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Bilateral transcatheter embolization of the hypogastric arteries is effective hemostatic treatment for patients with chronic life-threatening bladder hemorrhage from advanced pelvic cancers. We reviewed 9 cases in which this procedure had been done to investigate the immediate results, clinical effects, complications and late results. The minimum followup is 1 year except for 4 patients who were followed until death, which occurred in less than 1 year. Bleeding relapse occurred in only 2 cases and another embolization procedure was done in 1 case without major complications. A considerable decrease in the size of the tumor was noted in 1 patient after the bilateral hypogastric arterial embolization procedure. A rare complication, the Brown-Séquard’s-like syndrome, is discussed.

Transcatheter arterial embolization is a useful technique to manage urological tumors. Herein we describe a new embolic material (isobutyl-2-cyanoacrylate) in 5 cases of renal cancer embolization and in 1 case of bilateral hypogastric embolization for bladder cancer hemorrhage. Isobutyl-2-cyanoacrylate provides a complete, distal and irreversible embolization, making it suitable material in cancer embolization.

The mean percentage of T and B lymphocytes in peripheral blood was tested in 6 patients with renal cancer before and after preoperative transcatheter embolization and radical nephrectomy. While no significant difference was found in B lymphocyte levels compared to those in healthy control subjects a clear impairment in circulating T lymphocyte levels was observed in renal cancer patients who had not been treated. This reduction in T lymphocyte levels persisted after embolization but there was a significant increase after radical nephrectomy.

The cellular immune response has been reported to be impaired in patients with renal cancer and to be increased by removal of the tumor bulk. T lymphocyte levels in the vein of the neoplastic kidney were investigated in 4 patients to assess the presence of a T lymphocyte inhibiting factor produced by the tumor. T lymphocyte levels resulted in significantly decreased tumorous venous blood, whether compared to arterial, contralateral or peripheral blood. A similar result was not found in 10 control patients. Some hypotheses on the nature of this T lymphocyte inhibition are discussed.

A 6 cm.cystic right seminal vesicle was successfully removed using operative laparoscopy. Advantages of the laparoscopic approach over open surgery include excellent exposure of the deep pelvic structures and rapid convalescence. Among the disadvantages are the potential complications associated with laparoscopic transperitoneal access.

A case is described of idiopathic priapism successfully treated by transcatheter embolization of the left internal pudendal artery with autologous clots. The rationale for the use of this new approach in the treatment of priapism is discussed briefly.

During an operation for ureteropelvic junction obstruction an aberrant lower pole renal vessel was sectioned accidentally in a patient with a solitary kidney. Microsurgical techniques allowed for immediate repair of this important part of the renal parenchyma. Microvascular techniques in such instances offer a better surgical solution than partial nephrectomy

Ureteroarterial fistulas are rare, with less than 20 well documented cases reported. We report a case of a fistula between the left external iliac artery and the left ureter in a patient who underwent a previous operation for bladder cancer. The diagnostic and therapeutic approaches in these rare but high risk patients are discussed.