The veins of the spermatic cord are abnormally wide and tortuous in both primary and secondary varicocele. The primary form is by far the more common; among the causes of secondary varicocele are renal tumor (SPITTEL et coIl. 1959), hydronephrosis (WHITE 1914), aberrant renal artery (CAMPBELL 1944), and arching of the spermatic artery over the renal vein (NOTKOVICH 1955). The pathogenesis of primary variococele has not been clarified. BRODNY et coIl. (1955) stated that it most often starts at puberty and occurs in about 10 % of the male population, on the left side in about 90 %, bilaterally in 8 % and on the right side in 2 % of these. The clinical importance and treatment of the condition as well as the pathogenesis are dealt with in another report by the present authors (FRITjOFSSON et coll.).The scrotal veins may be considered as lying in two groups: a deep group and a surface network group (JAVERT & CLARK 1944). The deep system comprises the pampiniform plexus, the internal and external spermatic veins and the ductus deferens veins. The pampiniform plexus consists of a network of veins which originate in the testis and epididymis; it is drained by the three aforementioned larger vessels. The internal spermatic vein passes through the

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The effect of sodium pentosanpolysulfate (Elmiron) in the treatment of interstitial cystitis was observed in an open controlled multicenter trial. We studied 87 patients with symptoms for more than 2 years at 17 centers in Finland and Sweden. Patient selection was based on the typical chronic symptomatology but the material subsequently was stratified according to objective cystoscopic findings. The medication (400 mg. daily in 2 oral doses) was discontinued after 6 months. The response was evaluated every 4 weeks during treatment and every 3 months thereafter. Most patients responded favorably, many with diminution of pain within only 4 weeks from the start of treatment. The frequency of micturition decreased significantly and the mean volume per void per 24 hours increased in the patients without bladder ulceration but such changes were not found in the patients with ulcer. The bladder capacity was smaller in the ulcer group. In these patients the pre-treatment intensity of pain was somewhat greater than in those without bladder ulcer but the pain was alleviated in both groups and this effect was stable at the 3-month followup. The differences in responses in the 2 groups indicate a probable fundamental difference between ulcerative and nonulcerative interstitial cystitis. Side effects of the drug were few, slight and transient. Therefore, the study indicates that a significant number of patients with interstitial cystitis can be expected to benefit from treatment with sodium pentosanpolysulfate.

Ninety-one patients underwent radical retropubic prostatectomy. Forty-three specimens were examined after limited sectioning (series 1) and 48 underwent whole organ serial step-sectioning at 5 mm intervals (series 2) of the removed prostate gland. The latter allowed a more extensive assessment of tumour localization, multicentricity, extension, pT-stage and grade. Eighty-eight percent of specimens in series 1 had free surgical margins compared with only 41% in series 2 (p = 0.00001). Preoperative tumour grading by fine-needle aspiration biopsy, TUR-chips or 1.2 mm core biopsies was in agreement with postoperative grading in the prostatectomy specimens in 48% of the cases in series 1 and 67% in series 2, respectively. In series 2, preoperative localization of the tumours by palpation was accurately assessed in 75% of cases when compared to the findings at step-sectioning. Sixty-eight percent of 40 eligible glands in series 2 contained multiple tumours. 12/13 cases of unifocal tumours (92%) were classified as large single tumours. The sections were divided into four peripheral and four central parts/octants, and the tumour localization was marked within these octants. The apical and middle third of the prostate contained tumour in all cases, whereas the basal (cranial part) was engaged in 35%. Small tumours were localized mainly in the periphery of the gland, with no significant difference between dorsal and ventral octants. However, large tumours were situated mainly in the dorsal peripheral octants, concomitant with an increased involvement of the ventral and central octants.(ABSTRACT TRUNCATED AT 250 WORDS)

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