Satisfaction and treatment adherence in erectile dysfunction in the medium and long term. / Satisfacción y adherencia al tratamiento en disfunción eréctil a medio y largo plazo.

INTRODUCTION: The aim of this study was to show the satisfaction and treatment adherence in erectile dysfunction (ED) in the medium and long term. MATERIAL AND METHODS: A descriptive, comparative study was conducted in 2 centres through telephone interviews with patients who came for an initial visit between 2012 and 2014 for ED. A complete case history review was conducted on the use of and withdrawal from treatment. For current use, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Global Assessment Questionnaire (GAQ) were filled out; for past use, only the GAQ was filled out. For the statistical analysis, we employed Fisher's exact test for comparisons of percentages and the Kruskal-Wallis test to compare means. RESULTS: The study included 250 patients; 20.8% were prescribed intraurethral alprostadil (ALP-IU), 17.2% were prescribed intracavernous alprostadil (ALP-IC), 92.8% were prescribed a first IPD5, and 24.8% were prescribed at least a second IPD5. The treatment withdrawal rate was 62.07% for the first IPD5, 41.94% for the last IPD5, 69.23% for the ALP-IU and 65.11% for the ALP-IC (P=.007). The main reason for withdrawal for the IPD5 was a lack of response (32.76% of those who took IPD5). In addition to withdrawal, there were adverse reactions for ALP-IU and ALP-IC (28.85% and 11.63%, respectively). The mean duration of use until withdrawal was 4.3 months for IPD5, 2.2 months for ALP-IU and 5.5 months for ALP-IC (P=.064). The most favourable GAQ and EDITS scores were observed for IPD5 (EDITS score of 74). Sildenafil and tadalafil had the longest usage times (mean >5 months). CONCLUSIONS: The withdrawal rate for treating ED is high, with short usage times of a few months. A lack of response and adverse reactions were the main causes for withdrawal. The drugs that provide greater satisfaction are the IPD5, although there are no significant differences in the mean usage time between the different types and in aspects such as the mean usage time to withdrawal or the withdrawal rates.

[Hydatidosis in a single location]. / Enfermedad hidatídica de localización única.

Hydatidosis in our country an important health problem because of its high prevalence. We present a case of renal Hydatidosis in which we point out the renal single location of the disease and emphasize that MRI helped us to find a correct preoperative diagnosis.

[Leydig cell tumor: report of 2 cases]. / Tumor de células de Leydig: presentación de dos casos.

Tumors from the gonadal stroma represent 4% among testicular tumors. Leydig cell tumors are the most common neoplasms among them and account for 1-3% of all testicular tumors. Two cases of testicular Leydig cell tumors in adult patients are presented. Presentation, diagnosis and therapeutic aspects are discussed. Both were treated with radical orchiectomy through an inguinal approach. Cas 1 was diagnosed in a cryptorchid testis and developed hepatic metastasis that were successfully treated with chemotherapy. Cas 2 was incidentally diagnosed on ultrasound. Both of them remain alive and free of disease.

[Bilateral candida bezoar of the upper urinary tract]. / Bezoar candidiásico bilateral del tracto urinario superior.

Fungal urinary tract infections are due to candida albicans as first responsible germ. This sporulated oval fungus divides itself by gemmation and produces pseudohyphas when it is spread in culture mediums, organic tissues or their exudates. The most frequent predisposing factor is diabetes mellitus. Others predisposing factors are: long antibiotic administration, corticoids, immunosuppressors, neoplasias, neurogenic bladder, and catheter or foreign bodies into the urinary tract. Bezoar formation is a rare complication that sometimes produces obstructive uropathy. Although Candida albicans is the most frequent observed germ in bezoars, Candida tropicalis, Penicillium, Aspergillus, Mucor y Turolopsis have been found as well. We present the case of a diabetic patient with a bilateral bezoar formation into the upper urinary tract due to Candida albicans. Clinical features, diagnosis and treatment are described emphasizing in the are bilateral onset.

[Evaluation of urology training of resident internal physicians of the Valencian community. Quality control]. / Evaluación de la formación urológica de los médicos internos residentes de la comunidad valenciana. Control de calidad.

Report on the results of a survey conducted among Urology residents in the Valencian Community. Evaluation of the training level of the MIR system, both overall and by areas. Presentation of the views obtained with regard to possible modifications to raise their training level and improve their professional future.

[Candidiasis of the upper urinary tract. Report of a case]. / Candidiasis del tracto urinario superior. A propósito de un caso.

OBJECTIVE: We report a case of candidiasis of the upper urinary tract that presented as acute renal failure associated with septic syndrome. The patient initially required hemodialysis. Right hydronephrosis and perirenal collection were observed on ultrasound examination. METHODS: A percutaneous nephrostomy was performed. Nephrostomy urine cytology and cultures were positive for Candida tropicalis. An anterograde pyelography showed a 'fungus ball' in the urinary tract. RESULTS: Therapy with oral fluconazole and percutaneous amphotericin B achieved excellent results. CONCLUSIONS: Candidiasic urinary infection of the upper urinary tract often produces obstructive uropathy requiring percutaneous nephrostomy, which can also be used to instill amphotericin B. Combination therapy with amphotericin B and fluconazole can achieve excellent results.