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To analyze the series of patients who underwent inguinal lymphadenectomy in our Center due to squamous penile carcinoma, between years 1984 to 1999.Lymphadenectomy was carried out in 19 patients, with a mean age of 61 years. Bilateral ilioinguinal (42.1%) was the most frequent type of intervention. Only four patients underwent penectomy and lymphadenectomy simultaneously. We present the clinical and pathological results, according to the 1997 TNM classification.Palpable inguinal nodes after antibiotherapy remained in seven out of 12 patients. The overall correlation between N and pN stages in our series was 68.42%. Pathological results according to pT and pN stages are also presented. Postoperative complications were present in 13 cases (68.42%), (lymphedema being the most frequent one). In those patients with two or less pN(+) nodes, an overall one-year and five-year survival of 90 and 80% were obtained; compared to 11.11 and 0% when there were more than two.The importance about control of metastatic lymph nodes in squamous carcinoma of the penis, places inguinal lymphadenectomy as an essential tool, in those suitable cases. However, its incidence of complications makes a progressive agreement about its indications be necessary.

We present an unusual case of single kidney metastasis from an primary esophageal neoplasm. Its main clinical and diagnostic topics are described. They made us consider him as a good candidate for surgery. The pathological study of the nephrectomy specimen was surprising. The postoperative period was unfortunate, however.

To study the utility of PSA density and predicted PSA results in the diagnosis of prostatic cancer using gland volume.500 patients suspected as having prostatic cancer underwent ultrasound-guided transrectal biopsy. Prostate volume and ultrasound characteristics, serum PSA density, predicted PSA and the difference between both were determined.44.8% of the patients showed evidence of cancer in the biopsy specimen. These patients had a significantly smaller prostate. The 0.1 and 0.15 PSA density cutoffs had a sensitivity of 96% and 94%, specificity of 10% and 20% and positive predictive value of 46% and 49%, respectively. The statistical values for PSA difference of 1 and 2 were 94% and 92%, 13% and 18%, 47% and 48%, respectively.PSA density and predicted PSA results could be useful to avoid biopsies in patients with PSA between 4 and 10 ng/ml and no malignant tumor of the prostate.

The objective of this paper is to compare the hormonal changes and sexual activity between transplanted patients and patients in regular haemodialysis (HD).130 patients, 98 RT carriers and 32 with CRF were evaluated with regard to the sexual function. The etiology of CRF is similar in both groups. All patients underwent hormonal determinations (FSH, LH, Prolactin, Testosterone, Oestradiol and PTH), complete serum testing and other diagnostic studies done selectively, 38 of 130 patients (14 in HD and 24 transplants) answered a personal questionnaire on sexual activity.Oestradiol and prolactin levels are higher in the HD group compared to transplanted patients (p0.05). 70% of RT patients maintain their libido versus 35% of those in dialysis (p0.01). The former group refers good erection in 55% cases versus 21% of dialysis patients (p0.01). Intercourse frequency and degree of overall satisfaction is higher in the RT group (N.S.).No significant differences were found in FSH, LH and testosterone levels. The normality of FSH levels may be a reflection of the integrity of the germinal line. 65% HD patients refer decreased or absent libido, to which the higher levels of prolactin and oestradiol found could contribute. No relationship was found between sexual function with the type of immunosuppression or the graft function.

Experimental studies and the clinical course have shown that bladder cancer is confined to the bladder wall for some time, during which optimal treatment by complete surgical excision can be achieved. Failures are most often due to the presence of distant metastasis at the time of surgery and most patients invariably die although local and regional control of the tumor have been achieved. It is difficult to evaluate the benefits that neoadjuvant measures (radio and chemotherapy) contribute to surgery, basically due to the difficulty in classifying the tumor with precision. Preoperative chemotherapy in patients with less than a 40% likelihood of metastasis is unreasonable since 60% will not require it and will be unnecessarily exposed to the side effects of the cytostatic agents, which are not negligible. Furthermore, a considerable number of candidates to partial surgery have no metastasis at the time of diagnosis, therefore preoperative chemotherapy is not useful. It would be more reasonable to give chemotherapy postoperatively to those that are more likely to require it. Radiotherapy will not prevent tumor recurrence and is ineffective in carcinoma in situ. Furthermore, surgery is sufficiently aggressive in regard to the tumor and the possible dissemination to the lymphatics to require adjunctive measures with locoregional effects.

Priapism induced by intracavernous injection of vasoactive drugs is uncommon, easily managed and carries a very low risk of possible sequelae. The pathophysiology, diagnosis and treatment of postinjection priapism is discussed.The series of Schramer, Padma-Nathan, Levine and other authors are reviewed. The incidence of postinjection priapism has been found to be less than 0.5% in general, although the incidence has been reported to range from 3 to 12% when papaverine is used alone.Priapism induced by intracavernous injection of vasoactive drugs is uncommon and easily managed. Treatment, however, should be instituted rapidly.

Prostate cancer is the most common neoplasia in males and, since it is curable only when detected in the early stages, it was estimated that screening would detect tumours in curable stages which would enhance the results in the fight against the disease. This, however, has not been elucidated since the condition's natural history in many cases unknown and it may be that unnecessary and iatrogenic overtreatment is being induced. The paper analyzes the various tests and diagnostic procedures available, primarily digital rectal examination, PSA determination, and transrectal ultrasound all used individually and in combination. Several unknown aspects await to be answered and many long-term studies continue to be necessary to explain whether early diagnosis of asymptomatic disease and subsequent treatment can improve life expectancy and quality of life as compared to plain treatment of symptomatic cases. We hope the answer will be available shortly and that we are "able to diagnose cancer in time but treat it only when we know it is required.

Augmentation and substitution erocystoplastias are currently widely accepted techniques for the treatment of several benign and malignant diseases. Appearance of neoplasia on the various gut segments used after a latency period ranging from 5 to 25 years following initial surgery has been described. The paper presents one case of metastatic colon adenocarcinoma initially located in the region of ureteral reimplantation, in a patient with augmentation cecocystoplastia performed as a result of vesical retraction secondary to genitourinary tuberculosis. Appearance of this type of neoplasia in an increasing population, quite often young, compels the urologist to keep a tight watch. Endoscopic monitoring of the new bladder is the most effective diagnostic procedure. A once-a-year endoscopy after an interval as yet not definitely established, but which could be around 10 years after initial enterocystoplastia, seems advisable at least in cases at higher risk.

Reporting the case of a patient diagnosed with an abscess of the seminal vesicle, treated successfully through parasacral transgluteal percutaneous aspiration lead by computerized axial tomography (CAT). This represents the first case in the literature of percutaneous access to the seminal vesicles through this route. CAT is an effective diagnostic test which makes non-surgical treatment for this type of abscess simpler. A review is made of the literature with regard to the etiology, diagnosis and therapy of seminal vesicle abscesses.

The authors present the results from a retrospective study conducted on 42 patients with Peyronie's disease. For each case, all possible etiological factors were investigated, such as family history, history of trauma, history of other collagenoses, of diabetes, and so on. These studies yielded results comparable to published data. Calcifications within the plaques were found on simple X-ray films in 10.8% of cases. Out of 20 radiological examinations of the corpora cavernosa that were performed, 80% demonstrated pathological processes. It was possible, in some of the cases, to measure echographically the plaque widths, while autophotography was useful in a small number of cases. We were more particularly concerned with sexual dysfunction, impotence, and premature ejaculation, which could be observed in 14 patients.

Basal prolactin, FSH, LH and testosterone levels were determined in 47 patients presenting with impotence. Clinical history, physical examination, general analysis and personality questionnaire were normal. In two patients taking medications (imipramine and dogmatil), prolactin levels were high. The other patients had normal hormone levels. The authors discuss the various mechanisms which play a role in the secretion of prolactin and the various means available to assess changes therein.

In 268 patients seen for sterility, sexual impairment or suspected prostatitis symptoms, first and midstream urine fractions, prostatic secretion and post-massage urine cultures as well as semen cultures and exfoliative cytologies of the first urine fraction and prostatic secretion were performed. Gram-positive bacteria were isolated in 160 cases. Of these, 111 (69.3%) had significant cultures (Meares and Stamey criteria). Nevertheless, when we repeated the study without previous therapy, the results could not be confirmed. This shows that Gram-positive bacteria do colonize urethra and/or prostatic ducts, but are not responsible for prostatic infection.