Our study suggests that there are 2 types of urinary inverted papilloma. The lesions in 1 type behave in a benign fashion and in another they have malignant potential. At this time we have no strategy with which to distinguish the 2 types of urinary inverted papilloma. Our results indicate that we must follow all cases for at least more than 2 years after initial treatment.

Background : Peyronie's disease is an idiopathic fibrosis of the tunica albuginea of the penis, which often causes erectile dysfunction. No effective therapy except surgery has been available for Peyronie's disease. We investigated the clinical efficacy of extracorporeal shock wave treatment (ESWT) using EDAP LT-02 as an alternative method of treatment for Peyronie's disease. Methods : Five patients aged 35-65 years were treated by ESWT. All patients had undergone unsuccessful medical treatment before ESWT. Each patient was treated by ESWT (7-40 storages at an energy density of 45-96 MPa) between three and five times at 4-week intervals. Although no patient needed anesthesia, all were administered diclofenac suppository (50 mg) before ESWT. Results : Of the five patients, four were eligible for evaluation. The penile plaque disappeared in one patient (25%). In the other three patients (75%), the penile plaque did not disappear, but softened. Although no improvement of erectile penile curvature was recognized, erectile penile pain disappeared in all patients. Conclusions : These results indicate that ESWT is a possible alternative to surgery in the treatment of Peyronie's disease.

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Our clinical path for TUR-P was well accepted by both patients and comedicals. However, the present medical treatment system in Japan is not as yet prepared to promote the introduction of this clinical path, and it will take some time before this clinical path is introduced on a full scale.