Mikolaj Przydacz

Introduction: Urolithiasis and renal colic-like pain symptoms are prevalent conditions influenced by many factors, including diet. Regional assessments, particularly in culturally distinct areas, are essential for understanding specific risk patterns and for developing targeted public health strategies and educational programs. Therefore, the aim of this study was to identify associations between urolithiasis, renal colic-like pain symptoms, and diet, including body weight, in a representative sample of adult Poles. Methods: A population-representative online survey of 10,029 adults was conducted using census-based quota sampling to ensure balanced representation by age, sex, and residence across all 16 Polish voivodships, including urban and rural areas. Results: Normal-weight individuals had the lowest prevalence of urolithiasis and renal colic-like pain symptoms; overweight, obese, and underweight persons had higher prevalences (p < 0.001). Eighteen food items were linked to urolithiasis, with beef, legumes, soy, soda, coffee, and fast food found as independent predictors of urolithiasis. Nineteen foods were associated with renal colic-like pain symptoms, with processed meat, soy, legumes, fruit juices, soda, instant meals, and fast food identified as independent predictors of symptoms. Fast food showed the strongest effects, with daily consumption nearly tripling the risk of urolithiasis (OR=2.847; p = 0.001) and increasing renal colic-like pain symptoms by 64.5% (OR=1.645; p = 0.006) compared with no consumption of fast food. Conclusions: This study provides the first comprehensive, population-based analysis of urolithiasis, renal colic-like pain symptoms, and dietary patterns in Central and Eastern Europe. Our findings demonstrate that both conditions are influenced by body weight and a range of dietary factors.

DOI: 10.20452/jmr.2025.19999, Published online: July 29, 2025, Authors: Jakub R. Szymanski, Piotr Chlosta, Mikolaj Przydacz

The effects of erectile dysfunction (ED) and premature ejaculation (PE) on men’s mental health are well-studied, but their link to aggression has been less explored. Thus, we measured associations between ED, PE, and aggression of men in a large representative cohort with well-balanced demographic characteristics. Participants completed computer-assisted web interviews with reliable questionnaires to assess ED, PE, and aggression. These included the five-item International Index of Erectile Function (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the Aggression Module of the Hospital Anxiety and Depression Scale-Modified Version (A-HADS-M). A representative sample of adult men was generated based on the most recent census data, incorporating age and place of residence as quota controls, along with sample size calculations. We interviewed 3001 men, with a mean IIEF-5 score of 18.92 ± 5.04, a mean PEDT score of 7.15 ± 4.26, and a mean A-HADS-M score of 2.71 ± 1.64. We found that aggression was more prevalent in those with ED or PE (p < 0.001). The greater the severity of ED and PE, the greater was the intensity of aggression (Spearman’s rank correlation coefficients of −0.207, p < 0.001 and 0.19, p < 0.001 for ED and PE, respectively). Univariate regression models showed significant links between aggression and both ED and PE across age groups. Multivariate models confirmed that these associations were significant and independent of age, sociodemographic factors, comorbidities, and lifestyle habits (regression coefficients: −0.041, p < 0.001 for ED and 0.028, p < 0.001 for PE). Our findings convincingly demonstrated a consistent association between aggression, ED, and PE, warranting further investigation into the underlying mechanisms of these relationships.

Background: Urinary and sexual symptoms are common following neurological disease, and we aimed to develop multidisciplinary inter‐society evidence‐based management guidelines.Methods: The ADAPTE framework was used, and a systematic search of guidelines published in different languages was performed. Guidelines, consensus statements, and systematic reviews were included, and guideline quality was appraised using AGREE II. Patient representatives reviewed the relevance and suitability of recommendations. A modified Delphi process integrating the Evidence to Decision framework adapted from GRADE and the Oxford Centre for Evidence Based Medicine system was used to reach consensus on recommendation wording and strength.Results: Recommendations were drafted, using guidelines/consensus statements (59 urinary, 50 sexual), systematic reviews (8 urinary, 2 sexual) and others (7 urinary,13 sexual), and wordings/strengths achieved at least 80% consensus through 2 Delphi rounds. Eleven evidence‐based recommendations, 19 good practice statements, and 8 consensus‐based recommendations were made. Individuals with neurological diseases should be asked about urogenital symptoms and undergo targeted physical examination when appropriate. Urinary symptom assessments include urinalysis, bladder diary completion, and post‐void residual volume measurement. Treatments include fluid intake optimization, pelvic physiotherapy, tibial nerve stimulation, and oral medications. Urinary retention is managed by intermittent catheterization. Antibiotics should not be recommended to treat asymptomatic bacteriuria. Suprapubic catheterization is preferred for long‐term catheterization. A comprehensive sexual history should be taken, focusing on multidimensional factors affecting sexual health. Treatments include lubricants, vibrators, and phosphodiesterase‐5 inhibitors. Red flag symptoms warrant a shared‐care approach with specialist colleagues.Conclusions: The 38 NEUROGED recommendations will guide neurologists to comprehensively manage urogenital symptoms reported by individuals with neurological diseases.

The prevalence of urolithiasis and renal colic-like pain symptoms differs by region because of geographical, climatic, dietary, genetic, and lifestyle factors. In addition, reliable data for Central and Eastern Europe are lacking. Therefore, we analyzed the prevalence, correlates, and treatment behaviors for these conditions in a representative sample of 10,029 adult Poles. We used an Internet interview format and based our sample on the latest population census data. The lifetime prevalence of urolithiasis was 12.85% (n = 1289), and renal colic-like pain symptoms during lifetime were reported to be 43.05% (n = 4317). Sociodemographic factors such as age, place of residence, education, marital and employment status, and workplace-related circumstances (particularly exposure to high temperatures) were associated with urolithiasis and renal colic-like pain symptoms; no sex differences were observed. Over 20 conditions correlated with high prevalence of urolithiasis and renal colic-like pain symptoms. Lifestyle habits also influenced prevalence, with salting food increasing the risk of urolithiasis, and smoking and alcohol consumption being linked to renal colic-like pain symptoms. Encouragingly, most participants with urolithiasis and renal colic-like pain symptoms sought and received treatment. These findings, consistent with studies worldwide, provide valuable guidance for developing and implementing effective health improvement programs targeting urolithiasis in Poland.

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The Central European Journal of Urology is an open access quarterly-issued journal, which provides a forum for the presentation of original clinical, experimental and other research studies...

Context: Surgery is the gold standard for the local treatment of primary renal cell carcinoma (RCC), but alternatives are emerging. We conducted a systematic review and meta-analysis to assess the results of prospective studies using definitive stereotactic body radiotherapy (SBRT) to treat primary localised RCC. Evidence acquisition: This review was prospectively registered in PROSPERO (CRD42023447274). We searched PubMed, Embase, Scopus, and Google Scholar for reports of prospective studies published since 2003, describing the outcomes of SBRT for localised RCC. Meta-analyses were performed for local control (LC), overall survival (OS), and rates of adverse events (AEs) using generalised linear mixed models (GLMMs). Outcomes were presented as rates with corresponding 95% confidence intervals (95% CIs). Risk-of-bias was assessed using the ROBINS-I tool. Evidence synthesis: Of the 2983 records, 13 prospective studies (n = 308) were included in the meta-analysis. The median diameter of the irradiated tumours ranged between 1.9 and 5.5 cm in individual studies. Grade ≥ 3 AEs were reported in 15 patients, and their estimated rate was 0.03 (95%CI: 0.01–0.11; n = 291). One- and two-year LC rates were 0.98 (95%CI: 0.95–0.99; n = 293) and 0.97 (95%CI: 0.93–0.99; n = 253), while one- and two-year OS rates were 0.95 (95%CI: 0.88–0.98; n = 294) and 0.86 (95%CI: 0.77–0.91; n = 224). There was no statistically significant heterogeneity, and the estimations were consistent after excluding studies at a high risk of bias in a sensitivity analysis. Major limitations include a relatively short follow-up, inhomogeneous reporting of renal function deterioration, and a lack of prospective comparative evidence. Conclusions: The short-term results suggest that SBRT is a valuable treatment method for selected inoperable patients (or those who refuse surgery) with localised RCC associated with low rates of high-grade AEs and excellent LC. However, until the long-term data from randomised controlled trials are available, surgical management remains a standard of care in operable patients.