Urology for Practice - Latest articles
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Že kočka není pes…Editorial
MUDr. Radkin Honzák, CSc.
Urol. praxi. 2026;27(2):59
Urothelial carcinoma of horseshoe kidney with tumor triplicity - clinical presentation and treatment approachCase report
MUDr. Oleg Izmaylov, MUDr. Pavel Navrátil, Ph.D., FEBU, MUDr. Zdeněk Bělobrádek, prof. MUDr. Miloš Broďák, Ph.D.
Urol. praxi. 2026;27(2):115-118 | DOI: 10.36290/uro.2025.058
Horseshoe kidney (ren arcuatus) represents the most common renal fusion anomaly, occurring in approximately 1 in 400-1,800 individuals. It is generally a benign condition, yet predisposes patients to multiple urological complications, including an increased risk of neoplastic diseases. Urothelial carcinoma arising in a horseshoe kidney is exceedingly rare, complicating both its diagnosis and management. This case report presents an 81-year-old patient with high-grade invasive urothelial carcinoma located in the isthmus of a horseshoe kidney, further complicated by concurrent small lymphocytic lymphoma (CLL/SLL). Diagnosis required an open surgical...
Drug interactions in the therapy of bladder cancerDrug interactions
Mgr. Tereza Medková, Mgr. Tereza Vaňková
Urol. praxi. 2026;27(2):111-114 | DOI: 10.36290/uro.2025.054
The rapid development of oncological therapies is accompanied by an increasing incidence of drug interactions, which can significantly affect both the safety and efficacy of treatment. Most oncology patients suffer from additional chronic conditions, and due to age and comorbidities, this often leads to polypharmacy. As a result, the risk of interactions increases not only between prescribed medications, but also with over-the-counter products, dietary supplements, herbal preparations, or certain foods. Drug interactions in oncology may be both pharmacokinetic and pharmacodynamic, and can manifest as reduced therapeutic efficacy or an increased risk...
Indications and guidelines for active surveillance in men with prostate cancerAt a glance
doc. MUDr. Otakar Čapoun, Ph.D., FEBU
Urol. praxi. 2026;27(2):108-110 | DOI: 10.36290/uro.2025.097
Active surveillance represents a standard management strategy for localized prostate cancer in men with low-risk disease and selected patients with favorable intermediate-risk features. The aim is to delay or avoid curative treatment in those with a low risk of progression, thereby preserving quality of life without compromising oncologic safety. The use of magnetic resonance and targeted biopsies improves patient selection and minimizes the risk of missing clinically significant tumors.
Vasectomy and possible complicationsSexual and reproductive medicine in practice
MUDr. Jakub Szewczyk
Urol. praxi. 2026;27(2):104-107 | DOI: 10.36290/uro.2026.001
Vasectomy represents the most widely used method of male sterilization and is considered a safe, effective, and economically advantageous procedure in family planning. The main reasons for its growing popularity include reliability, procedural simplicity, short recovery time, minimal impact on hormonal function and sexual life, and increasing public awareness of the method. Modern techniques have significantly reduced the risk of complications as well as postoperative pain.
Ethical issues in the treatment of erectile dysfunctionSexual and reproductive medicine in practice
MUDr. Libor Zámečník, Ph.D., FEBU, FECSM, MBA
Urol. praxi. 2026;27(2):100-103 | DOI: 10.36290/uro.2025.053
Erectile dysfunction (ED) represents a significant medical, psychological, and social issue. The treatment of ED occurs within a context of numerous ethical challenges that extend beyond standard clinical practice. This article summarizes twelve key areas, ranging from informed consent, access to care, and media influence to the spiritual dimension of sexuality. Special attention is also given to testosterone misuse and the commercialization of treatment. The aim of the text is to promote a comprehensive, respectful, and ethically grounded approach to patients with ED.
Current procedures for urinary incintinence rehabilitation after radical prostatectomyFrom the boundary of urology
Mgr. Petra Bastlová, Ph.D., Mgr. Anna Garajová, MUDr. Ondřej Česák, doc. MUDr. Vladimír Študent, Ph.D., FEBU
Urol. praxi. 2026;27(2):94-98 | DOI: 10.36290/uro.2025.096
This narrative review summarizes current knowledge on rehabilitation approaches for urinary incontinence following radical prostatectomy. The foundation of therapy is the targeted activation of muscles responsible for continence control, coordinated with breathing and postural functions. Comprehensive functional physiotherapy, which includes the development of strength, endurance, and overall physical conditioning - and initiated even before surgery - improves postoperative outcomes and shortens recovery time. Adjunct methods such as biofeedback and electrostimulation demonstrate moderate to low levels of evidence for effectiveness and are recommended...
Individualization of systemic treatment for advanced prostate cancerFrom the boundary of urology
MUDr. Jana Katolická, Ph.D., MUDr. Lucia Tomková
Urol. praxi. 2026;27(2):91-93 | DOI: 10.36290/uro.2026.005
Renal cell carcinoma (RCC) accounts for approximately 2-3 % of all malignancies, and its incidence has been steadily increasing. From the perspective of systemic therapy, immunotherapy has become a key pillar of modern RCC treatment. Over the past decade, immune checkpoint inhibitors (ICI) have emerged as an essential component of therapy for both advanced disease and localized disease at high risk of relapse. This article summarizes the role of immunotherapy in the management of metastatic RCC and its position in the adjuvant setting following surgical treatment.
Prostatic artery embolization in the treatment of LUTS/BPH - a practical review for urologists and interventional radiologistsFrom the boundary of urology
MUDr. Oleg Izmaylov, MUDr. Pavel Navrátil, Ph.D., FEBU, prof. MUDr. Miloš Broďák, Ph.D., MUDr. Michal Balík, Ph.D., doc. MUDr. Jan Raupach, Ph.D., MUDr. Vendelín Chovanec, Ph.D.
Urol. praxi. 2026;27(2):83-89 | DOI: 10.36290/uro.2026.010
Benign prostatic hyperplasia (BPH) is one of the most common urological conditions in elderly men and often leads to lower urinary tract symptoms (LUTS) with a significant impact on quality of life. Prostatic artery embolization (PAE) has emerged as a minimally invasive endovascular treatment option performed under local anaesthesia, offering symptom relief in selected patients with an increased anaesthetic risk or a preference to avoid conventional surgery. Current evidence, including randomized trials and meta-analyses, shows that PAE significantly improves LUTS, quality of life and urinary flow, although the desobstructive effect is generally inferior...
D-mannose in urinary tract infections: mechanistic rationale, clinical effectiveness, and limitations of evidenceReview articles
MUDr. Marek Broul, Ph.D., MBA, FECSM, PharmDr. Kateřina Langmaierová, Mgr. Aneta Hujová, Mgr. Michaela Liegertová, Ph.D.
Urol. praxi. 2026;27(2):78-82 | DOI: 10.36290/uro.2026.002
Recurrent cystitis in women is a frequent outpatient urology problem, substantially impairing quality of life and increasing antibiotic exposure with consequences for antimicrobial resistance and microbiome disruption (1, 2). D-mannose is widely used as an antibiotic-sparing option supported by a plausible anti-adhesive mechanism, potentially blocking the binding of uropathogenic Escherichia coli to urothelium via the FimH adhesin (4, 5). However, clinical evidence remains heterogeneous. While earlier studies and some reviews suggested a possible prophylactic benefit (6-8), a large pragmatic placebo-controlled randomized trial in primary care...
Drug-induced urolithiasisReview articles
MUDr. Jiří Kladenský, RNDr. Vladimír Bulka
Urol. praxi. 2026;27(2):74-76 | DOI: 10.36290/uro.2026.007
Although drug-induced urolithiasis does not occur very frequently, it is by no means rare. It is reported to account for 1-2 % of cases of urolithiasis. This type of lithiasis should be taken into consideration in patients taking a medication from the group of potentially lithogenic drugs as well as in those who have recurrent lithiasis and are suspected to have a lithiatic-metabolic disorder. The article lists the most high-risk medications identified to date that can cause iatrogenic lithiasis, particularly when patients take these medications in the long-term and/or in higher doses.
Current pharmacological options for the treatment of acute cystitis and the prevention of recurrent cystitisReview articles
MUDr. Lucie Hopková, MUDr. Pavel Navrátil, Ph.D., FEBU
Urol. praxi. 2026;27(2):66-72 | DOI: 10.36290/uro.2026.009
Cystitis is the most common urinary tract infection and a major driver of antibiotic prescribing in outpatient care. Acute uncomplicated cystitis requires a rational selection of short antibiotic regimens with minimal ecological impact, consistent with antimicrobial stewardship principles. Recurrent cystitis - defined as three episodes within 12 months or two episodes within 6 months - results from complex mechanisms including intracellular bacterial reservoirs, alterations of the vaginal microbiota and functional disorders of the lower urinary tract. Modern prevention prioritizes non-antibiotic strategies such as vaginal estrogens in postmenopausal...
Stress incontinence in womenReview articles
MUDr. Kateřina Maxová
Urol. praxi. 2026;27(2):62-65 | DOI: 10.36290/uro.2025.095
Stress urinary incontinence (SUI) is the most common form of urinary incontinence in women. It is defined as the involuntary leakage of urine in the cases of increased intra-abdominal pressure in the absence of a detrusor contraction. Given the high prevalence of this disorder in the population, SUI poses a significant medical as well as psychosocial problem that negatively impacts the quality of life of affected women. The review article summarizes the current knowledge on the epidemiology, aetiology, pathophysiology, diagnosis, and treatment of stress urinary incontinence in women, including new trends in therapy.
Cítím s tebou aneb úvaha o empatiiEditorial
MUDr. Radkin Honzák, CSc.
Urol. praxi. 2026;27(1):3
Management of asymptomatic bacteriuria - when is treatment necessary?At a glance
MUDr. Lucie Sedláčková
Urol. praxi. 2026;27(1):52-54 | DOI: 10.36290/uro.2025.052
Asymptomatic bacteriuria (ABU) without clinical signs is a common clinical condition. It is usual in patients with urinary catheters and in patients with pathology of urinary tracts. The occurrence of ABU increases with age and is more pronounced in women. It is usually not treated and often disappears spontaneously. The administration of antimicrobial therapy to patients with asymptomatic bacteriuria should always be assessed on a case-by-case basis to avoid unnecessary burdensome treatment. According to current recommendations, we specifically search for and treat ABU in patients undergoing surgical procedures that affect the mucosa of the urinary...
Metastatic prostate cancer mimicking a primary urothelial carcinoma of the bladderCase report
MUDr. Michaela Uhrinová Vukušičová, MUDr. Ivan Viľcha, MUDr. Mária Cinová, MUDr. Mária Mikitová, MUDr. Ľubomír Ličák
Urol. praxi. 2026;27(1):48-51 | DOI: 10.36290/uro.2025.051
A 67-year-old patient with several months of recurrent urinary retention with subsequent occurrence of gross hematuria, while palpation of the prostate and the level of total prostate-specific antigen were not significant for prostate cancer. Cystoscopy revealed papillomatous formations in the prostatic urethra, subsequently also in the neck, trigone and posterior wall of the bladder, and urine cytology was suspicious for high-grade urothelial carcinoma. The patient underwent transurethral resection of pathological lesions with the finding of prostatic adenocarcinoma with Gleason score 10. As part of the differential diagnosis, in patients with lesions...
Nonpharmacological measures in recurrent urinary tract infections in children and adolescentsGood advice from practice
MUDr. Zuzana Vyoralová
Urol. praxi. 2026;27(1):42-47 | DOI: 10.36290/uro.2025.078
Urinary tract infections (UTIs) in children are a common reason for visiting a paediatrician as well as for being hospitalized. Children with recurrent UTIs are at a higher risk of kidney injury, particularly when concurrent with vesicoureteral reflux. Prevention involves a set of measures intended to reduce the recurrence rate and thus the risk of renal insufficiency. Given the increasing pharmacological resistance of bacteria, nonpharmacological measures are becoming increasingly important.
The influence of lifestyle on the prevention and treatment of benign prostatic hyperplasia from a pharmacist's perspectiveFrom the boundary of urology
Mgr. Ondřej Šimandl
Urol. praxi. 2026;27(1):37-41 | DOI: 10.36290/uro.2025.055
Benign prostatic hyperplasia is one of the most common non-malignant diseases affecting middle-aged and older men. In addition to pharmacological treatment and surgical options, lifestyle and dietary measures also play an increasingly important role, both in the prevention and supportive treatment of this disease. The article offers a view of the issue of benign prostatic hyperplasia from the perspective of a pharmacist, who, among other things, has an irreplaceable role in educating patients and supporting adherence to treatment. Attention is paid in particular to the influence of diet, physical activity, limiting alcohol consumption and non-smoking,...
Sexual health of patients after oncological treatment - how to improve quality of life, the impact of oncological treatment on sexual health and reproductive ability of men, rehabilitation options and psychological supportSexual and reproductive medicine in practice
doc. MUDr. Taťána Šrámková, CSc.
Urol. praxi. 2026;27(1):31-36 | DOI: 10.36290/uro.2025.061
Oncology treatment and the disease itself can significantly affect patients' sexuality, both in the area of physiological functions and in the psychological and relational aspects. The most common problems include sexual dysfunction, changes in self-concept and shifts in partner dynamics. Although sexuality remains an important part of the quality of life of cancer patients, it is often overlooked in the context of comprehensive cancer care. The goal of oncosexology is to identify and address these difficulties through a multidisciplinary approach, including education, psychological support, pharmacotherapy, and couples therapy. Acess to information...
Treatment of urinary dysfunctions in adult patients with neurological diseasesReview articles
doc. MUDr. Jozef Marenčák, PhD.
Urol. praxi. 2026;27(1):23-30 | DOI: 10.36290/uro.2025.077
Neurogenic lower urinary tract dysfunction significantly impairs patients´ quality of life, is associated with numerous life-threatening complications, and represents a significant economic burden on healthcare system. Diagnosis is based on patient history, physical examination, imaging procedures, and urodynamic testing, with the need to determine the individual risk level. The goals of treatment include preserving renal function, improving quality of life, preventing urinary tract infection, and maintaining a low-pressure bladder that is boht continent and capable of comlete emptying. The article provides an overview of current treatment options...
Imaging of tumours of the kidney and urinary tract using computed tomographyReview articles
MUDr. Jan Pernický, Ph.D., MUDr. Petr Stránský ml., prof. MUDr. Jiří Ferda, Ph.D., prof. MUDr. Milan Hora, Ph.D., MBA
Urol. praxi. 2026;27(1):18-22 | DOI: 10.36290/uro.2025.081
Computed tomography (CT) is the fundamental imaging technique in diagnosing tumours of the kidney and urinary tract. It enables the detection, characterization, and staging of renal and urothelial cancers and remains the method of choice owing to its high spatial and temporal resolution and wide availability. Multiphase protocols provide detailed information on lesion morphology and enhancement characteristics, including assessment of lymph node involvement and distant metastases. CT urography is crucial for diagnosing urothelial carcinomas of the upper and lower urinary tracts. The main limitations of CT are the difficult differential diagnosis of...
Pharmacotherapy of overactive bladder syndrome and modern methods of treatmentReview articles
MUDr. Jiří Sumara
Urol. praxi. 2026;27(1):11-16 | DOI: 10.36290/uro.2025.035
The following text provides a detail overview of the current pharmacotherapy for OAB (overactive bladder), a review of individual anticholinergics, their properties, side effects, and an possible combinations of medicinal substances. A special attention is given to the treatment of OAB in older adults. Due to frequent presence of comorbidities and polypragmasia, it is advisable to administer antimuscarinics that have higher tissue selectivity and do not pass through the blood-brain barrier. In addition to pharmacological treatment, the text also discusses other modern therapeutic options such as the application of botulinum toxin, neurostimulation/modulation,...
Urinary tract infections in patients with dysfunctional voidingReview articles
MUDr. Eva Burešová, Ph.D.
Urol. praxi. 2026;27(1):6-10 | DOI: 10.36290/uro.2025.059
Urinary tract infections are the most common complication in patients with dysfunctional voiding. Most cases involve asymptomatic bacteriuria. Symptomatic infections often require acute care and hospitalization; for this reason, it is necessary to focus on their prevention.
Umělá inteligence – příležitost, nebo hrozba?Editorial
doc. MUDr. Ondřej Volný, Ph.D.
Urol. praxi. 2025;26(4):179
The significance of the systematic component in MR/TRUS fusion biopsy for prostate diagnosis: a retrospective studyOriginal study
MUDr. Přemysl Grubský ml., MUDr. Libor Pochobradský, Mgr. David Brebera, MUDr. Daniela Tomčová
Urol. praxi. 2025;26(4):235-238 | DOI: 10.36290/uro.2025.094
Worldwide, prostate cancer is among the most significant malignancies in the male population. It is a serious health issue that requires ongoing improvements of diagnostic methods and treatment strategies. Effective and accurate diagnosis, especially of clinically significant prostate cancers, plays a key role in the entire management of this disease, treatment planning and improving both patient the quality of life and survival of patients. This article presents our experiences with the fusion biopsy program and its potential use in clinical practice. The primary aim of this retrospective study was to determine whether it is necessary to perform systematic...
Cystolithiasis formation caused by a forgotten intrauterine contraceptive deviceCase report
MUDr. Michaela Motolová, Ph.D., FEBU
Urol. praxi. 2025;26(4):231-234 | DOI: 10.36290/uro.2025.093
Cystolithiasis in women is a rare diagnosis. Its etiology is associated with the presence of foreign material (mostly stitches) in the bladder - most often iatrogenic in connection with gynecological interventions or urinary outflow insufficiency due to a neurogenic disorder, but also with changes in the architecture of pelvic floor - a higher grade cystocele (1, 2). This case report aims to highlight the not often discussed issue of neglected and migrating intrauterine devices (IUD) from the urologist's point of view. It also reflects the proper multidisciplinary management of a critical condition of a geriatric patient with obstructive pyonephrosis...
The impact of chronic diseases on male sexual functionSexual and reproductive medicine in practice
MUDr. David Čapka, doc. MUDr. Robert Grill, Ph.D.
Urol. praxi. 2025;26(4):226-230 | DOI: 10.36290/uro.2025.092
Chronic diseases can have a significant impact on male sexual function in several ways. Sexual dysfunction can be the first symptom of some chronic diseases. Treatment can vary depending on the cause and may include lifestyle changes or modifications, medication, or surgery. There is a clear need to prospectively collect data and information on all aspects of men's health, including cardiovascular disease (CVD) screening protocols and assessing the impact of primary and secondary prevention strategies. Overall, several studies have shown that lifestyle modifications, including physical activity, especially aerobic exercise, weight loss including bariatric...
Antibiotics and drug interactions in urologyDrug interactions
PharmDr. Aleš Šorf, Ph.D., PharmDr. Petr Domecký, Ph.D.
Urol. praxi. 2025;26(4):220-225 | DOI: 10.36290/uro.2025.091
Urinary tract infections represent the second most common group of bacterial infections in the general population, and their diagnostic and therapeutic management requires careful consideration of multiple factors. Key determinants include the location and severity of the infection, the risk of recurrence, and local epidemiological data on antibiotic resistance. Antibiotics from different classes vary in their pharmacokinetic and pharmacodynamic profiles, which influence their potential to cause clinically significant drug interactions. These interactions can substantially impact treatment outcomes, either by leading to therapeutic failure or by increasing...
Rational approach to the treatment and prevention of lower urinary tract infections in womenAt a glance
MUDr. Marcela Fontana, Ph.D., FEBU, MUDr. Michaela Matoušková
Urol. praxi. 2025;26(4):217-219 | DOI: 10.36290/uro.2025.090
Acute cystitis is the most common form of urinary tract infection (UTI), commonly treated by physicians across various specialties. The latest guidelines of the European Association of Urology introduce a new classification of UTIs into localized and systemic, replacing the previsous division into complicated and uncomplicated UTIs. They also emphasize the importance of antimicrobial stewardship and rational antibiotic use, considering potential adverse effects, the risc of insreasing bacterial resistance, and disruption of the patient's natural microbiome. The following text summarizes current recommendations regarding the treatment and prevention...
Genetic and molecular factors in the development of bladder cancer - a geneticist's viewFrom the boundary of urology
MUDr. Klára Nováková, Ph.D., doc. MUDr. Lenka Foretová, Ph.D.
Urol. praxi. 2025;26(4):210-215 | DOI: 10.36290/uro.2025.089
Bladder cancer development is influenced by a combination of genetic and molecular factors that affect cellular processes such as growth, division, and DNA repair. These factors may play a role in tumor initiation and progression. Key genetic and molecular factors associated with this disease include mutations in tumor suppressor genes (e. g. TP53, RB1, CDKN2A), oncogenes (e. g. FGFR3, HRAS, ERBB2, PIK3CA), microsatellite instability (MSI), aberrant protein expression (PD-L1), epigenetic changes (e. g. CDKN2A gene methylation) and chromosomal changes of the loss of heterozygosity type. It turns out that individual genetic...