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Przydacz M, Chlosta M, Chrobak AA, Rajwa P, Dudek P, Wiatr T, Gronostaj K, Czech AK, Miszczyk M, Skalski M, Dudek D, Chlosta P. Sexual activity in a large representative cohort of Polish men: Frequency, number of partners, correlates, and quality of life. PLoS One 2024; 19:e0296449. [PMID: 38241234 PMCID: PMC10798542 DOI: 10.1371/journal.pone.0296449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/13/2023] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION Sexual activity of men has been evaluated at the population-level in different regions of the world. However, reliable data are lacking for Eastern Europe. Therefore, the aim of this study was to analyze the frequency of sexual activity and the number of sexual partners in a large representative cohort of Polish men. METHODS We performed a cross-sectional investigation with computer-assisted web interviews. Participants were stratified by age (≥18 years) and place of residence. The most recent population census was used to produce a population-representative sample of respondents. Men's sexual activity was then correlated with multiple variables. RESULTS We enrolled 3001 men, representative for age and place of residence, including adequate proportions of respondents from urban and rural areas. Most Polish men were sexually active, predominantly having had sex at least weekly with one partner. Almost 18% of respondents declined sexual intercourse and/or sexual partner in the prior year. The highest sexual activity was observed for men 35-44-years-old (for sex frequency) and 18-24-years-old (for partner number), living in medium-sized cities, employed, and married (for sex frequency) or divorced (for partner number). Erectile dysfunction negatively affected the frequency of sexual activity and lowered the number of sexual partners, although premature ejaculation did not have any effect. Frequency of sexual activity and number of sexual partners correlated well with psychological distress, quality of sex life, and overall life quality. Whereas lifestyle habits including smoking and alcohol intake decreased the likelihood of sexual activity, all analyzed comorbidities did not affect sex life. CONCLUSIONS This study of men's sexual activity was the first population-representative and nationwide investigation performed in Poland. Most Polish men were sexually active and sexual activity correlated with multiple variables including sociodemographic factors, erectile functioning, mental distress, overall and sex-specific quality of life, and lifestyle habits.
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Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Chlosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Pawel Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Przemyslaw Dudek
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Wiatr
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Gronostaj
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Marcin Miszczyk
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Collegium Medicum Faculty of Medicine, WSB University, Dabrowa Gornicza, Poland
| | - Michal Skalski
- Department of Adult Psychiatry, Jagiellonian University Medical College, Krakow, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
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Bilski K, Kozikowski M, Skrzypczyk MA, Dobruch A, Hendricksen K, D’Andrea D, Czech AK, Dobruch J. Sex Remains Negative Prognostic Factor in Contemporary Cohort of High-Risk Non-Muscle-Invasive Bladder Cancer. Cancers (Basel) 2022; 14:cancers14246110. [PMID: 36551596 PMCID: PMC9776018 DOI: 10.3390/cancers14246110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Sex-specific differences in outcomes of patients diagnosed with high-risk non-muscle-invasive bladder cancer (HR-NMIBC) have been reported with controversial findings. This study aims to investigate sex-specific diversities in the treatment and oncologic outcomes of primary HR-NMIBC in a multicenter setting. A multicenter retrospective analysis of 519 patients (388 men and 131 women) treated with transurethral resection (TUR) for primary HR-NMIBC was performed. Univariable and multivariable Cox regression models were used to investigate the association of clinico-pathologic features and generate hazard ratios (HRs). Second-look TUR (reTUR) was performed in 406 (78%) patients. A total of 218 (42%) of patients were subjected to an induction course of intravesical BCG (Bacillus Calmette−Guérin) plus maintenance therapy. The median follow-up was 44 months. Among the entire cohort, 238 (46%) and 86 patients (17%) had recurred and progressed to muscle-invasive disease (MIBC), respectively. Female sex was associated with increased risk of disease recurrence in the entire cohort: HR = 1.94, 95% CI = 1.48−2.55, p < 0.001 and HR = 1.91, 95% CI = 1.39−2.60, p < 0.001 in univariate and multivariate analysis, respectively. In patients subjected to reTUR and treated additionally with BCG, female sex was associated with increased risk of disease recurrence in univariate analysis (HR 1.81, 95% CI 1.07−3.06, p = 0.03), but not in multivariate analysis (HR 1.99, 95% CI 0.98−4.02, p = 0.06). There was no difference between sexes with regard to disease progression. HR-NMIBC diagnosed in females is associated with higher risk of disease recurrence when compared to males.
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Affiliation(s)
- Konrad Bilski
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland
- Correspondence:
| | - Mieszko Kozikowski
- Polish Center of Advanced Urology, Department of Urology, St. Anne’s Hospital EMC, 05-500 Piaseczno, Poland
- Department of Diagnostic Imaging—Quadia, 05-500 Piaseczno, Poland
| | - Michał A. Skrzypczyk
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland
| | | | - Kees Hendricksen
- Department of Urology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - David D’Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria
| | - Anna Katarzyna Czech
- Department of Urology, Jagiellonian University Medical College, 31-008 Cracow, Poland
| | - Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland
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Gronostaj K, Czech AK, Fronczek J, Wiatr T, Przydacz M, Dudek P, Curyło Ł, Szczeklik W, Chłosta P. Changes in neoadjuvant chemotherapy utilization in muscle invasive bladder cancer treatment: a tertiary center retrospective study. Cent European J Urol 2020; 73:13-18. [PMID: 32395317 PMCID: PMC7203766 DOI: 10.5173/ceju.2020.0062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 01/20/2023] Open
Abstract
Introduction The year 2015 brought a major shift in the national health care system in Poland – the diagnosis and treatment of patients with malignant diseases became a priority. Close multidisciplinary collaboration was facilitated to optimize patients’ care. The aim of this study was to investigate temporal changes in neoadjuvant chemotherapy (NAC) utilization in patients who underwent radical cystectomy (RC) due to muscle invasive bladder cancer (MIBC) in a single academic center in Poland. Material and methods Patients who underwent planned curative RC with bilateral pelvic lymph node dissection between January 2013 and December 2018 in a tertiary care center were included in the study. To assess the response to chemotherapy, tumor regression grades (TRGs) were included into the standard pathological examination of RC specimens. Results Out of 183 patients enrolled into the study, 105 (57.4%) underwent NAC before RC. Only 1 (4%) out of 25 patients underwent NAC prior to RC in 2013. The percentage of patients who received NAC in subsequent years were: 4% (1/25) in 2013, 36% (9/25) in 2014, 55.3% (21/38) in 2015, 62.9% (21/35) in 2016, 83.9% (26/31) in 2017 and 89.7% (26/29) in 2018 (p-value for trend <0.001). Thirty patients (28.6%) had complete pathological response to NAC (TRG1), 50 patients (47.6%) showed strong response (TRG2) and 25 patients (23.7%) had weak or no response (TRG3). Conclusions This study showed an increasing utilization of NAC amongst MIBC patients who underwent RC. Close multidisciplinary collaboration is the key to optimizing perioperative care of patients with MIBC.
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Affiliation(s)
- Katarzyna Gronostaj
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | | | - Jakub Fronczek
- Jagiellonian University Medical College, Department of Intensive Care and Perioperative Medicine, Cracow, Poland
| | - Tomasz Wiatr
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Mikołaj Przydacz
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Przemysław Dudek
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Łukasz Curyło
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Wojciech Szczeklik
- Jagiellonian University Medical College, Department of Intensive Care and Perioperative Medicine, Cracow, Poland
| | - Piotr Chłosta
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
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Czech AK, Gronostaj K, Frydrych J, Fronczek J, Przydacz M, Wiatr T, Curyło Ł, Dudek P, Gąsowski J, Chłosta PL. Identification of potential prognostic factors for absence of residual disease in the second resection of T1 bladder cancer. Cent European J Urol 2019; 72:252-257. [PMID: 31720026 PMCID: PMC6830483 DOI: 10.5173/ceju.2019.1908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/22/2019] [Accepted: 09/02/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction The aim of this single centre retrospective study was to analyse the results of second resection (repeat transurethral resection of bladder tumour – reTURBT) after a macroscopically complete resection of T1 urothelial bladder tumour and to identify prognostic factors for absence of residual disease (T0) in the second resection of T1 bladder cancer. Material and methods Patients with T1 bladder cancer diagnosed in a macroscopically complete initial resection who underwent second resection within 12 weeks were included into the retrospective analysis. Based on the presence or absence of residual disease, patients were grouped for further analysis. Univariate and multivariable logistic regressions were performed to identify potential prognostic factors. Results Among the 139 patients who met the inclusion criteria, 96 (69.1%) had no residual disease (T0) and 43 (30.9%) had residual disease in the second resection (including muscle invasive bladder cancer in 2.2%). Adjusted odds ratios (OR) of T0 status obtained from the final model were as follows: detrusor muscle presence in the first resection (OR 3.05; 95% CI 1.12-8.35, p = 0.03), immediate post-operative intravesical mitomycin C administration after the first TURBT (OR 2.52, 95% CI 1.12–5.68; p = 0.03) and primary bladder cancer setting (OR 2.45, 95% CI 1.10–5.47; p = 0.03). Conclusions Our results add evidence regarding the importance of detrusor muscle presence in the first TURBT. Identification of predictors of T0 status at second resection could help design prospective studies assessing the possibility to avoid re-resection in selected patients with T1 bladder cancer without compromising oncological outcomes.
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Affiliation(s)
| | - Katarzyna Gronostaj
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Jakub Frydrych
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Jakub Fronczek
- Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Mikołaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Tomasz Wiatr
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Łukasz Curyło
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Przemysław Dudek
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Cracow, Poland
| | - Piotr L Chłosta
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
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Gronostaj K, Czech AK, Fronczek J, Wiatr T, Przydacz M, Dudek P, Curylo L, Szczeklik W, Chlosta P. Implementation of neoadjuvant chemotherapy in muscle invasive bladder cancer treatment in Poland: a single institution retrospective study. Cent European J Urol 2019; 72:100-105. [PMID: 31482015 PMCID: PMC6715095 DOI: 10.5173/ceju.2019.1892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/04/2019] [Accepted: 06/09/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Even though the survival benefit of neoadjuvant chemotherapy (NAC) in the treatment of muscle invasive bladder cancer (MIBC) is well established, NAC has not been widely used in Poland until recently. The aim of our study was to evaluate the utilization of NAC and its association with survival in MIBC. Material and methods Patients who underwent radical cystectomy (RC) for MIBC between December 2012 and December 2017 were included in the study. Data were collected in the perioperative period and long-term observation was continued up to August 2018. Kaplan-Meier curves were used to estimate the probability of survival. Results A sample of 155 patients with a median age of 65 (IQR: 60–69) years was analyzed. In this group, 79 patients (51%) were treated with NAC prior to RC. Patients in the NAC+RC group were younger, more often had a positive smoking history, and had lower preoperative levels of hemoglobin, white blood cells and C-reactive protein. A 90-day complication rate and mortality were similar in both groups and in the entire cohort were equal to 64.5% and 5.2%, respectively. The overall survival (OS) was on average 150 days longer in the RC+NAC group compared to the RC-only group when patients were followed-up for 3 years (95%CI:3 4 – 267; p = 0.011). Conclusions We demonstrated a high utilization of NAC at our institution. The use of NAC was associated with a better prognosis than RC alone and was not associated with an increased morbidity or mortality. Our results support the use NAC as a safe and effective treatment modality in MIBC.
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Affiliation(s)
- Katarzyna Gronostaj
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | | | - Jakub Fronczek
- Jagiellonian University Medical College, Department of Intensive Care and Perioperative Medicine, Cracow, Poland
| | - Tomasz Wiatr
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Mikolaj Przydacz
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Przemyslaw Dudek
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Lukasz Curylo
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
| | - Wojciech Szczeklik
- Jagiellonian University Medical College, Department of Intensive Care and Perioperative Medicine, Cracow, Poland
| | - Piotr Chlosta
- Jagiellonian University Medical College, Department of Urology, Cracow, Poland
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Skomarovska O, Stefura T, Kainka K, Radziszewski Ł, Czech AK, Gronostaj K, Hessel T, Curyło Ł, Chłosta PL. Assessment of knowledge concerning urology among medical students in Poland. Folia Med Cracov 2018; 58:81-95. [PMID: 30079903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Urological diseases represent a significant health issue worldwide. Presented study aimed at assessing current urological knowledge and confidence in performing urological diagnostic and therapeutic procedures among medical students at Jagiellonian University Medical College in Poland and compare it on different stages of the undergraduate medical education. MATERIAL AND METHODS We designed an anonymous survey distributed among Polish students from 1st to 6th year of medical studies, before and after clinical urology course. Questions concerned general urological knowledge, prostate diseases, erectile dysfunction, and self-reported practical urological skills. RESULTS Overall, 437 respondents participated in the survey. Mean total test score in our study group was 50.08%, mean general urological knowledge score was 53.44%, mean prostate diseases knowledge score was 55.43%, mean erectile dysfunction score was 36% and mean practical skills score was 45.83%. Mean total test score increased with consecutive years of studies (R = 0.58; p <0.001). The risk of an above average total test score was significantly influenced by the urology course (OR = 7.95, 95%CI = 1.81-34.84, p = 0.006) and the year of medical studies (4th-6th vs. 1st-3rd) (OR = 5.16, 95%CI = 3.41-7.81, p <0.001). Practical skills score above average was significantly more frequent in the group after the urology course (OR = 6.75, 95%CI = 1.54-29.58, p = 0.011). CONCLUSIONS Results of this study reveal low mean scores obtained by students, even after completing the urology course, which implies that curriculum requires further development. Urological knowledge and self-assessed practical skills increased with years of medical education. The urology course improved the score obtained in our survey, both in terms of total test score and practical skills.
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Affiliation(s)
- Oksana Skomarovska
- Students' Scientific Group at Department of Urology, Jagiellonian University Medical College, Kraków, Poland.
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