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Objective: To evaluate the role of ultrasound as a sole procedure for intraoperative localisation and management of complex renal calculi., Material and Methods: Between September 1997 and November 2001, 16 patients underwent complex surgery for multiple, large or recurrent renal stones using the ultrasound image as a the sole intraoperative diagnostic procedure. A 8.5 MHz sector transducer with a pulse Doppler signal was used to identify the avascular area, the shortest distance between the renal surface and the stone., Results: Complete stone removal was achieved in all patients without complications., Conclusion: Intraoperative sonography for localisation of the intrarenal arteries combined with B scan sonography for intraoperative localisation of stones allows complete removal via radial nephrotomies without peduncle clamping and cooling procedure. The advantage is the exact and quick localisation of stones avoiding X-ray.

In agree with President and Committee of Andrological Italian Society (S.I.A.), authors have carried on a research to know: 1) main features of Italian Structures interested in male sexual dysfunction 2) actual trend in diagnosis and therapies of male sexual dysfunction, Authors report results and data about this research, particularly regarding new trends in therapia (therapy).

In this article the Authors, after describing the history of the penile prosthesis surgery and analyzing the technical progresses made in the last twenty years, offer their personal experience and data from the most recent literature about treatment of erectile dysfunction through the application af penile prosthesis, about the indications for the operation and the choice of the type of prosthesis. They also explain all the possible complications and eventual mechanical failures, which have considerably decreased in the last few years.

Intracavernous administration of vasoactive drugs induces an erection in absence of erotic stimuli; we can use this property in the study of impotent patients, inducing the appearance on an erection to examine it in all its phases (FIC Test). In case of the appearance of a good erection, the test should rule out the presence of a penile arterial disease or of a corpora-veno-occlusive deficiency. When the administration of the drug does not cause complete tumescence, it is very probable that the erectile dysfunction is caused by arterial vascular alterations or by organic disorders of veno-occlusion mechanism, but we cannot exclude for a certainty a psychogenic dysfunction. In fact an excessive noradrenergic autonomic control, as during stress condition, may limit FIC Test response. Therefore we hope that more efficacious molecules will be available in a near future. Nevertheless, we consider the opportunity of enclosing tests in the diagnostic algorithm of impotent patients to reveal an excessive adrenergic tone, such as, for example, psychological tests, study of cavernous potential, or intracavernous catecholamine dosage.

The main histological alteration that happens to the structure of the corpora cavernosa as years go by, is the progressive increase of collagen fibers compared to the decrease of both smooth muscle and elastic fibers. This phenomenon is held responsible of consequences on the hemodynamic events occurring during the erection.