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Publications (13)13.56 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and Objective To assess the oncologic and functional outcomes of testicular sparing surgery (TSS) based on a single institution experience.Methods Forty-one patients with bilateral and 3 patients with solitary testicle tumors were referred to our institution. The inclusion criteria for TSS were normal serum testosterone levels, and tumor size (<2 cm). Sperm analysis and hormone status evaluation were performed preoperatively and postoperatively. None of the patients underwent local radiation therapy following TSS for reasons of fertility preservation.ResultsA total of 26 TSS were performed in 24 patients. The median follow-up period was 51.0 months. Seven patients developed local recurrence, of which 5 had TIN and were subjected to radical orchiectomy, whereas re-do TSS was done in remaining 2 patients. The overall survival of the study group was 100%, and the presence of testicular intraepithelial neoplasia (TIN) was associated with worse recurrence-free survival (P = 0.031, log-rank). Testosterone values were normal in all of the patients, while 4 patients achieved conception.ConclusionsTSS is acceptable from an oncological point of view, and it enables continuation of a patient's life without lifelong hormonal substitution. Additionally, local irradiation therapy could be delayed in patients with TIN who wish to father children, but with high local recurrence rate. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 09/2014; · 2.64 Impact Factor
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    ABSTRACT: To examine the relationship between biochemical markers and morphologic sperm characteristics, including head, neck, and tail changes. The study evaluated 154 patients who went to the Andrology Laboratory of the Clinic of Urology, Clinical Center of Serbia. Patients were divided into 4 groups: normozoospermic, oligozoospermic, severe oligozoospermic, and asthenozoospermic, according to the sperm concentration and motility. The differences in creatine kinase (CK) and CK-M levels between normozoospermic and the 2 groups of oligozoospermic patients were significantly different (P <.01). The CK and CK-M levels correlated negatively with sperm concentration and sperm motility, but correlated positively with the pathologic sperm form. Patients with CK values >0.093 have a total number of pathologic forms higher than 0.40 (87.5% sensitivity, 77.3% specificity, the area under the curve was 0.832, P <.001). Patients with CK values <0.09 U/L have normal spermatogenesis and pathologic disorder of the head <15%, neck <12%, and tail <10%. The relation between sperm morphology and biochemical markers included in the maturation process is established during the sperm genesis process. If the results of these markers are used together with the morphology of the spermatozoa in the interpretation of infertility, it would lead us to better insight of the fertility potential of the each patient.
    Urology 10/2013; · 2.42 Impact Factor
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    ABSTRACT: OBJECTIVE: To evaluate the prognostic factors for survival and disease recurrence in patients treated surgically for upper tract urothelial carcinoma (UTUC), focusing especially on the impact of history of non-muscle-invasive bladder cancer. PATIENTS AND METHODS: A single-center series of 221 consecutive patients who were treated surgically for UTUC between January 1999 and December 2010 was evaluated. Patients who had a history of bladder tumor at a higher stage than the upper tract disease, preoperative chemotherapy, or previous contralateral UTUC were excluded. None of the patients included in this study had distant metastasis at diagnosis of UTUC. In total, 183 patients (mean age 66 years, range 36-88) were then available for evaluation. Tumor multifocality was defined as the synchronous presence of 2 or more pathologically confirmed tumors in any upper urinary tract location (renal pelvis or ureter). All patients were treated with either open radical nephroureterectomy (RNU) or open conservative surgery. Recurrence-free probabilities and cancer-specific survival were estimated using the Kaplan-Meier method and Cox regression analyses. RESULTS AND LIMITATIONS: Fifty-one patients (28%) had previous carcinoma not invading bladder muscle. Previous history of non-muscle-invasive bladder cancer was significantly associated with tumor multifocality (P < 0.001), concomitant bladder cancer (P < 0.001), higher tumor stage (P = 0.020), and lymphovascular invasion (P = 0.026). Using univariate analyses, history of non-muscle-invasive bladder cancer was significantly associated with an increased risk of both any recurrence (HR = 2.17; P = 0.003) and bladder-only recurrence (HR = 3.17; P = 0.001). Previous carcinoma not invading bladder muscle (HR = 2.58; P = 0.042) was an independent predictor of bladder-only recurrence. Overall 5-year disease recurrence-free (any recurrence and bladder-only recurrence) survival rates were 66.7% and 77%, respectively. Previous history of non-muscle-invasive bladder cancer was not associated with cancer-specific survival. Our results are subject to the inherent biases associated with high-volume tertiary care centers. CONCLUSIONS: Patients with previous history of non-muscle-invasive bladder cancer had a higher risk of having multifocal and UTUC with higher tumor stages (pT3 or greater). History of bladder tumor was an independent predictor of bladder cancer recurrence but had no effect on non-bladder recurrence, and cancer-specific survival in patients who underwent surgical treatment of UTUC.
    Urologic Oncology 04/2012; · 3.65 Impact Factor
  • European Urology Supplements - EUR UROL SUPPL. 01/2011; 10(9):601-601.
  • European Urology Supplements - EUR UROL SUPPL. 01/2011; 10(9):599-599.
  • European Urology Supplements - EUR UROL SUPPL. 01/2010; 9(6):586-586.
  • European Urology Supplements - EUR UROL SUPPL. 01/2010; 9(6):616-616.
  • I. Vukovic, D. Djordjevic, P. Nikic, D. Nale
    European Urology Supplements - EUR UROL SUPPL. 01/2009; 8(8):613-613.
  • D. Nale, S. Micic, N. Bojanic, P. Nikic, D. Djordjevic
    Urology 01/2009; 74(4). · 2.42 Impact Factor
  • N. Pakevic, N. Bojanic, N. Lalic, D. Djordjevic
    European Urology Supplements - EUR UROL SUPPL. 01/2009; 8(8):627-627.
  • D. Djordjevic, D. Nale, S. Micic
    European Urology Supplements - EUR UROL SUPPL. 01/2009; 8(8):628-628.
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    ABSTRACT: Penile fracture presents with rupture of corpora cavernosa. It is not rare but is remarkable. Treatment options are controversial. To establish the incidence, what are early and late complications in patients treated surgically or with conservative treatment options (prospective/retrospective and randomized analysis). To find out what therapy verified as superior. The total of 32 patients with typical acute penile fracture were analyzed. The patients were between 20 and 56 years of age (Mean age 40+/-7.25 SD). A total of 11 patients that presented up to 48h after the rupture of tunica albuginea (34.37%) were operated, while 9 patients (28.13%) were conservatively treated. 12 patients (37.5%) reported to andrology consulting room due to penile fibrous alterations and/or erectile dysfunction 6 to 14 months after the anamnesticaly established, typical penile fracture ("primary latent penile fracture"). Both groups of patients were strictly clinically followed 3, 6, 9 and 12 months after the penile fracture. Eventual development of late complications (erectile dysfunction ED, penile curvature, induratio, caverno-urethral fistula and urethral stenosis) was also recorded. Etiology of ED was investigated: anamnesticaly, by hormone and laboratory analysis, using penodynamic test (PGE1), Duplex Doppler echosonography, and dynamic cavernosography. In the operated group of patients, (11 pts, 34.37%) preserved erectile capacity was recorded and no penile deformity or plaque lesions on the site of suture, after the patients were recommended to have 4 weeks of sexual abstinence. The rupture of tunica albuginea was always transversal in relation to penile axis i.e. in relation to axial force against which the penis acts during the intercourse. The rupture is always on the basis or mid penile portion . Out of 21 (65.63%) conservatively treated patients in 13 (61.9%) plaque lesions (longitudinal diameter 2 cm) was recorded, while sexual dysfunction was established in 13 patients (12 with ED and 1 patient with incapability for vaginal penetration). Evaluation of post therapeutical complications in relation to type of treatment, significantly higher frequency was recorded in the group of conservatively treated patients (p<0.01). Penile veno-oclusive dysfunction was registrated as significantly most frequent cause of ED (in 10-76.92% out of 13 patients). All patients with ED had palpable fibrous lesion similar to Peyrone's plaque, while the degree of penile deviation correlated to the size of plaque lesion. The late complications of penile fracture were significantly more frequently recorded in the group of conservative treated patients (p<0.01) which proves that this lesion presents as urgent urological entity. The penile rupture is always transversal, and most probable place of rupture is physiological penile curve since this is the site of weakened structural integrity.
    Acta chirurgica iugoslavica 02/2008; 55(1):107-14.
  • Article: UP01.19
    Urology 01/2006; 68:228-228. · 2.42 Impact Factor