Objective: To determine whether urinary incontinence (UI) and lower urinary tract symptoms (LUTS) persist over years, patients treated for UI and LUTS in childhood were reevaluated in adulthood. Materials and methods: Forty-seven women (cases) treated in childhood for daytime UI/LUTS (group A) and nocturnal enuresis (group B) self-completed (average age: 24.89 AE 3.5 years) the International Consultation on Incontinence Questionnaire for Female with LUTS (ICIQ-FLUTS). ICIQ-FLUTS was self-administered to 111 healthy women (average age: 23 AE 5.1 years) from a nursing school as a control group. Data obtained from ICIQ-FLUTS and quality of life (QoL) score (0e10) were compared (Fisher's exact test) between patients and controls, and between group A (n Z 28) and group B (n Z 19). Results: Prevalence of LUTS was higher in patients than in controls. The difference between patients and controls was statistically significant (p Z 0.0001) for UI (34% vs. 7%) and feeling of incomplete bladder emptying (49% vs. 28%). QoL score was >5 in 59% of patients and 1% of controls (p Z 0.0001). No significant differences were found between groups A and B. Conclusions: UI and LUTS are confirmed in young women who suffered for the same condition in childhood. Longitudinal studies are needed to assess if these symptoms persist or are newly onset.

Noninvasive urodynamic evaluation seems to be as safe and effective as invasive urodynamic study in the long-term management of boys with posterior urethral valves. Based on these findings, invasive urodynamics may be reserved for cases of progressive deterioration of lower urinary tract dysfunction or renal function.

While retaining efficacy, the endo-injector needle technique appears to be more rapid than the standard procedure for botulinum toxin type A injection for neurogenic bladder dysfunction. Whether patients may be treated with sedation only remains to be clarified.

Objective: Prenatal diagnosis of urinomas has long been established with underlying obstructive uropathy generally responsible for urinary extravasation. Because urinoma formation represents a pop-off mechanism in cases of posterior urethral valves, the number of affected males greatly exceeds the number of females. Fetal urinoma has rarely been reported without obstruction and in females it has only been described as a consequence of a complicated amniocentesis. Methods: Three cases of fetal urinoma in female fetuses without any dilatation of the urinary tract are described. Since the fetus remained healthy, they were all conservatively managed. Results: Two urinomas resolved after birth and 1 exhibited significant regression. In the second case, a compressed kidney was visualized with fetal MRI. Renal function was impaired in cases 1 and 3 and absent in case 2 (the kidney was no longer visualized). Conclusions: Fetal urinomas can occur even in the absence of urinary tract obstruction and in a low-pressure system as is found in female fetuses. Fetal MRI may help both visualize the ipsilateral kidney and differentiate the mass from other conditions. In a healthy fetus, fetal urinomas can be conservatively managed, but renal function after birth is often absent or impaired. Whether or not in utero aspiration may be beneficial for the preservation of renal function remains unclear.

Background Primary malignant melanoma (PMM) of the bladder represents a very rare clinic-pathologic entity. Given the rarity of the disease, the best treatment option is not well recognized. Case presentation We describe a case of neoplasm of the bladder in a 74 years-old Caucasian man presenting with massive hematuria. Based on clinical, instrumental and histological findings a diagnosis of PMM was made. The patient underwent trans urethral resection of bladder tumor plus intravesical Bacillus Calmette–Guérin. Conclusions To make a correct diagnosis, clinical history, endoscopic evaluation, histopathological examination and immunohistochemistry, are necessary. Multidisciplinary evaluation is required to discriminate primary from metastatic malignant melanoma.

VURD syndrome has been repeatedly described as unilateral reflux into a nonfunctioning renal moiety. This syndrome is considered a pop-off mechanism dissipating pressure in lower urinary tract obstruction: it may be found in association with other protective mechanisms occurring in utero, such as ascites and/or urinomas, and has been exclusively described in male patients. A premature female baby with signs and symptoms of outflow obstruction underwent diagnostic workup revealing congenital urethral hypoplasia with unilateral reflux into a dysplastic kidney. Obstetrical history was positive for early onset, serologically negative ascites without cardiomegaly, which required serial aspirations. Reconstructive surgery was carried out with good results: ascites and VURD syndrome were both deemed to be perinatal protective mechanism against excess pressure in the urinary tract. Although rare, lower urinary tract obstruction in the female can lead to the same protective mechanisms seen in male fetuses/newborns. VURD syndrome and ascites should be interpreted as such and require perinatal specialist counselling.

children and adolescents (3-18years) suffering from severe sphincteric incompetence (exstrophy-epispadias 33, neuropathic bladder 44, bilateral ectopic ureters 5, miscellaneous 4) have been treated and followed for a minimum of 18months up to 12 years (median 60 months). A third had had a previous failed bladder neck procedure. Preoperative evaluation consisted in medical history and questionnaire about incontinence, urine culture, urinary tract ultrasound and videourodynamics. This evaluation was repeated at six months and one year after treatment and then on a yearly basis,except for videourodynamics performed only when necessary for further management. 25 patients had two and 13 three treatment sessions. Mean injected volume was 4,6 ml per session. At each evaluation, the patient was classified as cured (dryness interval of four hours ), significantly improved (minimal incontinence requiring no more than one pad per day; no further treatment required) and treatment failure when no significant improvement was observed.RESULTS: 32 (37,2%) patient are dry, 13/86 (15,1%) are significantly improved, and 41/86 (47,7%) patients had treatment failure. After 18 months of FU 2 male patients became dry at puberty 2 Female patients became incontinent again. All the other patients remained perfectly stable.CONCLUSIONS: Endoscopic treatment of urinary sphincter insufficiency with Deflux® is effective in around 50% of cases after 18months; our study with the largest reported cohort and the longest FU confirms that this result is durable up to 12 years thereafter.

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