Early diagnosis of genito-urinary tumours by urinary cytology.

Urinary Cytology, if performed with accuracy, plays an important (sometimes decisive) role in early diagnosis of genito-urinary tumours. It offers many advantages: easiness in carrying out, possibility to repeat the examination at will, painless execution, no invasiveness and restricted cost. The Authors report on their experience in performing cytologic examination on fresh urine specimens, formalin-fixed in Swinnex milliphore-filter and stained according to a slightly modified Papanicolau method (Alcohol 80 degrees + Haematoxylin-). Thanks to a carefully executed technique of concentration and cellular preservation, the Authors were able to obtain complete specimens, interpreted easily, and to identify the main morphologic changes of neoplastic cells, namely the characteristic nucleo-cytoplasmatic alterations. Between 1986 and 1987 the Authors examined 600 patients, admitted to Urologic Dept. of Saronno General Hospital, employing, amongst others diagnostic procedure (cystoscopy, needle biopsy, CAT, ecc.), urinary cytology: they observed 94% of true results (positive or negative for genito-urinary tumours) in comparison with 4% of false positive and 2% of false negative only; these results compared to others, appeared until now, in Medical literature, lead to regard this technique, further improved by more experience in cytology, as a greatly valuable and highly reliable diagnostic method, mainly in early discovery of genito-urinary neoplasms.

Polyvinilpyrrolidone-iodine (P.V.P.-I) bladder irrigation for prevention of catheter-associated urinary infections in patients treated by T.U.R.

The incidence of urinary infection in catheterized patients is very important in those undergoing T.U.R. for bladder neck and prostatic obstructions because the risk of jatrogenic defilement, and any method of preventing, reducing or delaying the occurrence of infection in catheterized patients, should be tooking considerations. Between March 1984 and September 1985 300 male patients, requiring catheterization after T.U.R. for out-flow obstruction (80% benign, 40% malignant prostatic disease, 16% bladder-neck obstruction), were introduced to the trial. All patients were managed by closed drainage system and treated, immediately after T.U.R., by continuous bladder irrigation with saline solution of iodine and polyvinylpyrrolidone (1:150-1:50 in 3000 ml) until elective removal of the post-operative catheter; use of antibiotics was restricted to preoperatory stage. At the elective removal of the post-T.U.R. catheter (between 3d and 7th day) the urino-culture in 79% showed no bacteriuria, in 15% showed mild infection (less than 500.000 organisms/ml) and in 6% revealed a severe infection (greater than 500.000 organisms/ml). At the same time 300 other patients-the control group-underwent to T.U.R. for the same diseases (out-flow obstruction) and received pre- and post-operative antibiotics only without P.V.P.-I irrigation. This treatment revealed sterile urine only in 40% of cases and persistent bacteriuria in 60% of cases. This original method in preventing and treating catheter infection of patients operated of T.U.R. has revealed itself as effective, simple, not too much expensive and without severe side effects.