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Renal colic in pregnant patients can be complicated by pyelonephritis and premature labor, especially if misdiagnosed or inadequately treated. Ultrasound is a safe and sensitive diagnostic test. Approximately two-thirds of renal calculi will pass spontaneously. For those who require intervention, placement of a Double-J stent is a safe and effective option.

The model AMS800 artificial urinary sphincter was implanted in 117 patients with urinary incontinence resulting from radical prostatectomy. The indication for implantation was total incontinence in 107 patients and stress incontinence in 10. All patients had bulbous urethral cuff insertion and 20 had previous pelvic irradiation. Followup questionnaire indicated a 90% significantly improved continence rate and a 90% satisfaction rate among patients. There were 64 surgical revisions required in 37 patients: inadequate cuff compression in 21 (33%), tubing kinks in 10 (16%), urethral cuff erosion in 8 (13%), scrotal hematoma in 6 (9%), control assembly malfunction in 4 (6%) and cuff leaks in 4 (6%). Of the 20 patients with previous pelvic radiation 2 (10%) had at least 1 erosion, compared to 5 of 97 (5%) in the nonirradiated group. At followup 5 patients did not have at least 1 component of the AMS800 device indwelling (2 cuffs and 3 entire devices had been removed).

Concurrent sphincteric incontinence and organic impotence are not uncommon; they can be caused by many congenital and acquired conditions. In the past simultaneous implantation of the artificial sphincter and penile prosthesis was met with skepticism. Of 65 patients who had concurrent implantation of the artificial sphincter and various categories of penile prosthesis 60 were followed for a mean of 35.74 months (range 8 to 55 months). Continence was graded as good or satisfactory in 95 per cent of the patients and poor in 5 per cent. The penile implants were functional in 98 per cent of the patients. Of the 60 patients 33 required 59 corrections, for an average of 0.98 correction per patient. These results indicate that staged or concurrent implantation of dual prostheses is feasible technically, functionally and cosmetically, and without increased risk for surgical or mechanical problems.

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