Paraurethral leiomyoma is a rare, benign, hormone-dependent neoplasm of mesenchymal origin affecting women. The clinical evidence varies, but it tends to be asymptomatic or associated with the sensation of a foreign body; urinary symptoms are rarely described. The distinction among urethral, paraurethral, and anterior vaginal wall leiomyoma can be very difficult owing to their anatomic proximity. Excision of the mass is the recommended treatment, and the diagnosis is confirmed by the pathologic finding to rule out the presence of a sarcoma. A case of paraurethral leiomyoma associated with dysuria, dyspareunia, and obstructive voiding symptoms is reported.

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Encrusted cystitis is a severe chronic inflammatory disease of the bladder characterized by excessively alkaline urine and calcifications within the bladder wall. A case of a 60 year-old man affected by systemic lupus erythematosus (SLE), which developed encrusted cystitis due to Corynebacterium urealyticum with E. coli coinfection, shows that the treatment of encrusted cystitis with a endoscopic debulking of the encrusted stones and an antimicrobial therapy specific for C. urealyticum often is not sufficient for the complete resolution of symptoms.C. urealyticum is a Gram-positive, slow-growing, multiresistant, urease-positive microorganism with diphtheroid morphology. Since 1985 it has been known as a cause of alkaline encrusted cystitis and other urinary tract infections (1), occurring mainly in patients subjected to urological manipulation. Alkaline encrusted cystitis is a condition characterized by the deposition of inorganic salts on a damaged urothelium. The patient presents symptoms of cystitis (2). Moreover C. urealyticum has been involved in endocarditis, pneumonia, peritonitis, osteomyelitis and soft-tissue infections (3). We report a case of encrusted cystitis due to Corynebacterium urealyticum in a patient with SLE. MATERIALS AND METHODSA 60 year-old man, affected by SLE and in treatment with steroid therapy, presents with persistent symptoms of urinary tract infection including dysuria, pollakiuria, and intermittent hematuria with urinary gravel. He had undergone cystoscopy, which showed stone deposits in the bladder wall. Analysis of the urinary stone deposits on the bladder mucosa revealed the presence of ammonium magnesium phosphate (struvite) and calcium hydroxy phosphate (apatite).The urine sample was plated onto modified MacConkey agar (Oxoid) and CLED (cystine-Iactoseelectrolyte-deficient) agar and incubated at 37°C for 48 h. The identification and the antibiotic sensitivity testing for common pathogen germs were performed with the Phoenyx identification system (Becton Dickinson, USA). The urine and pus culture for Corynebacterium spp. on 7% sheep blood agar (Oxoid, England) was performed with incubation at 37°C in air for 24 h. The microbiological criteria for identification of C. urealyticum were the presence of gram-positive bacteria with diphtheroid morphology catalase-positive and strongly urease-positive. For identification the APICoryne identification strip (API Laboratory' Products; bio-Merieux, France) and the Phoenyx identification system (Becton Dickinson, USA) were utilised. The

Objectives: A well performed vesico-urethral anastomosis (VUA) allows an early catheter removal and cystography is mandatory to exclude urinary extravasation. Aim of the study is to investigate whether transrectal ultrasonography (TRUS) is as reliable as cystography in detecting anastomotic leakage after radical retropubic prostatectomy (RRP) in order to avoid the use of X-rays. Methods: 50 patients (pts) underwent RRP. VUA integrity was assessed 7 days after surgery by cystography and subsequently by TRUS to assess the patency of VUA. Patients who showed extravasation at the cystogram underwent ultrasonography in order to evaluate the leakage shown with cystography. Results: Catheter was removed after 7 days in all patiens except 2 pts (4%) showed extravasation at the cystography that was exactly detected at the TRUS investigation, therefore the catheter was maintained for another week. TRUS investigation, performed after cystography, also revealed the presence of a lymphocele and a retropubic hematoma, in two different patients, both completely asymptomatic and misdiagnosed at the cystography. Conclusions: Urinary leakage in the first days after RRP can be frequent and cystography is mandatory to assess VUA integrity, when early catheter removal is planned. TRUS as an alternative investigation technique to cystography, showed a high sensitivity and specificity in detecting extravasation and was also able to diagnose complications related to RRP that cystography didn't show.

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