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The percutaneous biopsy of native kidneys according to the classic methodology, takes place with the introduction of the needle and its guide with ultrasound sagittal viewing planes, with a 30-degree angle, up to the lower pole of the kidney. Since the longitudinal axis of the kidneys converges towards the spine with a sharp angle, we observed that starting from a longitudinal scan of the kidney (conducted along the posterior axillary line with the patient prone) you can drive the needle by a perforated probe through a shorter path perpendicular to the end section of the lower pole of the kidney where the front and rear rims of the cortex bearings without the renal sinus interposed so increasing the chance to obtain, even with a single pass, a good sample of cortical tissue while limiting the possibility to damage the lower chalices that may cause hematuria. We biopsied in that manner 26 patients and we compared the data with those reported in the literature performed with the same needle gauge and post-biopsy monitoring period. With a statistically lower number of needle passes, it is thus obtained the 100% of the sample validity for histological analysis, in absence of major complications and statistically hemoglobin variance when compared with a group of 44 patients biopsied with a significantly greater number of needle passes in the only work carried out with classical technique in the literature (Ori et al.) which is directly comparable to our for gauge of the needles and duration of monitoring., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Primary hyperparathyroidism (PHPT) is a disease involving a broad range of alterations of calcium homeostasis, sustained by parathyroid hormone (PTH) levels that are clearly abnormal. The anomalies directly associated with hyperparathyroidism are nephrolithiasis and fibrocystic bone disease. Since PHPT resolves when abnormal parathyroid tissue is removed, surgery is clearly the only definitive approach to this type of hyperparathyroidism. However there are large subgroups of patients for whom medical therapy should be considered instead of surgery. Pharmacological therapy consists largely of bisphosphonates, or calcimimetics such as cinacalcet. However, recent preliminary data suggests that cinacalcet could also be effective in the specific group of patients with primary hyperparathyroidism associated with nephrolithiasis. Finally, since cinacalcet reduces calcemia in most PHPT patients without improving bone mass, whereas bisphosphonates and especially alendronate improve bone mass, it could make sense to combine the two drugs in PHPT patients with concomitant bone loss and possibly nephrolithiasis who cannot or do not wish to undergo surgery.

Background: In Italy the visit during conscription is a valid instrument for epidemiologic research. The aim of this study was to evaluate the incidence of andrologic diseases in a population of 18 years old young Italian men and to estimate in how many of them it was a first diagnosis., Methods: This randomized study was conducted during 1998 at the Military District of Florence where an andrological visit was performed on 11,649 young men living in Tuscany. An evaluation of external genitals and secondary sexual characters was made. All the visits were performed by the same doctor. They were requested to specificity if they were familiar with the professional figure of the andrologist., Results: Some andrological disorders were found in 3892 (33.4%) of them and in 3469 (89.2%) it was the first diagnosis. Only 3.7% knew the role of the andrologist and 70% didn't know where to apply for their problems., Conclusions: The results of this study showed a poor familiarity with the figure of the andrologist even though about 1/3 of them should be treated for an andrologic disease which is often undiagnosed. It is personal opinion that these results should make us to think about the consequences that the abolition of male conscription may have given that, for many young Italians, the medical check-up for military service is the first, and often the last, occasion for a control of the genital system.

The dysuria syndrome consists of the persistence or accentuation following adenomectomy of the symptoms which caused the patient to seek the urologist's advice. It is frequent event whose causes are largely connected to physiopathological events which are also influenced by the developing role between the urologist and patients in view of prostate disease. The authors analyse the various causes of post-adenomectomy dysuria and emphasise the importance of a precise diagnosis and the correct indications for surgery for the prevention of this disease.

A review of published series about 56 cases with unilateral nonvisualization on excretory urography after external trauma have been described: the renal injury causing the nonvisualization was contusion in 8 patients, laceration in 13, rupture in 12 and renal pedicle in 19. The acquisition of the most important methods has allowed a total view as about minimal lesions (contusion, laceration), as rupture or fragmentation of the kidney and renal pedicle. We have evaluated 32 cases of renal traumatic injuries and we have studied one case with unilateral nonvisualization stressing the diagnostic, etiopathogenetic and therapeutic problems.

Are described some observation on the ultrastructure of the muscular coat in three cases of the ureteropelvic junction pathology; the patients were undergone at ureteropelvic resection. The authors underline the presence of an important damage of smooth muscle cells at the ureteropelvic junction, also at the renal pelvis and the upper third of the ureter. The abnormalities of muscle cells are of various type: some of these could be cause of the altered motility and fibrosis of the ureteropelvic junction, constantly observed in such pathological abnormality.