Bladder leiomyoma: a rare cause of urinary stress incontinence.

Lejomyoma of the bladder is an uncommon lesion and usually present as small intramural or submucosal lesions. Preoperative evaluation based on careful physical and radiologic examinations must rule out malignant and other lesions. It is readily and successfully treated in most cases with transurethral or open resection. The prognosis of this tumor is excellent and no malignant degeneration has been reported. The most common presentations are obstructive voiding symptoms, irritative symptoms, and hematuria. Occasionally, it may be a cause of urinary stress incontinence. Although this condition is rare, it should be considered in the causes of urinary stress incontinence.

Use of new automated biopsy device for percutaneous testicular biopsy. A preliminary clinical experience.

Testicular biopsy is indicated in the azoospermic patients to determine if the cause of azoospermia is ductal obstruction or testicular pathology and in certain patients who have severe oligozoospermia. The technique traditionally used is an open testicular biopsy. New Automated Biopsy Device has been used successfully for renal diseases. This instrument is now used by the urologist for transrectal prostate biopsy. The aim of this study was to evaluate whether percutaneous testicular needle biopsy with new automated device can replace open testis biopsy or not. 90 testes of 48 patients between 22 and 43 years olf underwent percutaneous testicular biopsy with a new 18-gauge automated biopsy device. Adequate samples were recovered from 90% cases (average 24.77 tubule sections per testis). When needle biopsy and open biopsy samples were compared in 30 testes of 15 patients, complete agreement was obtained in 93%, whereas slight differences in 7%. These results show that percutaneous needle biopsy with new automated systems is cost-effective, quick, safe, repeatable, relatively painless and effective way to obtain largest possible cores through full cut technique. No serious complications were encountered during or after the procedure. The diagnosis were found to be comparable to those obtained by open biopsy. For these reasons, it is concluded that this new technique can replace the open biopsy.

The role of ESWL in the treatment of calculi with anomalous kidneys.

OBJECTIVE: To evaluate the efficacy of Extracorporeal shock wave lithotripsy (ESWL) in renal anomalies. MATERIAL AND METHODS: From 1991 to May 1995. 53 patients with calculi in anomalous kidneys presented to our clinic for treatment with ESWL. Average patient age was 39 years, a range of 6-66 years. These patients (32 male and 21 female) underwent ESWL treatments. ESWL was performed in 27 patients with urolithiasis in duplex system, 18 with horse-shoe kidneys, 4 with unilateral renal agenesis, 2 with pelvic ectopic kidneys, 1 with sigmoid kidney and 1 with L-shaped kidney. RESULTS: Among patients who completed ESWL the rate free of stones was 60.4% and the rate of clinically insignificant residual fragments was 30.2%. No sign of stone disintegration was observed in 2 patients. They underwent open surgery. The shock waves per therapy varied between 811 and 18,101. Double-J stents were placed in 13 patients. CONCLUSION: Most patients with calculi in anomalous kidneys can be managed primarily with ESWL.