vs. 5.8 +/- 1.3, p = 0.003) and higher uPSA (389.4 +/- 340.8 vs. 193.1 +/- 229.7, p = 0.014). There were no differences in serum PSA levels between the groups., Conclusion: Relative tumor-biopsy volume (RTV) is useful parameter in the preoperative assessment of tumor volume. Patients with higher RTV had significantly higher G and GS. However, these patients had significantly lower uPSA. This phenomenon could be the consequence of compromised PSA drainage from the peripheral zone of the prostate, caused by the tumor.

Objective: To present the rare case of penile metastasis from bladder cancer., Patient Report: A 68-year-old man with invasive bladder cancer disseminated in penile shaft and the pelvic lymph nodes is presented. The patient underwent cystoprostatectomy, total penectomy and adjuvant chemotherapy., Results: Ten months after surgery, patient is in complete remission., Conclusion: Despite the fact that secondary penile tumors usually require palliative therapy, in selected cases surgical treatment of primary tumor and penectomy, followed with chemotherapy, can improve survival.

A case of an adenocarcinoma within a horseshoe kidney (HK) is presented. Male patient presented with a history of a painless hematuria. A contrast enhanced magnetic resonance (MR) scan showed a horseshoe kidney. A large soft tissue mass was also noted on the right side. Kidney was receiving supply from two arteries on the left side and one at the right side. Angiography of the right renal artery demonstrated hypervascular tumor staining. The kidney was approached through midline abdominal incision, and a right heminephrectomy was performed. The histopathology examination showed pT2, grade 2 renal cell carcinoma. To conclude, angiography is indispensable for guiding surgical interventions.

Fracture of the penis, or rupture of the corpus c avernosum is an uncommon injury, but probably under-reported entity. Only approximately 180 cases have been reported in the literature. Penile fracture with urethral injury is even more uncommon, accounting for approximately 10 to 20% of the cases reported. Early reports on this injury suggest conservative therapy as the choice of treatment. Recent reports emphasize immediate surgical repair to prevent late sequelae of injury, especially those associated with urethral rupture. We review 5 cases with evaluation, treatment and followup. Delays in treatment lead to long-term complications.

Surgical complications subsequent to the kidney transplantation are not infrequent and they are characterized by the high percentage of graft loss (596-18% in standard surgical procedures and up to 37% in atypically performed transplantations). The study included 311 transplanted patients (206 (66.2%) living donors and 105 (33.8%) cadaver donors). Surgical complications developing during the immediate posttransplantation period as well as during the late period (after a year and a half) were classified as: I urinary complications; II vascular complications; III other complications. In majority of the cases urinary complications (urinary fistulas, ureteral obstructions, vesico-ureteral reflux) as well as other complications (cholecystopancreatitis and lymphocele) did not necessitate urgent treatment, unlike most of the vascular complications. All the vascular complications (29/311) developed during the immediate postoperative period, except for occurrence of arterial stenoses which ensued later on, while the development of symptoms was rapid. Severity of both symptoms and clinical picture necessitated urgent surgical re-intervention in order to preserve the graft and patient's life. Vascular complications were classified as: true vascular complications, hemorrhages and kidney ruptures in order to distinguish technical and other factors contributing to development of the complications. Onset of the true vascular complications related to the graft and recipient blood vessel changes was evidenced in 20 patients (69%/29 patients) while the incidence of hemorrhages and ruptures was considerably lower (14%/29 patients and 17%/29 patients). As for the true vascular complications, vascular stem thrombosis subsequent to cadaveric transplantations was the most frequent, and transplantectomy was performed in all the cases in absence of any lethal outcomes. Two cases with iliac artery rupture resulted in graft loss subsequent to urgen exploration. In all cases with hemorrhages the applied therapy resulted in positive responses, except in one case in which massive gastrointestinal hemorrhage led to lethal outcome. The response to the urgent surgical treatment of spontaneous kidney graft ruptures was positive in 60% of the cases, while in the remaining 40% transplantectomy was necessitated due to the extensiveness of the lesion in order to preserve patient's life.

Bladder cancer has poor prognosis. Outcome of the treated patients is dependent on correct staging, histologic grade of the tumor, and correctly realized surgical intervention, i.e. radicality of the operation. During the period from 2002. to 2004, on the Department for Urology in Smederevo, 120 patients were surgically treated because of bladder tumors. Of that number, in 34 patients radical cystectomy and derivation by Sygma-Rectum pouch was done. Of these 34 patients, 22 (64.7%) were being followed during the five-years period.

A number of urethral stents made of different materials, with different time of indwelling and different designs, primarily based on the vascular stent concept, have been applied in the clinical practice so far. According to the published studies, urethral stents have justified their clinical application, however with certain limitations. Within an attempt to overcome the limitations, a covered, temporary urethral stent was initially designed by Daniel Yachie and Ijko Markovi in Allium corporation from Israel. With its triangular shape, the stent is a replica of the obstructive prostatic urethral lumen. In has been applied in a series of 14 patients with lower urinary tract symptoms caused by the obstruction at the level of the prostatic urethra. The subjects were averagely aged 77.4 +/- 5.1 years. Allium prostatic stent remained in place in the patients for 4.93 +/- 3.17 months, at the average.

The male urethral stricture treatment is actual clinical issue with its resolution being increasingly frequently based on application of minimum invasive therapeutic interventional uroradiology methods. Since the methodology is applied over the last two decades, the most reasonable therapeutic algorithm has not been defined yet with respect to the correlation with the contemporary surgical treatment. The results of application of the temporary covered self-expandable nitinol Allium stents, which have been applied for the first time ever at our Institution in October 2003. Over the last 3 years, the method was applied in 40 males, averagely aged 54 years with urethral strictures previously treated by urological methods. In four cases, stent placement was performed after endourethral incision. The most common etiology of the stricture was the posttraumatic (55%), post-inflammatory (32%) and iatrogenic (10%). In all the cases, stents were removed 12-14 months after their insertions. The results are evaluated using uroflowmetry and urethrocystography, revealing in 85% of the cases permanent recanalization free of dysuric complaints. Development of a stricture on the anterior stent end was evidenced in 15% of the cases.

Our own experience in application of a combined percutaneous-retrograde approach for recanalization of the urethral structures in 4 patients in presented. Metallic guide is placed via the previously created percutaneous nephrostomy while dilatation or insertion of the metallic stent is performed retrogradely. The approach is used in the strictures in which percutaneou's placement of the recanalization balloon catheter into the stricture site was impossible. The method was successfully applied in all 4 cases in absence of any complications.

Cancer of the urinary bladder is the fourth most common cancer in men and the ninth in women. Approximately 67,000 people (50,000 males and 17,000 females) develop bladder cancer each year in the United States, and 13,750 individuals (9,630 males and 4,120 females) are expected to die from it. In the showing of the morphologic characteristics of the tumors, authors underlining the increasing of the incidence, pathogenesis, premalignant lesions and the risk factors of disease.