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We present a rare case of complete avulsion of the kidney collecting system as a result of blunt abdominal trauma. Emergency celiotomy precluded radiographic studies. Perinephric hematoma was mild, the lesion was not detected and this later led to a nephrectomy. Pelvis disruption diagnosis is frequently delayed, and this compromises surgical reconstruction.

T1 G3 bladder carcinoma are classified as superficial tumours and treatment results are included in low stage tumour groups. A review of survival rates shows that there is a high risk of progression about 50-70%. The grade is by now considered the most significant prognostic factor and many other prognostic biological tests have been suggested. We treated 41 cases of T1G3 bladder tumours with a first therapeutic TUR and second staging TUR two months later. Subsequently a group of 15 has had "wait" and see" endoscopic follow-up with bad results, a group of 7 underwent "early cystectomy", a group of 12 has been treated with adjuvant cytotoxic chemotherapy with poor results on recurrence and good results on progression percentages, a group of 6 radiotherapy with poor results. We got confirmation of high risk of progression, 4 cases with high stage from beginning, 3 with precocious metastatic disease. Apart the cases with precocious metastases, the best survival rates are achieved with early cystectomy.

The results of anesthesia and perioperative assistance on a series of 84 patients who underwent since 1982 to 1990 a one-stage radical cystectomy and urinary diversion are reported. Reduction of the high risk of operation is particularly dependent on preoperative preparation, use of a safe anesthesia technique with continuous evaluation of vital signs, control of blood loss and use of low dose of heparin for prevention of venous thromboembolism. The complication rate was low, 7.1% for the early one, 16.6% for late one. General mortality of 5.9% is dependent on the high average age of the patients and on the fact all the cases were deeply invasive cancer.

The improvement of the endoscopic strumentation and technique has permitted a large diffusion of the transurethral resection of the vesical (TURV) for malignant neoplasms. We report the complications of this method described in literature and a review of the cases observed at the Urological Division of Niguarda Hospital in Milan from January 1985 to December 1989 has presented. The adequate treatment of the complications permits to minimize the damage for the patient.

The use of percutaneous transhepatic biliary drainage (PTBD) has allowed the development of new diagnostic examinations, such as biliary exfoliative cytology. This is extremely important in patients with biliary tract strictures, in order to obtain a diagnosis about the real nature of the stricture. Forty-nine patients underwent exfoliative biliary tract cytology from bile samples. Exfoliative cytology was performed on bile samples taken at different times for each patient. The results of our study proved this examination to be highly specific (there were no false positive samples), although the diagnostic sensitivity was not as high (63.9%). It is important to underline that whenever the epithelium of the biliary tract is involved by neoplasm, the result of examination is always positive. These data may be useful to choose an appropriate surgical procedure.