Secondary amyloidosis of the bladder is a rare cause of hematuria, with only 10 previous reports. Findings and treatment in 5 patients with histologically verified bladder amyloidosis secondary to long-standing rheumatoid arthritis are presented. All patients were hospitalized for massive hematuria. One patient died before cystoscopy. Clot evacuation and fulguration through a cystoscope stopped the bleeding in 1 patient. In the other 3 patients hemostasis was achieved by cystotomy, bilateral percutaneous nephrostomy and continuous alum irrigation of the bladder, respectively.

The treatment of infertility caused by retrograde ejaculation has often been ineffective. The unphysiological composition of the urine is the main reason complicating the recovery of motile sperm. We describe a case of retrograde ejaculation caused by a congenital defect of the internal sphinchter muscle of the urinary bladder. In this case, motile sperm were only recovered if the bladder had been filled previously with artificial culture medium (Ham's F-10) supplemented with the patient's own serum. Two pregnancies followed intrauterine insemination with sperm recovered in this way.

A-22-year-old woman with long-standing rheumatoid arthritis and secondary amyloidosis of the bladder had recurrent profuse macroscopic hematuria. She was treated with intravesical dimethyl sulfoxide instillation every 2 weeks for 1 year. She remained asymptomatic during the treatment and at 6 months. Progressive disappearance of amyloid from the superficial mucosa of the bladder was demonstrated in sequential histological examinations.

Sixty patients with bladder carcinoma were examined by CT prior to radical cystectomy. CT indicated perivesical tumour growth or extension to neighbouring organs correctly in 68% of these cases. Overstaging was observed in 23% and understaging in 8% of the cases. Most of the difficulties concerned assessment of tumours in the anterior bladder wall and identification of the plane between the bladder and the seminal vesicle. In most instances CT provided no supplementary information to clinical staging, but was useful when obesity or previous irradiation impeded clinical staging.

A 41-year-old female patient with a profusely bleeding intrarenal arteriovenous malformation is described. The bleeding site was localized to the left kidney by cystoscopy and excretory urography. The diagnosis was confirmed by angiography and the malformation was treated by intra-arterial embolization without complications.