[Experimental study of the expression of the bladder wall proteins in bladder outlet obstruction in the rabbit]. / Estudio experimental de la expresión de las proteínas de la pared vesical en la obstrucción del tracto urinario inferior en el conejo.

OBJECTIVES: To determine the relationship of the bladder wall levels of the contractile proteins: whole actin, beta-actin, alpha-sarcomeric-actina caldesmon and of the Heat Stress Protein HSP-70, with the partial bladder outlet obstruction. MATERIAL AND METHODS: It was carried out an experimental study on 43 New-Zealand rabbits. These animals were divided into a control group and six experimental groups with partial bladder outlet obstruction induced by an incomplete tie around the urethra. The experimental groups were defined according the day when the animals were sacrified: at 24 hours, 7 days, 15 days, 1 month, 3 months and 6 months of the obstruction. It was determined in all animals the muscular bladder wall concentration of whole actin, beta-actin, alpha-sarcomeric-actin, caldesmon and HSP-70 protein, according to Western Blotting technique. The results were analyzed by means of ANOVA, using the Scheffe post hoc method. RESULTS: The bladder weight of the obstructed animals increased significantly in two stages: until the day 15 and between the day 15 and the end of the study, corresponding to theoretical phases of initial hypertrophy and compensation. The level of whole actin showed a significant decrease at the beginning of compensation phase, while the beta-actin level increased in the phase of initial hypertrophy and the alpha-sarcomeric-actin level increased at the end of the compensation phase, while the caldesmon and the HSP-70 made it at the end of the initial hypertrophy phase. CONCLUSIONS: Analysing our data we conclued that the determination of the caldesmon levels is the marker that better adjusts to the changes associated with partial bladder outlet obstruction in the rabbit.

[Evaluation of new intraurethral occlusive depot (ORIS FEMININO) in the management of female stress urinary incontinence]. / Evaluación de un nuevo dispositivo oclusivo intrauretral (ORIS FEMENINO) en el manejo de la incontinencia urinaria de esfuerzo femenina.

OBJECTIVE: To determine the utility and safety of an intraurethral device (Oris Femenino) in the management of female stress urinary incontinence. METHODS: A prospective clinical study was conducted on 54 female patients, mean age 46.4 years, with stress urinary incontinence. The degree and severity of the incontinence was determined before and one month after treatment with the intraurethral device. The reasons for the dropouts were analyzed and the rehabilitative effects two months after treatment had been completed were evaluated in 22 patients. RESULTS: 83% of the patients who completed the study referred positive results. A significant improvement was demonstrated for the degree of incontinence as well as the number of absorbent pads used. Age and severity of incontinence inversely correlated with positive results. A correlation between the absence of a previous urethropexy and positive results was also found. The dropout rate was 44% (24 patients) and was chiefly due to symptomatic bacteriuria in 14 cases and the difficulty in fixation and degree of incontinence. A statistically significant reduction was found in the number of pads used in the group of patients evaluated two months after treatment had been completed. CONCLUSIONS: The intraurethral device analyzed in this study significantly reduced urinary incontinence. This method appears to be more effective in younger women who are not severely incontinent and have not previously undergone urethropexy. The intraurethral device appears to have some rehabilitative effect on the perineal muscle. Symptomatic bacteriuria was found to be the main disadvantage.

[Reliability of fractal dimension measurement of uroflow curves]. / Fiabilidad de la medición de la dimensión fractal de las curvas de flujo miccional.

OBJECTIVE: To determine the reliability of fractal analysis of uroflow curves. METHODS: We analyzed the correlation between the fractional dimension analysis of two series of uroflow curves with an interval of 88.21 days. The fractal dimension was calculated by two methods. RESULTS: A good correlation was found for both methods, although it was lower than that of maximum flow. A relationship was found between the fractal dimension and maximum flow. CONCLUSIONS: The fractional dimension is a reliable parameter that appears to be related with urinary flow.

[Diabetic neurocystopathy: multivariate study]. / La neurocistopatía diabética: estudio multivariante.

OBJECTIVE: To analyze the prevalence of urodynamic disorders and the factors associated with bladder instability in patients with diabetes mellitus. METHODS: We conducted a clinical and urodynamic study on 138 diabetic patients (71 males, 51%; 67 females, 49%) with a mean age of 64.04 years. Patient evaluation included patient history, neurological physical examination, cystometry, pressure-flow test, filling videocystography and selective EMG of the periurethral sphincter. Data obtained were analyzed by multivariant logistic regression analysis, taking the probability of developing bladder instability as a dependent variable. RESULTS: Bladder instability was the most frequent urodynamic finding (52%), followed by lower urinary tract obstruction (44%), involvement of bladder contractility (41%) and stress urinary incontinence (22%). Lower motor neuron (S2-S4) pudendal nerve lesion was observed in 33% of the cases and 24% had upper motor neuron involvement. Multivariant analysis showed age and stress urinary incontinence (inverse correlation) to be the only independent variables for bladder instability. The other variables that correlated with instability (but dependent on the foregoing variables) were involvement of bladder contractility and type of diabetes (higher probability for diabetes type II). No correlation was found for sex, duration of the diabetes, stroke (CVA), urinary obstruction or pudendal nerve lesion. CONCLUSIONS: Bladder instability was found to be the most frequent urodynamic disorder in diabetic patients. The probability of developing bladder instability increases with age and decreases in patients with stress urinary incontinence.

[Urinary excretion of cytokines in bladder carcinoma]. / Excreción de citocinas urinarias en los carcinomas vesicales.

OBJECTIVE: Analysis of the urinary excretion of cytokines in vesical carcinoma. MATERIAL AND METHOD: The study includes the results obtained in the quantification of several interleukins (IL-1, IL-2, IL-4, IL-6, INF-gamma and TNF-alpha) in urine samples corresponding to 60 patients with transitional cell carcinoma (TCC) with vesical location (40 surface and 20 infiltrant). Concurrently, 40 healthy donors and 20 patients with urinary tract infections were studied. Determination of the various cytokines was done with ELISA enzyme-linked immunoassays. RESULTS: The results obtained in the study show that: a) urinary concentrations of IL-1, IL-2, IL-6, TNF- and INF- in surface TCC, are similar to those found in healthy subjects; b) levels of the mentioned cytokines are significantly higher in patients with urinary infections; c) in patients with infiltrant TCC, IL-6 urinary concentration is significantly higher than in those with S-TCC; d) urinary IL-4 levels show no difference between the various groups under study. CONCLUSION: From all the above it is concluded that there is a large diversity in the excretion of urinary cytokines from the vesical urothelium based on antigenic stimulation (bacterial or tumoral) to which it has been exposed and the tumoral stage, and that baseline determination of IL-6 urine level in patients with vesical TCC could have some prognostic influence.

[Giant liposarcoma of the spermatic cord]. / Liposarcoma gigante del cordón espermático.

Liposarcomas (LS) are malignant mesenchymal tumours which develop in fatty tissues. They are basically found at the retroperitoneum where they are relatively frequent in adults. The most common type is myxoid LS which, although less malignant, has like any other LS a high incidence of local relapses. Primary myxoid liposarcoma of the spermatic cord is an unusual, low-aggressiveness tumour. Under natural development, it can reach large dimensions with only local symptomatology. Pre-operative diagnosis of the paratesticular tumour is often difficult to establish, cuenca the teste suénate be differentiated from the tumoral mass by physical examination. A diagnostic approach of paratesticular tumours, scarcely reported in the literature, can be made by means of a vascular study with radionuclides. The choice therapy is surgical, through orchiectomy and extensive local removal. Considering the frequency of local relapse of myxoid liposarcoma, long-term follow-up is recommended. This paper reports the unusual presentation of one case of primary myxoid LS of the spermatic cord with an intrascrotal mass of 38 x 24 cm weighing 4,950 gr which is exceptional not only because of the site's infrequency but also for its size.

[Retrovesical hemangiopericytoma]. / Hemangiopericitoma retrovesical.

The hemangiopericytoma is an uncommon variety of the mesenchymal tumour derived from pericapillary structures, most frequently located in limbs and exceptionally at the retroperitoneum level. Although macroscopically the aspect is benign, this tumour has a recognised ability for local invasion and distant dissemination.

[Renal hydatid cyst: a nuclear magnetic resonance study]. / Quiste hidatídico renal: estudio con resonancia magnética nuclear.

A case of renal hydatid cyst (R.H.C.) in which study both traditional diagnostic methods (such as serology, radiology, ecoraphia, C.A.T., etc.) and the newer ones, including Nuclear Magnetic Resonance (N.M.R.) were used, is presented. The diagnostic characteristics of this type of cystic pathology were reviewed through N.M.R. study, as well as current criteria to outline a correct differential diagnosis with simple Renal Cysts (R.C.). Finally, a theoretical place for each of these methods within the diagnostic algorithm of renal masses is suggested.