Updated

Scandal-mired Italian Premier Silvio Berlusconi has raised the stakes in Sunday's local elections, equating them to a kind of plebiscite on how he is faring as the country's leader.

The most closely watched mayoral race is in Milan, an important power base for the media mogul where he stumped hard for the incumbent candidate from his Freedom People party, Letizia Moratti. Another important city is Naples, struggling with mountains of garbage that Berlusconi had promised would disappear.

Italians can vote Sunday or Monday, with ballot-counting starting immediately after polls close on Monday afternoon, and first results expected shortly after.

Berlusconi is battling back after recent opinion polls showed that scandals were starting to take a toll on his popularity. The 74-year-old premier, in his third term in office, has been spending much of his time defending himself in four criminal cases brought by Milan prosecutors.

In the most sensational case, he is on trial for allegedly paying for sex with a Moroccan teenager and using his office to try to cover it up. Berlusconi has denied all wrongdoing, including in other cases stemming from dealings in his multibillion business empire. He contends left-leaning prosecutors are out to get him.

With Berlusconi campaigning so hard for his party's candidates — especially in Milan, which hosts the soccer team he owns, AC Milan — voters could be forgiven for speaking as if the premier is actually running.

"I am convinced that Berlusconi will win on the first round," voter Andrea Martiri told APTN in Milan.

In cities and towns where no candidate clinches more than 50 percent of the vote, runoffs will be held in two weeks.

Other citizens wondered what the impact might be from the sex scandal, in which Berlusconi is accused of having sex with an underage nightclub dancer who goes by the stage name "Ruby."

"I hope voters will keep in mind what happened, all of the scandal tied to Ruby," said Daniela Vergara after casting her ballot in Milan. She also hoped voters would be indignant over what critics say are tailor-made justice system reforms pushed through Parliament by Berlusconi loyalists with the aim of helping him in his many judicial woes.

Nearly 13 million Italians were called to the polls in some 1,200 cities, towns and provinces across much of the nation. Sicily's vote was scheduled for later this month.

Berlusconi had posted a message on his party's website saying a win would "confirm and strengthen the national government."

His government was shaken last summer by a falling out with a key ally, leaving his main coalition partner the anti-immigrant Northern League led by the sometimes fickle and volatile Umberto Bossi.

A particularly strong showing by League candidates in local races in the northern provinces that are their stronghold could force Berlusconi to give the League a greater share of power in his Cabinet.

Bossi has openly criticized the government's decision to participate in NATO bombing strikes against Libya. He fears the military operations will prompt more migrants in Libya to flee in boats for Italian shores.

Berlusconi is hoping his conservative forces will end a long run of the center-left in Naples, where Rosa Russo Jervolino has been mayor for 10 years but isn't running again. In recent years, Berlusconi has held Cabinet meetings in Naples to convince Neapolitans he was working hard to rid their streets of tons of trash that piled up when local dumps ran out of space. But the garbage returned.

Other large cities up for grabs are Turin and Bologna, both held by the center-left.

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Prospero Bozzo contributed this report from Milan.