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Introduction: We assessed clinical and urodynamic effects of solifenacin versus mirabegron in women with overactive bladder (OAB) syndrome. Material and Methods: Eighty women with OAB were randomized into 2 groups. In group A, the patients received solifenacin 5 mg once a day for 12 weeks; in group B, the patients received mirabegron 50 mg once a day for 12 weeks. Symptoms were assessed with OAB Symptom Score (OABSS). Patients underwent urodynamic investigation with pressure flow study. OABSS and urodynamic study were performed before and after treatment. Results: Both solifenacin and mirabegron were effective in improving OAB symptoms. Mirabegron showed greater tolerability with fewer patients discontinuing therapy because of side effects. Both solifenacin and mirabegron were effective in improving the storage function in the pressure flow study, but solifenacin showed a significant reduction of the detrusor pressure in the voiding phase with an increase in the postvoid residual urine volume. Conclusions: Mirabegron has shown to be a drug with the better balance between efficacy and tolerability in women with OAB.

Purpose To assess effectiveness and durability of Solifenacin (SS) versus tibial nerve stimulation (PTNS) versus combination therapy (PTNS + SS) in women with overactive bladder syndrome (OAB). Materials and Methods 105 women with OAB were divided randomly into three groups of 35 patients each. In group A women received SS, in group B women underwent PTNS, in group C women underwent combination of PTNS + SS. Improvements in OAB symptoms were assessed with OABSS questionnaire; patients’ quality of life was assessed with OAB-q SF questionnaire. Evaluation of effectiveness of treatments was performed with PGI-I questionnaire. OABSS and PGI-I were also assessed monthly for ten months. Results All treatments were effective on symptoms. PTNS showed a greater effectiveness than SS, but PTNS + SS was more effective than SS and PTNS. Furthermore, PTNS + SS showed a greater duration of effectiveness than PTNS and SS. Conclusions Combination of PTNS with SS showed more effectiveness and more durability than PTNS and SS alone.

Introduction This study compared percutaneous tibial nerve stimulation (PTNS) versus electrical stimulation with pelvic floor muscle training (ES + PFMT) in women with overactive bladder syndrome (OAB). Materials and Methods 60 women with OAB were enrolled. Patients were randomized into two groups. In group A, women underwent ES with PFMT, in group B women underwent PTNS. Results A statistically significant reduction in the number of daily micturitions, episodes of nocturia and urge incontinence was found in the two groups but the difference was more substantial in women treated with PTNS; voided volume increased in both groups. Quality of life improved in both groups, whereas patient perception of urgency improved only in women treated with PTNS. Global impression of improvement revealed a greater satisfaction in patients treated with PTNS. Conclusion This study demonstrates the effectiveness of PTNS and ES with PFMT in women with OAB, but greater improvements were found with PTNS.

Introduction: To assess efficacy and tolerability of a new complementary and alternative medicine (CAM) consisting of vitamins (C and D), herbal products (cucurbita maxima, capsicum annum, polygonum capsicatum) and amino acid L-Glutammina, in the treatment of female Overactive Bladder syndrome (OAB). Materials and methods: 90 consecutive women with OAB symptoms were enrolled in this prospective, randomized, controlled study. Women were divided randomly into two groups of 45 patients each. In group A, women received Solifenacin Succinate (SS), 5 mg. once a day for 12 weeks. In group B, women received CAM, 930 mg, twice daily for 12 weeks. Women were assessed with 3-day micturition diary, Patient Perception of Intensity of Urgency Scale (PPIUS), Overactive Bladder questionnaire Short Form (OAB-q SF) and Patient Global Impression of Improvement questionnaire (PGI-I). Results: 8 patients in group A and 1 patient in group B dropped out from therapy because of side effects. A reduction in the number of daily micturitions, nocturia and episodes of urge incontinence was present with both SS and CAM with statistically highly significant differences, but CAM was significantly more effective than SS. PPIUS and OAB-q SF showed improvements with both SS and CAM with a more significant efficacy of CAM. PGI-I, demonstrated improvements in the two groups of patients with a greater satisfaction expressed by patients treated with CAM. Conclusions: the small number of patients does not permit definitive conclusions; however, the results of the research showed the greater effectiveness and tolerability of CAM.

Introduction: The study evaluates the impact of three different sized (4.5-, 6- and 7-Fr) catheters on pressure-flow studies in women undergoing urodynamic evaluation for lower urinary tract symptoms. Material and Methods: 60 women referred for the evaluation of lower urinary tract symptoms were enrolled in this randomized controlled study. Patients were divided into two groups (A and B) of 30 women each. The patients underwent non-invasive free-flow uroflowmetry with determination of post-void residual urine volume (PVR) and two consecutive pressure-flow studies using two different transurethral catheters. In group A the two consecutive pressure-flow studies were performed using a 4.5-Fr catheter once and a 6-Fr catheter once; in group B the two consecutive pressure-flow studies were performed using a 4.5-Fr catheter once and a 7-Fr catheter once. Patients were also randomized for the consecutive order in which the two different transurethral catheters were used. Results: The pressure-flow parameters were significantly different from the equivalent free-flow findings. The maximum and average flow rate in all pressure-flow studies performed were significantly lower than the equivalent free-flow parameters and the flow time was significantly longer for all pressure-flow versus free-flow studies. Furthermore, there was a significantly larger PVR for pressure-flow than for free-flow measurements. There was no significant difference in maximum flow rate, average flow rate and flow time between 4.5- and 6-Fr pressure-flow studies (group A). However, there was a statistically significant difference between 4.5- and 7-Fr pressure-flow studies (group B) in those uroflowmetry parameters. Detrusor pressure at maximum flow (Pdet.Qmax) and maximum detrusor pressure (Pdet. max) in group A did not show statistically significant differences between 4.5- and 6-Fr pressure-flow studies whereas in group B Pdet.Qmax and Pdet. max were significantly different between 4.5- and 7-Fr pressure-flow studies. Conclusions: A 4.5-, 6- or 7-Fr transurethral catheter may obstruct micturition changing uroflowmetry parameters. A statistically significant difference was found in all but PVR parameters particularly in all detrusor parameters between 4.5- vs. 7-Fr whereas no statistically significant difference was found in all but PVR parameters between 4.5- vs. 6-Fr. We can thus state that pressure-flow findings may be influenced by different sized transurethral catheters. A misinterpretation of pressure-flow findings may have clinical implications on establishing an accurate diagnosis.

Obiective: To assess the degree of satisfaction of women undergoing surgical repair of prolapse, compared with the clinical and urodynamic findings. Materials and Methods: 72 women hospitalized for pelvic organ prolapse (POP) were enrolled in this prospective study. Patients underwent clinical evaluation and urodynamic study before and 4 months after POP repair. Women were assessed for urinary symptoms by micturition diary and patient perception of intensity of urgency scale. Women were also questioned about defecation and sexual life. POP repair was performed in all cases without the use of a mesh. Subjective evaluation was performed by patient global impression of improvement questionnaire. Results: 56 women were evaluable. Improvements were found in all micturition symptoms and in particular in voiding symptoms. Feeling of vaginal bulging disappeared in all patients. A slight improvement was found in constipation; 62% of patients had a normal sexual life but 27% refrained from sexual activity. Judgement of patients was between “much improved” and “very much improved”. Conclusions: Disappearance of the feeling of vaginal bulging was by far the best result. Improvements were found in most of the symptoms particularly in voiding symptoms and urodynamic findings.

Overactive bladder syndrome (OAB) is a chronic disease, the prevalence in the general population is reported to be 14-16%. Anti-muscarinic agents are considered the first-line pharmacological treatment for the management of OAB; although a long lasting therapy is indicated to reach a better control of OAB symptoms an high percentage of patients discontinue the cure after a brief period. Our attempt is to investigate whether the cost of solifenacin succinate may influence the long lasting regimen and patients' drug efficacy.70 consecutive women, with symptoms of OAB were enrolled in this randomized controlled study. In group A, all patients received solifenacin 5 mg by the urologist, without any cost; they were instructed to get the drug once daily for 4 months, differently, in group B, patients need to buy the drug which was administered as in the group A. Frequency, nocturia, incontinence, voided volume, were evaluated by a 3-day micturition diary. Overactive Bladder Questionnaire Short Form (OAB-qSF) was used to assess the impact of OAB symptoms on patients' quality of life (QoL). Urgency was assessed by patient's perception of intensity of urgency scale (PPIUS). Micturition-diary, OAB-qSF, PPIUS, were completed at baseline and after four months.A greater number of patients discontinued solifenacin in the group B who need to buy the drug. We observed significant differences in groups A and B in relation to frequency, nocturia, urge incontinence and voided volume comparing the pre and post treatment symptoms. The patients' perceptions of intensity of urgency and the PGI-I scale showed a significant improvement greater in group A in respect with group B.The cost of anticholinergic may be responsible for both early discontinuation of treatment and incomplete adherence to therapy with unsatisfactory results on symptoms and an incorrect assessment of the effectiveness of the drug by the urologist.

Aims: This study compared the effectiveness of solifenacin succinate (SS) versus percutaneous tibial nerve stimulation (PTNS) in women with overactive bladder syndrome (OABS). Methods: A randomized controlled crossover study of 40 women with OABS was performed. Patients were randomized into two groups. In group A, patients received SS and then PTNS. In group B, patients underwent PTNS and then SS. Voiding diaries, quality of life surveys and patient perception of intensity of urgency questionnaire were performed before and after each treatment. The global impression of improvement questionnaire was performed at the end of the study. Results: A reduction in the number of daily micturitions, episodes of nocturia and urge incontinence were found with both SS and PTNS in all groups, but PTNS showed a greater effectiveness than SS. There was an increase in voided volume in all groups with both SS and PTNS, but patients treated with PTNS had a greater increase. PTNS showed greater effectiveness in patient perception of urgency and quality of life. Conclusion: This study demonstrates the effectiveness of SS and PTNS In women with overactive bladder symptoms. However, greater improvements were found with PTNS.

This study was performed to assess the feasibility and possible advantages of bowel sonography after fluid filling of intestinal loops compared with conventional sonography. Forty-five consecutive patients with known or suspected coeliac disease (35 females, ten males; age range 11–65 years) prospectively underwent sonography before and after ingestion of 750 ml of an aqueous solution of polyethylene glycol. Results before and after fluid distension were compared to assess whether luminal filling improved small-bowel visualisation. Luminal filling improved visualisation of intestinal features (luminal diameter, mucosal folds, parietal layers) in 77.6% of cases (marked, moderate or mild improvement in 2, 16 and 17 patients; 4.4%, 35.5% and 37.7%), respectively, and showed no change or worsening in 20% and 2.2% nine and one patient), respectively. Baseline examination showed abnormal features in 13/25 celiac patients (dilated fluid-filled loops, increased peristalsis, transient intussusception, mesenteric lymph nodes, intraperitoneal fluid). Reexamination after luminal filling showed additional abnormalities in six of the previous 13 and in three further coeliac patients. There were no false positive signs due to fluid administration. Luminal filling can improve visualisation of bowel walls and fold pattern and may be helpful in selected cases.

The aim of the study was to evaluate, in a group of female patients with urinary incontinence (UI), the effect of aging on: a) urodynamic findings; b) incidence of detrusor overactivity; c) types of urinary incontinence; d) pelvic organ prolapse; e) body mass index; f) anorectal disorders.Eighty four consecutive patients with urinary incontinence were enrolled in this study. Patients were divided into two groups according to their age: group A: patients with ageor = 65 years, group B: patients with age65 years. Patients underwent a full urogynaecological workup with a clinical evaluation and urodynamic study.In older patients urge and mixed urinary incontinence were the most prevalent type of (UI). In these patients an increase of the bladder sensation with a decrease of the bladder capacity, an increase of detrusor overactivity and a reduction of the maximum urethral closure pressure were found. Furthermore, a higher body mass index was observed in older patients.The results of this study show an age-associated correlation of types of urinary incontinence, urodynamic findings, body mass index and incidence of detrusor overactivity.

A prospective study was conducted on 62 female patients with overactive bladder syndrome, to check for differences in clinical profiles, subjective symptoms and urodynamic findings, between patients with or without cystometric evidence of detrusor overactivity (DO). Later both groups of women were assessed for the effect of an antimuscarinic agent, solifenacin succinate (SS), on the considered parameters.Each patient underwent a full history, a physical examination, urinalysis and a urodynamic study. Provocative manoeuvres - cough, postural changes - were used when the cystometric study was performed. Hence two groups of patients were formed, divided according to the presence or absence of DO at the cystometric study: patients with overactive bladder syndrome (OAB) with DO (29), patients with OAB without DO (33). The two groups were compared before and after treatment with SS.When we compared the two groups, before treatment with SS, we saw statistically significant differences in just a few of the parameters assessed in the clinical profiles: patients with DO had a higher rate of constipation; whereas patients without DO had a higher rate of stress incontinence and a larger number of deliveries. Following treatment with SS, in both groups, significant differences were shown in subjective symptoms and urodynamic findings, with a reduction of the numbers of voids and incontinence episodes and an improved urge score. A significant increase in bladder capacity during the cystometric study was shown only in patients with DO. Whereas no statistically significant improvement was shown in patients without DO. Treatment with SS was connected with delayed involuntary detrusor contractions during cystometry and a reduction of their number and amplitude. Finally, SS did not produce any significant negative effects on detrusor function during voiding.The findings of this study suggest that it is important to conduct a urodynamic study in patients with OAB, to check for DO. In our experience, treatment with SS was shown to be effective only in patients with involuntary detrusor contractions at the cystometric study.

The aim of the study was to evaluate differences in urodynamic findings in women with urinary incontinence between subjects with or without intrinsic sphincter deficiency (ISD).Sixty consecutive female patients with a history and urodynamically confirmed diagnosis of pure urinary incontinence were evaluated. Patients were divided into two groups according to their abdominal Valsalva leak-point pressure (AVLPP) values using a cutoff of 60 cm H(2)O: group A patients with AVLPP/=60 cm H(2)O and group B patients with AVLPP60 cm H(2)O.Qmax and Qave in group A were higher than in group B; flow time was significantly shorter in group A than in group B. PVR in group A was lower than in group B. In pressure flow study, all detrusor findings in group A had a pressure value lower than in group B. MUCP in patients with AVLPP/=60 cm H(2)O was significantly lower than in group B, but the degrees of specificity and sensitivity in group A and B were 90% and 43.3%, respectively.The results of this study confirm a more efficient bladder emptying in patients with AVLPP/=60 cm H(2)O.

Objectives: The aim of this study was to evaluate the importance of a) urethral and/or vaginal infections caused by common germs or Mycoplasmas, Chlamydia, Candida; b) age of patients; c) pelvic floor disorders in the development of irritative urinary symptoms in women. Methods: 77 consecutive abacteriuric symptomatic female patients were compared with 55 asymptomatic women. A detailed micturition history and a genitourinary physical examination were performed. Urine samples as well as vaginal and urethral swabs were taken for cultures. Results: No statistical difference was found between the two groups regarding both urethral and/or vaginal infections and pelvic floor disorders. Whereas a significant statistical difference was found in the age of the patients. In the symptomatic group the women were older than in the asymptomatic group. Conclusions: The results of this study confirm that ageing is a very important cause in the development of the lower urinary tract symptoms in women.

The aim of our prospective study was to evaluate the diagnostic accuracy of MR Enteroclysis (MRE) to assess the extension and complications of Crohn's Disease (CD) in comparison with conventional enteroclysis (CE).The study comprised 30 consecutive patients affected by Crohn's disease (18 women and 12 men; age range 16-76, mean age 40.6 years), who underwent conventional and MR enteroclysis. The MR enteroclysis protocol includes three sequences: coronal and axial FIESTA and ssFSE sequences and T1-3D-FSPGR sequences before and after intravenous injection of gadolinium, acquired after administration of 1.6-2 l of iso-osmolar polyethylene glycol solution via a nasojejunal catheter. Two radiologists blindly scored each sequence for opacification of the lumen, small bowel distension and image quality and evaluated the following parameters: presence of wall ulcers, pseudopolyps, stenoses and fistulae.The accuracy of the FIESTA sequence was significantly higher (p0.01) than the ssFSE and 3D FSPGR sequences in the evaluation of lumen opacification and bowel distension, and for the overall quality of the images (p0.01). The sensitivity and specificity of MRE were 82% and 100% for the visualisation of parietal ulcers, 87% and 100% for pseudopolyps, 100% and 88% for stenoses, 75% and 100% for parietal fistulae. High-grade stenoses with prestenotic dilation (n=6) and low-grade stenoses (n=9) were visualised both by MRE and CE. MRE also showed abscesses in two patients, not seen at CE. The FIESTA and ssFSE sequences had higher accuracy in the detection of wall ulcers and fistulae, whereas the 3D FSPGR sequences showed higher accuracy in the evaluation of wall thickening.MRE is able to demonstrate the spectrum of superficial, intramural and exoenteric alterations in Crohn's disease and closely correlates with CE in demonstrating alterations of the bowel lumen and wall.

Objective: To evaluate the relation between post-voiding residual urine (PVR) and urodynamic findings, voiding patterns, and the degree of prolapse in women with cystourethrocele. Patients and Methods: According to the average PVR value measured by means of catheterization after three separate and spontaneous micturitions, 73 women with minimal urethral hypermobility (n = 8) or colpocystocele (n = 65) were subdivided into 3 groups: group 1 = patients with a PVR of ≤50 ml; group 2 = patients with a PVR of >50 ml and ≤150 ml, and group 3 = patients with a PVR of >150 ml and ≤500 ml. The patients underwent a thorough physical examination, and prolapse was evaluated and graded. The women then underwent a complete urodynamic investigation. The 3 groups of patients were statistically correlated according to the urodynamic findings, voiding patterns and degree of prolapse. Results: A large PVR in women with cystourethrocele was often associated with poor maximum flow rate, intermittent flow and with the highest degree of prolapse. Conclusion: The present study suggests that uroflowmetry is a very simple, noninvasive, but also essential method of investigation in evaluating female patients with cystourethrocele, particularly when a large PVR is suspected.

To evaluate the usefulness of MRCP, before and after secretin administration, in diagnosing Santoriniceles in patients with pancreas divisum.One hundred and eight patients with suspected pancreatic disease, underwent dynamic magnetic resonance cholangiopancreatography (MRCP) before and after secretin administration (S-MRCP). S-MRCP images were evaluated for presence/absence of pancreas divisum, Santorinicele; size of the main pancreatic duct and of the Santorinicele. The onset of duodenal filling was calculated on dynamic S-MRCP images. S-MRCP findings were compared to endoscopic retrograde cholangiopancreatography (ERCP) ones (39/108).Pancreas divisum (PD) was detected in 6/108 patients (6%) at MRCP, and in 16/108 patients (14%) at S-MRCP. ERCP confirmed the diagnosis in 12/16 patients, with 1 false positive. 3 patients did not undergo ERCP. Santorinicele was detected in 4/108 (3%) patients at MRCP and in additional 4/108 (3%) patients at S-RMCP, only in patients with PD. Santoriniceles were confirmed in 7/8 patients at ERCP; in 1/8 patient CPRE was unsuccessful. The duct of Santorini was significantly larger (p0.05), in the pancreatic head, in patients with PD and Santorinicele (3.6 mm) compared to those with PD only (2.2 mm). A significant reduction in size of the pancreatic duct (26%) and of the Santorinicele (63%) was observed after sphincterotomy. The onset of duodenal filling was significantly delayed in patients with Santorinicele (2.1 vs 1.3 minutes)(p0.05).S-MRCP helps to identify patients with pancreas divisum and Santorinicele, a known cause of impeded pancreatic outflow which benefits from endoscopic treatment.

To evaluate the possible optimization of a well-tolerated and versatile method of intestinal preparation able to adequately free the lumen and consequently improve diagnostic results with a lower risk of prolonged hospital stay for incorrectly prepared patients.We examined 40 patients, namely 20 men (mean age 70 years, range 52-87) and 20 women (mean age 68 years, range 49-81) referred to the Institute of Radiology of the Università Cattolica del Sacro Cuore, Gastrointestinal tract Unit, to undergo double contrast colonic enema. The patients were divided into two groups by one-to-one randomization: group 1 was prepared with the conventional method and group 2 with the new protocol for intestinal preparation. On the two days before the examination a low-residue diet was administered; the day before the examination a phial of Fosfo-soda fleet was administered in two times (at 8 am and 4.30 pm), which was diluted with half a glass of water. Bread, pasta and vegetables were strictly forbidden at lunch and soup or milk at supper; the patients were fasted on the examination day. Two evaluations were performed: one to assess tolerance to the preparation and the other, a radiographic study, to assess the grade of intestinal preparation, the presence of secretions/bubbles, and the degree of painting.Of the 20 patients given X-prep, 3 had to discontinue it and 4 exhibited severe side-effects, but completed the treatment; tolerance was satisfactory in the remaining 13 patients. The grade of intestinal preparation, the presence of secretions/bubbles, and the degree of painting were considered satisfactory in 9, 17 and 16 patients respectively. None of the patients given Fosfo-soda fleet had to discontinue it and tolerance was satisfactory in 19 patients. The grade of intestinal preparation, the presence of secretions/bubbles, and the degree of painting were considered satisfactory in 15, 18 and 18 patients respectively. The statistical analysis of all data was performed with Wilcoxon test.Intestinal preparation with Fosfo-soda fleet appeared to be definitely better than the conventional method relative to tolerance (p = .02, a statistically significant difference), while providing similarly satisfactory data relative to the other parameters.Our results, coupled with the versatility of Fosfo-soda fleet (possible application in colonoscopy) and its ease of use recommend this preparation not only for inpatients but also for outpatients in whom self-administration is feasible.

Thirty-two female patients affected by urinary incontinence were enrolled for rehabilitative treatment (functional electro-stimulation by vaginal electrode performed three times a week for one month followed by biofeedback performed three times a week for one month). Complete clinical and urodynamic studies, urethrocystography in order to allow Blaivas and Olsson radiologic evaluation were performed. Echography of the bladder and urine cultures were done too. Patients with severe urogenital prolaxus and obesity, neurologic urinary disorders and surgery for incontinence, were excluded. The same patients were urodynamically reassessed at the end of the treatment and a detailed clinical evaluation was obtained from each patient. 78% of patients reported a considerable improvement in clinical symptoms and only 9% reported no improvement. Urodynamic findings showed an increase of maximum cystometric capacity in 6 patients, improvement of maximum urethral closure pressure and/or functional profile length in 17 patients. Disappearance or reduction of involuntary detrusor contractions were found in 2 out of 6 patients with unstable bladder.

A total of 60 patients with transitional cell carcinoma of the bladder G1-G2, pTa pT1 previously subjected to TUR, were randomised to receive Mitomycin-C (MMC) 30 mg for 12 months (A group) or Mitomycin-C 40 mg for 6 months (B group). The objective of this trial was to compare the prophylactic activity of MMC using two different dosages and treatments. All patients were evaluated with cystoscopy. Follow-up was of 24 months. The incidence of recurrence in the A group was 40% with a recurrence rate of 3.3. In the B group the incidence of recurrence was 27.6% with a recurrence rate of 2.2. One case of progression was present in the A group. The side effects were more frequent in the A group (37% vs 13.3%) and they were mainly due to chemocystitis. These data suggest that MMC 40 mg for 6 months appears to be superior to MMC 30 mg for 12 months in the prophylaxis of superficial bladder carcinoma.

The oncocytic cell is an epithelial cell with granular eosinophilic cytoplasm extremely rich in mitochondria. It may be observed in different parenchymal tumors of the kidney: oncocytoma, granular cell carcinoma (oncocytic adenocarcinoma), clear cell adenocarcinoma. Renal oncocytoma, a benign tumor, is made up exclusively of regular oncocytic cells.In granular cell carcinoma (oncocytic adenocarcinoma), different aspects of malignancy are present as necrosis, cellular pleomorphism. In clear cell adenocarcinoma, on the contrary, it is possible to observe only some nests of oncocytic cells.The Authors underscore the presence of oncocytic cells in such different neoplasms and the possibility, especially in clear cell adenocarcinoma with nests of oncocytes, that needle biopsy or aspiration cytology from such an area can lead to a misdiagnosis.

Unsuspected neoplastic disease of the ureteric stump was discovered in 4 of 47 patients (8.5%) undergoing cystectomy for bladder cancer between 1988 and 1990. Carcinoma in situ was found in one case; invasive cancer was present in 3 cases. Ureteric malignancy was found only in patients with undifferentiated bladder tumor or with a widespread involving of the upper tract of ureter and pelvis. No carcinoma in situ or tumor was discovered in the distal ureter in patients with localized transitional cell carcinoma of the bladder. This research emphasizes the low risk to constructing uretero-intestinal anastomosis with unsuspected tumor in the distal margin of ureter in patients with a transitional cell carcinoma of the bladder.

62 men with prostatic hypertrophy and bladder obstruction and 31 age matched women without lower urinary tract obstruction, underwent urodynamic testing which included uroflowmetry, gas cystometry, urethral pressure measurement: electromyography and pressure flow study was only performed to the patients with prostatic hypertrophy. No patient with neurological disease, diabetes mellitus, pelvic operation, neoplasm or stone of the bladder was admitted to the study. Involuntary detrusor contractions (unstable detrusor) were found in 74.2% of male patients and in 25.8% of female patients. In male patients aged over 72 the percentage was 81.8% while in the female patients of the same age was 60%. All the 62 male patients underwent prostatectomy. Two months after surgery, acystometry was done. Unstable detrusor was found in 63.1% of cases. Patients over 80 had a percentage of 100%. These data suggest obstructive prostatic hypertrophy as an important factor in development of involuntary bladder contractions, but the primary pathophysiological factor appears to be age of patients.

During the period 1988-1990, 683 patients with diagnosis of benign prostatic hyperplasia underwent transvesical prostatectomy. The purpose of the study was to establish the possible presence of incidental carcinoma of the prostate (ICP). Prostatic tissue was studied with sections taken every 0.5 cm. The incidence of ICP was 12.00%. The mean age of patients was 73.5 years. 60.98% of tumors classified T1a, 39.02% T1b. No case of G3 tumor was observed while 92.68% of neoplasms was classified G1 and 7.32% G2. 74.95% of tumoral nests into the prostatic tissue had a breadth about one millimetre.

The Authors report their personal experience of pure squamous cell carcinoma of the bladder. Between 1984 and 1988 they have observed 389 tumors of the bladder; squamous cell carcinoma was present in fifteen cases (3.8%). Epidemiology, pathology (gross configuration of tumor, histologic grading, staging according to the criteria of the UICC of 1987), presenting symptoms, treatment and survival have been considered. The Authors underline the importance of a careful histologic examination of the vesical tumors.

Five cases of chronic perirenal hematoma are reported. Preoperative tests were performed to assess the malignant or benign nature of the lesions which were observed some time after the dramatic episode which marked their onset. The varying characteristics of the disease showed by different imaging techniques (urography, arteriography, US, CAT) are such that only surgery can remove all doubts in the majority of cases.

The purpose of this study has been to establish the possible presence of incidental carcinoma among men with benign prostatic hyperplasia. During the period 1983-1987, 954 patients with benign prostatic hyperplasia, have been undergone transvesical prostatectomy. Prostatic tissue has been studied with sagittal sections. Sections on the surgical specimens were taking every 0.5 Cm. In this way we have obtained from 6 to 15 sections in every prostate gland for microscopic examination. The incidence of incidental carcinoma of the prostate was found to be 5.45 per cent and it represent 24.88 per cent of all prostatic adenocarcinomas.

The Authors report a case of leiomyoma of the prostate. It's a relatively rare neoplasm and although usually benign, malignant changes have been noted.