Lithotripsy in the treatment of urinary lithiasis.

Based on an extensive review of the literature and on our own clinical experience, this article attempts to present clear guidelines for the management of various kidney stones, particularly regarding the extracorporeal shock waves lithotripsy (ESWL) treatment nowadays. Few technical developments have changed medicine more within a short period of time than ESWL. Fifteen years after the first clinical application, ESWL has gained world-wide acceptance as first choice therapy for most forms of urolithiasis.

[Iatrogenic obstructive azoospermia].

Obstructive azoospermia is a common cause of sterility in men. In the past infection played an important role in the aetiology of obstructive azoospermia. Recently, however, the aetiology of obstructive azoospermia appears to be changing.

[Orthotopic ileal neobladder of the Emikock type: technical points and functional results].

Ileal orthotopic neobladder represents, nowadays, the best urinary diversion after cystectomy. Emikock procedure was performed, in our institution, in 26 patients with bladder cancer T2-T4. At 6-60 months of follow-up 3 pts were died with local or at distance neoplastic recurrence, 2 were alive with neoplasms and 21 were NED.

[pT1G3 bladder carcinoma: parameters of a correct therapy].

Between 13.8% and 27% of all superficial bladder cancers are represented by pT1G3 neoplasm. In the Department of Urology of Policlinico S.

[External devices: for which patients?].

Vacuum therapy is a reversible, non-invasive form of treatment for partial impotence, with great success in USA. The story of vacuum therapy begins about 1960, when Osbon developed a vacuum tumescence device which he personally used for more than 20 years. The device was made commercially available many years ago and has been marketed under several names.

[Radical prostatectomy: our experience].

Between July 1989 and June 1994 32 men (48-73 years old) underwent radical retropubic prostatectomy for prostate cancer. 26 patients (70%) presented with symptoms of bladder outflow obstruction. The primary tumour was understaged preoperatively in 5 patients (15.

[TURP: what and when. Indications, results, complications: our experience].

Transurethral resection of the prostate (T.U.R.

[Penile nuclear magnetic resonance (NMR)].

Nuclear Magnetic Resonance (NMR) is a new diagnostic technique with great opportunities of application in the field of the penile pathologies. A new interest for this diagnostic technique was born when the use of vasoactive agents, like papaverine or PGE1, and the use of para-magnetic contrast agents, like gadolinium, were introduced. The introduction of dynamic NMR in andrology allowed a better definition of anatomical details and a better knowledge of penile micro-circulation.

[Urologic laparoscopy: preliminary experience].

Laparoscopy is a safe and reliable procedure for treatment of cryptorchid testicle, varix ligation, staging of lymph nodes in prostatic and in bladder cancer. Recently this procedure is adopted in management of renal cysts. From 2/92 to 7/92, we performed laparoscopic assessment in 31 patients: in 15 cases for varicocelectomy, in 9 for renal cysts, in 2 for lymph nodes dissection, in 3 for preoperatory evaluation, in 1 for unpalpable testicle and in 1 case for ileal perforation in orthotopic neobladder.

[Intracavernous infusion of drugs].

In 1982 Virag presented the initial experience of use in diagnosis and treatment of impotence. PGE1 has been showed a safe and effectiveness drug. From september 1989 to october 1991 210 patients with erectile disorders were managed by I.

[Endocavernous drug infusions revisited].

From the beginning of the eighties papaverine was well established as the drug of choice for diagnosis and management of vasculogenic impotence. In the second half of the eighties decade many authors referred on experimental use of PGE1 in erection disease. PGE1 has been showed a safe and effectiveness drug.

[Complications and limitations of transurethral prostatic resection: retrospective study of 366 patients].

In present paper we report our experience on 366 patients underwent to transurethral resection of prostate from January 1988 to January 1990. All patients were controlled by uroflowmetry and retrograde plus minctional urethrography, with evaluation of the possible immediate and latest complications. Among the latest complications, the most representative had been urethral stricture, occurred in 24 patients (6.

[Complications of percutaneous litholapaxy].

Percutaneous nephrolithotomy has been proved an efficient management of renal calculi. We report, in present review, the complications of PCNL procedure referred by several authors and our casistic since 1985. Major complications occurred in 3-6% of treated patients: severe bleeding, arteriovenosal fistulas, haematoma perirenal, water syndrome, sepsis, DIC, etc.

[Neoadjuvant chemotherapy of locally advanced tumors of the bladder: preliminary experience].

From february 1988 to march 1989, 6 patients with locally advanced bladder cancer (T3b-T4, N0-N1, M0) were treated with 4 courses of neoadjuvant MP chemotherapy (methotrexate 300 mg/mq. + cisplatinum 100 mg/mq). In two patients chemotherapy was stopped because minimal or no response after two courses.

[Possibility of using the piezoelectric lithotriptor in the treatment of severe cavernous fibrosis].

The treatment of serious cavernous corpora fibrosis due to priapism, a prosthesis explantation, iatrogenic causes, or Peyronie's disease, is by now still uncertain. Therefore we tried, when medical and physical therapy failed, to find out the possibility of extracorporeal lithotripter to treat such a complicated cases. From February 88 until now 16 patients underwent extracorporal shock waves treatment, out of 16, 9 had a serious Peronie's disease (a), in 3 fibrosis was a consequence of priapism (b), in 3 of prosthesis explantation (c), 1 patient of cavernosography (d).

[The Wolf piezolith 2300: lights and shadows].

Extracorporeal piezoceramic Wolf lithotripter was developed in West Germany by Ziegler and Associates in collaboration with Wolf GmbH. Piezolith 2300 has no cumbersome water tube and it was constructed as a mobile unit. It requires no patient irradiation, a special room adaptation, a electrodes replacement or any auxiliary staff.