CT is an efficient imaging method for diagnosis, guiding the drainage procedures and monitoring response to percutaneous drainage of emphysematous pyelonephritis. Antibiotic therapy combined with CT guided percutaneous drainage of emphysematous pyelonephritis is an acceptable alternative to antibiotic therapy with surgical intervention.

Alterations in the p53 tumor suppressor gene appear to be important in the development of many human tumors. The wild‐type p53 gene has a polymorphism at codon 72 that presents the arginine (CGC) or proline (CCC) genotype, which recently has been reported to be associated with genetically determined susceptibility to smoking‐related lung cancers. To determine whether this p53 genotype influences individual risk of urologic cancer and/or its progression, we used polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) analysis to assay the allelic frequencies of this polymorphism in 85 renal cell carcinoma patients, 151 urothelial cancer patients, 33 testicular cancer patients, 28 prostatic cancer patients and 56 patients without neoplastic disease. The allelic distributions of the three genotypes (Arg/Arg, Arg/Pro, Pro/Pro) in patients with renal cell carcinoma (29.4%, 55.3%, 15.3%), urothelial cancers (45.7%, 39.7%, 14.6%), testicular cancer (45.4%, 48.5%, 6.1%) or prostate cancer (42,9%, 50.0%, 7.1%) did not differ significantly from those in the normal controls. However, Pro/Pro genotype in renal cell carcinoma and urothelial cancer (smoking‐related cancers) was more frequent than that in prostate cancer and testicular cancer (smoking‐unrelated cancers) with borderline significance (P=0.0881). There was no particular correlation between frequency of the three genotypes and grade or stage of each type of tumor. The association of genetic predisposition to urologic cancers with p53 gene codon 72 polymorphism is not so clear as the previous study of Japanese lung cancer patients, but this polymorphism may play some role in urothelial cancers and renal cell carcinoma, in which smoking is an epidemiological risk factor.

From 1967 through 1986, 55 patients with chyluria were treated by renal pelvic instillation of 10 ml. 0.5% silver nitrate solution and surgical disconnection of the renal pedicle lymphatics was done in 9 (16.3%) due to persistent chyluria after instillation therapy. Among these 46 renal pelvic instillation patients and 9 operated patients followed for 2 years chyluria recurred in 11 (22.7%) and 5 (55.5%), respectively. Renal pelvic instillation is a safe and effective method to treat chyluria.

No abstract

Twelve patients with fracture of the penis have been treated in this department during the last 18 years. Their mean age was 41.5 years (range 25-55) and two-thirds of the injuries resulted from coitus. Eleven patients underwent immediate exploration and repair of the tunica albuginea and only 1 still has sexual dysfunction. One patient was treated conservatively and remains impotent. Immediate surgical treatment is recommended, since it avoids the formation of penile plaque, penile fibrosis and angulation and accelerates restoration of normal penile function.