[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.

[A rare case of bilateral granulomatous orchitis]. / Un caso raro di orchite granulomatosa bilaterale.

A rare case of bilateral granulomatous orchitis is presented and the problems of diagnosis and treatment are discussed. There are no relationships between echography and granulomatous orchitis. At present, granulomatous orchitis remains a disease with a difficult etiology treatment.

[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.

[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).

[Cyproterone acetate in benign prostatic hypertrophy]. / Il ciproterone acetato nella iperperplasia prostatica benigna.

The literature reports that the use of an anti-androgen receptor like CPA is capable of reducing the epithelial component of BPH. The clinical results of the treatment carried out in 20 patients suffering from BPH with a prevalent epithelial component are presented.

[Adjuvant therapy with vinblastine and interferon in metastatic renal carcinoma]. / La terapia adiuvante con VBL + IFN nel carcinoma renale metastatico.

An integrated therapeutic approach was adopted to treat metastatic renal carcinoma, the reason being: 1) to effect a regression of metastasis that could not be attacked surgically either because of its location or extent; 2) to limit micrometastatic diffusion in patients with N+.0.05 mg/kg Vinblastine was used every three weeks in association with alfa-2A-IFN in a dose of 18 X 10(6) U 3 times a week. Included in this study were twelve patients with renal carcinoma subjected to nephrectomy with lymph nodal metastases and with or without remote M+. Without drawing hasty conclusions, this therapy can be said to have a useful role after correct surgical approach.

[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.

[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.

[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.

[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.

[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.

[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.

[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.

[Asymptomatic, right reno-ureteral calculi in a cake kidney]. / Calcolosi reno-ureterale destra asintomatica in "rene a focaccia".

The primary caudal site of the urogenital anlage in the embryo explains why certain positional anomalies occur during cranial migration and are the outcome of various associated factors. A case of ectopic fusion in the ileo-sacral site known as cake kidney whose peculiarity consists of totally asymptomatic right multiple reno-ureteral lithiasis identified by chance is reported.

[Adjuvant M-VEC in advanced urotheliomas of the bladder]. / M-VEC adiuvante negli uroteliomi avanzati della vescica.

The therapeutic efficacy of chemotherapy in bladder's carcinoma is today supported by many statistical reports; the response rates are ranging from 35% to 45%. Results of the treatment with adjuvant chemotherapy (M-VEC in 22 patients with or without metastatic tumor are presented. Favourable objective responses were seen in 25% of the patients. The conclusion is drawn that this therapy is very useful in the treatment of metastatic diseases, but it can be used also in non-metastatic (M0) patients to prevent the growth of micrometastasis.

[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.

[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.