Hemangioma de uretra anterior, tratamiento con láser Holmium: reporte de un caso y revisión de la literatura / Hemangioma of the anterior urethra, Holmium laser treatment. Case report and literature review

El hemangioma uretral es una causa muy infrecuente de uretrorragia. Es un tumor benigno que tiende a recurrir si el tratamiento no es el adecuado. El método diagnóstico de elección es la uretrocistoscopía orientada por una adecuada y exhaustiva anamnesis. Existen diferentes modalidades de tratamiento las que deben ser individualizadas según las características del hemangioma. Presentamos el caso de un paciente joven con uretrorragia intermitente secundario a hemangioma único en uretra anterior tratado mediante fotocoagulación con láser Holmium.

Urethral hemangioma is a rare cause of urethral bleeding. It is a benign tumor that tends to recur if treatment is not adequate. The diagnostic method of choice is urethrocystoscopy guided by adequate and thorough history. There are different treatment modalities, which should be individualized according to the characteristics of the hemangioma. We report the case of a young patient with intermittent urethral bleeding due to a single hemangioma in anterior urethra treated by holmium laser photocoagulation.

Leiomioma uretral durante a gravidez: relato de caso / Urethral leiomyoma during pregnancy: a case report

The authors report a case of urethral leiomyoma diagnosed during pregnancy, which was conservatively treated up to the 38th week, when the pregnancy was interrupted. Thirty days after delivery, exeresis of the lesion was performed from the upper border of the urethral meatus and sutured with interrupted delayed-absorbable suture. The patient evolved favorably and presented no lesion recurrence during three months of follow up.

Clear cell adenocarcinoma of the male urethral tract.

We present a rare case of clear cell adenocarcinoma of the male bulbomembranous urethra. Mostly these tumors have been described in the female urethral tract with its possible origin from mullerian remnants, wolffian remnants or paraurethral glands. Histologically, these tumors have typically tubulocystic pattern comprising of hobnailed cells with clear glycogenated cytoplasm along with well-defined cytoplasmic membranes. This case is being presented due to its rarity, aggressive behavior and to discuss, trauma as its possible etiological factor

[Primary carcinoma of the female urethra: case report]

The authors report a case of primary carcinoma of the urethra in a 53-year-old woman. She presented with a 4-month history of dysuria, and clinical examination revealed a hemorrhagic tumor 2 cm in diameter in the center of the urethral meatus. Histopathological examination of the biopsy specimens showed a moderately differentiated adenocarcinoma of the urethra. The patient underwent urethrocystectomy with colpohysterectomy and Bricker-type urinary diversion. The post-operative period was uneventful. The patient received adjuvant chemo- and radiotherapy. The diagnostic and therapeutic aspects of cancer of the female urethra are discussed with a review of the literature

Adenocarcinoma de uretra femenina: revisión de un caso clínico / Urethral adenocarcinoma in the female: case report

El cáncer de uretra es muy infrecuente siendo además la única neoplasia urológica con predilección por las mujeres, por lo que rara vez nos vemos enfrentados a un caso. Son en general de un mal pronóstico y existe escasa literatura al respecto por lo que su manejo es siempre un desafío. Presentamos un caso de carcinoma uretral de una paciente de edad media que lleva 5 años de seguimiento sin recaída.

The cancer of urethra is very infrequent being in addition the only(unique) neoplasia urológica with predilection for them mujeres, for what rarely we meet faced a case. They are in general of an evil forecast (prediction) and scanty literature exists in the matter for what his (her,your) managing is always a challenge. Let's sense before hand a case of carcinoma uretral of a patient of middle ages who goes 5 years of follow-up without relapse.

[Tumors of the male urethra. A study of 7 cases]

To study the epidemiological, diagnostic and therapeutic features of primary tumors of the male urethra. In this retrospective study we evaluate 7 cases with tumors of the male urethra seen at our department over a period of 16 years [1989 -2005]. The following parameters were studied: the age of the patients, their medial history, clinical signs and symptoms, imaging and treatment modalities used and follow up. The patients' mean age was 56.1 years. Medical history revealed episodes of urethritis in 4 cases and treatment of cervico-urethral strictures in 4 cases. All patients complained of chronic irritating and obstructive symptoms - most patients presented with more than one symptom. Acute urinary retention was found in 5, bleeding per urethram and pyuria in 5 cystourethrography and confirmed by urethrocystoscopy and biopsy. All our patients were found to have squamous cell carcinoma. The tumor was localized in 6 patients. Treatment consisted endoscopic transurethral resection in one patient. Two patients were subjected to surgery. One of them with a stage T3N0M0 tumor of the prostatic urethra underwent urethrectomy in combination with cystoprostatectomy followed by urinary diversion [Coffey], while the other patient with a tumor at the bulbomembranous urethra [stage T4N0M0 with scrotal invasion] was subjected to penectomy and orchidectomy combined with perineal urethrostomy. Both these patients received adjuvant radiotherapy. Excision of a penile phlegmon was carried out in 3 patients. In one of them a urethral stent was left indwelling, while two were subjected to cystostomy. Due to bilateral lymphatic invasion, the remaining patient received preoperative radiotherapy, but he died three months later due to lung metastases. None of our patients received chemotherapy. Mean follow up was 9.5 months. At the end of the follow-up period 3 patients [one treated endoscopically and the two patients that had been subjected to surgery] were disease-free, while one patients had died and the 3 remaining ones were lost to follow up. Despite the availability of a variety of treatment modalities, tumors of the male urethra still have a poor prognosis. Due to their rarity, it is difficult to properly evaluate the treatment options which mainly depend on the tumor stage and whether or not there is lymphatic invasion

Nefroureterectomía radical por videocirugía: técnica quirúrgica y resultados / Radical nephroureterectomy through videosurgery: surgical technique and results

Se revisan los datos de 18 pacientes portadores de carcinoma de células transicionales del tracto urinario superior (TCT), 13 hombres y 5 mujeres, tratados entre junio de 1998 y julio de 2004. Con una edad promedio de 62 años (34-84), diez y seis pacientes presentaban un tumor de pelvis renal y dos un tumor de uréter. En 13 pacientes se utilizó la vía transperitoneal y en 5 la vía retroperitoneal. El tiempo promedio de cirugía fue de 150 minutos (80-240) y el sangrado estimado promedio fue de 209 cc (50-400). El tiempo promedio de estadía hospitalaria fue de 72 horas. Dos pacientes presentaron complicaciones. Uno de ellos en el intraoperatorio presentó una lesión aórtica, reparada en forma laparoscópica. Otro paciente evolucionó con una obstrucción intestinal, requiriendo una exploración abierta al décimo día de la cirugía. No hubo conversión a cirugía abierta. El seguimiento promedio fue de 40 meses, no se han presentado recidivas en los pacientes con enfermedad localizada. La factibilidad de realizar esta cirugía, con un adecuado control oncológico, con un bajo nivel de complicaciones y todas las ventajas de la cirugía laparoscópica, nos llevan a considerar esta técnica como una alternativa a la cirugía convencional, en pacientes portadores de TCT de la vía urinaria superior en una etapa localizada

Cáncer de uretra femenino / Cancer of the female urethra

Se presentan dos casos de pacientes portadoras de cáncer de uretra, ambos carcinomas de células transicionales, en diferente etapa de propagación tumoral, presentación clínica, tratamiento y resultado final. Se comenta incidencia, principales tipos histológicos y diferentes vías de tratamiento de acuerdo a la literatura médica

Leiomyome de l'urethre feminin [. propos d'un cas et revue de la litterature]

Leiomyoma of the urethra is a benign tumor. Leiomyoma of the female urethra is extremly rare. The tumor is often asymptomatic, but can cause dysuria, urinary frequency, urinary retention, and dyspareunia. The diagnosis is rarely suspected before surgery, but currently, because of the sonographic appeerance of this tumor on transvaginal sonography, it can be suggested as the diagnosis. Simple surgical resection remains the treatment of choice. Only a few cases of leiomyoma of the female urethra have been reported in the literature. We describe an additional case, and review the literature on this rare neoplasm

Pólipo uretral: una presentación inusual / Benign urethral polyp: an unusual presentation

Un niño de dos años de edad, sin antecedentes, consultó por dolor miccional y varios episodios de retención urinaria, necesitando reiterados cateterismos vesicales. En la ultrasonografía se descubrió una masa redonda, que en la cistoscopia mostraba un pedículo cuya base estaba en la uretra, cerca del cuello vesical. Se extrajo por vía endoscópica en coincidencia con lo cual los síntomas desaparecieron. La biopsia reveló que se trataba de un pólipo uretral benigno

Leiomioma de uretra feminina: relato de caso / Leiomyoma of the femele urethra: a case report

Os autores apresentam um caso de tumor em uretra feminina que se apresentou como massa de 5 cm de diâmetro e localizava-se no contorno superior do meato uretral externo. A paciente foi submetida a excisão cirúrgica do tumor e o estudo histopatológico e a imuno-histoquímica revelaram tratar-se de leiomioma. Este tumor é sempre uma neoplasia benigna, rara, que dificilmente retorna após excisão cirúrgica. Sua patogenia, bem como seus aspectos clínicos, são também objeto de discussão no presente trabalho.

Carcinoma epidermóide da uretra feminina associado ao vírus do papiloma humano: relato de um caso / Epidermoid carcinoma of the female urethra associated with human papillomavirus: a case report

O carcinoma da uretra feminina é uma doença rara. Os autores relatam o caso de uma paciente de cor preta, com 32 anos de idade, que procurou o serviço com quadro de retençÝo urinária em nível vesical. A investigaçÝo pré-operatória demonstrou tratar-se de um carcinoma epidermóide de uretra a causa da obstruçÝo. O tratamento consistiu da cisto-uretrectomia combinada com linfadenectomia pélvica, histerectomia, salpingo-ooforectomia e ressecçÝo da parede vaginal anterior. A reestruturaçäo do trato urinário foi realizada com a confecçÝo de um reservatório urinário pela técnica de Indiana Pouch. Ao estudo imuno-histoquímico da peça operatória, demonstrou-se reaçÝo positiva para o antígeno do vírus do papiloma humano (HPV, sigla em inglês). Atualmente, após 12 meses de seguimento, a paciente nÝo apresenta sinais de recidiva da neoplasia e desfruta de boa qualidade de vida.

Carcinoma da uretra feminina / Carcinoma of the female urethra

O carcinoma da uretra feminina é uma neoplasia de grave prognóstico. Seu tratamento está relacionado ao estadiamento e à porçäo uretral comprometida. A experiência mundial é pequena com estes casos, mas os autores adiantam que possivelmente a melhor forma de tratamento, no momento seja a utilizaçäo de radioterapia para os tumores iniciais e radioterapia pré-operatória seguida de exenteraçäo pélvica nos casos mais avançados