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In recent years stone disease has become more widespread in developed countries. At present the prevalence is 5.2 and 15% of men and 6% of women are affected. The increase is linked to changes in lifestyle, eating patterns and obesity which has become very common. The ‘metabolic syndrome’ includes all the diseases, e.g. hypertension, lipid imbalances, type 2 diabetes mellitus, gout and cardiovascular disease, which are concomitant in the majority of stone formers. Dietary patterns, besides leading to stone formation, also determine stone chemistry. With a diet that is rich in oxalates, calcium oxalate will constitute 75% of stones, struvite 10–20%, uric acid 5–6% and cystine 1%. As approximately 50% of patients with stones suffer recurrences, metabolic and/or pharmacological prophylaxis is recommended. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Focuses on the retirement of Dieter Hauri as Chairman of the Department of Urology at the University of Zürich Hospital and as an editor of the "Urologia Internationalis" journal. Contributions of Hauri on the journal.

Objective: To investigate what changes are endoscopically evident after glycosaminoglycans (GAGs) therapy by hyaluronic acid (HA) and chondroitin sulphate (CS) (Ialuril®) in female patients affected by bladder pain syndrome(BPS)/ interstitial cystitis (IC) or recurrent urinary tract infections (rUTIs). Patients and Methods: 21 female patients over 18 years affected by rUTIs or BPS/IC received intravesical instillation of HA and CS (4 weekly instillations followed by 2 instillations every 2 weeks and 2 instillation monthly). Post-treatment evaluation included cystoscopy and patient assessment of improvement in symptoms and satisfaction on a visual analogue scale (VAS) from 0 to 10. Results: The post-treatment endoscopy showed a positive effect on bladder mucosa morphology. In 2 cases, treatment did not change endoscopic findings and clinical symptoms. In the other patients, when macroscopic features of the bladder mucosa normalized, the clinical picture improved. Conclusions: GAGs therapy by HA and CS (Ialuril) improves the morphology of bladder mucosa in patients with rUTI or BPS/IC. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Although botulinum toxin (BoNT/A) injected into the detrusor muscle improves overactive bladder symptoms in patients with neurogenic detrusor overactivity, how it does so remains unclear. In this study, we investigated whether BoNT/A improves detrusor overactivity by modulating bladder afferent activity. Methods: To do so, during urodynamic assessment, we tested the soleus muscle Hoffmann (H) reflex during bladder filling before and after intradetrusor BoNT/A in patients with Parkinson's disease (PD) and in patients with complete chronic spinal cord lesion (SCI) and detrusor overactivity refractory to conventional therapy. Healthy subjects underwent H reflex studies during urodynamic assessment and acted as controls. Results: Our findings show that BoNT/A injected into the detrusor muscle effectively reduces clinical overactive bladder symptoms in patients with PD and SCI. In healthy subjects and patients with PD, bladder filling [at maximum cystometric capacity, (MCC)] significantly decreased the H reflex size, whereas in patients with SCI, it slightly facilitated the H reflex size. At MCC, in patients with PD, BoNT/A significantly reduced the expected H reflex inhibition, whereas in those with SCI, BoNT/A turned the H reflex facilitation at maximum bladder filling into a slight inhibition. Conclusions: These findings show that BoNT/A injected into the detrusor muscle in patients with PD and SCI modulates bladder afferent activity. Modulation of bladder afferents possibly explains why BoNT/A improves detrusor overactivity. [ABSTRACT FROM AUTHOR]

The ideal lithotripter which all companies hope to achieve in the near future, should be characterized by high efficacy, low impact on the patient's sensitivity to pain and least detrimental action on the surrounding tissues. Yet, even the most modern technology seems to be still very far from achieving these goals. For around 1 year our Department has been using the last generation lithotripter Piezolith 3000® (variable triple-focus). Compared to its predecessor, this machine has some changes such as: a) triple focus module that allows to adjust the focal distance to the size of the calculation, b) greater focal depth ranging from 15 cm in Piezolith 3000® fixed focus to 16.5 cm in the new lithotripter, allowing for an easier and more effective treatment of obese patients, c) increase in power by opening the SW variable focal length (F1: 0.20-3.26 mJ/mm2, F2: 0.08-1.64 mJ/mm2, F3: 0.030-0.41 mJ/mm2). The objective of our work is to assess whether the technical characteristics of the new Piezolith 3000® determine a real improvement in management of urinary calculi. METHODS. 265 patients undergoing ESWL with variable triple-focus lithotripter from January 2008 to January 2009 (Group A) were compared to 265 patients treated with an equal lithotripter Piezolith 3000® fixed focus (Group B). The two groups were homogeneous as for the following variables: age, size and location of the calculi, which are distributed as follows: superior calyx (6), medium (20), inferior (32), renal pelvis (36), pyeloureteral junction (12), lumbar ureter (50), iliac (12), pelvis (6), iuxtavesical (70), bladder (7), multiple sites (14). The ESWL was performed in both groups with ultrasound exclusive point. RESULTS. In Group A the time of fragmentation is lower compared to Group B (p<0.01), with fewer days required for fragment expulsion and lower number of re-treatments (p<0.05). The latter result is probably due to increased average energy applied (2.35 mJ/mm2). However, the increase of this energy results in parallel increased perception of pain during ESWL. CONCLUSIONS. Piezolith 3000® represents a real improvement in the effectiveness of fragmentation but there is, compared to the previous model, a significant reduction in the time of expulsion. This suggests that this variable is affected by other factors. [ABSTRACT FROM AUTHOR]

This work aimed to study the activities of the glyoxalase system enzymes (glyoxalase I (GI) and glyoxalase II (GII) and their gene expression in human bladder carcinomas compared with the corresponding normal mucosa. Samples of these tissues were collected from 26 patients with superficial (SBC) or invasive bladder cancer (IBC) and used to evaluate enzyme activity and gene expression by northern blot analysis. In keeping with the electrophoretic pattern and the expression level of the respective genes, GI activity significantly increased in SBC samples, while it remained unchanged in IBC samples compared with the normal mucosa. In contrast, GII showed a higher activity in the tumour (either SBC or IBC samples) versus normal tissues. These results confirm the role of the glyoxalases in detoxifying cytotoxic methylglyoxal (MG) in bladder cancer. The differing levels of GI activity level and gene expression of GI between the SBC and IBC samples could help in their differential diagnosis. [Copyright &y& Elsevier]

This work aimed to study the activities of the glyoxalase system enzymes (glyoxalase I (GI) and glyoxalase II (GII) and their gene expression in human bladder carcinomas compared with the corresponding normal mucosa. Samples of these tissues were collected from 26 patients with superficial (SBC) or invasive bladder cancer (IBC) and used to evaluate enzyme activity and gene expression by northern blot analysis. In keeping with the electrophoretic pattern and the expression level of the respective genes, GI activity significantly increased in SBC samples, while it remained unchanged in IBC samples compared with the normal mucosa. In contrast, GII showed a higher activity in the tumour (either SBC or IBC samples) versus normal tissues. These results confirm the role of the glyoxalases in detoxifying cytotoxic methylglyoxal (MG) in bladder cancer. The differing levels of GI activity level and gene expression of GI between the SBC and IBC samples could help in their differential diagnosis. [Copyright &y& Elsevier]

The preservation of NANC nerve fibers (producing nitric oxide, NO) is necessary for erection recovery after retropubic radical prostatectomy (RRP). Yet, it is impossible to establish when and if a patient will recover erections; therefore, we investigate the prognostic value of cavernous blood NO levels on this parameter. Nerve-sparing RRP was performed on 14 patients for localized prostate cancer. We evaluated all patients 3 months after surgery by IIEF score: no patients had erections. A cavernous blood sample was also taken to determine NO levels (as nitrite). Patients were evaluated again 18 months after surgery. In six cases, erectile function was compromised, whereas in seven cases, potency was restored. Statistical analysis showed a relationship between nitrite levels in cavernous blood 3 months after surgery and the recovery or erectile function at 18 months. We propose that cavernous NO blood levels are a prognostic index of erection recovery.International Journal of Impotence Research (2006) 18, 198–200. doi:10.1038/sj.ijir.3901392; published online 8 September 2005 [ABSTRACT FROM AUTHOR]