A bipolar cuff electrode for electrical stimulation of small diameter peripheral nerves is described. The cuff is made of a highly flexible rubber-impression material, and the electrode assembly is suited for chronic implantation. Its manual construction is easy and reliable, utilizing only simple tools. The cuff completely envelopes nerves of varying diameter and requires a minimal amount of manipulations of the nerve, thereby reducing the chance of surgical trauma. The snug envelope prevents the nerve from drying, and minimizes shunting between the two leads by extracelfular fluids. Small outer dimensions were achieved: 1.4 × 1.1 × 2.3 mm (width × height × length) when used with nerves of 1 mm diameter, which minimizes pressure and damage to surrounding tissues. Morphometric analysis of nerves enclosed in cuffs for 28–30 h revealed a small decrease in the number of large-diameter fibers. Stimulation thresholds remained, however, constant throughout the experiments.

There is still extensive debate as to the preferred diagnostic and therapeutic approach to urolithiasis in pregnancy. We report our experience with 15 pregnant patients with renoureteral colic marked by pain not responsive to analgesia, dilatation and fever. We focused on the usefulness of ureteroscopy with thin instruments and ultrasound in the diagnosis and treatment of ureteral stones and ureteral colic during pregnancy.Between 1990 and 1993 we performed ureteroscopy and ureterolithotripsy on 15 pregnant patients 16 to 30 years old. Gestation time ranged from 20 to 34 weeks. All patients underwent ureteroscopy with thin rigid 7.0F or 9.5F ureteroscopes without dilation of the ureteral meatus. The use of ionizing radiation was avoided before, during and after the procedures. A stone was extracted from the lower third of the ureter in 2 cases, displaced into the kidney from the middle third of the ureter in 3, and fragmented with the pulsed dye laser in 3, the holmium: YAG laser in 3 and the ballistic lithotriptor in 2. Finally absence of ureteral calculi was confirmed in 2 cases. A double pigtail ureteral catheter was placed via echographic guidance in 14 cases to monitor curling of the pigtail in the renal pelvis, while in 1 a cylindrical ureteral catheter was used. In 5 cases no anesthesia was necessary, while 10 required neuroleptic analgesia.There were no complications after the procedure. All pregnancies were full term.Rigid ureteroscopy may be performed on the entire urinary tract even during advanced pregnancy. Stones may be fragmented, extracted or displaced and double pigtail ureteral catheters may be applied with only sonographic guidance, at times without use of anesthesia. The use of small instruments, such as the Gautier ureteroscope, that do not require dilation or any particular manipulation of the ureteral meatus seems to be essential together with an accurate ureteroscopic technique. In this manner it is possible to diagnose and treat ureteral calculi during pregnancy without resorting to ionizing radiation but using only ultrasound monitoring and ureteroscopy.

Women with kidney transplant and anterior vaginal wall prolapse should be operated early. Infact the anatomical and functional alteration of pelvis, in this case, can cause urological diseases which can deteriorate antireflux system of kidney transplant. These women can be submitted to colpopromontoriosacropexy using a Stratasis bandage. Stratasis, is a biomaterial derived from submucosa of pig bowel. It is inert, not immunogenic, it does not cause sensitization or extra body reaction, it will be biotransformed, it is progressively colonised and substituted by tissue where it is placed. It is suitable to be used in transplanted patients, because of its early colonisation and rapid neo-vascularization, that means supply of nutritive substance and infection resistance. We operated with this technique two women with kidney transplanted six years before. They were 47 and 55 years old with III-IV degree cystocele. We made hysterectomy, adnexectomy and indirect colpopromontoriosacropexy with Stratasis bandage. Both patients have no complications, no urinary infections, no altered renal function, no changes in immunosuppressive therapy, bladder catheter was removed on sixth day. They were dismissed in eighth and fourteenth day. Patients have spontaneous and regular micturition, they are continent, post-micturition residual is less than 30 cc.

The evidence of symptomatic vesico-ureteral reflux after kidney transplant impose its correction. In our experience the incidence of this correction is 1%. The first choice is endoscopes treatment with periorifitial injections (75% good results) with Teflon or Macroplastique. In the latest four patients with symptomatic vesico-ureteral reflux III degree (recurrent urinary infections, serum creatinina >20–40%) we applied Coaptite®, with three periorifitial injections. Coaptite® is a biocompatible material, natural and inert, made of calcium idrossiapatite spheres of 100 micron suspended in a water and glycerine gel. These characteristics made Coaptite® much more suitable in transplanted patients with immunosuppressive therapy. Coaptite® is X-ray opaque: treatments and results are more easily measurable. The results with Coaptite® are superimposable to Teflon or Macroplastique. We observed any complications.

The authors present the use of "Hemorrhage Occluder Pins" in pelvic urologic radical surgery, as a means of hemostasis for the retropubic venous plexus. The application technique and the bio-technological characteristics of the occluder pin are discussed.

A young man presented with a little perineal mass that was found to be secondary to partial priapism of the proximal corpora cavernosa. This is a very rare condition with only 3 previously recorded cases in the urology literature. The patient made a good recovery and was able to resume sexual activity.

Aim of this study is the evaluation of the increased overall inhibitory power of whole urine induced by the in-vitro addition of glycosaminoglycans (GAGs). The inhibitory power, and its variations are assessed with the Sarig test, using ionometric measurements to follow the oxalate precipitation in different experimental conditions. The study is performed on the urine collected from 160 patients with a history of calcium-oxalate lithiasis; mesoglycan, sulodexide and sodium citrate (for comparison) are each tested on 110 urine specimens. A statistical significant difference is found between the basic evaluation and after addition of GAGs, comparable with the results obtained with sodium citrate. No significant differences in activity among the three drugs are found in those cases where simultaneous testing is possible.

Carbohydrate Antigen 19-9 (CA 19-9) histological expression in transitional cell bladder carcinoma (TCBC) was studied by means of immunohistochemistry and its findings compared with those of Tissue Polypeptidic Antigen (TPA) and Carcino Embryonic Antigen (CEA). Twenty-one TCBC of various grade and stage were analyzed by using Avidin-Biotin complex method for CA 19-9 and TPA Peroxidase-Antiperoxidase method for CEA. Grade 3 and pT1, pT2/pT3 carcinomas showed a constant staining for CA 19-9 antigen, grade 2 showed a 50% positive immunoreaction while all grade 1 cases were negative. TPA showed an inverse correlation with well differentiated carcinomas which were better and more extensively stained than anaplastic ones. CEA expression was not correlated either with grade or stage. CA 19-9 could be considered as a dedifferentiation marker in TCBC.

In this study, the Authors evaluate a simple test proposed by Sarig for the discrimination of kidney stone-formers, based on the overall urine inhibitory effect. A solution of the tested urine is added with sodium-oxalate and the kinetics of calcium-oxalate precipitation is indirectly followed with ionometric selective measurement of the progressive reduction of free calcium ions. A Discriminating Index may be therefore calculated; higher values are obtained in lithiasic patients in comparison with normal controls.

The evidence of symptomatic vesico-ureteral reflux after kidney transplant im- pose its correction. In our experience the incidence of this correction is 1%. The first choice is endoscopes treatment with periorifitial injections (75% good results) with Teflon or Macroplas- tique. In the latest four patients with symptomatic vesico-ureteral reflux III degree (recur- rent urinary infections, serum creatinina >20-40%) we applied Coaptite ® , with three peri- orifitial injections. Coaptite ® is a biocompatible material, natural and inert, made of calci- um idrossiapatit e spheres of 100 micron suspended in a water and glycerine gel. These characteristics made Coaptite ® much more suitable in transplanted patients with immuno- suppressive therapy. Coaptite ® is X-ray opaque: treatments and results are more easily mea- surable. The results with Coaptite ® are superimposable to Teflon or Macroplastique. We ob- served any complications. (Urologia 2004; 71: 170-1)