Condiloma acuminado gigante (Tumor de Buschke-Löwenstein) / Giant condyloma acuminatum (Buschke-Löwenstein tumor)

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[Primary psoas abscess due to Streptococcus pneumoniae]. / Absceso primario de psoas por Streptococo pneumoniae.

INTRODUCTION AND OBJECTIVES: To report to the literature a new case of primary psoas abscess. METHODS: The patient is a 65 years old woman who suffered back and left hip pain for approximately 1 month. A CTA showed a retroperitoneal mass that involved the left Psoas. It was drained 1800 cc of purulent fluid infected by Streptococo pneumoniae. RESULTS: In a CTA made 21 days after drainage, showed a very small residual collection. CONCLUSIONS: Primary Psoas Abscess are a very rare entity, with a low rate of mortatility if well treated.

Factores pronósticos en la recidiva y progresión del cáncer superficial vesical. Grupos de riesgo (Parte II) / Pronostic factors on recurrence and progression of superficial bladder cancer. Risk groups (PArt II)

Introducción: Intentamos establecer grupos de riesgo en función de la combinación de las características de cada tumor vesical, para un mejor seguimiento de estos pacientes. Material y Métodos: Una vez conocidas las variables implicadas en recurrencia y progresión analizamos los datos para establecer los grupos extremos, es decir, los de peor y mejor pronóstico, quedando un grupo residual que correspondería al de los tumores de pronóstico intermedio. Resultados: A partir de los resultados obtenidos, nos hemos planteado establecer tres grupos de riesgo: Grupo de mal pronóstico (alto riesgo): Tumores de alto grado (G3), Tis aislado o asociado y tumores de grado 2 múltiples o recurrentes que hubieran recidivado en menos de 6 meses; Grupo de pronóstico intermedio: Tumores TaG1 múltiples, así como neoplasias Ta-1G2 y T1G1 no múltiples (menos de 3 tumores) y Grupo de bajo riesgo: Tumores TaG1 únicos. Discusión: De acuerdo con estos resultados el grupo de mal pronóstico, conlleva un alto riesgo de recidiva y progresión. El tratamiento más efectivo resultó la BCG (bacilo Calmette-Guerin) con mantenimiento, exigiendo, un seguimiento prolongado, más intenso en los 2 primeros años tras la RTU. En el grupo de pronóstico intermedio, las tasas de recidiva superficial a largo plazo fueron tan altas como las de alto riesgo, requiriéndose un seguimiento largo, en éste resultó efectivo el empleo de quimioterapia o BCG siendo preferible el mantenimiento. Por último, en el grupo de buen pronóstico no objetivamos progresiones, siendo el tiempo hasta la recidiva el más largo, con estabilización de la tasa de recurrencias tras 1 año

Introduction: We try to establish risk groups combining the characteristics of each bladder tumour, for a better monitoring of these patients. Material and Methods: Once known the variables implied in recurrence and progression we analyze the data to establish the extreme groups, so, the one with the worse and the one with the better prognostic, remaining a residual group that would correspond of the tumours of intermediate prognostic. Results: From the results obtained, we can establish three risk groups: Bad prognostic group (high risk) : High grade tumours (G3), isolated or associated Tis and multiple or recurrent grade 2 tumours that were recurred in less than 6 months; Intermediate prognostic group: multiple TaG1 tumours, as well as not multiple Ta-1G2 and T1G1 (less than 3 tumours) and Group of low risk: Single TaG1 tumours. Discussion: According to these results the group of badly risk, involves a high risk of recurrence and progression. The most effective treatment was the BCG (bacillus Calmette-Guerin) with maintenance, requiring a long-term control, more intense in the 2 first years after the RTU. In the group of intermediate risk, the rates of long-term superficial recurrence were as high as those of the high risk group, being needed a long-term control, in this group was effective the treatment with chemotherapy or BCG being preferably the maintenance. Finally in the group of good risk we don’t objectify progressions being the time to the recurrence the longest one, with stabilization of the rate of recurrences after one year

Absceso primario de Psoas por Streptococo pneumoniae / Primary psoas abscess due to streptococo pneumoniae

Introducción y objetivos: Aportar a la literatura un nuevo caso de absceso primario de Psoas, con afectación también del Cuadrado Lumbar. Métodos: La paciente es una mujer de 65 años que consultó por dolor en fosa renal izquierda y en cadera izquierda de 1 mes de evolución. En TAC se objetivó la presencia de una masa retroperitoneal con componente quístico que infiltraba el Músculo Psoas y el Músculo Cuadrado Lumbar. Se drenó obteniéndose 1800 cc de material purulento, aislándose en él un Streptotococo pneumoniae. Resultados: En TAC de control 21 días después de su drenaje, presentaba una mínima colección en pelvis menor. Conclusión: Los Abscesos primarios de Psoas son una entidad poco frecuente y con una baja tasa de mortalidad si se realiza un tratamiento adecuado

Introduction and objectives: To report to the literature a new case of primary psoas abscess. Methods: The patient is a 65 years old woman who suffered back and left hip pain for approximately 1 month. A CTA showed a retroperitoneal mass that involved the left Psoas. It was drained 1800 cc of purulent fluid infected by Streptococo pneumoniae. Results: In a CTA made 21 days after drainage, showed a very small residual collection. Conclusions: Primary Psoas Abscess are a very rare entity, with a low rate of mortatility if well treated

[Pronostic factors on recurrence and progression of superficial bladder cancer. Risk groups (part II)]. / Factores pronósticos en la recidiva y progresión del cáncer superficial vesical. Grupos de riesgo (parte II).

INTRODUCTION: We try to establish risk groups combining the characteristics of each bladder tumour, for a better monitoring of these patients. MATERIAL AND METHODS: Once known the variables implied in recurrence and progression we analyze the data to establish the extreme groups, so, the one with the worse and the one with the better prognostic, remaining a residual group that would correspond of the tumours of intermediate prognostic. RESULTS: From the results obtained, we can establish three risk groups: Bad prognostic group (high risk) : High grade tumours (G3), isolated or associated Tis and multiple or recurrent grade 2 tumours that were recurred in less than 6 months; Intermediate prognostic group: multiple TaG1 tumours, as well as not multiple Ta-1G2 and T1GI (less than 3 tumours) and Group of low risk: Single TaG1 tumours. DISCUSSION: According to these results the group of badly risk, involves a high risk of recurrence and progression. The most effective treatment was the BCG (bacillus Calmette-Guerin) with maintenance, requiring a long-term control, more intense in the 2 first years after the RTU. In the group of intermediate risk, the rates of long-term superficial recurrence were as high as those of the high risk group, being needed a long-term control, in this group was effective the treatment with chemotherapy or BCG being preferably the maintenance. Finally in the group of good risk we don't objectify progressions being the time to the recurrence the longest one, with stabilization of the rate of recurrences after one year.

[An alternative technique to prevent obturator nerve stimulation during lateral bladder tumours transurethral resection]. / Tecnica alternativa para prevenir la estimulación del nervio obturador durante la RTU vesical de neoformaciones en cara lateral.

OBJECTIVES: We presents an alternative to prevent the obturator nerve stimulation during TUBR. MATERIAL AND METHOD: We revise 400 bladder tumours corresponding to 218 patients, 46.8% of them localized in lateral bladder wall. An alternative technique is used for that blockade. RESULTS: There have been no adductor contractions in more than 95% of TUBR. CONCLUSIONS: The alternative technique may reduce the stimulation of the obturador nerve and the risk of bladder perforation.

Tecnica alternativa para prevenir la estimulación del nervio obturador durante la RTU vesical de neoformaciones en cara lateral / An alternative technique to prevent of obturator nerve stimulation during lateral bladder tumors transurethral resection

Objetivo: Presentamos una alternativa de abordaje para el bloqueo del nervio obturador durante la RTU vesical. Material y Metodos: Se revisan retrospectivamente 400 tumores vesicales intervenidos, correspondientes a 218 pacientes, localizándose un 46,8% de estos en caras laterales. Se utiliza una vía de abordaje alternativa para el bloqueo del nervio obturador. Resultados: Mediante este abordaje, que simplifica, en posición de litotomía, el bloqueo nervioso del obturador, conseguimos en más del 95% de resecciones el que no se produzca estimulación muscular. Conclusiones: Aplicando esta técnica, disminuimos el riesgo de perforación vesical por esta causa, evitando las complicaciones asociadas

Objetives: We presents an alternative to prevent the obturator nerve stimulation during TUBR. Material and Method: We revise 400 bladder tumours corresponding to 218 patients, 46,8% of them localized in lateral bladder wall. An alternative technique is used for that blockade. Results: There have been no adductor contractions in more than 95% of TUBR. Conclusions: The alternative technique may reduce the stimulation of the obturador nerve and the risk of bladder perforation. Objetives: We presents an alternative to prevent the obturator nerve stimulation during TUBR. Material and Method: We revise 400 bladder tumours corresponding to 218 patients, 46,8% of them localized in lateral bladder wall. An alternative technique is used for that blockade. Results: There have been no adductor contractions in more than 95% of TUBR. Conclusions: The alternative technique may reduce the stimulation of the obturador nerve and the risk of bladder perforation (AU)

[Treatment of erectile dysfunction with penile prothesis. Our experience]. / Tratamiento de la disfunción eréctil mediante el implante de prótesis de pene. Análisis de nuestra serie.

INTRODUCTION AND OBJECTIVES: The aim of this study was to review the current situation of penile prosthesis in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in our experience. MATERIAL AND METHODS: From 1984 to 2003, 48 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 55 years. Vascular disease, Diabetes and pelvic surgery were the most common pathologies recorded. The type of prothesis inserted were malleable inactive in 7 cases (14.58%), Jonas6, Acu-form1. Inflable active with 3 components in 19 cases (39.58%), AMS 700 plus17, Alpha2. Inflable active integrated in 5 cases (10.41%) Hydroflex4, Dynaflex1. Inflable active with 2 components in 17 cases (35.4%), Ambicor2, Mark II15. RESULTS: Infection of the prosthesis was observed in 6.25% of the cases. This infectious complication required removal of the prosthesis. 4.16% of the cases complained of mechanical failure that required change of the prosthesis. 80% of the patients were satisfied with the results. CONCLUSIONS: Penile prostheses continue to be an effective and valid therapeutic alternative in impotent. Although the complication rate is low, adequate information must be provided to the patient.

Tratamiento de la disfunción eréctil mediante el implante de prótesis de pene. Análisis de nuestra serie / Treatment of erectile dysfunction with penile prothesis. Our experience

INTRODUCCIÓN Y OBJETIVOS: El objetivo de este estudio fue revisar la situación actual de las prótesis de pene en el tratamiento de la disfunción eréctil; así como analizar las indicaciones, el grado de aceptabilidad y las complicaciones en nuestra experiencia. MATERIAL Y MÉTODOS: Entre 1984 y 2003 implantamos 48 prótesis de pene en varones con edad media de 55 años. Los antecedentes patológicos más frecuentes fueron: enfermedad vascular, diabetes mellitus y cirugía pélvica. El tipo de prótesis utilizada fue inactiva maleable en 7 casos (14,58%), Jonas6, Acu-form1. Activa inflable o hidráulica de 3 componentes en 19 casos (39,58%), AMS 700 plus17, Alpha2. Activa inflable, integrada o autocontenida en 5 casos (10,41%), Hydroflex4, Dynaflex1. Activa inflable de 2 piezas en 17 casos (35,4%), Ambicor2, Mark II15. RESULTADOS: El 6,25% presentó infección protésica que obligó a retirar el implante, y el 4,16% complicaciones mecánicas. El 80% de los pacientes se mostraron satisfechos con la prótesis. CONCLUSIONES: Las prótesis peneanas continúan siendo una alternativa válida y eficaz en el tratamiento del varón con disfunción eréctil, presentando un bajo índice de complicaciones

INTRODUCTION AND OBJETIVES: The aim of this study was to review the current situation of penile prosthesis in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in oir experience. MATERIAL AND METHODS: From 1984 to 2003, 48 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 55 years. Vascular disease, Diabetes and pelvic surgery were the most common pathologies recorded. The type of prothesis inserted were malleable inactive in 7 cases (14.58%), Jonas6, Acu-form1. Inflable active with 3 components in 19 cases (39.58%), AMS 700 plus17, Alpha2. Inflable active integrated in 5 cases (10.41%) Hydroflex4, Dynaflex1. Inflable active with 2 components in 17 cases (35.4%), Ambicor2, Mark II15. RESULTS: Infection of the prosthesis was observed in 6.25% of the cases. This infectious complication required removal of the prosthesis. 4.16% of the cases complained of mechanical failure that required change of the prosthesis. 80% of the patients were satisfied with the results. CONCLUSIONS: Penile prostheses continue to be an effective and valid therapeutic alternative in impotent. Although the complication rate is low, adequate information must be provided to the patient

[Primary renal lymphoma in a patient with IgM monoclonal gammapathy]. / Linfoma renal primario en paciente con gammapatía monoclonal IgM.

Reports on primary renal lymphoma are scarce in the urological literature, the most part of them are secondary on a lymphomatous infiltration of the kidneys. We report the case of a 77 year old man with an incidental mass on the kidney. After radiological studies (CT), we practise nephrectomy with a pathological result of a non-Hodgking B primary lymphoma. The patient present a IgM monoclonal gammapathy who need complementary treatment with chemotherapy. A literature review on currently recommended diagnostic and treatment practices in presented.

Linfoma renal primario en paciente con gammapatía monoclonal IgM / Primary renal lymphoma in a patient with IgM monoclonal gammapathy

Son infrecuentes los casos de linfoma renal primario, ya que la afectación renal por un proceso linfoproliferativo es, por lo general, secundaria a una enfermedad sistémica. Presentamos el caso de un paciente varón de 77 años que acude por hallazgo ecográfico incidental de una masa en su riñón izquierdo. Después de realizar estudios (TC), se practica nefrectomía cuyo resultado anatomopatológico fue de linfoma no-hodking B primario renal. Asimismo el paciente presentaba una gammapatía monoclonal IgM asociada, por lo que precisó tratamiento quimioterápico sistémico. Realizamos una revisión bibliográfica centrándonos en los criterios diagnósticos y terapéuticos actuales (AU)

Reports on primary renal lymphoma are scarce in the urological literature, the most part of them are secondary on a lymphomatous infiltration of the kidneys. We report the case of a 77 year old man with an incidental mass on the kidney. After radiological studies (CT), we practise nephrectomy with a pathological result of a non-hodking B primary lymphoma. The patient present a IgM monoclonal gammapathy who need complementary treatment with chemotherapy. A literature review on currently recommended diagnostic and treatment practices in presented (AU)

Infertilidad por microdeleciones AZF. Un nuevo caso de azoospermia / Infertility by AZF microdeletions. A new case of azoospermia

Presentamos el caso de un varón azoospérmico estudiado por infertilidad. Entre las causas de azoospermias u oligozoospermias severas detectadas en estudios por infertilidad en varones, se encuentran las causadas por microdeleciones del brazo largo del cromosoma Y, como en este caso. Mediante estudios con técnicas de PCR se demuestra la existencia de regiones en el cromosoma Y, donde se encuentran los genes responsables de la espermatogénesis. Hombres con azoospermia presentarán alto riesgo de tener microdeleciones en estas regiones Ya con las técnicas de ICSI (inyección intracitoplasmática de espermatozoides), estos pacientes podrán transmitir a la descendencia estas deleciones, con lo cual, el consejo genético es fundamental. Por lo tanto el estudio de microdeleciones debería ser considerado en varones infértiles severos (AU)

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[Urachal actinomycosis: apropos of a case]. / Actinomicosis uracal: a propósito de un caso.

The report a new case of infected urachal cyst. The embryologic origin of the urachus, its anomalies, clinical features, diagnosis and treatment are discussed with the case of a 51 years old man who presented an hypogastric mass with the diagnosis of urachal actinomycosis.

Actinomicosis uracal: a propósito de un caso / Urachal actinomicosis: a propose of one case

Se presenta un caso nuevo de quiste de uraco infectado. El origen embriológico del uraco, sus anomalías, clínica, diagnóstico y tratamiento son discutidos con el caso de un varón de 51 años que presentó una masa hipogástrica con el diagnóstico de actinomicosis uracal (AU)

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[Infertility caused by AZF microdeletions. A new case of azoospermia]. / Infertilidad por microdeleciones AZF. Un nuevo caso de azoospermia.

We report report a case of a man with azoospermia who was studied because of infertility. Between the causes of azoospermia and severe oligospermia, in male patients with infertility evaluations, small deletions in regions of the Y chromosome must be considered, as in our case. Regions for spermatogenesis in the Yq chromosome can be evidenced using PCR analysis. Men with azoospermia are at high risk to have small deletions in that regions. Yq chromosome deletions could be transmitted when ICSI (intracytoplasmic sperm injection) is applied. Thereafter, study of microdeletions would be included in severe infertile men.

[Post-traumatic high flow priapism in a child]. / Priapismo de alto flujo postraumático infantil.

We report on the case of a post-traumatic high-flow priapism in a 14 year-old boy, which was confirmed by cavernous blood gas measurement color flow Doppler sonography, and arteriography. It was successfully treated with superselective embolization of the right internal pudendal artery, resulting a clear disappearance of cavernus rigidity.

Priapismo de alto flujo postraumático infantil / Post-traumatic high-flow priapism in childhood

Presentamos el caso de un priapismo de alto flujo tras traumatismo perineal directo en un varón de 14 años, que se confirmó mediante gasometría de cuerpos cavernosos, estudio Eco-doppler peneano, y arteriografía pudenda. Se trató satisfactoriamente mediante embolización supraselectiva de una rama de arteria pudenda interna derecha, obteniendo disminución manifiesta de la rigidez cavernosa (AU)