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Acute urinary retention in women is rare. The varicella-zoster virus causes inflammatory lesions of the sensory-root ganglions, meninges and, less frequently, spinal cord. Herpes zoster has been reported to affect, although rarely, lower urinary tract innervations, and acute urinary retention can be thought to occur in the presence of sacral dermatome involvement. Usually it is located in S2-4 dermatome and the prognosis for acute urinary retention is benign resolving in about 20 days. We present a case in which the S1 dermatome was involved and acute urinary retention developed. After 10 days of specific therapy and self-catheterization the problem resolved.

Background: Thanks to the introduction of new optical systems and advances in technology, transurethral resection is now the most widely used method in the management of prostatic adenoma., Methods: A study has been carried out on 25 patients aged from 50 to 80 years submitted to an uncomplicated transurethral resection of the prostate for benign hyperplasia. Patients with intense retention of urine, capsular perforation, bladder neck undermining, considerable haemorrhage in the recovery room and postoperative fever have been excluded from the study. The urethral catheter which is normally removed 3 to 5 days post operatively, was removed within 24 hours of surgery., Results: 80% of patients were discharged within 48 hours and the follow-up carried out by means of bacterial urinary culture, urinary pressure monitor and echography, showed that there were no significant complications., Conclusions: In conclusions, this study made it possible to select patients on which an early catheter removal is possible and to evaluate the real advantages of such a method.

The Authors report their experience about 40 patients who presented urinary retention by cervico-prostatic obstruction with anesthetic counterindications or limited life expectancy, cured with the urethral prosthesis of Nissenkorn (IUC). Our data permit to say that in selected patients IUC may represent an effective treatment with minimal invasiveness, low cost and few side effects.

Five cases of acute urinary obstruction during pregnancy are presented. A complete urodynamic workup, including pressure-flow studies showed high micturitional pressures with little or no flow, with at least 60% residual urine. Filling cystometry, urethral profilometry (static and dynamic), pelvic electromyography were normal. Two cases were due to uterine pelvic incarceration. One of these cases happened very early during pregnancy, because of extensive fibroids. Any cause of abnormal uterine enlargement can lead to early obstruction. Three cases were associated with paraurethral abscess (skenitis in 2 cases, urethral diverticulum in 1). Manual reduction in case of pelvic incarceration or surgical draining and antibiotic therapy in case of abscess were effective in all cases. Immediate catheterization is possible and indicated as soon as urinary obstruction is diagnosed. This prevents neuromuscular dysfunction due to excessive bladder distention. The transurethral catheter might work as a stent, and periurethral surgical drainage is probably safer with a catheter in place. Suprapubic catheterization is probably less useful in this respect. An indwelling catheter removes any urgency in treatment. Voiding difficulties can persist for some days after surgical treatment. Urodynamic testing performed in all indicated acute micturitional obstruction. Anyway, it added little to the clinical understanding of the problem, which was obvious, and the Authors feel that extensive urodynamic testing should be limited to cases presenting with a complex preexisting dysfunction or performed after treatment if symptoms do not disappear completely. All clinically doubtful cases should likewise be investigated. If periurethral abscess or incarceration are evident, simple evaluation of residual urine percentage should be sufficient in establishing the diagnosis.

The authors report their preliminary experience with the insertion of intraprostatic spirals in the treatment of chronic urinary retention due to prostatic hypertrophy in 8 inoperable patients. The value is stressed of transrectal US guidance during spiral insertion together with the advantages of US over other positioning techniques (i.e., better visualization of prostatic urethra and urethral sphincter, real time visualization of spiral progression and correct positioning). All patients were successfully treated without complications; spiral positioning was easier in the patients with a Foley's catheter (22 CH). US-guided positioning of intraprostatic spirals appears an easy and safe treatment of chronic urinary retention in inoperable patients.

The management of cancer patients with a lesion in its end stage is a clinical problem a satisfactory solution to which has not been found yet, because of the ethical and legal problems involved. The authors analyzed the survival rates of 218 patients with advanced neoplastic disease and obstructive renal failure who had undergone external/internal urinary diversion. One month after the procedure 20% of the patients were dead. The figure rose to 75% at 6 months and reached 98% at one year. Urinary diversion in cancer patients with renal failure is aimed not only at avoiding death and assuring a prolonged survival, but also at providing a good quality of life. Several clinical criteria are therefore analyzed which are used in the selection of patients to submit to nephrostomy. The most important factors seem to be the actual stage of the tumor, its primary location, the possibility of an effective antineoplastic therapy, and the patient's consent. Randomized long-term studies are still necessary to analyze not only survival rates but also quality of life after urinary diversion for obstructive renal failure.

22 patients affected by BPH have been treated with a spiral urethral prosthesis under local anesthesia with ultrasonic guidance and endoscopic technique. All the patients either refused the surgical procedure or had high operative risk. Insertion guided by ultrasound and endoscopic technique was successful in 19 patients (86%) with a follow-up of 12 months. In our experience the insertion of this prosthesis is a favorable alternative to an indwelling catheter in selected patients.