The aim of this study was to evaluate the following methods of postmastectomy lymphedema treatment: pneumatic massage with uniform pressure, pneumatic massage with differentiated pressure, and manual lymphatic massage. The study concerned three groups of 20 mastectomized patients with secondary early developed arm lymphedema. The measurement of circumference on seven points of both arms, the self-scoring mood questionnaire, and the visual analogue scale (VAS) were evaluated before, at the end, and 3 months after the treatment. We observed a permanent edema reduction, which was statistically significant, with uniform pressure pneumatic massage and with manual lymphatic massage, but not with differentiated pneumatic massage. The VAS and the self-scoring mood questionnaire made from measuring the subjective ratings of the patients confirmed the objective evaluations.

A clinical study was made of 21 patients (13 men and eight women) who had undergone anterior resection of the rectum for cancer at the National Tumour Institute of Milan between April 1984 and April 1985. After surgery, 13 patients (including three men with benign prostatic hypertrophy) showed voiding dysfunctions (hesitancy, dysuria, and weak stream) and bladder areflexia. Two of them also had positive Lapides' tests. An early rehabilitative treatment was started after surgery and the entire group was thoroughly reexamined one year later. Only the two patients with positive Lapides' tests still had bladder areflexia with residual urine greater than 100 ml. One of them also had a urinary tract infection. None of them showed decreased renal function.

Here we report 42 cases of postirradiation lesions of the brachial nerve plexus in patients treated with radiotherapy after radical mastectomy. These lesions usually appeared at least 1 year after treatment, and motorial disturbances always developed, even if initially they may have been absent. A comparison of the case material indicates that a reduction in the dose administered to the supraclavicular region and exclusion of the axillary region from the treatment resulted in a significant reduction in the incidence of these lesions. In fact, in a group of 490 patients treated by the old radiotherapy method at the Istituto Nazionale Tumori of Milan (i.e., administration of 6000 rad to the brachial nerve plexus), 16 cases of lesions at this plexus were observed. In a group of 200 patients treated instead with a new method (i.e., administration of 4900 rad to the brachial nerve plexus and exclusion of the axillary region), no nerve lesions were observed, with significance levels, according to Fisher's test, less than 0.9%. Since radiolesions at the brachial nerve plexus have a very bad prognosis with regard to functioning of the limb and physiotherapy is of little help, this new therapeutic method is very useful, and it is not accompanied by an increase in the number of local recurrences as compared to the old method.

Biofeedback training is proposed as rehabilitative training for patients with permanent colostomies to help them achieve fecal continence. The results of a preliminary study of 18 patients are reported.

We studied bladder and urethral function prospectively in 64 patients before and after Wertheim's radical hysterectomy. Immediately after surgery, neurogenic bladder dysfunction of various degrees was found in 70% of all patients who presented difficulty of voiding, with high residual urine and/or stress incontinence. All the patients have received an early rehabilitative treatment with kinesitherapy and/or pharmacological therapy after the bladder catheter removal and the urodynamics' results. We have obtained a satisfactory functional recovery of the bladder activity in 91% of the symptomatic patients.