Thirty female patients with urge incontinence or bypassing an indwelling urethral catheter have been treated by subtrigonal phenol injection. All were proven to have detrusor instability. The injection method is described. Seventy-six per cent of patients were rendered dry. The urodynamic changes are recorded.

The standard surgical management of patients presenting with transitional cell carcinoma of the upper urinary tract is nephroureterectomy with excision of a cuff of bladder around the ureteric orifice. Recently a modified technique of resecting the lower ureter endoscopically and completing the nephroureterectomy through a single loin incision has been advocated as a safe and simple procedure. We consider that this technique may have a risk of tumour implantation at the site of the resected lower ureter. We report our experience of this operation in five patients, two of whom developed invasive tumour at the site of the ureteric orifice after only a short follow-up.

The value of cephradine prophylaxis in reducing urinary infection was assessed in 243 patients undergoing endoscopy for bladder carcinoma. Patients were randomised either to receive 3 peri-operative doses of cephradine or to receive no antibiotic. Urine specimens taken on the fifth post-operative day showed a significantly lower urinary infection rate in those patients receiving cephradine prophylaxis.

The potential impact of breast cancer-related lymphedema (LE) is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1) time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ); (2) referral to LE management with limb volume increase (LVI) and/or LBCQ symptoms; and (3) cost of LE management at lower LVI (≥5%–≤10%) versus traditional (≥10%). Findings revealed a visit timeframe mean of 40.3 min (range = 25–60); 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9). LBCQ symptoms and LVI were significantly (p < 0.001) correlated to LE referral; six of the nine patients referred (67%) displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings).

Urinary fibrin/fibrinogen degradation products (FDPs) were measured in 210 specimens from 174 patients with newly or previously diagnosed transitional cell carcinoma of the bladder. They were detected in 94% of patients with deeply invasive bladder tumours (pT2-4) compared with 17% of superficial tumours. Microalbuminuria (greater than 50 micrograms/g creatinine) was also found in 80% of patients with pT2-4 lesions. Both were compared with urine cytology. Urinary FDPs are markers of bladder tumour invasion. Our results suggest that urinary FDPs are not of value in screening for the presence of bladder neoplasia but their role may be in following patients with superficial bladder tumours to detect those tumours which become invasive. The mode of excretion of the FDPs in the urine is discussed.