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An analysis of the clinical symptoms has been carried out in the group of 110 patients who underwent nephrectomy for a clear-cell carcinoma. Total hematuria (47.3% of patients) has been a predominant symptom of the tumour. Pain felt in the back has been noted in 39.1% of patients. Palpable tumour has been noted in 34.5% of patients. Such symptoms have been present simultaneously (Israel's triad) in 12.3% of patients. Tumour has been diagnosed accidentally, mainly with USG, in 37.3% of patients. It has been found that classic clinical symptoms of this cancer are nowadays less frequent than before introducing ultrasound examination.

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The 134 patients (aged 53 to 84 years) with symptoms of benign prostatic hyperplasia were drawn from two medical centers in Warsaw. The patients were randomly assigned to receive two capsules of the standard dose of an urtica/pygeum preparation (300 mg of Urtica dioica root extract combined with 25 mg of Pygeum africanum bark extract) or two capsules containing half the standard dose twice daily for 8 weeks. After 28 days' treatment, urine flow, residual urine, and nycturia were significantly reduced in both treatment groups. After 56 days' treatment, further significant decreases were found in residual urine (half-dose group) and in nycturia (both groups). There were no between-group differences in these measures of efficacy. Five patients reported adverse effects of treatment; treatment was not discontinued in any patient because of side effects. It is concluded that half doses of the urtica/pygeum extract are as safe and effective as the recommended full doses.

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Prazosin--a selective blocker of alpha 1-adrenergic receptors--was administered to 30 patients with benign prostatic hypertrophy. Twenty four patients (80%) reported an improvement in voiding and observed more potent urinary stream after the treatment. Average and maximum flow rates increased in 18 patients (60%). Therapy had to be discontinued in 2 patients because of the adverse reactions (hypotension and syncope in one and exacerbation of the coronary disease symptoms in another patient).

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Endoscopic treatment of vesicoureteral reflux (VUR) is based on transurethral injection of Teflon paste or collagen gel into the submucosa of the bladder wall beneath the distal ureter, resulting in support of the intramural part. This endoscopic procedure was performed in 75 children with VUR of varying severity. Altogether 111 ureters were treated, 94 with injections of Teflon paste and 17 with collagen gel. Improvement of VUR in the early postoperative period was achieved in 91.5% of the ureters treated with Teflon and in 82.4% of the ureters treated with collagen. No complications were observed. Endoscopic treatment of VUR seems to be an worthwhile alternative to open surgery. However, since long-term follow-up has not been completed, the efficacy of the method cannot yet be finally assessed.

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Calicocystostomy or calicopyelocystostomy was performed for the treatment of hydronephrosis of ectopic or transplanted kidney into the region of the iliac fossa. To the best of our knowledge there is no description of this treatment modality for hydronephrosis in a normally situated kidney. This prompted us to present 2 such cases observed in our clinic.

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A case of calicopyelocystostomy and one of pyelocystostomy are reported. In the first case, the operation was performed on an autotransplanted kidney. The operation was done in a patient with sponge kidney to facilitate spontaneous excretion of calculi. In the second case, the operation was performed in a patient with long-lasting urinary fistula which developed in a cadaver kidney transplant. Although the authors present only 2 cases, calicopyelocystostomy and pyelocystostomy can be recommended as a valuable method in complicated cases of recurrent nephrolithiasis and in patients with nonhealing long-lasting urinary fistulas which developed in transplanted kidneys.

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Ten patients (4 boys and 1 girl, 4 adult women and 1 man) were operated upon for incontinence due to epispadias (5 children and 2 women), or the result of multiple operations for stress incontinence (2 women), or of a transurethral bladder neck resection (the adult man), using Leadbetter's technique, which is described. In 4 patients with a sufficiently long trigonum, it was not considered necessary to perform ureterovesical reimplantation. Interesting results were obtained as they were assessed as very good in 4 and good in 2 of the 7 cases of epispadias, good in 1 of the 2 cases of sphincter lesions following surgery, and poor after endoscopic resection of the bladder neck in the man. All patients retained a normal upper urinary tract. In those patients who became continent, the new urethra measured 3.3 to 5 cm in length, whereas it was too short and dilated in cases remaining incontinent. Initial pollakiuria improved in the children after several months. These findings suggest that the ureter should be reimplanted in all cases, to allow the formation of a muscular, newly formed urethra of sufficient length. This operation appears to be effective for treating incontinence due to epispadias and traumatic sphincter lesions in women. It gives poor results in incontinence after prostate surgery and from neurological bladder. Reeducation of the child is as important as selection of patients for operation and a strict operative technique.

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