[Topical treatment of erectile dysfunction. Possibilities and perspectives]. / Il trattamento topico dei deficit erettili. Possibilità e prospettive.

In this work the Authors speak about topical treatment in diagnosis and therapy of erectile deficit with prostaglandin, papaverine, phentolamine, V.I.P., nitroglycerine, minoxidil and others. These drugs must have some chemicophysical trait to be adsorbed by the skin. The concepts of microangiotettonic, microangiopathy, microangiokinesis are very important in erectile dysfunctions. For the future there are perspectives to use microvasculokinesic and antiperossidasic complex, alone or in association with intravenous pharmacotherapy.

[The "aging" of the male genital system: erection]. / L'"invecchiamento" dell'apparato genitale maschile: l'erezione.

Between 1/2/89 and 31/1/92 we have studied 300 old patients (the average patient age was 72 years). We used scores of sexual functionality to study the accordances between voluntary and spontaneous erection, the characteristics of the erection per age, the frequency of intercourse per age, the sexual preferences in males and females. Also the partner's extrangement has been valued. These factors together with the socio-economic conditions, in the same body causes represent an important obstacle in the sexuality of the old man.

[Adjuvant chemotherapy in infiltrating bladder carcinoma. Long-term results]. / La chemioterapia adiuvante nel carcinoma vescicale infiltrante. Risultati a distanza.

The authors present the long-term of adjuvant chemotherapy using M-VEC scheme (Mtx 20 mg/mq; vinblastine 0.1 mg/kg; CDDP 40 mg/mq; epirubicin 30 mg/mq each 21 day for six cycles) effected in 28 patients (21 males and 7 women with average age of 67) undergone radical cystectomy for invasive bladder carcinoma p G2-3 T-4 N + M0. Total survival after 5 years was 28.6% while disease-free survival is 18.8%; in 71.3% there are been clinical progression and the mortality to 5 years was 62%.

[Complications of intracavernous pharmacologic infusion in impotence. Long-term results]. / Le complicanze del trattamento FIC nell'impotenza. Risultati a distanza.

The large scale employment in recent years of vasoactive drugs in the treatment of impotence forms the basis for a significant statistical study on incidence of complications and collateral effects. We studied 658 patients submitted to ICF (intracavernous pharmacoinfusion) diagnostic and therapeutic in the last 6 years (1986-1992). The patients have been shared groups according to the period and the treatment: in 226 cases we have utilized papaverine, in 224 cases phentolamine-papaverine association and in 208 cases prostaglandin E1. In the last group the complications have been lower: echymosis and haematoma 0.5%, priapism 1.5%, intracavernous fibrosis 1%, fibrotic knots 0.5%. In conclusion we confirm the validity of treatment with PGE1 intracavernous infusion.

[Adjuvant chemo-immunotherapy with VBL + INF in renal carcinoma. Long-term results]. / Chemioimmunoterapia adiuvante con VBL + INF nel Ca Renale. Risultati a distanza.

Authors show results of adjuvant chemoimmunotherapeutic approach (0, 10 mg/kg Vinblastine every three weeks plus INF - alpha 2a - and INF - alpha 2b in a dose of 3 x 10(6) U.I. three times a week) adopted after radical nephrectomy in 45 patients with renal carcinoma (p. T3/4. NO.MO; pT3/4. N+/O. M+/O). The treatment may be summed up: 1# to effect a regression of metastasis that is not possible surgically to remove either because of its location or extent; 2) to limit micrometastatic diffusion in patients with N+. 3) It is important to perform this treatment in stage T3 N0M0 where clinical progression is (21.1%) in our group.

[Treatment of prostatic pathology with local hyperthermia. Analysis of the results of a study on 60 patients]. / Il trattamento delle patologie prostatiche con l'ipertermia locale. Analisi dei risultati da uno studio su 60 pazienti.

The authors report the results of the hyperthermic treatment employed from January 1989 to April 1991 in 60 patients with BPH, PR and NP. Analysis of the results shows a determinant role for prostatitis (RC: 73.91%); the results for BPH are equally valid (RC: 56.25%). The authors used the same treatment for BPH with initially obstructive urinary symptomatology.

[Percutaneous use of vasoactive drugs in the diagnosis and treatment of erectile impotence]. / Impiego percutaneo di farmaci vasoattivi nella diagnosi e nella terapia dell'impotenza erettile.

The Authors report their experience of topical and intracavernous treatment with papaverine and phentolamine in patients with erectile dysfunction from May 1988 to March 1992. Topical application of drug cream proves efficacious both alone or combined with intracavernous injection with PGE1. Topical treatment besides may be carried out without systemic or local complications.

[A case of Leydig cell tumor of the testis]. / Su di un caso di tumore del testicolo a cellule di Leydig.

Leydig cell tumors represent about 3% of all testicular neoplasms. Actually no specific pathologic criteria has really distinguished the benign from the malignant tumors which represent about 11% of the cases. The presence of metastases is the only unequivocal criteria of malignancy. Authors present a rare Leydigoma case with gynecomastia. Clinical, diagnostical and most of all therapeutical aspects are discussed reconfirming the role of the orchifuniculectomy in T1 N0 M0 stage.

[Neoplasia of the testis: surgical, radiological, and chemotherapeutic approach. Analysis and results of a retrospective study]. / Le neoplasie del testicolo: approccio chirurgico, radioterapico e chemioterapico. Analisi e risultati da un campione storico.

The Authors report the results of a retrospective study in patients with testicular cancer admitted to hospital between January 1979 and July 1991. A total of 59 cases of testicular cancer were treated: 42 seminomatous and 17 non-seminomatous. Radiotherapy was carried out with satisfactory results in patients with stage 1 and 2 seminoma (22 cases). A "wait and see" policy was adopted in 2 cases. The majority of non-seminomatous tumours underwent retroperitoneal lymphadenectomy followed by chemo- and/or radiotherapy (9 cases). Retroperitoneal lymphadenectomy plays a vital role in correct pathological staging and the evaluation of neoadjuvant chemotherapy.

[Occupational factors and andrological problems]. / Fattori occupazionali e problemi andrologici.

The Authors shows effects of various environmental agents on spermatogenesis and testicular androgen synthesis. In particular we analyse a large use of chemical substances as pesticides, biological as the hormones and psychological factors as the overwork. We underline the importance of a careful working anamnesis before a andrologic patient.

[Pharmacologic treatment of benign prostatic hypertrophy (BPH): a combination of mepartricin and simvastatin. Analysis and results]. / Un razionale farmacologico per l'ipertrofia prostatica benigna (IPB): associazione di mepartricina e simvastatina. Analisi e risultati.

The Authors propose a medical treatment for Benign Prostatic Hyperplasia (BPH) using mepartricina-simvastatina, two drugs with a hypocholesterolemizing action. We have treated fifty patients with BPH (twelve with permanent catheters) obtaining a complete clinical results in 40% of the total and a partial clinical result in 38%. This therapy, in association with a correct diet and adequate physical activity, significantly improved not only the cervicurethral obstruction but also general hematochemical and, above all, lipidemic parameters.

[Urotheliomas of the upper excretory tract. Analysis and results after 10 years]. / Gli uroteliomi dell'alta via escretrice. Analisi e risultati dopo dieci anni.

The recent introduction of endourology and accumulated experience has led to the development of concepts regarding the effective role of conservative surgical treatment in cancer of the upper urinary tract. The Authors report their experience in 59 patients with cancer of the upper urinary tract; 36 (61.2%) underwent radical surgery whereas 23 (38.9%) were treated using conservative surgical therapy. The results of this retrospective study confirm the role of conservative surgical therapy in cases at an initial stage of cancer development, together with an attentive endourological follow-up.

[The therapy of plastic penile induration using superoxide dismutase per os and injection combined with vasoactive intracavernous pharmacotherapy]. / La terapia dell'IPP con superossidismutasi per os e iniettiva associata a FIC vasoattiva.

The Authors report their experience of the treatment of IPP using injection and per os superoxide dismutase therapy associated with vasoactive FIC. Ninety carefully selected patients were included in the study. Although a complete recovery was not obtained, pain disappeared and incurvation improved in the majority of patients thus enabling normal sexual activity.

[Our experience with the medico-sexual treatment of premature ejaculation]. / Nostra esperienza nel trattamento medico sessuologico della eiaculatio precox.

The paper examines 66 cases of early ejaculation treated from January to December 1989. Following a short etiopathological review of the literature, the paper illustrates the therapeutical methods used and results obtained using a combined and interdisciplinary medical and sexological approach.

[Metastasis of thyroid carcinoma. A rare case of secondary renal tumor]. / Metastasi da carcinoma tiroideo. Un raro caso di tumore secondario del rene.

Secondary tumours of the kidney are becoming an increasingly frequent pathology due to the accurate follow-up and longer survival of cancer patients. The paper reports a rare case of renal metastasis from a thyroid carcinoma, which started as a Hürthle cell adenoma and was transformed into a carcinoma with a follicular appearance after 26 years. The suspicion of a secondary site was based on the high serum levels of HTG (human thyroglobulin); metastasis was identified following scintigraphic tests using a dual marker (99mTC, 201TL) and renal scintigraphy with 123I Hippuran. The definitive diagnosis was obtained following histological tests; conservative surgery was performed to treat the metastasis (tumorectomy with removal of healthy pericapsular tissue).

[Palliative embolic treatment of synchronous bilateral renal carcinoma with metastasis]. / Trattamento embolizzante palliativo nel carcinoma renale bilaterale sincrono con metastasi.

The paper reports the use of embolic treatment in a case of synchronous bilateral renal carcinoma with caval thrombosis extending to the right atrium. Embolic treatment was also used for a large metastatic mass in the right iliac wing. The problems associated to palliative embolic treatment are discussed together with the relative histopathological aspects and the use of intrarterial IFN.

[Intracavernous pharmacotherapy in men who have undergone cystectomy for neoplasia]. / Farmacoterapia intracavernosa nei cistectomizzati per neoplasia.

Impotentia erigendi is a consequence of radical surgery such as cystectomy due to neoplasia. It is caused by damage to neurovascular structures, and in particular to the nerve fibres of the sacral plexus. Current therapies include the use of penile prostheses or drug therapy. The paper reports the Authors' personal experience of the use of intracavernous drug therapy in 24 patients cystectomised due to vesical carcinoma. Objectively valid results were obtained in 33% of patients. No complications were observed and the treatment represents a valid alternative to mechanical prosthesis.

[Clear-cell carcinoma of the kidney in a patient with hairy-cell leukemia. Immunologic and epidemiologic considerations]. / Carcinoma a cellule chiare del rene in portatore di hairy cell leukaemia. Considerazioni immunologiche ed epidemiologiche.

The paper describes a case of light-cell carcinoma of the kidney in a patient affected by hairy-cell leukemia. The immunological status is assessed revealing a severe deficit of NK phenotype lymphocytes. Therapy with alpha interferon was proposed in order to stimulate killing and recruitment processes of new NK cells.

[Salvage cystectomy. Current indications from a retrospective study]. / La cistectomia di salvataggio. Attuali indicazioni da uno studio retrospettivo.

Salvage cystectomy is a surgical procedure performed for hemostatic purposes in patients with massive hematuria, in addition to playing an symptomatic and humanitarian role. In order to clarify the role and problems connected with this operations, a group of 26 patients (out of a total of 154 cystectomies performed between 1984-1989) were examined. In many cases salvage cystectomy was radical on account of its rapidity and on-going associated immunotherapy and chemotherapy.

[Male-female transsexualization with glandular preservation]. / Transessualizzazione andro-ginoica con conservazione del glande.

The choice of the tissue to build up the neovagina is an important step in the surgical treatment of transsexualism. Both the penile skin and an intestinal segment are possible solutions to the problem. However intestinal segments have some defects like continuous secretions and painful intercourse. For these reasons the authors prefer the penile skin with the neuro-vascular bundle preserved. One hundred cases of this surgery are presented.