G. Carmignani

Up-Front Intravesical Chemotherapy for Low Stage, Low Grade Recurrent Bladder Cancer

PURPOSE We evaluated the ablative and prophylactic potential of short schedule, up-front topical chemotherapy on low stage and grade recurrent bladder tumors. MATERIALS AND METHODS The study design consisted of 4 weekly instillations followed by transurethral resection during week 5. Mitomycin C was administered initially and mitoxantrone was administered following the same schedule if disease recurred during followup. RESULTS After up-front mitomycin C, 29 of 42 patients (69%) had a complete response with no need for transurethral resection, whereas residual disease was resected in the remaining 13 (31%). Disease recurred during followup in 22 of the 42 patients (52.4%), who were then treated with up-front mitoxantrone with a complete response in 14 (63.7%). Residual disease was resected in 8 patients (36.3%) with progression to grade 3 in 2. CONCLUSIONS Short schedule intravesical chemotherapy can completely ablate small volume recurrent superficial bladder cancer in a relevant number of patients but it is not adequate prophylaxis.

Cavernous artery revascularization in vasculogenic impotence: New simplified technique

A new simplified technique of cavernous artery revascularization is presented. The arterial inflow to the corpora is obtained through a counterflow end-to-end anastomosis of the inferior epigastric artery to the proximal stump of the transected dorsal penile artery. The revascularization of the cavernous artery occurs through the common penile artery. This operation is particularly suitable for patients showing pudendal or common penile artery obstruction at arteriography. Optimal distal perfusion is obtained by a cross end-to-side anastomosis of the distal stump of the dorsal artery to the contralateral dorsal penile artery. To date 5 patients have been operated on using this method with good functional results in 80 per cent.

Experimental varicocoele in the rat — A new experimental model

SummaryA new experimental model of a varicocoele in the rat is proposed. The study has been carried out on the Wistar rat in which the gonadal vein enters into the iliac vein. A varicocoele was induced in different ways: by complete or imcomplete ligature of the iliac vein medial to the entry of the gonadal vein (Group I and II); by creating a venous compression by positioning the iliac artery in front of the vein, thus reproducing the so called “nut cracker” phenomenon (Group III); by creation of a small arterio-venous fistula by means of a side-to-side anastomosis between the iliac artery and vein. The results were studied macroscopically and histologically. The damage was most evident in Group III and significant in Group IV, but the absence of damage to the contralateral testis remains unexplained.

Renal angiomyolipoma with extrarenal involvement--in vascular, lymph-node and perirenal tissue. Reports of four cases.

Extrarenal involvement was found in four cases of renal angiomyolipoma. In one case the wall of the inferior right bronchial artery was infiltrated, lymph nodes were involved in two cases and the perirenal fat in one case. Extrarenal extension does not seem to alter the prognosis of renal angiomyolipoma. Expectant treatment of this rare condition therefore appears to be warranted.

Experimental Varicocoele in the Rat - A New Experimental Model II. Effect on Impregnating Ability

SummaryIn this paper the impregnating ability of rats in whom a varicocoele was induced according to principles described in a previous work was assessed. The animals, 20 adult male Wistar rats, were subdivided into 4 groups and treated as follows. In Group 1 a varicocoele was produced by partial ligature of the iliac vein proximal to the entry of the testicular vein. Group 2: same as Group 1 but incomplete ligature. In Group 3 an anterior transposition of the common iliac artery to the vein was carried out. In Group 4 a small side-to-side fistula between the common iliac artery and vein was created. The impregnating ability was evaluated by caging each operated animal with two fertile female rats. Only two animals, one belonging to Group 1 the other to Group 2, were unable to impregnate their partners.

Short schedule intravesical mitomycin preceding transurethral resection for recurrent Ta-T1, G1-G2 bladder cancer.

Aims and Background Intravesical instillations commonly follow resection, when all visible lesions have been removed, making impossible any direct assessment of efficacy. The study was conceived to evaluate the ablative effect on the tumor and the efficacy in reducing the risk of recurrence of short schedule intravesical chemotherapy administered before endoscopic resection. Study design Four weekly intravesical instillations of mitomycin C followed by transurethral resection (TUR) were administered to 31 patients with recurrent small volume superficial bladder cancer. Results At TUR no evidence of disease was found in 22 patients (70.9%) and residual disease in the remaining 9 (29.1%). At a median follow-up of 15 months (range, 3-33) 16 of 31 patients (51.6%) had recurrence of disease. The treatment was well tolerated. Conclusions Short-schedule intravesical chemotherapy can completely ablate small volume recurrent superficial bladder cancer in a relevant number of patients but is probably not sufficient to obtain long-term prophylaxis.