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Background: Tuberculosis (TBC) is a disease that is found throughout the world with a particularly high incidence in under developed countries. Genitourinary tuberculosis has been reported in 8-10% of all cases in developed countries and in 20% in Third World countries. This study aimed to describe a method of diagnosis applicable to so-called "closed" forms of tuberculosis affecting the urinary tract, namely those with negative results for KB bacteriological and culture assay, but in which suspected diagnosis based on clinical grounds and diagnostic procedures call for further analysis; these forms account for 10% of the total cases., Methods: A prospective study was carried out in order to tritade the antigenic fraction A60 of the group of thermostable macromolecular antigens (TMA); the latter belong to the pool of liposoluble antigens forming the cell wall and represent the main component of tuberculin and purified protein derivative (PPD). The identification and assay of antigen A60, which can stimulate both the antibody and cell-mediated response, was performed using the ELISA method in order to identify IgG and IgM specific antibodies (TB-test). Twenty-nine patients were selected (11 males, 18 females) with a clinical history of recurrent symptomatic manifestations of upper and lower urinary tract infections resistant to common antibiotic treatment. Urinary tests showed that 96.5% of patients presented an acid urinary pH associated with pyuria, and the urographic imaging revealed calico/pyelic lesions of the excretory tracts., Results: Seven patients (24%) showed a form of urinary TBC of an areactive type (AA) or with intermediate reactivity (RI.AI); six patients (20.64%) showed reactive TBC or in the process of resolution; fifteen patients (51.6%) were negative to the TB-test, and after one year's follow-up still showed no positivity to assays for Koch's bacillus., Conclusions: The authors affirm that the TB-test, a rapid and relatively inexpensive diagnostic method, is a valid aid for the diagnosis of "closed" forms of urinary tract TBC.

Liposarcoma is the most common adult soft tissue sarcoma. The hallmark is the immature fat cell or lipoblast. It occurs in late adult life, frequently in the lower extremities, in the retroperitoneal, perineal and mesenteric region. Retroperitoneal liposarcoma doesn't produce symptoms until it is very large. A review of the literature is made and the case of a 65-years old man, submitted to surgical treatment for a bulky retroperitoneal mixoid liposarcoma is reported.

Urinary fistulae between ureter and iliac arteries are very uncommon. A case of fistula connecting ureter and bypass between iliac and femoral arteries is reported. This kind of surgical complication, due to arterial lesion during coxo-femoral arthroprosthesis implant has never been reported in the literature.

Primary absolute anorgasmia is the impossibility to have orgasm and ejaculation during wake or every kind of sexual activity, in men with normal erectile function and nocturnal emission. In this syndrome the nervous system is unimpaired; the frequency is very low, with a very small number of reported cases in literature. Andrologists are generally requested by the patients for the first clinical approach. They should collaborate with sexologists for the diagnosis and treatment. Personal experience in 3 cases of anejaculatory men aged between 28 and 34, observed in the years 1995-1996, is presented and the clinical features of the patients and therapeutic strategy described. In two cases a sexual behavioral therapy was performed with success; in the third an electrovibration was employed to obtain the first orgasmic sensation.

Background and Aims: Urethral diverticula is a rare pathology with an incidence varying between 0.3 and 6%. It is difficult to diagnose owing to the aspecificity of its clinical symptoms. The aim of this study was to evaluate the imaging techniques now available for its diagnosis., Methods: The sample consisted of 19 female patients aged between 20 and 53 years old undergoing diverticolectomy owing to urethral diverticula between 1980 and 1996 at the 4th Division of the Department of Urology at "La Sapienza" University of Rome. All patients underwent preoperative X-ray examinations (micturitional cystourethrography and P positive urethrography). A retrospective study was performed in order to evaluate the accuracy of the individual methods., Results: Micturitional urethrocystography showed a sensitivity equivalent to 77% of cases. P positive urethrography showed a 85.7% accuracy rate. Lastly, transvaginal ultrasonography, which always showed the diverticular sac in all patients in which it was used, also highlighting multiple and divided diverticuli which were not visible using traditional radiology. The latter method is easy to use and well tolerated by patients; moreover, it shows the spatial relations of the diverticulum and allows the characteristics of periurethral tissues to be evaluated., Conclusions: The authors affirm that transvaginal ultrasonography is the first method of choice for the diagnosis of urethral diverticula.

The paper examines to treatment of 40 cases of urinary infections and compares the efficacy of pipemidic acid, norfloxacin, cinoxacin and ofloxacin. All these compounds demonstrated a good level of therapeutic efficacy, both in terms of management and effectiveness; in particular, norfloxacin and ofloxacin were preferable to the other compounds since they caused fewer side-effects.

The Authors describe a case of congenital diverticulum of hypopharynx in a newborn. The lesion, early recognised, is successfull treated with surgical removal by a transcervical approach. The revision of the literature confirms the extreme rarity of this affection in the newborn and the correlated mortality if not early diagnosed and then confused with an atresia of the oesophagus it often simulates whose symptomatology.

One hundred fifty sera from handlers of squirrel monkeys and 100 sera from individuals who had never handled monkeys were tested by immunofluorescence for antibodies reactive to structural proteins of Herpesvirus saimiri (HVS). Eleven (7.3%) of the occupationally exposed group and 4 (4%) of the noncontact group were seropositive for HVS by immunofluorescence assay, and 10 of these 15 (6.7 and 2%, respectively) were also seropositive for either the major glycoprotein (140 kD) or the major capsid protein (160 kD) of HVS by radioimmunoprecipitation assay. Two sera from handlers of squirrel monkeys, however, recognized many different HVS structural antigens by immunoprecipitation, and it seems unlikely that they could also be cross-reactive antibodies. Since these two sera did not contain antibodies to HVS early antigens or to the nonstructural antigens present in infected owl monkey kidney cells, and follow-up sera collected from the same individuals several months later were negative for antibodies to HVS, these individuals do not appear to have been infected by the virus. The risk that HVS poses to humans appears to be very low.

Two rare cases of cervico-urethral obstructive lesions are described, illustrating two typical examples of the twofold pathogenic possibilities of the affection. The first patient had a probably congenital cervico-trigonal cyst due to a ureteral bud in the bladder wall. The second case presented different symptoms and signs, and this together with histology findings suggested an acquired nature of the lesion from cystic transformation of an infected glandular structure. The published literature is reviewed and diagnostic difficulties are emphasized, particularly differentiation from a prostate median lobe lesion.