(Background) The aim of our study was to evaluate the efficacy and safety of testosterone replacement therapy (TRT) in men with chronic kidney disease and hypogonadism on conservative and hemodialysis treatment. (Methods) The studied population consisted of 38 men on hemodialysis (HD), 46 men with CKD stages II-IV (predialysis group, PreD) and 35 men without kidney disease who were similar in age to others (control group). Serum total testosterone level (TT) was measured, and free testosterone level (fT) was calculated. Hypogonadism criteria according to the EAU definition were fulfilled by 26 men on HD (68.4%) and by 24 men from the PreD group (52%). Testosterone replacement therapy (TRT) with testosterone enanthate in intramuscular injections every 3 weeks was applied in 15 men from HD and in 14 men from PreD. The safety of TRT was monitored by measuring PSA and overhydration. (Results) A significant rise of TT and fT was observed after 3 months of TRT, but no significant changes were observed after 6 and 12 months in the HD and PreD group. An intensity of clinical symptoms of hypogonadism measured by ADAM (androgen deficiency in the ageing male) questionnaire gradually decreased, and the intensity of erectile dysfunction measured by the IIEF-5 (international index of erectile functioning) questionnaire also decreased after 3, 6 and 12 months of TRT in the HD and PreD group. (Conclusions) The applied model of TRT is effective in the correction of clinical signs of hypogonadism without a significant risk of overhydration or PSA changes.

Purpose: In patients with chronic kidney disease (CKD), hypogonadism is more frequent than in the general population and its prevalence ranges between 40% and 60%. The aim of the study was to investigate the prevalence of hypogonadism and its association with kidney function, body composition, inflammatory markers and lipid disorders in patients with CKD. Materials and Methods: The study population consisted of 112 men aged ≥ 40 years in different stages of CKD: 33 participants with eGFR ≥ 60 mL/min/1.73 m², 27 men with eGFR 30– 59 mL/min/1.73 m², 17 predialysis patients with eGFR < 30 mL/min/1.73 m², and 35 men on hemodialysis therapy three times a week for more than 3 months (G5D stage). Total testosterone (TT) levels were measured and free testosterone (FT) levels were calculated. Body composition was assessed using bioimpedance spectroscopy (Body Composition Monitor, FMC). Statistical analysis was performed using Statistica version 13.1. Results: CKD stage was a strong predictor of hypogonadism (providing an information value of 0.83). The weight of evidence technique allowed us to differentiate the high-risk group, which was a group of patients with advanced CKD, defined as eGFR < 30 mL/min/1.73 m². In this group, the likelihood of hypogonadism was 69.23%. Another significant predictor of hypogonadism was lean tissue index (LTI). TT and FT levels were significantly lower in the advanced CKD group in comparison to the control group, whereas prolactin, luteinizing hormone and C-reactive protein levels were significantly higher in the advanced CKD group. The LTI was significantly lower in advanced CKD and was positively correlated with TT and FT. Conclusion: Decreased eGFR and decreased LTI are predictors of hypogonadism associated with CKD. The study results suggest that hypogonadism screening should be carried out when eGFR deceases below 30 mL/min/1.73 m².

Background/Objectives: Radical prostatectomy is a standard treatment for localized prostate cancer. We aimed to compare perioperative outcomes and functional results between laparoscopic radical prostatectomy (LRP) and robot-assisted radical prostatectomy (RARP). Methods: A retrospective analysis was conducted on 120 patients who underwent LRP (n = 60) or RARP (n = 60). Perioperative parameters, including operative time, hospitalization duration, blood transfusion rate, wound healing complications, urinary catheterization duration, urinary tract infections (UTIs), and urinary incontinence, were assessed. Statistical analyses included Student’s t-, Mann–Whitney U, and χ² tests. Results: RARP was associated with significantly shorter operative time, compared with LRP (147.25 vs. 188.30 min, p < 0.0001). No significant differences were observed in hospitalization duration, transfusion rates, or overall complication rates. However, impaired wound healing was less frequent in the RARP group, with a 10% lower incidence, compared with the LRP group (p = 0.0946). Similarly, UTIs occurred less often in the RARP group (six vs. one cases; p = 0.0544). Urinary incontinence was significantly less frequent following RARP, with its incidence being more than twice as low, compared with the LRP group (p = 0.0032). Additionally, the RARP group had significantly lower International Prostate Symptom Scores, with a mean difference of 7.83 points, indicating improved urinary function. No significant differences were found in sexual function (IIEF-5 scores). Conclusions: RARP offers advantages over LRP, including reduced operative time, lower rates of wound healing complications, decreased incidence of urinary incontinence, and improved postoperative urinary function. Further studies with larger cohorts are warranted to confirm these findings and assess long-term functional and oncological outcomes.

Background: Modern radiotherapy techniques have improved the safety of prostate cancer treatment, but acute gastrointestinal and genitourinary toxicity remains a common clinical problem. Early identification of patients who are likely to develop treatment-related adverse effects may help optimize supportive care. This study evaluated the relationships between clinical characteristics, radiotherapy planning parameters, systemic inflammatory biomarkers, and acute pelvic toxicity during hypofractionated radiotherapy. Materials and Methods: We retrospectively analyzed 142 patients with histologically confirmed prostate cancer who underwent external beam radiotherapy at the Provincial Integrated Hospital in Płock, Poland, between October 2024 and March 2026. Clinical, laboratory, and radiotherapy planning data were obtained from institutional electronic records. Laboratory analyses included CRP, creatinine, total leukocyte, neutrophil, lymphocyte, erythrocyte and platelet counts, hemoglobin, and hematocrit. Rectal and bladder toxicity was prospectively graded according to the RTOG/EORTC criteria at 2 and 4 weeks after treatment initiation. Correlation and multivariable regression analyses were performed to identify factors associated with acute treatment-related toxicity. Results: Radiotherapy significantly reduced leukocyte and lymphocyte counts (both p < 0.001) and produced smaller reductions in erythrocyte count, hemoglobin, hematocrit, and absolute neutrophil count (all p < 0.05). Patients who reported rectal or urinary symptoms early during treatment generally continued to experience toxicity later in the treatment course. Rectal and bladder toxicities were positively correlated, indicating that patients with toxicity affecting one pelvic organ frequently developed symptoms in the other. Routine inflammatory biomarkers and most dosimetric parameters showed limited independent value for predicting clinically relevant acute toxicity. Conclusions: Early gastrointestinal and genitourinary toxicity appears to be a useful clinical indicator of persistent treatment-related symptoms during hypofractionated prostate radiotherapy. Early rectal and bladder toxicity was associated with toxicity later during treatment, whereas routine laboratory markers and most dosimetric parameters showed limited independent associations with acute pelvic toxicity.