Antonio D'Amico

Leiomyosarcoma of the bladder fourteen years after cyclophosphamide therapy for retinoblastoma.

We report a case of bladder leiomyosarcoma which occurred in a 22-year-old female who had been treated with cyclophosphamide for a period of 68 months for retinoblastoma diagnosed at 18 months postpartum. Partial cystectomy was performed. Forty-two months after the operation she is tumor-free.We report a case of bladder leiomyosarcoma which occurred in a 22-year-old female who had been treated with cyclophosphamide for a period of 68 months for retinoblastoma diagnosed at 18 months postpartum. Partial cystectomy was performed. Forty-two months after the operation she is tumor-free.

MP63-02 PURE STRESS URINARY INCONTINENCE: ANALYSIS OF THE PREVALENCE, ESTIMATION OF COSTS AND FINANCIAL IMPACT

INTRODUCTION AND OBJECTIVES: Aim of our study was to evaluate the prevalence of ‘pure’ SUI (P-SUI), in a cohort underwent urodynamic test (UD) for urinary incontinence (UI), and the correspondence with UD findings. We also estimated the amount of costs of UD, and if the UD data could change the surgical indications. METHODS: We did a retrospective evaluation of the UDdatabase selecting 544 women with UI between January 2012 and July 2016. Pure SUI was defined by the International Continence Society criteria (table 1). Two very experienced urologists evaluated data. Data researched were: Prevalence of clinical and UD P-SUI Correspondence between clinical P-SUI and UD findings Accurate estimation in V of a single UD examination, including the human resources and materials used Total amount of UD costs in V in P-SUI patients Number of surgical procedures avoided due to UD results Related avoided surgical costs in V in P-SUI patients

Original flow chart for the management of hydroureteronephrosis caused by pessary placement

Hydroureteronephrosis due to pessary is a dangerous complication that can become critical if urosepsis is present. We propose a flow chart to manage the condition. Introduction The use of a pessary to treat a pelvic organ prolapse (POP) is a valid non-invasive option. Severe complications are usually associated with neglected, oversized, or misplaced pessaries. Major complications include fistulas, bowel or bladder erosion, and hydroureteronephrosis (HUN). Materials and Methods We reviewed the literature and our experience in the management of HUN in the last decade, as a consequence of pessary placement. Results We used flow charts to take an accurate medical history of each patient. Blood and urine analyses were taken at admission to assess the potential presence of sepsis, renal failure, and urinary tract infection. Physical examination included vaginal examination. In cases of pessary presence with a concomitant increase of serum creatinine value, a possible ureteral obstruction is suspected. In order to assess the presence of HUN and its underlying causes, a computed tomography (CT) scan should be performed to assess the mechanism of urinary tract obstruction. However, in case of renal insufficiency, abdominal ultrasonography (US) could be sufficient. If HUN is detected in a patient with no signs of urosepsis, we suggest a conservative management by the removal of the pessary and catheter placement. When urosepsis is suspected, it is mandatory to administer antibiotic therapy and evaluate the HUN drainage by nephrostomy. Conclusions There is no uniform management of women with HUN and a concomitant pessary. For this reason, and based on the literature and our experience, we propose an original management flowchart.