[Incrusted cystitis after Mitomicin-C]. / Cistitis incrustante tras Mitomicina C.

Incrusted cystitis is an infrequent process characterized by precipitation an incrustation of salts on the vesical mucosa. An alkanine urine is required to this precipitation. The urinary infection with urolithic activity microorganisms can also be a very important factor. We present a case of incrusted cystitis after using Mitomicine as vesical chemotherapy.

Cistitis incrustante tras Mitomicina C / Incrusted cystitis after Mitomicin-C

La cistitis incrustante o incrustada es un proceso frecuente que se caracteriza por la precipitación de sales en la mucosa vesical. La presencia de orinas alcalinas parece ser un factor fundamental para dicho depósito. Las infecciones urinarias por gérmenes urealíticos también parece ser un factor importante. Presentamos un caso de cistitis incrustante tras el uso de Mitomicina C como quimioterápico intravesical (AU)

Incrusted cystitis is an infrecuent process characterized by precipitation an incrustation of salts on the vesical mucosa. An alkanine urine is required to this precipitation. The urinary infection with urolithic activity microorganisms can also be a very important factor. We present a case of incrusted cystitis after using Mitomicine as vesical chemotherapy (AU)

[Cavernous hemangioma of the penis]. / Hemangioma cavernoso de pene.

We report one case of cavernous hemangioma of penis shaft appeared in a 35 years old man like a painful mass. The blood analysis and radiologics examinations hadn't any important contribution to the diagnostic that, finally, was confirmed during the surgical extirpation and the posterior histological study. We make a brief description about the mentioned pathology.

Uretrocistopexia con anclajes óseos: modificación técnica / Urethrocystopexy with bone anchors: a technical modification

OBJETIVO: Comunicar una modificación técnica de uretrocistopexia, consistente en la suspensión de los ligamentos uretropélvicos a la cara posterior del hueso púbico mediante la utilización de anclajes óseos insertados con el sistema In-Fast. MATERIAL Y METODOS: Entre Agosto de 2000 y Enero de 2001, trece pacientes con una edad media de 56,1 años fueron sometidas a dicha técnica. Usando una vía transvaginal y tras amplia apertura de la fascia endopélvica, colocamos un tornillo de anclaje a cada lado de la sínfisis púbica, dando posteriormente 2 ó 3 pasadas al ligamento uretropélvico con la sutura de polipropileno del nº 1 que cada uno de ellos lleva unido a su extremo. RESULTADOS: La estancia media ha sido de 5,1 días. La cistostomía se ha mantenido durante una media de 10,1 días. No se observaron complicaciones intra ni postoperatorias. Con un seguimiento medio de 5,3 meses todas las pacientes presentan desaparición de su incontinencia de esfuerzo. CONCLUSIONES: A falta de confirmar con un mayor seguimiento y casuística, la suspensión de los ligamentos uretropélvicos mediante anclajes directamente colocados en el hueso púbico por vía vaginal, se ha mostrado como un método sencillo, seguro y altamente confortable para las pacientes (AU)

Hemangioma cavernoso de pene / Cavernous hemangioma of penis

Presentamos un caso de hemangioma cavernoso de raíz de pene, aparecido en un varón de 35 años en forma de una masa dolorosa. Los estudios analíticos y radiológicos no tuvieron una aportación importante al diagnóstico que, finalmente, se confirmó durante la exéresis quirúrgica y el posterior estudio histológico (AU)

[Urethrocystopexy with bone anchors: technical modification]. / Uretrocistopexia con anclajes óseos: modificación técnica.

OBJECTIVE: To communicate a technical modification of urethrocystopexy which consist in the suspension of the urethropelvic ligaments to the posterior pubic bone with using bone fixations inserted with the In-Fast system. MATERIAL AND METHODS: Between August 2000 and January 2001, thirteen patients with an mean age of 56.1 years were operated with this technic. Using a transvaginal approach and after great opening of the endopelvic fascia we insert one fixation screw in each side of the symphisis pubic bone, later we give two or three stitches to the urethropelvic ligament with the polypropylene no. 1 suture that each screw have joined to their end. RESULTS: The mean stay has been 5.1 days. The cystostomy has been remained for a mean of the 10.1 days. We didn't observe any complication neither intra nor postoperatives. With a mean follow-up of 5.3 months all the patients present a disappearance of their stress incontinence. CONCLUSIONS: Lack of confirm with a larger following and more cases, the suspension of the urethropelvisc ligaments with screw fixations directly situated into the pubic bone per vaginal approach, has been a simple method, safe and highly comfortable for the patients.

[Self-administered questionnaire for assessing the Raz technique in stress urinary incontinence: analysis of results]. / Un cuestionario de diseño propio para la evaluación de la técnica de Raz en la incontinencia urinaria de esfuerzo: análisis de resultados.

OBJECTIVES: Knowing our results in the treatment of the stress incontinence by means of the use of the Raz technique evaluated by sending a questionnaire. MATERIAL AND METHODS: From July 1995 until the 31st of December 1998, 137 patients were operated by the Raz technique. The 102 people who were monitored for over 12 months were sent a questionnaire asking them about the postoperative evolution and the degree of the satisfaction obtained. From the 78 (76.47%) people who answered, 75 were included in this study with an average age of 53.96 and an average follow-up of 27.12 months. RESULTS: Thirty patients (40%) showed the disappearance of their stress incontinence, seventeen patients (22.7%), an important improvement and ten (13.3%) a slight improvement, but only 58.20% of the patients were very or quite pleased with the results. None of the preoperatives variables analysed showed any meaningful influence in the outcome, while the longest time of persistence of postmiccional residue was shown as a factor of prediction in a better result. CONCLUSIONS: The mediocre results and the low rate of satisfaction got with this technique justifies the research of other therapeutic and more effective options.

Un cuestionario de diseño propio para la evaluación de la técnica de Raz en la incontinencia urinaria de esfuerzo: análisis de resultados / An own design questionnaire for the evaluation of the Raz technique in the urinary stress incontinence: analysis of results

OBJETIVO: Conocer nuestros resultados en el tratamiento de la incontinencia urinaria de esfuerzo mediante el uso de la técnica de Raz, evaluados a través del envío de un cuestionario. MATERIAL Y MÉTODOS: Desde Julio de 1995 hasta el 31 de Diciembre de 1998, 137 pacientes fueron intervenidas mediante la técnica de Raz. A las 102 cuyo seguimiento superó los 12 meses les fue remitido un cuestiona-rio interrogándoles tanto sobre la evolución post-operatoria de su incontinencia como sobre el grado de satisfacción obtenida. De las 78 (76,47 por ciento) que respondieron, 75 quedaron incluidas en el estudio, con una edad media de 53,96 años y un seguimiento medio de 27,12 meses. RESULTADOS: Treinta pacientes (40 por ciento) mostraron desaparición de su incontinencia de esfuerzo, 17 (22,7 por ciento) una mejoría importante y 10 (13,3 por ciento) una mejoría leve; sin embargo sólo un 58,20 por ciento se mostraron muy o bastante satisfechas con el resultado. Ninguna de las variables preoperatorias analizadas mostró influencia significativa en el resultado, mientras que el mayor tiempo de persistencia de residuos post-miccionales post-operatorios, se mostró como factor predictivo de un mejor resultado. CONCLUSIONES: Los mediocres resultados y la baja tasa de satisfacción obtenida con esta técnica justifica la búsqueda de otras opciones terapéuticas más eficaces (AU)

[Scrotal digestion caused by pancreatic ascites]. / Digestión escrotal por ascitis pancreática.

One case of scrotal necrosis during acute necro-haemorrhagic pancreatitis. A histological study of the resected tissue demonstrated presence of fatty digestion caused by the pancreatic fluid. Discussion of the etiological possibilities, including a review of the relevant literature.

[Seminal changes in unilateral cryptorchism: course after orchidopexy. Experimental study]. / Alteraciones seminales en la criptorquidia unilateral: evolución tras orquidopexia. Estudio experimental.

The present study was conducted to determine the reversibility of the seminal alterations following experimental unilateral cryptorchidism in relation to the time orchiopexy is performed. Two groups of 45 Wistar rats were subjected to mechanical unilateral cryptorchidism followed by prepubertal, early and late orchiopexy, respectively. A third group of 45 animals was subjected to a sham operation. We analyzed the semen obtained separately from both epididymal tails of subgroups of 15 animals at 2.5, 5 and 8 months for the number of spermatozoa, percentage of motile spermatozoa, survival time and the number of heads and tails of loose spermatozoa. The statistical analysis of the results by variance analysis showed that the significant reduction of the number of spermatozoa and the percentage of motile forms observed in the ex-cryptorchid testis at age 2.5 months in both groups of animals that were subjected to a testicular retention had been completely recovered at age 5 months. A significant reduction of the percentage of motile spermatozoa at age 2.5 months was observed in the contralateral testis of animals subjected to a longer period of retention. This alteration was also found normalized at age 5 months. In conclusion, experimentally, pre-pubertal orchiopexy preserves fertility at an adult age, regardless of the timing of the procedure.

[Fecundity following prepubertal orchiopexy in unilateral cryptorchism. Experimental study]. / Fertilidad tras orquidopexia prepuberal en la criptorquidia unilateral. Estudio experimental.

Study of fecundation ability following unilateral experimental cryptorchism as a function of the timing of orchiopexy. Two groups of 45 Wistar rats underwent unilateral mechanical cryptorchism and early and late prepuberal posterior orchyopexy, respectively. A third group of 45 rats underwent a dummy intervention. Mating taking place in subgroups of 15 animals at different ages showed that in the experimental animal, and therefore in any non-dysgenetic test, orchiopexy performed at the prepuberal period allows preservation of fecundation ability.

[Matrix stones]. / Litiasis blanda.

We report a case of matrix stone in a patient with a previous history of infective staghorn stone for which the patient had previously undergone surgery to reduce stone volume and ESWL. The ureteral matrix stone had caused purulent intrarenal retention. Puncture nephrostomy and antibiotics resolved the foregoing condition and the calculus was successfully removed by ureteroscopy. The features of this uncommon disorder and the possibilities of endoscopic treatment are discussed.

[Supernumerary spleen]. / Bazo supernumerario.

The diagnosis of the accessory spleen, if unsuspected, is basically anatomopathological due to its frequency and, above all, its nonspecific clinical features. We report a case of a retroperitoneal mass that was shown to be composed of accessory splenic tissue.

[Current validity of urethroplasty in two stages]. / Vigencia actual de la uretroplastia en dos tiempos.

Review of 18 patients with complex urethral stenosis, who underwent a two-stage urethroplasty in our Unit over the last three years. Clinical results have been favourable in all patients and, from the radiological point of view, there has been only one re-stenosis. Complications rate has been low and can be superimposed to that of any urethroplasty procedure. The paper emphasizes the enormous relevance of the care taken between both surgical stages on the procedure's final result.

[Secondary ureterectomy in an ectopic ureteral opening into the seminal vesicle]. / Ureterectomía secundaria en la desembocadura ureteral ectópica en vesícula seminal.

The ectopic ureter opening to the seminal vesicle is uncommon in the male and even less in a duplex kidney. It commonly presents as recurrent urinary infection with pelviperineal pain. Treatment is by heminephrectomy with total ureterectomy and removal of the seminal vesicle if it is cystic. Herein we describe a 70-year-old patient who had previously undergone a heminephrectomy and partial ureterectomy due to an ectopic ureter opening to the seminal vesicle of the ureter of the upper pelvis of the left kidney. The patient was submitted to a second ureterectomy procedure due to pyoureter in the ureteral stump. The main features of this pathological condition are described and the surgical approach is discussed.

[Non-radical treatment and bladder conservation in infiltrating tumor of the bladder]. / Tratamiento no radical y conservación vesical para el tumor infiltrante de vejiga.

The fate of some infiltrant tumours of the bladder locally advanced (pT2-3NxM0) which were radically resected, with or without association to other treatments, has been similar to those in which initial radical treated was used. To carry out simultaneously a radical RTU as a local action plus systemic chemotherapy (M-VAC), for microscopic metastasis, clinically undetected, seems to us the most effective combination. In our Urology Unit, the evolution (September 88-January 91) of 9 patients presenting this tumour and preservation of the bladder is being followed-up. The primary tumour was treated with radical RTU in 7 cases and partial cystectomy in 2. There are 5 tP2, 1 pT2 + "in situ" carcinoma (Ca) and 3 pT3, 4 G1, 4 G2 and 1 G3. All tumours were single, small (2-4 cm), with varied location and nearly all with medium to low differentiation. Later all patients underwent systemic chemotherapy with M-VAC (3 cycles). Following RTU and QMT every three months, the likely local and systemic progression of the disease has been evaluated through cystoscopy and multiple biopsies including from the prostatic urethra, RTU of anterior scar, two-hand palpation, urinary cytology, blood testing, CAT, abdominal ECO, chest X-ray and laparoscopic lymphadenectomy (coinciding with its development within the Unit) in the last case. Average follow-up (at the time of the review) has been 15.77 months (6-28 months).(ABSTRACT TRUNCATED AT 250 WORDS)

[Trigono-cervico-prostatic incision]. / Incisión trígono-cérvico-prostática.

Trigone-cervico-prostatic incision is a surgical alternative in the treatment of urinary obstruction induced by small size prostate. Twenty-three patients were treated in our unit with this procedure, 17 because they were carriers of small size prostate and 6 because they were high risk surgical patients in which the simplicity and swiftness of this technique were essential. Good results have been obtained both clinical and in urological flow in 95.7% cases. The only complication was one stenosis of the urethra requiring internal urethrotomy but there were no cases of vesical cervix contracture or urinary incontinence. Average follow-up was 12.5 months. It is concluded that this is a valid, low morbidity alternative that can be offered to patients with small sized and symptomatic prostate.

[Value of CAT staging in renal adenocarcinoma. Correlation with anatomo-pathologic findings]. / Valor del estadiaje del TAC en el adenocarcinoma renal. Correlación con los hallazgos anatomo-patológicos.

On a total of 128 renal adenocarcinomas diagnosed in our Unit between January 1975 and August 1990, the data provided by CATs carried out in 85 of them was compared with that from surgical and anatomo-pathological findings. The precision in both the diagnosis and the tumour staging was determined, evaluating the involvement of perirenal, nodular, venous and neighbouring structures fat. The diagnosis of renal adenocarcinoma was made correctly in 96% cases. With regard to staging, maximal precision was achieved in the involvement of adjacent structures and vena cava, followed by the renal vein, perirenal fat and lymphatic nodes, in this order. We conclude that CAT provides a high diagnostic reliability, permitting with a single study the determination of the most defining parameters of renal cancer staging.

[Excretory azoospermia secondary to a cyst of the seminal vesicle]. / Azoospermia excretora secundaria a quiste de vesícula seminal.

A case report of malformation of the right mesonephric ductus, involving a seminal vesicle cyst and ipsilateral renal and ureteral agenesis. The infrequency of such pathology is recalled and the oddity, in our case, of its presentation in the fashion of infertility secondary to excretory azoospermia highlighted. The deferentovesiculography, ultrasound scanning, urography and CAT were highly illustrative in the diagnosis. The treatment of choice in symptomatic cases is surgical exeresis, which in our patient secured the resolution of the azoospermia.

[Laparoscopic lymphadenectomy for lymphatic staging in prostatic cancer: preliminary experience]. / Linfadenectomía laparoscópica para estadiaje ganglionar en cáncer prostático: experiencia inicial.

The current diagnostic methods, primarily transrectal ultrasound scanning (supported with ultrasound-directed biopsy), CAT and tumoral markers, allow an earlier and more reliable diagnosis of prostatic neoplasias. The chances of diagnosing these tumours while in low stages (A, B, and C without affecting the seminal vesicle) imply a higher indication for radical surgery (prostatectomy) with an intention to cure. However, the prognosis and therefore the indication will be determined by the presence of regional nodular affectation. Imaging diagnostic methods (lymphography, CAR, NMR) have been proven incapable of providing an acceptable degree of diagnostic safety, therefore staging lymphadenectomy continues to be mandatory. Laparoscopic lymphadenectomy allows to meet requirements of surgical radicality comparable to those of traditional open surgery while showing an irrefutable decrease of morbidity and being more convenient for the patient. Our early experience with this surgical technique of staging in prostatic neoplastic pathology is illustrated.