urinary and sexual function and bother was also constructed. RESULTSThere were no differences in the QoL scores among the three groups; group 3 (control) tended to have a better QoL for all domains except emotional functioning. Urinary function was seriously affected in group 1, with more daytime leakage than in groups 2 and 3 (37.8% vs 10%, P = 0.005, and 9.3%, P = 0.01), night loss of urine (39.5% vs 28%, P = 0.07, and 3.7%, P = 0.002) and urine odour (58.6% vs 4%, and 5.5%, both P = 0.001). Patients in group 2 differed from healthy individuals only in night loss of urine. Consequently urinary bother was more pronounced in group 1, as fewer were satisfied (68.9% vs 86% and 83.2%, both P = 0.03). Sexual function was seriously and similarly affected in groups 1 and 2; the erection rate was 28.9% for group 1, 35.5% for group 2 ( P = 0.1) and 83.3% in group 3 ( P = 0.003), while firm erections were present at 17.7%, 22.2% ( P = 0.2) and 83.3% ( P = 0.002). Women reported equivalent dysfunction in all three groups (15.4%, 20% and 16.6%, P = 0.3). Sexual desire was also equal in all groups (48.2%, 50% and 48.1). Patients in group 1 expressed more bother, while those in group 2 seemed more satisfied by their sexual life (84.4%, 68% and 68.5%, P = 0.04). CONCLUSIONSRadical cystectomy does not affect QoL whichever urinary reconstruction is used, and this implies a determination by the patients to live and adjust to their new conditions. On the contrary, urinary and sexual function are affected and related to the method used to reconstruct the urinary system. KEYWORDSquality of life, bladder cancer, radical cystectomy, ileal conduit, modified S-pouch. OBJECTIVESTo measure the quality-of-life (QoL) outcome and urinary and sexual function and bother after radical cystectomy and different types of urinary tract reconstruction (Bricker vs modified S-pouch neobladder), also assessing differences between them and a normal population. PATIENTS, SUBJECTS AND METHODS

OBJECTIVE To study the urological manifestations of familial multiple endocrine neoplasia type 1 (MEN‐1). PATIENTS AND METHODS The study included 26 adults (median age 38.5 years, range 18–80) from two unrelated MEN‐1 pedigrees. In 15 of the patients the diagnosis was confirmed by genetic analysis, while in the rest the diagnosis was based on clinical criteria combined with genealogy data. RESULTS Urolithiasis associated with primary hyperparathyroidism was present in 65% of MEN‐1 patients and in 77% of those who were symptomatic. In 68% of patients complications of urolithiasis (renal/ureteric colic, urinary tract infection) were the presenting clinical manifestations of MEN‐1, whereas in 50% they constituted the only clinical manifestation of the syndrome. The mean time from the onset of symptoms of urolithiasis to the diagnosis of the polyendocrinopathy was 17.2 years. Initial failure to recognize the presence of MEN‐1 in patients with primary hyperparathyroidism led to conservative parathyroid surgery, with subsequent relapse of the hyperparathyroidism, requiring re‐operation. Serious renal morbidity included one case of pyonephrosis necessitating nephrectomy. While urolithiasis was a cardinal clinical manifestation of MEN‐1, there was otherwise considerable phenotypic polymorphism, even among patients bearing the same MEN1 gene mutation. CONCLUSION In patients with familial MEN‐1 the complications of urolithiasis are the commonest presenting clinical manifestations and the cause of significant morbidity. In the presence of a family history of renal stones, appropriate investigations may lead to the timely diagnosis of this important, albeit rare, disorder.

potency were evaluated at 3, 6 and 12 months in all patients and compared between the groups. RESULTSAt 12 months, 57% and 60% of patients were potent in group 1 and 2, respectively; the respective mean International Index of Erectile Function (5-item) scores were 14.76 and 15.43 ( P = 0.59). Potency rates at 3, 6 and 12 months were not significantly different between the groups, and the continence rates at 12 months were also similar, with 93% and 90% of patients in groups 1 and 2 being continent, respectively. Ten and five patients in groups 1 and 2, respectively, required a blood transfusion ( P = 0.23). There were no fistulae, wound dehiscence or rectal perforations. One patient in group 2 presented 4 months after RRP with a bladder neck contracture. CONCLUSIONSLocal application of betamethasone does not improve or expedite the recovery of erectile function after BNS-RRP, but there were no complications associated with its use. KEYWORDSprostate cancer, radical prostatectomy, management, steroids OBJECTIVETo evaluate the effect on potency rates after surgery of applying local steroids to the neurovascular bundles (NVBs) of the prostate after bilateral nerve-sparing radical retropubic prostatectomy (BNS-RRP). PATIENTS AND METHODSSixty potent men undergoing BNS-RRP for clinically localized prostate cancer were prospectively randomized equally into two groups. In group 1, 10 mL of betamethasone cream 0.1% was applied locally to both NVBs, and group 2 had only the usual BNS-RRP with no corticoid cream. Complications and

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