[Role of MCP-1 chemokine in the response of monocytes of patients with superficial tumors of the bladder treated with BCG immunotherapy]. / Ruolo delle chemiochine MCP-1 nella risposta dei monociti di pazienti affetti da tumore superficiale della vescica sottoposti ad immunoterapia con BCG.

Mechanism by which intravesical BCG treatment mediates antitumor activity are currently poorly understood. We initiated studies to determine the sequence and the factors that produce the immunological events. During the inflammatory answer a lot of molecules are produced. Chemokines MCP-1 and RANTES induces the mast-cell recruitment, that begins the "immunological fall". In our study 5 patients with superficial bladder cancer treated with BCG present an improvement of this cytokines correlated with a tumor-free status.

[Half-life of blood PSA after radical prostatectomy. Correlations with pathological stage and clinical course of the disease]. / Vita media del PSA sierico dopo prostatectomia radicale. Correlazione con lo stadio patologico e l'evoluzione clinica della malattia.

PSA half-life was calculated in 37 patients after radical prostatectomy to identify earlier patients with residual disease. The half-life calculated in patients potentially "cured" with absolute PSA values inferior to 0.5 ng/ml after 28 days, was significantly different (P = 0.0008) from the group of patients "uncured" (PSA > 1.0 ng/ml) and from those ones that, despite of detectable PSA level, had evidence of recurrence in the following follow-up. In comparison with the absolute value, the PSA half-life is able to define in the group of patients potentially "cured" those who could have a recurrence in the future.

[Orthotopic continent urinary diversion according to Hautmann: 1989-1995. Physiopathologic, morphologic and urodynamic, metabolic considerations and follow-up]. / Derivazione urinaria continente ortotopica sec. Hautmann: 1989-1995. Considerazioni fisiopatologiche, morfologiche ed urodinamiche, metaboliche e follow up.

The orthotopic ileal neobladder is a completely detubularized, low pressure, high capacity reservoir created from the ileum without any valve. After cystoprostatectomy, a bowel segment of 40-60 cms is dissected free at a distance of 15 cms from the ileo-cecal valve. The bowel is detubularized and configurated in a cylinder. Then the neobladder is anatomized to the urethra and ureters. From 1989 to 1995 20 patients underwent ileal orthotopic urinary diversion according to Hautmann. Two patients died, the others are still disease free (mean follow up 36 months). The high capacity and low pressure allow a good continence control, while among metabolic alterations the most frequent is metabolic acidosis. The ileal neobladder represents a valid alternative to any form of cutaneous urinary diversion and is associated to a low incidence of complications.

[Role of transrectal echography in the evaluation of obstructive seminal vesicle pathology in prostatitis syndrome]. / Ruolo dell'ecografia transrettale nella valutazione della patologia ostruttiva delle vescicole seminali nella sindrome prostatitica.

Prostatitis syndromes are frequent and cause pain and discomfort in adult males. Non bacterial types occur more often than bacterial prostatitis. Transrectal ultrasound permits a perfect evaluation of prostate, seminal vesicles and ejaculatory ducts. Fifty-five patients affected by prostatis syndrome and with negative bacteriological studies, underwent transrectal ultrasonography performed with 7.5 MHz probe. In 38 cases (70%) we found abnormalities such as subacute vesiculitis, asymmetric dilation of the seminal vesicle, dilated and calcific ejaculatory ducts, mullerian duct cyst, utricular cyst and calcification. Ultrasonography is able to detect these lesions that often are responsible of the clinical symptom of the prostatitis syndrome, and may have a therapeutic value through guided transperineal needle aspiration or in the planning specific endoscopic surgery.

[Hemospermia: role of transrectal echography]. / Emospermia: ruolo dell'ecografia transrettale.

Hemospermia is a common benign condition, but is prevalence remains unknown, and can result from several causes. The etiology is idiopathic in about 50% of cases. The advent of transrectal ultrasonography has afforded the opportunity to best evaluate patients with hemospermia. Eighty patients affected by hemospermia were studied with Stamey test, semen analysis and culture, and transrectal ultrasonography (TRUS). Infection was detected in 16/80 of the cases (20%), while in 11/80 patients (14%) was present only excessive white blood cells in expressed prostatic secretions. TRUS showed abnormalities in 70/80 of patients (88%), including periurethral and ejaculatory calculi (42/70 pt., 60%), dilated seminal vesicles (22/70 pt., 31.4%) and müllerian duct cyst (6/70 pt., 8.6%). Stamey test and TRUS are the more usefulness investigations in hemospermia, since they can demonstrate the pathologic causes in about 90% of the cases.

[Acute urinary retention caused by intraprostatic cysts: diagnostic and therapeutic role of transrectal prostatic echography]. / Ritenzione urinaria acuta da cisti intraprostatica: ruolo diagnostico e terapeutico dell'ecografia prostatica transrettale.

There are two type of congenital prostatic cyst, the müllerian duct cyst and the utricular cyst. They are not common and rarely symptomatic. We report a 16-year-old male who presented with acute urinary retention and a 3-month history of urine stream diminished in force and reduced sperm volume. Transrectal ultrasonography showed a prostatic cyst in the midline near the seminal colliculus. Transperineal aspiration of the cyst resulted in return to normal miction and sperm volume.

[Androgen deprivation in benign prostatic hypertrophy]. / La suppression androgénique dans l'hypertrophie prostatique bénigne.

Benign prostatic hypertrophy is the cause of urinary outflow obstruction in the majority of men older than 50 years. Even if the pathophysiology of BPH is multifactorial, its development needs testicular androgens and aging. Androgen deprivation is the only approach that may reduce the hyperplastic state. This article reviews the endocrine aspect of BPH and the various hormonal treatment strategies, concerning clinical efficacy and side effects.