The November - December 2000 issue of the Brazilian Journal of Urology presents outstand-ing contributions from USA, Europe, and Brazil.
     Doctors Carvalhal, Novick and Gill from Cleveland Clinic, Cleveland, USA, present on
page 558 both experimental and clinical results of the advanced technique of laparoscopic renal cryoablation for nephron-sparing treatment of patients with small renal tumors. The laparoscopic approach is dependent on the anatomic location of the tumor on the kidney. If the lesion is posterior or lateral, the authors employ a etroperitoneoscopic technique, while the transperitoneal route is selected if the tumors are anterior or anterolateral. The authors current practice is to offer laparoscopic renal cryoablation only to carefully selected patients who are candidates for open partial nephrec-tomy, having a small (< 4 cm), peripheral, exophytic, localized renal tumor located at a distance from the collecting system. In 32 patients, hospital stay was 1.8 days (22 patients were discharged within 23 hours), mean surgical time was 2.9 hours and mean blood loss was 66.8 cc (range, 10-200 cc). The authors also outlined the historical aspects, pathophysiology, radiologic evaluation, clinical experience and future horizons of this advanced technique.
     Doctors Silva and co-workers from Coimbra, Portugal, present on page 571 an impressive series of 268 staghorn calculi treated by extracorporeal shock wave lithotripsy (ESWL) ambulatory monotherapy. The patients received an average of 6.1 sessions of ESWL per stone and achieved stone-free rate of 53%. All patients underwent a double-J stent placement, which lasted a whole the treatment. The most frequent complication was acute pyelonephritis (11.5%). Doctor Segura, from Mayo Clinic Rochester, Minnesota, USA, provided and important Editorial Comment which gives adequate balance on this controversial article.
     Doctors Gettman and Pearle from Dallas, Texas, USA, discusses on page 579 the controver-sial issue of residual stones evaluation after percutaneous nephrostolithotomy (PCNL). The final recommendation is that patients with large stones requiring fragmentation at PCNL who constitute a high-risk group for residual fragments undergo non-contrast, thin-cut (5 mm) helical CT and antegrade nephrostogram on the first post-operative day to identify those patients who would ben-efit from second look flexible nephroscopy. Helical CT in conjunction with antegrade nephrostogram provides an accurate “road-map” with which to precisely locate residual stones at flexible ephroscopy. In those patients with residual stones, flexible nephroscopy is performed on post-operative day-two to retrieve residual fragments.
     On page 621 Doctor Laurence Baskin from University of California, San Francisco, USA, one of the leaders in the study of several aspects of hypospadia, presents a comprehensive article on this subject. The author analyzed the current understanding on hypospadia etiology. Also, recent knowledge on the morphology of male and female genitalia is discussed with emphasis on surgical treatment, and the current techniques for hypospadias repair are reviewed. This article is truly rel-evant because the incidence of hypospadias has been increasing in Europe and USA.
     On page 630 Doctor Cardoso and co-workers from Rio de Janeiro, Brazil, present prelimi-nary original data on glycosaminoglycans (GAG) concentration in the prostatic tissue of patients with benign prostatic hyperplasia (BPH). The results were compared with those obtained from the transitional zone of young adults prostates. The concentration of GAG in BPH was increased by 62%. The prevailing sulfated GAG both in the normal and hyperplastic prostates is dermatan sul-fate.
The proportions of heparan sulfate are unchanged in both cases, whereas the content of dermatan sulfate is decreased and that of chondroitin sulfate is increased in BPH samples. The authors con-cluded that GAG composition in BPH differs markedly from that of the normal transitional zone. In addition, the results suggest that interstitial proteoglycans are more affected in BPH, which may result from cytokine-mediated stimulation of stromal cells.

Francisco J.B. Sampaio
Editor-in-Chief