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The incidence and intensity of schistosomal infection in 50 African malignant bladders determined by quantitative analysis have been compared with a matched control group of nonmalignant cadaver bladders, and the incidence of radiological calcification in the former has been compared with that of 50 adult urinary bilharziasis patients without associated malignancy. Compared with 45% in the non-malignant group, schistosomal infection was present in an overwhelming 94% of the malignant cases. Radiological calcification in the malignant bladders (38%) was slightly more than in patients with urinary bilharziasis (35%). In the majority of the malignant bladders (55.3%) the parasitic infection was noted to be of moderate to low intensity. It has been suggested that the overall severity of schistosomal infection is unlikely to be the sole factor in the pathogenesis of carcinoma of the urinary bladder.

The pattern of urological malignancy among the indigenous population of Zambia (determined on the basis of histopathological reports from a major national hospital during an 8-year period) is presented. A total of 6514 malignancies were observed, of which 784 (12%) were of urological origin. Bladder carcinoma, predominantly squamous type, was the commonest urological tumour (51%), followed by carcinoma of the prostate (26%), carcinoma of the penis (18%), renal tumours (4.3%) and testicular malignancy (0.7%). In nearly 32% of the bladder tumours, bilharzial ova were demonstrated histopathologically. Nephroblastoma accounted for 70% of the renal tumours and from a total of 7 cases of testicular tumours 5 were embryonal carcinoma and 2 seminoma. A brief reference is made to the pattern and aetiology of urological malignancies in some neighbouring countries.

A giant fibrous pseudotumor of the right testicular tunics in a 27-year-old Zambian is presented. It has been suggested that associated Schistosoma haematobium infection could have contributed to the giant size and rapid growth of the lesion.

SummaryThirty-seven cases of second and third degree haemorrhoids have been treated by cryosurgery. Although the number of cases treated is small and the follow-up is short, we are greatly encouraged by the early excellent results. It is a simple and effective procedure with minimal complications, and it is especially recommended for those patients who are medically unfit for general anaesthesia. The rapidity of this procedure combined with the painless operative and postoperative course enables the patient to leave hospital the next day. More cases with long-term follow-up are needed before adequate evaluation of this form of treatment can be made.

Observations are presented on 11 cases of haemospermia in the University Teaching Hospital, Zambia, a country where bilharziasis is endemic. Seven patients were severely hypertensive but only two had urinary bilharziasis. The incidence of Schistosoma haematobium infection of the prostate and seminal vesicles is discussed and it is concluded that there is no significant association between the parasitic infection and haemospermia.

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