[Unusual case of inverted papilloma in a fibro-epithelial polyp of the ureter]. / Raro caso di papilloma invertito in polipo fibroepiteliale dell'uretere.

Inverted papilloma of the upper urinary tract is a rare lesion and the differential diagnosis with transitional cell carcinoma is really hard. A case of 49 year-old male with recurrent right flank pain is reported. Excretory urogram suggested a filling defect involving the right mid ureter and bilateral retrograde pyelogram that confirmed a solitary filling defect in the right mid-ureter, while selective urinary cytology was positive for transitional cell carcinoma G1. Conservative therapy was carried out and 2 years follow-up with several excretory urograms and ultrasound studies revealed no recurrence.

[Interstitial laser therapy in benign prostatic hyperplasia]. / Terapia laser interstiziale nell'iperplasia prostatica benigna.

The interstitial laser therapy is a low invasivity system for prostatic benign hyperplasia. We report our experience with Indigo 830e new system where diode laser and optical temperature sensor warrant a laser-induced interstitial thermal therapy able to continuously adjust energy delivery to the tissue.

[Surgical treatment of urologic complications of idiopathic retroperitoneal fibrosis. Our experience]. / Trattamento chirurgico delle complicanze urologiche della fibrosi retroperitoneale idiopatica. Nostra esperienza.

The chief complications of retroperitoneal fibrosis RPF in the ureteric compression ab extrinseco by fibrotic tissue. In the period 1994 to 1999, we treated two cases of idiopathic RPF: the first case a 49 years aged man, presented a left hydronefrosis and bilateral ureteral displacement to the midline. RMN showed widespreads fibrotic tissue in the retroperitoneal space. At operation, the histological findings was that of aspecific fibrositis. The surgical procedure was ureterolysis and lateralization of both ureters with the aid of a wrapping with a pedicled omental graft. The patient was also treated with metilprednisolon, 8 mg-die, for altogether twelve months, Now he is asymptomatic. The second case, a man aged 60, had a compression of both ureter by fibrotic tissue down to the pelvic tract; the histologic picture was the same of that of the first case. A difficult ureterolysis was carried on, plus an omentoplasty and a left ureteral reimplantation to the bladder. Medical treatment followed, following the above scheme. Seven months after surgery the patient is well. This experience of ours urological complications of RPF is confirmatory of the importance of a sound surgical approach and of a tight follow up as well as a sustained corticosteroid therapy in order to prevent relapse.

[Report of 2 cases extragonadal germ cell neoplasia with primary burnt out tumor of the testis]. / Descrizione di due casi di neoplasia extragonadica a cellule germinali in tumore primitivo burnt out del testicolo.

If the histogenesis of the extragonadal germ cell tumor is a still debatable subject, its clinical diagnosis remains a question of no immediate solution. In fact, only the keen histologic evaluation of microfocuses and/or scar tissue in the testis, possibly on the guide of US finding, could give the answer about the primitiveness or not of the extragonadal neoplasia. Which implies, of course, some problems of compliance on the part of young locally symptomless men, especially on the ground of possibly bilateral involvement.

[Pelvic floor rehabilitation as treatment of female urinary incontinence. Our experience]. / Riabilitazione del pavimento pelvico come trattamento dell'incontinenza urinaria femminile. Nostra esperienza.

We refer herein on a simple program of rehabilitation that may be a first approach the treatment of, U.S.I. In our urodynamic service, we treated 38 female patients, affected by this condition, aged between 37-73 years. The same procedure was applied to all the patients, consisting of 10 seances twice weekly, during which we subjected the patients to biofeedback and vaginal electrostimulation of 50 Hz frequency. The results after 3 months were: 38% restored to normal, 51% improved, 11% unchanged; after 1 year were: 27% restored to normal, 49% improved, the remaining unchanged. As a whole, perineal rehabilitation by this technique can be curative in selected cases and, should it be necessary, can be repeated; its advantages are simplicity, low cost and lack of collateral effects. Motivation and compliance on the part of the patients are, anyhow, the chief factor of success. Moreover, the procedure does not preclude alternative treatments. It is suitable to chose cases where surgery is not so, or else is ill-accepted or has failed.

[Sarcomatoid carcinoma of the bladder]. / Carcinoma sarcomatoide della vescica.

Two cases of bladder sarcomatoid carcinoma, a rare tumor (0.3% of all bladder histotypes) are described and the difficult histological diagnosis and the utility of immunoassay markers analysed. Moreover, clinical observations are shortly discussed.

[Eosinophilic cystitis: an incidental diagnosis. An underdiagnosed entity]. / Cistite eosinofila: reperto occasionale. Una realtà clinica sottostimata?

The authors report on two cases of eosinophilic cystitis diagnosed by chance, are reported. Both patients had suffered from prostatic and vesical diseases. Since the endoscopic appearance and clinical manifestation of this disease are aspecific, the diagnosis of eosinophilic cystitis is always made on histological specimen. Even if it has been described as a rare entity, personal opinion is that the real incidence of eosinophilic cystitis is underestimated. The main features of pathogenesis and therapy are also described.

[Repair of vesicovaginal fistula by the Martius technique]. / Riparazione di fistola vescico vaginale secondo la tecnica di Martius.

Vesico-vaginal fistula (VVF) is still an unpleasant complication of female genital system surgery. We report the case of a 57-years-old woman undergone to neoadjuvant radiotherapy and afterwards abdomino-perineal resection who developed after one months a VVF.

[Ileal conduit: our experience]. / Condotti ileali, nostra esperienza.

In the last 100 year, many progresses have been done in the ileal urinary diversion after cystectomy. Although the interest for the continent urinary diversion has increased enormously in the last ten years, the ileal conduit still represents the golden standard. We report our experience.

[Value and limitations of transrectal ultrasonography and computer tomography in preoperative staging of prostate carcinoma]. / Valori e limiti dell'ecografia transrettale e della tomografia computerizzata nella stadiazione preoperatoria del carcinoma prostatico.

A careful evaluation of local tumoral extension is mandatory in patient selected for radical surgery for prostate cancer. Nevertheless, prostatic imaging, achieved with transrectal ultrasonography (TRUS) and CT scan, is often unable to stage accurately the disease. The Authors report a retrospective analysis of 43 patients treated with radical retropublic prostatectomy: their findings support the idea that both TRUS and CT scan are unable to define the extent of the tumor, reaching respectively accuracies of 38 and 46%. From these data they conclude that CT can be excluded from the preoperatory workup of prostate cancer, except in selected patients, at high risk of nodal metastasis on the basis of PSA. TRUS is the mainstay of prostate cancer diagnosis and staging because it guides transrectal biopsies, but any conclusion made exclusively on the base of its imaging seems not reliable.