Renal cysts are a common, usually incidental finding on routine radiological studies, including ultrasound (US), computed tomography (CT), and magnetic resonance (MR). In general, renal cysts may be classified as simple or complicated. Simple cysts are benign and do not require any follow-up or treatment. Most of the cysts belong to this category. Complicated cysts however include a wide range of cystic kidney lesions, from completely benign to definitely malignant. Bosniak classification is a useful and applicable method for renal cyst evaluation. It was developed from clinical experience with the intent that morphologic features of a cyst could serve as a predictor for reliable categorization and differentiation of “nonsurgical” and “surgical” lesions. Although other imaging modalities like MR and US are used for diagnosing renal cysts, CT is the imaging method of choice. Standard CT protocol includes a noncontrast and postcontrast arterial and/or parenhymal phases. Size, location within the kidney, shape, and density of the cyst, the number and morphology of the septa and/or calcification, and postcontrast opacification are evaluated. US is most commonly used as a “screening” method, appropriate for frequent examinations, while MR is the initial method of choice for young patients, those with renal insufficiency and hypersensitivity to iodinated contrast agents, and is proven helpful when CT findings are equivocal.

Urodynamics is a method for evaluation of urinary tract function, specially lower urinary tract. Lower urinary tract is a unique functional entity consisted of urinary bladder, sphincteric mechanism and urethra. Their main function is storage of urine, voiding and continence. Urodynamics is used for evaluation of all this functions. Urodynamics is performed as adjunct to the basic clinical evaluation. The most frequently used methods are uroflow, cistometry, and urethral profilometry. Uroflow represent urinary flow during micturation. Cistometry is used for measurement of pressures during storage and expulsion of the urine. Urethral profilometry measured urethral pressure and show data about patient’s continency. In this review article we present basic information about urodynamic tests with clinical examples.

Poglavlje opisuje mogucnosti derivacije urina te kreiranje mokracnog mjehura od tkiva pacijenta

In the past the development of urology was as the part of the development of surgery. In the beginning the well known specialist come from Zagreb medical school to Susak and the era of surgery and urology started. The new hospital “Opca javno banovinska bolnica” was open in 1935 with Prim. dr. Janko Komljenovic as first chief of Department of Surgery. He applied new surgical techniques and also new surgery specialites as was urology. He was a founder of endoscopic urology. Afer the Second World War, in the same department, urology started to grow with more complicated operations such as those for urolithiasis and prostate adenomectomy. As independent ward urology was established in 1950, with doc. dr. Zlatko Sestic as first chief. The ward has 30 beds. In the 1959, the Urological secton of Croatian Medical Associaton was established in Rijeka with doc. dr. Sestic as frst president. In the 60-ties, prof. dr. Vinko Franciskovic became a new chief of Surgery and the urology become an independent surgical speciality. He started with the experimental programme of transplantaton surgery and on January 30th 1971 the first kidney transplantation was performed in former Yugoslavia. In that time the chief of urology was prof. dr. Tomislav Ticac. Except the transplantation programme urologists developed hemodialysis programme, use intestinal segments as substituton or urinary diversion, performed longitudinal nephrolithotomy, different resections of the kidney and surgery of the adrenal gland. Prim. dr. Vjerislav Peterkovic become chief of urology in 1986 with special emphesasis on transurethral resections, ureterorenoscopy, percutaneous treatment, radical treatment for prostate and bladder cancer and development of andrology. In 2000 the chief of urology, and also surgery, become prof. dr. Željko Fuckar. The ward was renovated, the new urologist was coming and also the extracorporeal shock wave lithotripsy was introduced. In 2005 ward become a Clinic of Urology with prof. Fuckar as first chief. The next year urology become an independent department in the Rijeka Medical School. Also in 2006 Urology Clinic become Referral center for kidney transplantaton in Croata. The Clinic improved professional, scientific and educational activites and re-established programme of experimental urology. Prim. dr. Maksim Valencic was chief to 2013, after him prof. dr. Anton Maricic and finally doc. dr. Josip Spanjol. In the last years the Clinic made a substantal improvement of transplantation programme and in performing minimally invasive procedures.

Improvement in knowledge of molecular pathways of growth and developement of malignant kidney cancer has led to development of a number of efficient drugs. In this way the treatment of this condition nowadays is possible and successfull as documented by many clinical trials. New ways of treating kidney cancer tend to fulfill primary oncology goals which are to cure completely the patient or to make this serious disease a longlasting chronic disease.

Premature ejaculation is one of the most common sexual problems of men. Annoyances are affected by both partners, and solving the problem should be approached as soon as possible. Urologists are part of a multidisciplinary team made up of psychiatrists, psychologists, psychotherapists, sexologists, endocrinologists, family doctors and trained nurses. Since the etiology and possible diagnostic and therapeutic methods, only approach with the active participation of the patient and his partner can lead to satisfactory results. This article describes the etiology and types, as well as diagnostic methods and treatment of premature ejaculation.

Aim: Autosomal dominant polycystic kidney disease is the most common renal hereditary disease. During many years renal cysts become larger, the functional nephron mass decreases and enlarged kidneys compress the surrounding structures. We present the case of a patient with polycystic kidney disease and inferior vena cava thrombosis after kidney transplantation. Case report: Three months after kidney transplantation into the left iliac fossa, the 67 year-old woman was admitted to our hospital due to swelling oft the right leg. Clinical and ultrasound examination revealed deep vein thrombosis of right leg and therapy with heparine was introduced. Since there was no improvement, a computerized tomography examination was performed that confirmed deep vein thrombosis of the right leg, thrombosis of iliac veins on the right side and partial thrombosis of the distal part of the inferior vena cava. As radiologic imaging revealed compression of the right polycystic kidney onto the inferior vena cava, we performed nephrectomy of the polycystic kidney to prevent complete thrombosis. The postoperative course was uneventful, with a regression of the right leg edema and stable graft function. Discussion and conclusion: In patients with large polycystic kidneys, compression of the inferior vena cava may lead to its thrombosis. A nephrectomy should be performed in time.

Aim: To present a case of a very reduced capacity and compliance of urinary bladder in a young men who was successfully treated with bladder autoaugmentation. Case report: Thirty six years old male patient came to urology department complaining of iritative lower urinary tract symptoms. Dominant symptoms were frequency, nicturia, urgency and urge incontinence. Symptoms were so severe that patient was psychologically altered and his private and professional life suffered. After extensive workup and after failure of conservative treatment, autoaugmentation cystoplasty was performed. The postoperative course was uneventful. At the time of discharge from hospital he had frequency of four to five times daily and two times by night. Average voided volume was 400 mL. Discussion and conclusion: In selected cases, bladder autoaugmentation significantly improves quality of life in patients with reduced bladder capacity and compliance. Surgical procedure is safe and free of severe complications. Since the procedure is extraperitoneal and there is no need for use of intestinal segments, it is always possible to perform ileocystoplasty, orthotopic or supravesical urine diversion using intestinal segments.