Laparoscopy in urology after five years: Urinary incontinence

The authors have reviewed the literature on stress urinary incontinence (SUI) treatment by laparoscopy or pelvioscopy. They report their experience with the pubo-vaginal percutaneous colposuspension assisted by pelvioscopy. Out of 22 patients they had a total correction of incontinence in 15 patients (68.12%) with an average follow-up of 18.6 months. They also report their first experience with the Retzius plasty of Manhes by laparoscopy (average follow-up 13 months, 3/4 patients treated are continent, 1/4 SUI with high stress). They conclude that laparoscopy and pelvioscopy treatments can be a valid alternative to tradizional surgery if performed on selected patients.

[Laparoscopic surgery of stress urinary incontinence in women]

The Authors carried out a literature review on stress urinary incontinence (SUI) treatment using laparoscopy or pelvioscopy. They report their experiences in using a pubo-vaginal percutaneous colposuspension assisted by pelvioscopy. Of 22 treated patients, there was a total correction of the incontinence in 15 patients. (68.12%) with a median follow-up of 18.6 months. They report also their first experience with the Retzius plasty of Manhes by laparoscopy (3/4 patients treated are continent, 1/4 has recurrent SUI during times of stress). They conclude that laparoscopy and pelvioscopy treatment can be valid alternatives to traditional surgery if made on selected patients.

Urologic laparoscopic surgery: Light and shade

— Analysing material and world-wide urologic laparoscopie surgery experience, the Authors try to define, also according to their experience, the indications for which the laparoscopic technique is established and well accepted and, on the contrary, those which are still controversial. Critical evaluation about laparoscopic surgery indications are often supported by the costs of the “minimally invasive” technique compared to the traditional surgical approach.

[Firing patterns of the pontine omnipause neurons during sleep in the cat]

The omnipause neurons (OPNs), located in the nuculeus raphe pontis, cease firing during all rapid eye movements and otherwise fire at a steady rate in the awake state. Firing patterns of the OPNs were studied during the awake state, non-REM sleep, and REM sleep in chronically prepared adult cats, to examine whether the OPNs' firing participates in the genesis of eye movements during each state. During non-REM sleep, the OPNs continued their firing, and their firing patterns had little correlation with slow drifting eye movements appearing in this state. During REM sleep, the OPNs maintained a tonic firing and ceased their firing during rapid eye movements in all directions. These results suggest that cessation of OPN firing plays an important role in the generation of rapid eye movements during REM sleep as well as during the awake state in the cat.

Stage A1 prostate cancer: follow-up with digital rectal exploration, prostate markers, fine-needle aspiration, ultrasonographically guided needle biopsy and biopsies of the residual prostate with resectoscope

From January 1985 to December 1990, we performed 921 TURP and 23 retropubic adenomectomies. In 70 patients (7.4%) histological examination revealed an incidental carcinoma of the prostate (stage A), 51 of which (72.8%) were A1 and 19 (27.2%) stage A2. In our classification A1 covers cases with < 3 G1 focal lesions [Boxer, 1977]. Thirteen of the A2 cases underwent radical prostatectomy: 1 pT1G1-2, 9 pT2G1-2, 3 pT3G2 (TNM 1978); the remaining 6 were given palliative treatment. The 51 stage A1 patients were recalled for follow-up evaluation, only 20 came for checking. They were reassessed by means of DRE, markers, prostate cytologic aspiration, echo-guided transperineal needle biopsy and resection of the prostatic cavity. Our experience seems to suggest that, if we define A1 as < 3 G1 chips or less, this stage is to be considered an incidental illness that seems not to require further treatment, but only a policy of surveillance with yearly markers, DRE and echo-guided needle biopsy.

Laparoscopic nephrectomy with vaginal delivery of the intact kidney

The first case of laparoscopic nephrectomy in Italy is described. The patient was a 51-year-old woman with a small, nonfunctional, tuberculous left kidney. The organ, once detached from its lumbar site, was brought in to the pelvic cavity and extracted from the body via a posterior colpotomy. In this way, the integrity of the organ is preserved, hence, this could be the preferable route when dealing with a little kidney tumor in a woman.

Treatment of hydrocele: randomised prospective study of simple aspiration and sclerotherapy with tetracycline

Following reports in the literature on the efficacy of tetracycline sclerotherapy in the treatment of hydroceles, we carried out a randomised prospective study of 45 patients (50 hydroceles), comparing simple evacuation with tetracycline sclerotherapy. The results revealed no statistically significant difference in the percentage of success between the 2 groups, but complications were more common in the patients treated with tetracycline. The good results reported by other authors in non-randomised studies are, therefore, not confirmed.

[Effect of GABA antagonists on the rat electroretinogram]

It has been shown that gamma-aminobutyric acid (GABA) is densely packed in the inner nuclear and plexiform layers in the rat retina, where it is mainly located within a subgroup of amacrine cells. This study examined the effects on the electroretinogram of GABA antagonists infused into the vitreous cavity of urethan-anesthetized rats. Infusions of the GABAA antagonist, bicuculline (0.1-10 mM, 3 microliters) significantly enhanced the b-wave amplitude and reduced the oscillatory potentials (OPs). Similar effects were also produced by infusions of the GABAB antagonist, phaclofen (10 mM, 3 microliters), although lower doses (0.1-1 mM, 3 microliters) had no effect. These results suggest that the actions of GABA, presumably released from amacrine cells, on both GABAA and GABAB receptors are involved in the normal generation of the b-wave and OPs.

Nomogram for penile biothesiometry

Three hundred and fifty men, aged between 17 and 80 years, with normal sexual anamnesis and without any neurological pathology, underwent finger (index) and penile biothesiometry using a biothesiometer. Tabular and graphical nomograms were obtained according to age and instrumental values. The use of the above-mentioned nomograms is an effective aid in detecting each individual case.

[Cost-benefit relationship between endoscopic resection (TURP) and open surgery (Millen) in prostatic hypertrophy ]

Evaluation of the cost/benefit relationship between TURP (50 cases) and Millin (30 cases). The factors considered are as follows: average post-operative hospitalization, average catheterisation time, average operation time, cost of materials, number of operators employed, number of transfused blood units. The post-operative hospitalization relating to the two kinds of operation varies considerably with a difference of 5.15 days less for the TURP, while the average catheterisation time doesn't seem to be affected. Blood transfusion was necessary in the 43.3% (0.75 unit/patient) of cases for the Millin compared to the 14% (0.26 unit/patient) for the TURP. Evaluation of economical advantages between TURP and Millin shows a relationship of 1:2.3 in favour for of TURP.

Influence of microinjection of glucagon into the amygdala on hepatic acetate metabolism in rabbits

Glucagon was injected directly into the medial amygdala (AMYG) of rabbits, and changes in hepatic acetate metabolism were studied. The injection of 3 ng glucagon into the AMYG of intact rabbits increased the rates of 14C transfer from 14C-1-acetate into CO2, glucose, ketone bodies, cholesterol ester, free fatty acids and phospholipids but decreased those of 14C transfer into triglyceride. However, the glucagon injection into the AMYG of rabbits with lesions of stria terminals or into the parietal cortex of intact rabbits had no effects on the hepatic acetate metabolism. These observations support the hypothesis that the AMYG is a part of the glucagon-sensitive brain regulator system in the hepatic acetate metabolism.

Influence of microinjection of corticosterone into hippocampus on hepatic acetate metabolism in rabbits

Corticosterone was injected directly into the hippocampus of rabbits, and changes in hepatic acetate metabolism were studied. The microinjection of corticosterone with seasame oil into hippocampus decreased the rates of 14C transfer from 14C-1-acetate into CO2 and free cholesterol, and increased 14C transfer into glucose, ketone bodies, triglyceride, free fatty acids and phospholipids. But after microinjection of corticosterone into the hippocampus of rabbits with lesions of dorsal fornix, hepatic acetate metabolism did not differ from that of control rabbits, which received injection of seasame oil into the same brain region. From these results it might be suggested that the hippocampus is a part of corticosterone-sensitive brain regulator system in the hepatic acetate metabolism.