Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters?

The lower urinary tract is affected by multiple sclerosis in many patients. We screened urologically and neurologically 120 patients with a confirmed diagnosis of multiple sclerosis. The mean age was 42 years (range 22 to 69 years). Urodynamic investigation as well as neuro-urophysiological investigations were performed in all patients. Renal ultrasound was used to study morphology, and excretory urogram (IVU) was used to assess renal function and the upper urinary tracts in 105 patients. Obstructive symptoms were found more commonly than irritative symptoms. The urinary symptoms were found to be related to disease duration and not to disability status. Urodynamic abnormalities were statistically significantly related to disease duration (X2 = 38.51; P = 0.0001), and to the disability status (X2 = 76.70; P = 0.0001). Few patients, only 3.3%, had upper urinary tract dilatation. With medical management, hydronephrosis disappeared in all of the patients and did not recur. A combination of oral pharmacological agents and clean intermittent catheterization was used in the majority of the patients. We conclude that lower urodynamic abnormalities can be present in every patient with multiple sclerosis, and appear to be related to disease duration and disability status, thus early treatment based upon urodynamic evaluation and close follow-up can reduce morbidity and improve the quality of life.

Evaluation of bladder contractility in men undergoing transurethral resection of the prostate.

OBJECTIVE AND METHODS: We analyzed preoperative and postoperative urodynamic parameters in 26 patients who underwent transurethral prostatic resection with the aid of a computer program. The parameters URA, W and Wmax were evaluated: URA affords a monitoring of the removal of obstruction, while Wmax and W function monitor changes in detrusor contractility, which appear significant after prostatic resection in obstructed patients. RESULTS: Many patients had a fading contraction, that is detrusor contractility decreased during micturition: in most of them the removal of obstruction restored this pattern to normal. CONCLUSION: Evaluation of these parameters is recommended for preoperative assessment and postoperative follow-up.

[Simple renal cysts, biochemical analysis of the cystic fluid, and comparison with blood parameters]. / Cisti renali semplici, analisi biochimica del liquido cistico e confronto con i parametri ematici.

62 specimens of cystic fluid drawn back by ultrasound guided needle-aspiration in 37 males and 25 females were evaluated biochemical analysis including magnesium, calcium, phosphorus, chloride, uric acid, total protein, sugar, urea, creatinine, sodium, potassium, total cholesterol, AST, ALT, ALP, ACP, PAP, alpha-amilasys. In our study Cl, Na and sugar showed similar concentrations in the two fluids. Uric acid, and urea were more concentrated in the cystic fluid while Mg, Ca and total protein were more pronounced in the blood. The results obtained seem to indicate that simple renal cyst could originate from glomerular proximal tubulus part of the nephron as consequence of an obstructive cause.

[Clinical observations about an oligomineral water from the "Funtana Piscamu" of San Leonardo di Siete Fuentes]. / Osservazioni cliniche sull'acqua oligominerale di "Funtana Piscamu" di San Leonardo di Siete Fuentes.

In this study we evaluated the effects induced by the administration of a natural oligomineral water "Funtana Piscamo" di San Leonardo di Siete Fuentes on patient with urinary stone disease. Urine from 30 stone formers attending our metabolic stone clinic were compared with freshly voided urine of 20 normal volunteers. A marked increase in urinary magnesium (p less than 0.001) and a change in the urinary Ca/Mg ratio (p less than 0.005) were the most striking features disclosed in patients with stone disease. This natural oligomineral water drawn from "Funtana Piscamu di San Leonardo di Siete Fuentes" seems to have a long-term efficacy in urinary stone prevention.

[Monitoring of erection function in patients with prostatic carcinoma treated with Casodex]. / Monitoraggio della funzione erettile in pazienti con carcinoma prostatico trattati con Casodex.

This study evaluates the sleep-related erections in 5 patients with locally advanced prostate cancer (T3NOMO) during 6 months treatment with Casodex by multinight continuous monitoring of penile tumescence and rigidity. Mean serum LH, Testosterone and Estradiol levels shown a no statistically significant increase at the six months control. We found no significant modifications in the number of NPT episodes, maximum penile circumference and rigidity time before and after therapy. Penile arterial flow and neurologic examination were also unmodified. All patients had a stable disease and unchanged performance status after 6 months. This pure antiandrogen in a men with prostate cancer does not seem to interfere with self reported libido and erectile capability.

[Qualitative analysis of 1447 patients with urinary calculi in the period 1979-1989 in Sardinia]. / Analisi chimica qualitativa di 1447 calcoli urinari nel periodo 1979-1989 in Sardegna.

In this work we have examined the results obtained from the chemical analysis of 1447 urinary stones. The data concerning the frequency are distinguished according to the sex. Then we examined the difference between frequency of pure and mixed calculi in a sample, analyzing the results obtained by a subdivision in two periods of five years each. Our data are compared with those obtained in other regions of our country.

[Frontal radiogram of the thorax in the present-day diagnosis of the mediastinum. Technic of execution and semeiology]. / Il radiogramma frontale del torace nella moderna diagnostica del mediastino. Tecnica di esecuzione e semeiologia.

The advantages of high kilovoltage and pulmonary filters in frontal chest X ray are described, underliing the possibility of a simultaneous demonstration of both pulmonary fields and mediastinal structures. A description is given of the most important mediastinal lines and of their semeiological value in pathologic conditions. The excellent results obtained by means of hemifiltration in patients with opaque hemithorax are stressed. An increased diffusion of such technique could be justified by its simplicity, and by the low cost and high benefit.