Urologia Journal

Pudendal nerve somatosensory evoked potentials (PN-SEPs), bulbo-cavernosus reflex (BC reflex) and perineal motor evoked potentials (BC MEPs) following transcranial magnetic cortical stimulation (TMS) were performed in patients with primary premature ejaculation (PPE), to investigate the somatic sensory and motor function of the genital area.

A prospective case-control study on simultaneously occurring abdominal aortic aneurysm (AAA) and invasive transitional cell carcinoma of the bladder (TCCB) was carried out to evaluate short- and long-term mortality and morbidity of the one-stage surgical treatment.

Although the majority of renal cell carcinomas (RCC) are sporadic, hereditary types of kidney cancer such as Von Hippel-Lindau (VHL) disease and hereditary papillary renal carcinoma syndromes are thought to account for approximately 4% of kidney cancers. A germline mutation seems to predispose to the development of specific histologic types of RCC. Hereditary kidney cancers are bilateral multifocal kidney tumors that, in some instances, occur at a younger age than do sporadic renal cancers.

A better knowledge of the genetic basis of renal carcinogenesis has been useful in identifying genetic causes of renal tumorigenesis, such as inactivation of the VHL tumor suppressor gene in clear cell carcinoma. Moreover, the genes responsible for hereditary renal cancer syndromes seems to play a role in the development of sporadic counterparts. Knowledge of genetic cancer syndromes may allow clinicians to screen and counsel family members, identify those patients at risk for multiple cancer development, and give the chance to intervene therapeutically when cancers are still treatable by identifying localized tumors through early screening. This article reviews the current status and recent advances in the field of familial kidney cancer syndromes.

ESWL is today the gold standard in the treatment of most cases of urolithiasis. The new generation lithotriptors let an easier patient management, reduce hospitalisation time, optimize therapeutical and economic outcomes. We show our experience first with Storz Modulith SLX from 1996 to 1999 then with Sonolith 4000+ form 1999 until today.

Intrarenal pseudoaneurysms generally derive by renal trauma. They usually present with hematuria after a few time. Angiography combined with embolization represent the best diagnostic and therapeuthic procedure, with a success rate of about 100%.

We report a case of voluminous renal pseudoaneurysm, incidentally discovered and treated with angio-embolization.

Emphisematous pyelonephritis is a rare, life–-threatening infection of the renal parenchyma, most frequently found in diabetic patients. It is due to gas forming bacteria such as E. Coli, Kleibsiella or Citrobacter and is linked with an hight mortality rate sometime also after an appropiate therapy. We describe our experience with a case of emphisematous pyelonephritis in an old diabetic female.

The majority of renal artery aneurysms are clinically silent. They generally growth slowly and may give pain (15%), hematuria (30%), hypertension (55%), spontaneous rupture (10%). We present a case of unusual spontaneous rupture of a renal artery aneurysm.

Our understanding of the natural history of renal cell carcinoma and the possibilities of new technologies are evolving and being integrated with advances in classification and staging. In this article we reviewed the literature in order to provide an analysis of the changing epidemiology of renal cell carcinoma.

Radiological evaluation of renal masses has rapidly progressed from conventional angiography and intravenous urography to ultrasounds, CT and MRI. As more patients are imaged for many opportunities, the incidental detection has increased. This article reviews the imaging and not techniques in order to characterize these lesions accurately.

Surgical resection remains the cornerstone of treatment renal cell carcinoma. In the last 15 years a better understanding of tumor biology and the early diagnosis permitted an evolution of the surgical treatment towards a minimal invasive approach by nephron-sparing surgery. Together with absolute and relative indications, nephron-sparing surgery is performed also as an elective indication, in patients with small, localized, often incidental tumors and a normal controlateral kidney. The oncological outcome in these cases is identical with that of radical nephrectomy. In order to achieve a complete tumor resection with the maximal preservation of unaffected renal parenchyma, tumor enucleation is the best technique when feasible. With the use of the harmonic scalpel, clamping of the renal pedicle and renal ischemia can be avoided in most of the cases during enucleation of small tumors, while the thermal damage in the remaing renal parenchyma is minimal.

Prostate cancer is, today, the most frequent cancer and the second most frequent cause of death for cancer in USA. The watchful waiting approach, that has been traditionally proposed by urological communities in Northern Europe, is still matter of debate. The following review will consider the clinical studies published in Literature and will discuss the most controversial issues.

Transrectal prostatic tumor thermal ablation with High Intensity Focused Ultrasound (HIFU) is an alternative treatment of prostate cancer in non surgical patients.

TRUS-guided transcutaneous cryotherapy in the treatment of the prostatic carcinoma is performed by perineal approach, the intraoperatory monitoring of temperatures and a mechanical hydraulic sonorguided separation between prostate and the anterior rectal wall. Six to eight probes are used, the Argon gas in the freezing phase (-10 °C and -40 °C) and Helio gas for heating phase.

TRUS-guided cryoterapy is a possible therapeutich option in the treatment of localized or locally advanced prostatic carcinoma and after RT, in case of the relapse in alternative to the rescue prostatectomy.

We examined in both procedures the most significant series concerning the oncologic results and morbility.

At present, TRUS-guided cryotherapy represents a mininvasive therapeutic option in selected patients (ASA 2–3).

For the future an evaluation of the survival years compared with quality of life and randomized studies will be necessary.

The modern interstitial brachytherapy plays a first-rate role in the treatment of the organ-confined prostatic carcinoma as a substantial alternative to radical prostatectomy and external beam radiotherapy in selected patients.

Treating prostate cancer, pelvic lymphadenectomy is still a debating topic in current international licterature. Surgical removal of both internal iliac vessels and obturatory fossa lymphonodes is usefull in order to stage lymphatic spreading of prostate cancer. We evaluated possible indications to laparoscopic limphadenectomy according to present know-ledges.

Nelle lesioni traumatiche renali, la metodica angiografica, oltre ad essere di valido ausilio nella diagnosi di sede dell'eventuale emorragia associata, permette una terapia immediata di queste lesioni, evitando così manovre chirurgiche ben più invasive e rischiose.

We report a case of Churg-Strauss syndrome, with bilateral ureteral involvement. We describe the endourological approach to the disease and we also discuss the literature about this argument.

The cryptorchidism is associated with an increased incidence of testicular malignancy. We report a case of a 55-year-old man with a seminoma arising in an uncorrected abdominal undescended testis. The authors analyse the diagnostic aspects and management of seminoma of an undescended testis.