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Objective: The purpose of this study is to present the role of embolization in the treatment of renal angiomyolipoma (AML) in cases of hemorrhage and to prevent bleeding., Methods: Over a period of 10 years, 35 AMLs in 34 patients, recruited in two medical centers, were treated with embolization: 16/35 AML were treated urgently to stop bleeding, and 19/35 AML had preventive embolization. Six patients were completely asymptomatic and 13 had a history of previous hematoma or flank pain. Catheterization was highly selective in all cases (coaxial microcatheter in 19 cases), and for embolization we used nonresorbable microparticles, coils, and alcohol., Results: When patients presented with acute bleeding, embolization was efficient in 80% of cases; another embolization was necessary in two cases, and surgery in two others. In six of these cases, surgery was planned and done at a later date. When treatment was preventive, one embolization was necessary in 17 cases, and two embolizations per case were necessary in the other two. Over a period of 18 months of follow-up, we observed a 28% decrease in tumor volume; four patients were treated by surgery at a later date., Conclusion: Embolization is the technique of choice to treat a bleeding AML urgently. When preventive treatment is considered, in symptomatic or asymptomatic AML, embolization can be an alternative for surgery, but more data is needed to specify its proper place in the management of these tumors.

Cutaneous transureterostomy was performed in 14 patients, this bypass procedure being necessary in 9 cases for neoplasm (7 after total cystectomy) and in 5 patients for non-neoplastic lesions. The simplicity of this method is emphasized, particularly when compared with Bricker's operation, beneficial effects with respect to the comfort of the patient being similar. However, at least one ureter must be dilated: one failure of treatment was due to narrow ureters and a repeat operation was necessary to exteriorize each ureter on to the skin. The essential problem concerns the skin stoma, if an apparatus is to be fitted without a catheter. In 8 of 12 patients the cutaneous ureterostomy remained patent without artificial assistance. Two operated cases required ureteral catheters, while two others had prosthetic replacement of the foot of the ureterostomy in Y. One patient died after cystectomy for cancer. A new cutaneous and aponeurotic reconstructive mode appears capable of guaranteeing more consistent results.

A double-blind prospective trial investigated effects of Nicergoline on micturitional disorders in 60 selected patients with dysuria in the absence of prostate hypertrophy and neurologic disease. Results evaluated from 29 men treated with the product and 25 receiving placebo, taking into account functional improvement and urinary output variations, showed a statistically significant improvement in patients in the Nicergoline group.

The authors report a case of appendiculoplasty of the right ureter within the context of the course of a bilateral tumour of the excretory tract necessitating conservative surgery with a single remaining kidney. The result is good at three years. The literature is reviewed, there being 13 published cases. Of the 10 cases with a follow-up of more than 1 year, there were only 5 good results and stenosis may develop several years after the reconstructive procedure.

In a series of 118 patients treated by percutaneous nephrolithotomy over a period of 18 months, 12 had staghorn calculi and 4 only one kidney. Punctures were made into the inferior calyx in 94% of cases. Two-plane control was by two brilliance amplifiers. The calculus had to be fragmented before removal in 53 patients. The nephrostomy catheter was left in situ for 3 days, 5 patients requiring a second operation. Results showed successful removal of calculi in 90% of cases, failure of puncture in 1.6%, the impossibility of removing calculi in 3.2% and the presence of residual calculi in 5.6%. Perforated colons in two patients healed spontaneously, two cases of secondary hemorrhage were treated by embolization and there was one death (a patient in a debilitated condition). Increasing experience in the use of the method and a more selective choice of patients should dramatically reduce the incidence of complications.

Lack of reliability of lymphography and morbidity associated with lymphadenectomy lead authors to use lymph node puncture-cytology in assessment of the state of the pelvic nodes in evaluating carcinomas of the bladder and prostate. 38 patients were thus investigated (21 CA prostate and 17 bladder tumours). In 83% of cases the material collected was uninterpretable. Proof of a lymph node metastasis was obtained in 15 cases. 23 cases were further evaluated at surgery, confirming the absence of false positives. 3 false negatives would raise the question of the limitations of the method. The absence of complications would appear to justify this harmless method, with the potential of increasing its reliability by puncture of the majority of opacified nodes regardless of their radiological appearance.

Seventy-two patients with strictures of the urethra were treated by endoscopic urethrotomy over a period of 2 years, the strictures being of iatrogenic origin in 37.5% and of undetermined etiology in 22% Important features of this series were the advanced age of the patients (57% between 60 and 80 years) and the iatrogenic nature of the lesion in many cases. Strictures were perineobulbar in 36 cases, of the anterior urethra in 13, multiple or extending in 6, and of the membranous urethra in 17 cases. Retromeatal and cervical strictures were not included. Urethrotomy (at 12 o'clock) was followed by insertion of a urethral catheter retained for 5 days. Complications included one case of severe infection and 2 cases of epididymo-orchitis. Follow-up has been for from 6 to 36 months. Good results were obtained in 41 cases (57%), with absence of dysuria and lack of the need for dilatation. Results were moderate in 9 cases (12.5%), with functional improvement but altered flow and the need for less than 2 dilatations per year. Treatment was a failure in 23 cases (32%), the condition remaining unaltered and requiring either multiple dilatations or a repeat urethrotomy. Overall therapeutic efficacy was 70%, the poorest results being observed in extensive or membranous urethra strictures.

A report of two cases of aorto-caval and ilio-caval A.V. fistulas, where the authors examine the mechanisms for anuria. The renal venous hypertension, which is due to the arteriovenous shunt, seems to be a determining factor in the occurrence of this unveiling complication, as shown by the roentgenological findings.