Severe forms of early-onset polycystic kidneys in children represent a large group of diseases with overlapping clinical manifestations. A characteristic feature is enlarged kidneys with reduced function, which may be the result in Potter´s sequence in the prenatal period. However, the etiology of this manifestation is genetically very heterogeneous and can be caused by a disorder of a wide range of genes. The most common are PKHD1 mutations that lead to an autosomal recessive form of polycystic kidney (ARPKD). In almost the same number of cases the clinical manifestation of a severe form of polycystic kidney with onset in childhood is the result of PKD1 or PKD2 mutations associated with an autosomal dominant disease form (ADPKD). These mutations often arise de novo or can affect both alleles and lead to a recessive model of inheritance. Mutations in DZIP1L are a relatively new cause of the so-called ARPKD-like phenotype. Early and unambiguous diagnosis of these diseases will be confirmed by genetic testing. The current possibilities of next-generation sequencing allow simultaneous analysis of whole group of genes and represent a key role in the rapid diagnosis of these diseases. Causal gene identification is an essential tool for determining the correct diagnosis and parental counseling.

In patients with multiple sclerosis the neurological deficit is manifested by a wide spectrum of clinical symptoms, including voiding dysfunction. Urinary tract infections worsen patients´ quality of life and can significantly affect the course of the disease. This article presents an overview of current treatment options of urinary tract dysfunctions. Moreover, treatment and prevention of urinary tract infections and the area of sexual dysfunctions are also mentioned.

Testicular germ cell tumors represent a significant challenge in the field of oncology, despite their relatively low incidence. This article focuses on current approaches in their treatment, emphasizing the optimization of care and minimizing the risk of relapse and treatment toxicity. Standard procedures such as orchiectomy, chemotherapy, radiotherapy, and lymphadenectomy are discussed. Special attention is given to the role of new biomarkers, such as miR-371a-3p, which improve the accuracy of diagnosis and treatment monitoring. The article also reflects current trends in therapy de-escalation and research of new targeted therapeutic approaches, including currently studied substances and drug combinations. There is a need for a personalized approach in the treatment of these tumors allowing better outcomes while reducing side effects of the therapy.

This article explores the emerging trends and technologies in urology, focusing on telemedicine and artificial intelligence. It provides a brief overview of the benefits of telemedicine and its impact on the patient-physician interactions. The article subsequently explores in detail the use of artificial intelligence, which is currently gaining considerable interest from both general public and medical professionals. Its potential in urology has been tested in a number of clinical studies, particularly in the field of uro-oncology and, to a lesser extent, in benign urological diseases. The aim of this article is to identify the key advances in this rapidly evolving field, while also highlighting the current limitations of its implementation into clinical practice.

Vitamin D plays a very significant role in human health. Its deficiency is associated with many health complications. However, its influence on reproduction and sexual function in both men and women is generally less known. This article provides an overview of this issue and informs about the possibilities of vitamin D supplementation. Vitamin D supplementation is beneficial for health and quality of life in almost all areas. The most effective treatment is with prescription drugs. A new treatment option with calcifediol is an even more effective and safer choice.

This review article presents current recommendations for prostate cancer detection, while considering local specifics. It discus­ses the topics of initiating diagnostics, prostate cancer screening, the use of imaging methods, and indications and techniques of prostate biopsy. The article is based on the latest guidelines of the European Association of Urology.

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 of acute cystitis in women.

Urolithiasis is a complex multifactorial disease resulting from interactions between genetic and environmental factors as well as multiple disease states. The debate about whether urinary calculi induce subsequent malignant changes has continued without a consistent conclusion for several decades. Earlier diagnosis of urolithiasis and its appropriate management can prevent/provide a longer time period for the stones to cause chronic irritation of the local environment or for potentially harmful substances dissolved in the urine to apply their carcinogenic effect. The article clearly deals with current knowledge, opinions and hypotheses in the issue of a possible oncological link between urolithiasis and some urological malignancies. Further studies are needed to clarify the causal relationship and the carcinogenic mechanisms involved. Unequivocal recommendations for clinical practice are still insufficient.

Urinary tract infections represent one of the most common bacterial diseases, predo­minantly affecting women. In recent years, the growing trend of antibiotic resistance has significantly influenced the management of infections, including those of the urogenital tract. This highlights the critical need for rational antibiotic prescribing, with an emphasis on the use of narrow-spectrum agents that maintain a favorable resistance profile. Due to its ability to achieve high urinary concentrations, low preva­lence of resistant strains, and minimal impact on intestinal microflora, nitrofurantoin remains a cornerstone in the treatment and prophylaxis of acute lower urinary tract infections. This article provides an overview of the pharmacological properties of nitrofurantoin and its clinical relevance in modern therapeutic practice.

For selected patients with low-risk prostate cancer (PC), active surveillance (AS) represents the method of choice aimed at delaying or avoiding radical treatment. However, AS can cause anxiety and uncertainty. Patients also often receive insufficient, confusing, and difficult-to-understand information, leading to anxiety and stress. Psychosocial support and interventions focused on lifestyle improvement can play a key role in managing uncertainty and enhancing patients' confidence in AS. Patient and family education is essential, as it also reduces stress and improves cooperation. Patient support groups and psychotherapeutic interventions may be beneficial for patients experiencing psychological distress related to AS. This review article focuses on the psychosocial aspects of AS and interventions affecting psychosocial burden.

Benign prostatic hyperplasia (BPH) is a common urological condition that has a significant impact on patients' quality of life and an economic burden on healthcare systems worldwide, and is likely to become increasingly common in the aging population. While transurethral resection of the prostate and medical management still play an important role in the treatment of BPH, a number of alternatives are now available, including laser enucleation and minimally invasive techniques. The choice of the most appropriate therapeutic modality will depend on the patient's individual preferences, current health status, resource availability, cost, anatomical factors, and treatment goals.

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 the risk of drug toxicity. To minimize the impact of drug interactions, it is essential to conduct a thorough medical history assessment, promptly identify at-risk patients - particularly those with multimorbidity or polypharmacy - and ensure continuous monitoring throughout treatment. The aim of this article is to provide an overview of key drug interactions associated with antibio­tics most commonly used in the treatment of urinary tract infections and to outline approaches for their monitoring and management in clinical practice.

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 surgery, and treatment of CVD risk factors, can help improve the condition in men with erectile dysfunction (ED). The pitfalls of diagnosis are the lack of communication about impotence in general practitioners' and specialists' offices, and the underestimation of somatic causes, especially CVD risk. Men who have recovered from COVID-19 should be monitored to rule out any long-term consequences of sexual health pathologies, such as impaired sperm and testosterone production. Lifestyle modifications, such as weight loss, increased physical activity, and reduction of smoking and alcohol consumption, may have a positive effect on sperm quality parameters.

Pharmacotherapy is an effective treatment for most men with lower urinary tract symptoms (mLUTS). The goal of treatment is to improve symptoms and, especially, to improve the quality of life. Most men prefer treatment with the least risk of side effects, which effectively affects mainly overactive bladder symptoms and preserves sexual functions. There is increasing emphasis on personalized medicine and tailoring treatment as much as possible to the specific needs and preferences of the patient. Optimal therapeutic effect is often achieved through combinations of medications from multiple drug groups.

Overactive bladder is a syndrome that leads many patients to visit a urological specialist. Due to its high prevalence in both males and females of any ages, urologist should be well informed about the diagnosis and its treatment. Nowadays, in addition to recommendations of European Association of Urology Guidelines, the treatment tends to be highly individualized. Beside conservative treatment, such as lifestyle changes, pharmacotherapy represents a crucial treatment option. Antimuscarinics are considered a traditional pharmacological choice. Nevertheless, beta-3-mimetics have been successfully used as a combination therapy or even an effective replacement to antimuscarinics in recent years.

Gender confirmation surgery (GCS) represents a crucial step in the medical transition process for transgender individuals. This article provides a historical overview of the development of these procedures, current indications and contraindications, an overview of commonly used surgical techniques, and the clinical aspects of postoperative care. We focus in detail on the most frequent procedures for trans women and trans men, including their potential complications and long-term outcomes.

Urinary tract infections (UTIs) are among the most common bacterial infections in both community and hospital care. UTIs are primarily caused by gram-negative bacteria, which have shown a significant increase in antibiotic resistance in recent years, particularly to beta-lactams. This resistance is mainly due to the production of various beta-lactamases, with the most significant being carbapenemases. The article provides an overview of current knowledge on different types of beta-lactam resistance and presents information on newly available beta-lactams that can overcome some of these resistance mechanisms. It also includes a practical approach to the treatment of UTIs caused by multidrug-resistant bacteria.

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 changes are characteristic of certain subtypes of tumors, and the study of these changes can lead to a better understanding of the pathogenesis of bladder cancer, to a more accurate molecular classification, which will allow more accurate determination of the prognosis and the further development of personalized therapeutic approaches to this disease, including targeted therapy and immunotherapy. The article summarizes the most common genetic changes that occur in bladder cancer tumor cells and briefly discusses the effect of smoking on the development of these changes as the main risk factor.

Recurrent urinary tract infections are very common in clinical practice. Endovesical installation of hyaluronic acid helps to restore the protective glycosaminoglycan layer on the surface of bladder urothelium and reduces the frequency of recidives. This treatment represents an effective option especially for patients in whom regime measures in combination with non-antimicrobial or antimicrobial prophylaxis has been unsuccessful.

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 for patients with neurogenic lower urinary tract dysfunction.

Urodynamic testing is a set of diagnostic methods to assess the function of the lower urinary tract during the filling and emptying phases of the bladder. In most cases, this is not a basic examination, but just a tip of the iceberg of testing methods in urology. These methods aid in diagnosing non-neurogenic and neurogenic causes of lower urinary tract dysfunction as well as in monitoring the effect of treatment in a parti­cular patient.

The authors summarize the problem of premature ejaculation and modern treatment options.

Pelvic floor disorders in women are a very common issue. It is estimated that up to 11% of women are experiencing some form of pelvic organ prolapse (POP). It can hardly be assumed that this statistic will change significantly. Operating technologies are still evolving. Separate colporrhaphys performed in the past are no longer relevant and colpocleisis are indicated rarely. A high rate of unsatisfactory outcomes following conventional surgeries has driven the search for new surgical technologies in this area. Reoperation rates are notably high in countries where relevant clinical trials are ongoing. Olsen et al. report a 29.2% incidence of recurrences, while Whiteside et al. present even 58% of recurrences after vaginal surgery for POP in a prospective study (1, 2). The introduction of mesh implants into pelvic prolapse surgery meant a significant turning point in the treatment of this condition. Mesh implants began to be used in pelvic prolapse surgeries following successful experience with meshes in the treatment of abdominal hernias and also after groundbreaking experience in dealing with stress incontinence (SI) through tension-free suburethral tape implantation. They brought one essential element to POP operations - the ability to bridge even large surface defects of connective tissue caused by childbirth trauma or previous pelvic surgeries. However, their use in POP surgery is far more demanding than in abdominal hernia surgery, because POP is a specific type of hernia in a dynamically demanding space. These operations interfere with very sensitive functions such as urination, defecation and sexual function. While their introduction into surgical practice can clearly be considered a progress, the clinical results of their use have sometimes been less satisfactory. New types of complications emerged, and there was initially no experience in managing them. Despite these challenges, the development of pelvic implant technology has progressed to the point where it is possible to achieve practically anatomical reconstructions of the pelvic floor with excellent functional results. Pelvic implants can be inserted transvaginally or transabdominally. In the transabdominal approach, minimally invasive laparoscopic or robot-assisted implantation technology is currently available. A high-quality pelvic floor reconstruction is not possible without the use of mesh implants.

Urinary tract infections (UTIs) are among the most common bacterial infections. UTIs are the second most common infectious disease in the population, following upper respiratory tract infections. UTIs also represent one of the most common nosocomial infections. They are a common complication associated with urinary tract catheteri­zation (CAUTI), especially during long-term catheterization or catheterization related to the endoscopic procedures. The most effective way to prevent CAUTI is to avoid unnecessary or inproperly indicated catheterization. Modern medicine must repeatedly seek new strategies for prophylaxis before invasive procedures and for the treatment of UTIs, with particular attention to the reasing prevalence of bacterial resistance and the frequent overuse of unindicated antibiotic therapy. This article aims to evaluate the current evidence on the prevalence, risk factors, and preventive measures related to infection during urinary catheterization.

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, reducing stress and maintaining optimal body weight. The article also includes an overview of basic drugs indicated in the therapy of benign prostatic hyperplasia, including a reminder of the principles of their proper use, and a warning about groups of drugs that may worsen the symptoms of this disease. The aim of the article is also to point out the importance of an interdisciplinary approach in which the pharmacist actively contributes to improving the quality of life of patients through advice not only in the field of pharmacotherapy, but also through the promotion of a healthy lifestyle.

As one of the most common urological diagnosis of aging men, benign prostatic hyperplasia (BPH) affects almost 80% of males over 70. Despite dramatic progress in technological and surgical treatment options, it is still considered as feared diagnosis among patients. Majority of aging men choose conservative, pharmacological treatment which in many cases is unable to permanently solve the lower urinary tract symptoms (LUTS) and in many cases ends up with permanent catheterization of those unfortunate ones who missed a surgery while having a suitable performance status. For the past 70 years transurethral resection of the prostate (TURP) has been considered a gold standard in LUTS/BPH treatment. Although original monopolar technology is now replaced which much safer bipolar technology, TURP cannot be successfully used for prostate hyperplasias of excessive volumes. For these cases, open prostatectomy still remains a standardized option. Currently, modern literature points out that Holmium laser enucleation (HoLEP) has replaced TURP and open prostatectomy and is considered the new gold standard in BPH treatment. However, other technologies and techniques evolved, allowing transurethral bipolar enucleation of the prostate (TUBEP) without using laser technology and delivering similar results as HoLEP. We present an overview of existing transurethral enucleation methods for the treatment of BPH which are based on our knowledge performed in the Czech Republic, this article discusses the surgical principles and specifics of individual technologies as well as performance safety, side effects and long-term results.

Tubulointerstitial nephritis (TIN) represents a broad group of relatively heterogeneous diseases, characterized by predominant involvement of the tubules and interstitium. The pathophysiological process involves immune-mediated infiltration by inflammatory cells. When kidney cells are damaged, local antigens are expressed, leading to infiltration by inflammatory cells and activation of cytokines, which act both proinflammatory and as chemoattractant. Cytokine production by inflammatory cells (macrophages, lymphocytes) is also mediated by kidney cells (proximal tubular cells, vascular endothelial cells, interstitial cells, and fibroblasts), resulting in interstitial scarring, fibrosis, and tubular atrophy, ultimately leading to progressive chronic kidney disease. Chronic TIN can be etiologically divided into infectious, typically chronic bacterial pyelonephritis, and non-infectious, where the inflammatory process is triggered by medications, metabolic disorders, cystic diseases, autoimmune diseases or vesicoureteral reflux in childhood. Secondary involvement of the tubulointerstitium may also occur, for example, in vascular or ischemic kidney injury. The clinical presentation of chronic TIN is often nonspecific and rather oligosymptomatic, with milder mani­festations than in acute forms. It may present as various tubular dysfunctions or as progressive renal insufficiency. Treatment is targeted according to the primary cause.

Metabolic syndrome (MetS) is a complex unit of various metabolic disorders, inclu­ding abdominal obesity, dyslipidemia, elevated blood pressure and increased fasting glycemia, which act in mutual interplay as important risk factors for multiple diseases, including disorders of urinary tract. Increasing body of evidence suggest that MetS and its individual components predispose not only to the development of malignant tumors notably carcinoma of kidney, prostate, ureter or urinary bladder but also to the development of other urological diseases, such as urolithiasis, benign prostate hypertrophy, male hypogonadism or erectile dysfunction. Some patophysiological mechanisms or paradoxal findings are not currently sufficiently understood and require further research. From a clinical point of view it is important to respect the fact, that for successfull prevention and management of multiple urological disorders an increased interdisciplinary cooperation aimed to treat and decrease predisposing risk metabolic factors is required.