Experience with instrumental chemolysis for urolithiasis.

Purpose: We describe a more efficient solution for calcium magnesium stones, an irrigation technique devised by us, and the indications for and results of our 20-year experience with direct renal or ureteral chemolysis.

Materials And Methods: Renal and ureteral perfusion is performed with 2 coaxial catheters (where the interspace is 1-way circulation), a normal ureteral catheter to a nephrostomy tube or, if the ureter is impractical, a nephrostomy tube after inserting it in a thin catheter achieving coaxial circulation. The perfusion operates by gravity with continuous flow maintaining a negative pressure in the cavities and keeping the circuits sealed during treatment.

[Radical versus conservative therapy in prostatic adenoma. Open adenomectomy].

Our technical procedure for surgical adenomectomy of prostate is the Hey-Delinotte one. Indications for this type of procedure are large adenomas with a volume, estimated by ultrasonography, more than 50 cc. and with significant obstruction and urinary retention.

[Adjuvant interferon alpha in renal carcinoma with a high risk of recurrence. Multicenter pilot study].

Twenty-eight consecutive patients submitted to radical nephrectomy for Robson's stage II-III renal cell carcinoma underwent adjuvant recombinant a-2b interferon, 5 MUI s.c. 3 times a week, for 6 consecutive months.

[Treatment of symptomatic bone metastases of prostatic carcinoma using strontium chloride (Sr-89)].

Until now, patients with a progressive prostatic cancer, in whom all therapies failed and the disease spread locally and distally, was considered "a lost patient"; because it did not exist an effective therapy easily to be used. The skeletal pain control is a serious problem and it is a great responsibility also for the Urologists especially if the patient has not a short survival time and the quality of life is very poor. Physicians feel the need for a systemic, well tolerated and effective therapy also for a long time, uniform and repeatable, able to be efficient for these patients.

[Limitations and complications of the use of the basket].

During the last 15 years the Dormia stone dislodger has been used in 352 cases (80%) out of 435 of ureteral stones: 318 were at ileo pelvic, 34 at lumbar level. 303 ileo pelvic and 21 lumbar stones have been successfully removed (92%). Considering that the probability of stone removal is directly proportional to the ureteral expansibility and indirectly proportional to the volume of the stone, the Basket technique isn't indicated: When the stone is more than 1 cm.

[Neoadjuvant chemotherapy using methotrexate and cisplatin in locally advanced urothelial cancer of the bladder].

Thirty-one consecutive patients with clinically and histologically documented urothelial cancer of the urinary bladder of category T3-T4a, N0, M0 underwent a trial of neoadjuvant chemotherapy before radical cystectomy. All patients received 2 courses of methotrexate 300 mg/m2 day 1 followed by folinic acid rescue days 2 and 3 and cisplatin 100 mg/m2 day 4, q. 3 weeks.

Neoadjuvant medium-dose methotrexate, cisplatin in category T3b-T4a (N0M0) bladder cancer.

Between July 1985 and December 1988, 31 consecutive patients with category T3b-T4a (NOMO) urothelial cancer of the urinary bladder were entered into a phase II study of neoadjuvant chemotherapy with medium-dose methotrexate (300 mg/m2 followed by folinic acid rescue), cisplatin (100 mg/m2 continuous i.v. infusion) every 4 weeks for a total of 4 courses.

Adjuvant medroxyprogesterone acetate to radical nephrectomy in renal cancer: 5-year results of a prospective randomized study.

From July 1, 1979 to June 30, 1983, 136 consecutive patients from 5 centers in Lombardy entered a prospective randomized study to compare 500 mg. adjuvant medroxyprogesterone acetate 3 times a week for 1 year to no treatment following radical nephrectomy for category M0 renal cancer. After a median followup of 5 years (range 42 to 90 months) 40 of 120 evaluable patients (33.

[Hormone receptors and endocrine therapy of renal carcinoma].

One hundred sixty-five consecutive patients with resectable renal cancer entered a cooperative study to evaluate hormone treatment and steroid receptors. Twenty-nine patients with concomitant distant metastases (category M1) received intramuscular medroxyprogesterone acetate (MPA) 500 mg/day for at least two months after the operation. No measurable remission was observed, but 8 of 24 evaluable patients (33%) had disease stabilization for a median duration of 6 months.

Hormone treatment and sex steroid receptors in metastatic renal cell carcinoma: report of a multicentric prospective study.

Twenty-eight patients with metastatic renal cell carcinoma entered a multicentric prospective study to evaluate the response to high-dose medroxyprogesterone acetate (MPA) and testosterone in MPA failures in relation to sex steroid receptors. No objective remission was seen in the 24 evaluable patients, and only disease stabilizations of short duration were achieved in one-third of treated patients. Stabilizations achieved with second line testosterone were all seen in patients unresponsive to MPA.

Adjunctive medroxyprogesterone acetate to radical nephrectomy in category M0 renal cell carcinoma. Preliminary report of a prospective randomized trial.

From July 1979 to December 1981, 83 patients from 6 centers in the Lombardy underwent radical nephrectomy for category M0 renal cell carcinoma. Postoperatively they were randomly allocated to adjunctive medroxyprogesterone acetate (MPA) or to a control group. After the first year of follow-up, the relapse rate was 13% in the controls (5 of 38 evaluable patients) versus 28% in the MPA treatment group (9 of 32).