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Stone Cone® (Microvasive-Boston Scientific Corp, USA) is a device which prevents retrograde calculus migration during endoscopic ureterolithotripsy. We have studied the safety and efficacy of this device in endoscopic ureterolithotripsy with ballistic energy in proximal ureteral stones. MATERIALS AND METHODS. From 01/02/2006 to 01/02/2008 we carried out 36 ureterorenoscopies (URS) for proximal ureteral stones (average age: 46, range: 15-73). A ballistic energy was used for stones fragmentation. In 18 patients (Group A) we carried out URS with the aid of Stone Cone®, which was not used in the other 18 patients (Group B). Semirigid 8 Ch or 10 Ch Storz ureteroscope and ballistic lithotriptor Swiss Lithoclast Master EMS® were used. In cases of migration, edema, and ureteral damage, a ureteral stent was used. RESULTS. In Group B patients (URS performed without Stone Cone®) the migration of the whole stone, or of clinically significant fragments, occurred 8 times (45%). All of these patients underwent external shockwave lithotripsy (ESWL) at a center equipped with a lithotriptor. A ureteral stent was placed in 14 cases (78%). In Group A, the migration of a stone requiring ESWL treatment occurred only once (5%). The ureteral stent was placed 8 times (45%). We had no significant complications during the procedure. CONCLUSIONS. The Stone Cone® is a safe and easy-to-use device. The cost of this device can be balanced by the reduction of postoperative ESWL treatments for lithiasic fragments pushing up into the kidneys (p<0.01), and of ureteral stent applications at the end of the procedure (p<0.05).

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Many, varied techniques have been used over the years in the surgical treatment of Induratio Penis Plastica (IPP). From December 1994 to March 1998, 83 patients were operated for IPP and assessed with an average follow-up of 20 months (range 2–24). Results were analysed, the overall assessment taking into consideration not only the objective clinical finding by the doctor, but also the degree of satisfaction expressed by patients. The patients were given a subjective self-assessment test considering the pre and post-operative changes in the following parameters: rigidity, curvature, glandular sensitivity, length of penis and satisfaction with general result. Another doctor in the department (not the operator) clinically assessed the same parameters during follow-up. Results showed that the above parameters were more favourable in patients operated for plaque and incision of the same than in those who had undergone removal. The subjective version of almost all patients and the clinical follow-up assessment were, however, in disagreement with these results. Moreover, only 60% of patients reported that they were generally satisfied. The subjective and objective assessment by the patients and doctor respectively are not always in agreement, highlighting the fact that patient satisfaction is sometimes unrelated to the clinical evaluation of “success” of the surgical option. In IPP therapy, results for the patient would seem to be better when less aggressive surgery is carried out on the plaque as described, i.e. with minimum dissection of the anatomical structures of the penis.