Cystinuria: definition, epidemiology and clinical aspects.

Cystinuria ia an inheritable autosomal recessive disorder of amino acids transport affecting the epithelial cells of the renal tubules and gastrointestinal tract. It is characterized by abnormal concentrations of cystine and the other dibasic amino acids in the urine, resulting in a risk of renal stone formation because of the low solubility of cystine in urine. According to the recent advances in molecular genetics, two genes have been identified as responsible for this disease (SLC3A1 and SLC7A9), but other unknown genes may be involved in cystinuria.

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.

[The basquet in day hospital].

We use the basket as the first choice method to treat the pelvic ureteral stones, according to the standard technique. In the last two years ('96, '97) the basket has been used in 49 cases (27 and 22 respectively) with pelvic ureteral stone; 4 of them were treated also by ESWL. So, 45 Pz have been treated only by basket and the success was obtained in 43 cases (95.

[T1G3 bladder tumors].

Bladder tumors T1G3 are aggressive and difficult for their staging. Out of 176 p. with tumor pT1, 16 (9%) presented pT1G3.