COMPRESSION of the iliac veins is relatively common in pelvic tumours. Two patients are described below, each of whom developed massive oedema of the lower limbs and genitalia, because of pressure from an enormously distended bladder. CASE REPORTSCase l.-Mr J. S., aged 73, was admitted to a medical ward on 29th March 1966, with gross oedema of his lower limbs and genitalia. For several weeks his legs had become increasingly swollen, and two days prior to admission he had also developed swelling in the scrotum.It was only on direct questioning he admitted that for many years his urinary stream had been poor, and that, of late, he had only dribbled urine. He had become incontinent and often found his bed wet in the morning.He was a heavily built man who was not breathless at rest, but there was massive pitting oedema of both lower limbs, including the thighs. The scrotum was swollen to the size of a melon, the penis grossly oedematous, and the foreskin could not be retracted. No sacral oedema was present. The bladder was distended and palpable halfway between the umbilicus and xiphisternum.The pulse was regular at 80 and the blood pressure was 130/80 mm. Hg with no rise in jugular venous pressure. The heart sounds were normal and the E.C.G. was within normal limits for a man of his age.The urine did not contain protein; no casts were seen on microscopy and the culture was sterile. The blood urea was normal, but the intravmous pyelogram revealed bilateral hydronephrosis and hydroureter.Urethral catheterisation was not feasible owing to oedema of the prepuce, so the bladder was decompressed by the suprapubic insertion of a fine polythene cannula; 7,200 ml. of urine were drained in the first 22 hours.

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