Hungarian Society of Urology
  
  

2018-4 — Summary

Investigation and treatment of non-infectious scrotal elefantiázis – case collection and literature review

DOI: 10.22591/magyurol.2018.4.romicsm.163

Authors:
Romics Miklós dr.1, Jósvay János dr.2, Regőczi Tamás dr.3, Nyirády Péter dr.1
1Semmelweis Egyetem, Urológiai Klinika és Uroonkológiai Centrum, Budapest (igazgató: Nyirády Péter dr.)
2Szt. Imre Egyetemi Oktatókórház, Plasztikai Sebészeti Profil, Budapest (osztályvezető: Jósvay János dr.)
3Szt. Imre Egyetemi Oktatókórház, Általános Sebészeti Profil, Budapest (osztályvezető: Máté Miklós dr.)

Summary

Introduction: Scrotal elephantiasis is a rare, benign entity with radical impact on the quality of life. In the Third World chronic lymphedema and enlargement of the scrotum usually occurred due to filariasis or other infections, in more developed countries it mainly happens for other reasons like morbid obesity. Because of its rarity, investigation and treatment of the problem requires special care and coordinated cooperation between the urologist dermatologist and plastic surgeon team.
Patients and methods: In our work, written and visual documentation of 5 cases is presented with the proposed algorithm management of the condition. In addition, we summarize the available knowledge represented in domestic and international literature.
Results: After studying our well documented patients, it can be stated that proper preparation, surgical planning, pre- and postoperative antibiotic and wound management, the surgical solution of the problem can be achieved with good results and high safety.
Discussion: As the aftermath of the increasing incidence of morbid obesity in Hungary, scrotal elephantiasis is likely to become more common in the future, thus it is desired for all urologists to be familiar with the management algorithm of the condition.

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Thromboprophylaxis in urological patients: to whom, how long, too much or too little?

DOI: 10.22591/magyurol.2018.4.molnara.156

Authors:
Molnár Ágnes dr., Villányi Kinga dr., Szántó Árpád dr.
Pécsi Tudományegyetem KK, Urológiai Klinika, Pécs (igazgató: Szántó Árpád dr.)

Summary

Due to the hypercoagulable state induced by surgery, serious complications of urological surgery include deep vein thrombosis and pulmonary embolism – together referred to as venous thromboembolism (VTE) – and major bleeding. Decisions regarding thromboprophylaxis using perioperative and postoperative low molecular weight heparin (LMWH) administration in urologic surgery involve a trade‐off between decreased risk of venous thromboembolism and increased risk of bleeding. Currently, there exists substantial practice variation in the use of thromboprophylaxis in urology, both within and between countries. This variation is unsurprising when one considers that recommendations from national and international guidelines often conflict. Consideration of LMWV administration, timing, dosage and duration are also a matter of debate in international literature. However, the majority of existing guidelines typically suggest thromboprophylaxis for most patients. Both patient‐ and procedure‐specific factors are critical in making an informed decision on the use of thromboprophylaxis.
Our aim is to summarize Guidelines proposal and to provide procedure and patient risk-specific guidance weighing the benefit of reduced VTE with the harm of increased bleeding.

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Funding for urological inpatient care

DOI: 10.22591/magyurol.2018.4.szepesvaryzs.150

Authors:
Szepesváry Zsolt dr.
Petz Aladár Megyei Oktató Kórház, Urológiai osztály, Győr (főigazgató: Tamás László János dr.)

Summary

It is well known that many interventions were not reimbursed at a fair price in Hungarian health care at all levels. Although the HBCS-based funding settles the same cost per category, hospital spending is different for each patient. Most urological interventions are underfinanced nevertheless, the operations must be carried out, and interventions cannot be omitted by the nature of the illness.
In addition to steep financing, expectations are high. High quality and fast patient health care according to European norms, maintenance by the right professional work, patient complaints, litigation, profitable operation, and compliance with the rules are the expectation.
In a new approach, the author tries to demonstrate the minimum and ideal financial conditions of an average county department.
The author determines the minimum required and optimal funding standard of HBCS categories with that the healthcare provider can operate in compliance with professional, safety, law and ethical rules.

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