Background: Fournier disease (FD) is a worrisome infection of genital area caused by a polimicrobial infection and characterized by a rapid progression to necrosis. Scrotum, perineum and lower abdomen represent the primary sites of origin. Clinical presentation and laboratory strongly suggest FD, but if not precociously diagnosed, it may quickly evolve into septic syndrome and patient’s death. Case report: A 62 years old Caucasian male presented for fever and penile gross oedema recently occurred. No history of previous urinary tract infection, hematuria or genital trauma was referred. He did not complain any storage or voiding low urinary tract symptom (LUTS); no foci of infection in genitoperineal area was observed nor urethral discharge. The ultrasound (US) revealed a disomogeneous broad thickening of subcutaneous tissues with increased vascularity on Color-Doppler. When the penis was manipulated in order to reduce oedema, retract foreskin and evaluate the glans, clinical parametres rapidly worsened and the patient developed a septic shock with blood pressure falling down, dyspnoea and tachyarrhythmia, and he was fastly sent to Intensive Care Unit where it has been hemodynamically stabilized and subjected to antibiotic therapy. Considering the clinical absence of gangrene’s foci, we opted for a conservative treatment by maintaining bladder catheter and drug therapy.

Background: Neuroendocrine tumours (NET) are extremely rare and aggressive. Although they commonly affect intestine, many organs may be involved such as pancreas, lung or urinary tract. Bladder is rarely involved. Actually, two main forms of bladder NET have been described: small-cell and large-cell. The first one is considered highly agressive since it shows poor oncologic outcomes being mainly diagnosed at advanced stage: the second one is extremely rare and equally aggressive. Case report: A 78-years-old Caucasian male presented to our facility for lower urinary tract symptoms and gross hematuria recently occurred. He was a strong smoker since many years. No familiarity for urothelial cancer was referred nor previous episodes of hematuria until that time. Citology was negative; outpatient ultrasound of the bladder revealed a 3 cm bladder thickening highly suspicious for bladder cancer; patient underwent TC scan that confirmed the bladder lesion. A transurethral resection of the bladder (TURB) was performed. After 3 months total body TC showed multiple visceral metastases also involving brain and lymph nodes. Best supportive care was offered but the patient died 6 months later. Results: Pathology revealed a mixed bladder tumor: 30% of the specimen resulted as an high-grade urothelial cancer (G3) and 70% as small-cell neuroendocrine variant.Microscopic muscle involvement was excluded.Conclusions: Neuroendocrine tumors are uncommon entities which origin from cells of neuro-endocrine system and may potentially involve all human tissues. Neuroendocrine smallcell carcinoma of the bladder is a non-urothelial histotype: it is highly aggressive and diagnosed mainly at advanced stages. Whenever considering the high risk of metastatic spread and the poor prognosis, a multimodal approach is highly suggested. TURB alone is uneffective in disease control due to its aggressive nature. Unless metastatic, radical cystectomy and adjuvant chemotherapy represent the gold standard.

In the present work we have studied the success of HCG-PG-1 association in the treatment of male impotence. We recruited (January-June 1990) 60 patients suffering from impotence for at least six months, selected by means of appropriate inclusion criteria. They were subdivided into three groups after standard diagnostic screening. In the first group we employed therapy with HCG 5.000 U.l. a week for four months. In the second group we have made intracavernous pharmaco-therapie weekly with PGE-1 for the same period. In the third group we did both above - mentioned therapies associated. Anamnesics qualitative-quantitative criteria for numeral results determination were adopted. This association produced a better therapeutic result as regards single therapy, with rapid and durable progress and very good follow-up.

Medical treatment has a high placebo effect depending on the dynamic and/or obstructive nature of fibroleiomyoadenomatous hypertrophy in which the fibromuscular component may be three times as much as the epithelial one (Clark 1937). It is an indubitable fact that androgynoid transexuals do not develop BPH. This means that hormonal balance is fundamental for BPH control, both direct and through growth factors. The following medicines can be used in growth control: hormones, antihormones, organ extracts, vegetable extracts, anticholesteremics. Hormones are testosterone and its active DHT form, oestrogens, progestogens and their inhibitors, pituitary antiandrogens. The following are not to be discarded: organ and vegetable extracts, anticholesteremic antibiotics, long-term use anticholesteremics. Vasoplegic, ganglioplegic, antireceptory and parasympathomimetic drugs are used as symptomatic ones such as: prostaglandin, bethanechol, prazosin, alphuzosin. A specific temperature rise of the prostate obtained through microwaves (hyperthermia up to 11 °/45°C or up to 70° by thermotherapy) offers a 50% improvement rate. It is confirmed that medical or physical therapy is advisable in the initial stages or in very high risk cases: the placebo effect is remarkable and the ideal drug still has to be found.