abolished or significantly decreased the intensity of pain in renal colic. The painkilling effect was defined as a decrease by at least half in the PI scale, and/or a ≥ 40% decrease in the VAS 40 min after either the first or the second injection of 80 mg drotaverine or placebo (if necessary the dose could be repeated once). In all, 140 patients were enrolled but 38 withdrew, leaving 102 patients for analysis (48 drotaverine, 54 placebo; mean age 42.5 years, SD 11.25, and 41.7, SD 10.79). RESULTSDrotaverine was effective in 79% of patients and placebo in only 46% ( P < 0.001). There were no serious adverse effects. There were 20 minor side-effects in the drotaverine and four in the placebo group; none of the patients required treatment. The most frequent sideeffects were a transitory decrease in blood pressure, vertigo, nausea or vomiting. CONCLUSIONIntravenous drotaverine provides effective pain relief in more than two-thirds of patients with renal colic, with no serious side-effects.

According to our data, one of the possible pathways for impaired reproductive quality in male subjects >45 years could be related to infection and inflammation in the genital tract with subsequent (partial) obstruction and damage of prostate and other male accessory glands.

The aim of this study was to compare the reproductive parameters and the health-related, lifestyle and educational factors in middle-aged healthy men and male partners of infertile couples. Our patient group included 164 male partners of infertile couples with a preceding period of infertility of at least 12 months and 61 men attending a prostate health screening and considering themselves healthy. Significant differences between the groups were found in testicular volume, total sperm output, density and morphology as well as oestradiol levels in serum. The analysis showed significant positive correlations between testicular volume and semen quality, while negative correlations were observed between gonadotrophin levels and sperm parameters in both groups. Physical activity and sexual capability were higher in healthy men, while coital frequency and a history of sexually transmitted diseases were higher in male partners of infertile couples. The impact of physical activity and sexual capability on semen quality for all subjects was revealed. We can conclude that impaired reproductive function, that is, semen quality, in men >45 years is related not only with general male ageing but obvious differences between subjects of infertile couples and healthy middle-aged men can be seen. Their relations with lifestyle, environmental or physiological factors need further study.

Purpose: We aimed to compare the associations between semen quality, associated reproductive indicators and the main prostate-related parameters in middle-aged men. Materials and Methods: This is a prospective study on 422 middle-aged men who underwent the screening for prostate health. Their reproductive function, semen quality and prostate-related pathologies were investigated. Results: Significant associations between semen quality and prostate-related parameters could be seen. Total sperm count and sperm density decreased along with the increase of the I-PSS score and total prostate volume. Also, the related lower urinary tract characteristics showed a negative correlation with main semen parameters for all investigated subjects. no significant differences in age, testicular size, and hormonal parameters were found between the subjects with or without lower urinary tract symptoms and prostate enlargement. Conclusions: Our study suggests that altered seminal parameters in middle-aged men are associated with LUTS, prostate enlargement and/or bladder outlet obstruction. Although the assessments of prostate and lower urinary tract symptoms may not replace the semen parameters evaluating the male reproductive status, there is a need for further and more detailed investigations about the pathways behind these associations as well as possible related conditions.

This paper summarizes what is known about the occurrence and survival of bladder cancer in Estonia from 1968 to 1992. In 1988-92 the age standardized (world standard) incidence rate of bladder cancer was 11.1 per 100,000 person-years in males and 2.0 in females, and the age standardized mortality rate was 8.2 and 2.7, respectively; by July 1, 1990 the age standardized prevalence rate was 41.5 and 14.7, respectively. Between 1968-72 and 1988-92, incidence increased by 1.26 times (95% confidence interval 1.09 to 1.46) among males; incidence rates for females did not show a consistent trend. The time trends in mortality generally paralleled the trends in incidence. Higher rates of bladder cancer were found among males in five large towns. For patients diagnosed in 1983-87, the five-year relative survival was 32.4% (95% confidence interval 27.0 to 37.8) for males and 32.5% (23.8 to 41.2) for females; throughout the 20 years there was no improvement in survival. As the survival rates are less favorable than those in the Nordic countries, further hospital-based studies are needed to investigate the relation between survival and clinical characteristics.