Platelet adhesiveness, ADP-aetivated platelet a.ggregation and the activity of the ADP-splitting enzymes m blood and plasma have been studied in 22 diabetics with severe retinopathy, 22 long-duration diabetics with minimal or no retinopathy and 28 control subjects. The rate of platelet aggregation under the influence of 5, 3, 2 and t txM ADP, the maximum aggregation attained and the rate of disaggregation of these aggregates were measured. The platelets from actively deteriorating retinopaths were found to be more sensitive to the effect of low concentrations of ADP; a significant increase in the extent of aggregation and a decrease in the rate of disaggregation of platelet aggregates formed under the experimental conditions, in vitro were observed. If this should occur in vivo, then capillary occlusion might ensue. This increased sensitivity to ADP and inability to disaggregate, was not due to any differences in the activity of the ADP-splitting enzyme systems in blood. Significant differences in the parameters were not observed when the large diabetic groups were compared with the control subjects. Contrary to some reports, an increase in platelet adhesiveness was not apparent in either diabetic group.

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Between June 1, 1983 and June 30, 1988, 174 patients with stress incontinence were treated with a colposuspension operation; 144 patients were cured, 30 remained wet. Sixteen patients who remained wet had detrusor instability; 9 of these were cured by anticholinergic medications. Of 25 patients who had dual pathology 19 were cured. Seventy nine patients had urinary tract infections. Two patients had ureteric obstruction due to kinking; it is postulated that this can be an infrequent and sometimes unavoidable complication.

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