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- The EDAP LT.01 is a second generation shockwave lithotripter which employs ultrasound imaging and piezoelectric shockwave generation. We describe the first 12 months of its use in the treatment of urinary calculi by urologists with no previous practical experience of ultrasonography. A total of 406 calculi (359 renal and 47 ureteric) in 317 patients were treated. Analgesia or sedation was not routinely used and 59% of all treatments were performed as outpatient procedures. The clearance rate of renal calculi smaller than 1 cm was 81%, while that of calculi larger than 3 cm was 80% (mean clearance 77.5%). Lithotripsy of ureteric calculi following retrograde manipulation to a renal site resulted in 94.4% clearance compared with 39% for those treated at a ureteric site; 93% of 684 lithotripsy treatments were either painless or caused only mild pain. Our experience with imaging and treating urinary calculi with the EDAP LT.01 lithotripter has been excellent. Patients are treated effectively and inexpensively as out-patients without analgesia or sedation. [ABSTRACT FROM AUTHOR]

- The technique of transurethral ureterolithotomy for calculi impacted in the intramural ureter is described. Follow-up date on a group of 30 patients treated by this method are presented. Vesicoureteric reflux was found to occur in almost 50% of cases. The presence of reflux was not found to cause symptoms, infection or renal destruction. Therefore transurethral ureterolithotomy is recommended for the removal of intramural ureteric stones not suitable for basket extraction. [ABSTRACT FROM AUTHOR]

Objective: To assess the outcome of epididymectomy as a method of treating epididymal pathology., Patients and Methods: Forty-one patients who underwent epididymectomy between 1990 and 1995 were analysed retrospectively; their clinical records were reviewed and their satisfaction with the outcome and relief of symptoms assessed using a questionnaire and/or telephone interview., Results: Twenty-nine patients with pain were subdivided into three categories depending on the indication for epididymectomy, i.e. post-vasectomy epididymal engorgement (eight patients), complex cystic disease (11) or 'chronic epididymitis' (10). The outcome was satisfactory in 27 of the 29 patients. The best results were obtained in the group who underwent epididymectomy after vasectomy, where seven of eight improved after the procedure. Those with chronic epididymitis had the least favourable outcome, with only seven reporting any improvement in symptoms., Conclusions: Epididymectomy has a valuable role in the management of epididymal pathology in appropriately selected patients.

Objective: To determine the clinical and pathological features, methods and outcome of management in squamous cell carcinoma of the penis (SCCP)., Patients and Methods: A retrospective study was carried out of 42 patients (mean age 63 years, range 28-86) with a histological diagnosis of SCCP. The disease stage, grade, treatment of primary tumour, lymph node disease and survival were recorded; the mean follow-up was 4 years (range 1.5-25)., Results: The disease stage was T1 in 24 patients (57%), T2 in 14 (33%), T3 in three (7%) and T4 in one (2%); the tumour grade was well differentiated in 20 (47%), moderately differentiated in 14 (33%) and poorly differentiated in three (7%). Eight patients had histologically confirmed inguinal node disease at presentation, six of whom underwent lymph node dissection, while two underwent radiotherapy. Five patients developed inguinal node disease during follow-up (mean 10 months, range 4-21). Three of these patients were irradiated and two underwent lymph node dissection. Six patients (14%) had local recurrence, five of whom were managed surgically. One patient developed a local recurrence 11 years after initial surgery. Seven patients died from their disease (17%); four died within 2 years, being patients with high-stage and/or high-grade disease., Conclusions: Modern management should include a standard staging classification and treatment protocols to maximize survival.

Objective: To assess the role of in vivo staining with intravesical methylene blue in predicting tumour recurrence., Patients and Methods: Thirty-nine patients (27 men and 12 women, age range 43-75 years) newly diagnosed with bladder tumours were prospectively studied and followed for a minimum of 2 years. Potential biopsy sites were identified by staining intravesically with a 1% methylene blue solution and compared with random biopsy sites., Results: Biopsy directed by methylene blue staining detected carcinoma in situ more often than random biopsy. Rates of recurrence were similar in both stained and unstained groups., Conclusion: Methylene blue staining does not add significantly to the management of patients presenting with bladder tumours.