[Endoscopic treatment of vesicoureteral reflux in adults with bovine collagen]. / Il trattamento endoscopico del reflusso vescico-ureterale nell'adulto mediante collagene bovino.

Endoscopic subureteral collagen injection has become widely accepted a practiced method for the treatment of vesico-ureteral reflux in children. The aim of this study was to evaluate the efficacy of the treatment in adult patients affected by vesico-ureteral reflux. We have selected 45 patients with primary e 10 patients with secondary reflux (tot. 76 ureters) treated by endoscopic subureteric injection of collagen. The success rate after one injection in primary reflux was 74%. 13 ureters required a 2nd or 3rd injection to achieves success. The minimum follow-up time for the successfully treated patients was 12 months; we did not observe no reflux in 92% of ureters. Endoscopic injection of collagen is a reliable alternative to open surgery.

[Traumatic lesion of the glans penis. Reconstruction using a preputial flap]. / Lésion traumatique du gland. Reconstruction par un lambeau prépucial.

The authors report a case of glans trauma with partial avulsion of the foreskin repaired by means of a foreskin pedicle flap. The cosmetic and functional result was very satisfactory with a follow-up of 36 months.

[Radio-urodynamic evaluation of stress urinary incontinence in women]. / Valutazione radio-urodinamica della incontinenza urinaria femminile da sforzo.

This work is aimed at demonstrating the validity of conventional radiological procedures, correlated with urodynamics, in the study of female urinary stress incontinence. In a study population of 110 patients with a clinical-urodynamic diagnosis of stress incontinence, radiological evaluation was performed by means of retrograde cystography, bead chain cystourethrography, and voiding cystourethrography. Radiographic findings were correlated with urodynamic data, and in particular with urethral pressure profile (functional length of the urethra, maximum closing pressure, maximum urethral pressure). In all patients the posterior urethro-vesical angle values were higher than 100 degrees; moreover, a correlation was proven to exist between an increase in the angle of front urethral inclination, the lowering and mobility of the urethrovesical junction, and the severity of urodynamic findings. Furthermore, in the different stages of urodynamic severity , urethral funneling was most frequent, and the flattening of the posterior vesical floor in voiding cystourethrography. The high reliability of the radiographic findings, although obtained by means of conventional techniques, and the variability of the morpho-dynamic results confirm the importance of a combined radiographic and urodynamic study in the evaluation of stress incontinence.