Urinary symptoms in women with gynecological disorders: the role of symptom evaluation and home uroflowmetry.

OBJECTIVE: The aim of our study was to analyze the effect of gynecological dysfunction on voiding symptoms in women. METHODS: A modified AUA symptom index questionnaire was self-administered and an ambulatory home uroflowmetry was performed, using a specially designed home uroflowmetry apparatus for multiple flow measurements. Urinary symptoms and home uroflowmetry (Home Urodata TM System) were evaluated in 68 women: 34 patients with gynecological dysfunction, and 34 normal controls. A total of 156 urination episodes was recorded, with a mean of 5.4 measurements per patient. RESULTS: Symptom index showed lower values in the group of normal controls than in the group with gynecological dysfunction. Voided volume, peak flow rate and average flow rate were all significantly better in the group of normal controls than in the group with gynecological disorders; the most remarkable changes were observed in patients with genital prolapse and with large uterine fibroma. In both groups the total urine volume was lower between midnight and 8 a.m. (2460 ml), if compared with the total urine volume between 8 a.m. and 4 p.m. (3360 ml) and the total urine volume between 4 p.m. and midnight (3072 ml) (p < 0.05). CONCLUSIONS: Noninvasive home uroflowmetry combines the information of a typical flowchart with uroflow parameters and supplies the physician with multiple consecutive voiding episodes, minimizing the environmental artifacts of the study. In our experience it was found to be useful to evaluate urinary symptoms reported by 18/34 patients (52.9%) with gynecological dysfunction. It can help to select which patients require further urodynamic investigation to improve the diagnostic accuracy and choose the correct treatment.

[Prognosis of breast cancer (T1-4 No Mo) with reference to anatomo-pathological and clinical factors]. / La prognosi del carcinoma mammario (T1-4 No Mo) in rapporto ai fattori anatomo-patologici e clinici.

Using methods of multivariate statistical analysis, the Authors analyse the prognosis of 135 patients affected by No Mo breast cancer treated with radical mastectomy alone. Among eight risk factors examined, "vascular invasion" and "peritumoral infiltration" seemed to have the greatest influence on prognosis. Therefore, more aggressive treatment may be considered for the patients affected by breast cancer with the two factors former quoted.