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A series of 35 patients who were treated surgically by pericavernoplasty using a prosthetic band is presented. At the 1-year follow-up visit, 57% still had improved erectile capability. At the present time, it is difficult to determine whether or not surgical treatment will result in failure. However, according to recent histological studies, prognostic insight in the future might be provided through the analysis of erectile tissue, but for the present moderation must be used in deciding upon surgical treatment since there is a lack of precise physiopathologic understanding of erectile dysfunction.

This study was designed to evaluate the reliability and the role of percutaneous needle biopsy in the diagnosis of renal masses.85 biopsies were performed in 74 patients (mean age: 62 +/- 14 years). The median tumour diameter was 4.44 +/- 2.53 cm. Biopsies were performed with an 18G ASAP* needle with CT guidance. 2 to 4 cores were obtained per patients. All biopsies were performed as an outpatient procedure.Biopsies were uninterpretable in 15 cases (17%) (13 with normal or no renal tissue and 2 necrotic samples). A benign lesion was detected in 8 cases (4 fibrous lesions, 4 infectious lesions). In 3 cases, biopsies were suspicious of cancer, which was confirmed on definitive histology. In 59 cases, biopsies were neoplastic: 6 benign tumours (4 oncocytomas, 1 angiomyolipoma, 1 cystadenoma), 42 renal cell carcinomas (RCC) (conventional: 32, chromophobe: 3, tubulopapillary: 7), 5 urothelial carcinomas, 3 metastases, 2 lymphomas and 1 sarcoma. The median Fürhman grade was 2. 30 RCC were operated. The correlation coefficient for the biopsy and pathology histological type was 0.90. The median pathological Fürhman grade was 2. The biopsy results modified therapeutic management in 38% of cases. There was no morbidity, post-biopsy medical management was never required.Biopsy of renal masses is reliable for evaluation of the histological type. The introduction of the CT scope should increase the accuracy of biopsies. The morbidity is low compared to that of diagnostic surgery.

Malignant Leydig cell tumours of the testis occur in only 0.1-0.3% of patients with testicular tumours. Less than 50 cases of malignant Leydig cells tumours have been previously reported. A report of a new case is presented. This tumour was unusual because of high progesterone level. We analyzed malignant pathologic signs of Leydig cell tumours as immunohistochemical proliferation index. Management of this tumour, for which chemotherapy is not yet available, is discussed.

This single arm, open labeled, non randomized study was aimed to evaluate the toxicity of 3 cycles of MVAC (methotrexate, vinblastine, doxorubicin and cisplatin) with rhG-CSF (5 micrograms/kg/day from day 3 to day 14), on 14 patients with previously untreated infiltrating bladder carcinoma, 42 cycles were administered. Chemotherapy toxicity was very low, with 7% of neutropenia grade 3 or 4.4% of thrombocytopenia grade 2, no mucositis above grade 2 and no nadir sepsis. Bone pain related to rhG-CSF occurred in 14% of cycles. 88% of the cycles were given at full dose without any delay and mean relative dose intensity was 96.4% (RDI was 100% for 9 patients). One patient achieved a complete pathological response (cystectomy: 1) and 6 clinical responses with negative transurethral resection. Addition of rhG-CSF to MVAC chemotherapy allows a high dose intensity of MVAC with very low toxicity over 3 cycles. This association should be compared to standard MVAC or intensified regimens to evaluate efficacy, toxicity, and cost effectiveness.

The aim of this study is to evaluate the diagnostic value of percutaneous biopsies of renal masses with comparison of pathological data between the biopsies and the surgical specimens. Thus, we retrospectively studied 73 biopsies of patients, who were referred to our institution between 1995 and 1997. The mean age of the patients was 60 +/- 14 years with a male predominance (67%). Twenty per cent of the biopsies were negative. Eleven per cent of the biopsies were benign lesions (oncocytoma, angiomyolipoma, infectious lesions). For renal cell carcinomas, the correlation coefficient between biopsy histology and final pathology was 0.87. Conversely, it was only 0.36 for the Führman grading. Nevertheless, low (1-2) and high (3-4) grades were accurately separated (0.92). We conclude that the percutaneous biopsy is a useful tool for diagnosis of renal masses.

Objectives This European multicenter study was aimed to assess the clinical reliability of a modified prostatic UroLume Wallstent (American Medical System, Minnetonka, MN) in the treatment of 135 healthy patients with symptomatic benign prostatic hyperplasia. Methods Ninety-one patients who were obstructed but still voiding spontaneously and 44 patients who had an indwelling catheter were treated by placement of a modified stent. Results A significant improvement in mean peak flow rates and residual urine volumeswas maintained throughout follow-up. Both obstructive and irritative voiding symptoms were significantly improved after placement of the stent, although a greater amelioration was seen in obstructive symptoms. The rate of patients reporting erections increased after stent insertion. Eighty percent of sexually active patients reported the maintenance of antegrade ejaculation postoperatively. A greater than 80% epithelialization of the stent was seen in 28 patients (100%) examined at the 18-month follow-up. Long-term complications were seen in 51 patients (38%). Twenty-one of these patients had the stent removed due to intractable detrusor instability, stent encrustation, stent migration, or persistence of obstruction due to prominent median lobe, understenting, or severe hyperplasia of the epithelium of the prostatic urethra. In 6 of them another stent was reimplanted while the others were treated surgically. Conclusions Although this modified stent was abandoned due to an unacceptable rate of complications, this study demonstrates that bladder outlet obstruction in healthy patients with benign prostatic hyperplasia can be successfully relieved by the placement of a UroLume Wallstent.