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Our experience with urethral strictures in boys during a 15-year period confirms the findings of others that the most common etiology is iatrogenic. Traumatic and inflammatory strictures are rare. The congenital stricture differs fundamentally from acquired types of urethral strictures and would be termed more appropriately congenital urethral membrane. Urethral dilation and/or urethrotomy was unsuccessful in 47 per cent of our patients, leading to secondary formation of a new stricture in 2 instances. However, urethroplasty was successful in 83 per cent of our cases and seems to be indicated when 2 or more dilations are required.

Since 1950, 36 patients with exstrophic anomalies were seen at the Medical College of Virginia Hospitals. There were several modalities of treatment used, including primary reconstructive procedures in 11 patients, β of whom continue to have a functional bladder closure. Our results and current management are discussed.

We assigned randomly 90 patients treated previously for superficial transitional cell carcinoma to conventional followup or prophylactic treatment. This followup study details the late incidence of recurrence (29 of 45 patients in the prophylactic group and 34 of 45 controls), the progression of tumor grade and stage, the deaths and causes (24 patients), and the influence of initial stage, grade, carcinoma in situ and positive cytology on the outcome of treatment.

The tumors in 249 patients presenting initially with stages Ta and T1 bladder cancer were analyzed for tumor progression and recurrence. Only transurethral resection and/or fulguration was used before the first recurrence. Patients who received intravesical chemotherapy after the first tumor recurrence were excluded from an analysis of progression. Progression according to stages Ta and T1, and grades I, II and III was 4, 30, 2, 11 and 45 per cent, respectively. All differences were statistically significant. Progression also correlated with nontumor dysplasia and size. High tumor grade, lamina propria invasion, atypia elsewhere in the bladder, positive urinary cytology, tumor multiplicity and large tumors were associated with shorter intervals free of disease.