[Psoas muscle abscess: bibliographic review]. / Absceso de psoas: revisión de la bibliografía.

OBJECTIVES: To report the clinical characteristics, diagnosis and treatment of psoas abscess. METHODS/RESULTS: We report the case of a 77 year old female patient who was diagnosed of psoas abscess. Due to the unspecific symptoms, she was initially treated as a renal colic. Ultrasound was the test that oriented us to the diagnosis. Percutaneous drainage was effective, checking the resolution using CT Scan. CONCLUSIONS: Psoas abscess is an uncommon pathology the presenting features of which are usually unspecific. CT Scan is the astronomer diagnostic tests and percutaneous drainage has good results and is less aggressive therapeutic option for this disease.

Absceso de psoas: revisión de la bibliografía / Psoas muscle abscess: bibliographic review

OBJETIVO: Presentar las características clínicas,diagnostico y tratamiento del absceso de psoas.MÉTODO / RESULTADOS: Presentamos el caso de una mujer de 77 años diagnosticada de absceso de psoas. Debido a la inexpecificidad de sus síntomas se trató al inicio como un cólico nefrítico complicado, siendo la ecografíala prueba diagnóstica que nos orientó en el diagnóstico.Mediante drenaje percutáneo el tratamiento fue eficaz, comprobándose la resolución mediante TAC.CONCLUSIONES: El absceso de psoas es una patología poco común cuyas características de presentación son normalmenteinespecíficas. El TAC es el método estándar de diagnóstico y el drenaje percutáneo tiene buenos resultadosy es la opción terapéutica menos agresiva para esta enfermedad

OBJETIVES: To report the clinical characteristics, diagnosis and treatment of psoas abscess.METHODS/RESULTS: We report the case of a 77 year old female patient who was diagnosed of psoas abscess. Due to the unspecific symptoms, she was initially treated as a renal colic. Ultrasound was the test that oriented us to the diagnosis. Percutaneous drainage was effective, checking the resolution using CT Scan.CONCLUSIONS: Psoas abscess is an uncommon pathology the presenting features of which are usually unspecific. CT Scan is the astronomer diagnostic tests and percutaneous drainage has good results and is less aggressive therapeutic option for this disease

[Transurethral resection with saline solution: a technological achievement not yet assimilated by the urological community]. / La resección transuretral con solución sauna: un logro tecnológico aún no asimilado por la urología.

OBJECTIVES: To objectively demonstrate the advantages provided by TURP with saline solution (an adjustment made possible thanks to the technological development of new high frequency current generators), although it surprisingly has been received with scepticism in the urological community. METHODS: A first group of 51 patients (group A) underwent low hydraulic pressure TURP with a pulsed bipolar system (Gyrus Plasmakinetic, with large loop) using physiologic saline solution as irrigation. A second group of 49 patients underwent low hydraulic pressure TURP with a conventional monopolar system (Erbe 350) using glycine-ethanol solution. RESULTS: A better surgical performance was obtained in the first group, as well as a lower degree of bleeding. No intraoperative complications appear in either group. Only one case of late hematuria was registered one month after surgery in a patient of group A. CONCLUSIONS: Pulsed bipolar TURP has a minimal thermal in-depth diffusion, achieves vessel hemostasis by dessication instead of charring, has an extremely precise cutting quality, does not produce neuromuscular stimulation, and makes the use of saline solution irrigation possible. All these translate to lower tissue injury, null risk of sequelae secondary to electric current leak, a finer technique, a lower risk of accidental perforation, and the possibility of duplicate or triplicate the surgical time without risk, especially when working with low hydraulic pressure.

La resección transuretral con solución salina: un logro tecnológico aún no asimilado por la urología / Transurethral resection with saline solution: a technological achievement not yet assimilated by the urological community

OBJETIVO: Demostrar objetivamente lasventajas que reporta el uso de la R.T.U.P. con soluciónsalina (logro posible gracias al desarrollo tecnológicode los los nuevos generadores de corrientes de alta frecuencia),pero que curiosamente ha sido recibida porlos urólogos con cierto escepticismo.MÉTODOS: A un primer grupo de 51 pacientes (grupoA) se les sometió a R.T.U.P., a baja presión hidráulica,con un sistema bipolar por pulsos (Gyrus Plasmakinetic,con asa large loop) y empleando suero fisiológicocomo líquido irrigante. A un segundo grupo, de 49pacientes se les practicó una R.T.U.P., a baja presiónhidráulica, con un sistema monopolar convencional(Erbe 350) y empleando solución de glicina con etanolcomo líquido irrigante.RESULTADOS: En el primer grupo de pacientes se obtuvoun mejor rendimiento quirúrgico y menor grado dehemorragia. No se produjeron complicaciones intraoperatoriasen ambos grupos. Solo se registró un casode hemorragia tardía al mes de la intervención en unpaciente del grupo A.CONCLUSIONES: La R.T.U. bipolar por pulsos, tieneuna mínima inercia térmica en profundidad, es capazde hemostasiar los vasos por desecación en vez de carbonización,dispone de una calidad de corte extremadamentepreciso, no provoca estímulo neuromuscular yhace posible el uso de una solución salina como mediode irrigación. Todo ello se traduce en un menor dañotisular, nulo riesgo de secuelas por fugas de corriente,una técnica más depurada, un menor riesgo de perforacionesaccidentales, y la posibilidad de duplicar o triplicarsin riesgo el tiempo quirúrgico, especialmente sise trabaja con baja presión hidráulica

OBJECTIVES: To objectively demonstrate ;;the advantages provided by TURP with saline solution ;;(an adjustment made possible thanks to the technological ;;development of new high frequency current generators), ;;although it surprisingly has been received with scepticism ;;in the urological community. ;;METHODS: A first group of 51 patients (group A) ;;underwent low hydraulic pressure TURP with a pulsed ;;bipolar system (Gyrus Plasmakinetic, with large loop) ;;using physiologic saline solution as irrigation. A second ;;group of 49 patients underwent low hydraulic pressure ;;TURP with a conventional monopolar system (Erbe 350) ;;using glycine-ethanol solution. ;;RESULTS: A better surgical performance was obtained ;;in the first group, as well as a lower degree of bleeding. ;;No intraoperative complications appear in either ;;group. Only one case of late hematuria was registered ;;one month after surgery in a patient of group A. ;;CONCLUSIONS: Pulsed bipolar TURP has a minimal ;;thermal in-depth diffusion, achieves vessel hemostasis ;;by dessication instead of charring, has an extremely ;;precise cutting quality, does not produce neuromuscular ;;stimulation, and makes the use of saline solution irrigation ;;possible. All these translate to lower tissue injury, null ;;risk of sequelae secondary to electric current leak, a ;;finer technique, a lower risk of accidental perforation, ;;and the possibility of duplicate or triplicate the surgical ;;time without risk, especially when working with low ;;hydraulic pressure

[Laparoscopic treatment of varicocele]. / Tratamiento del varicocele por laparoscopia.

OBJECTIVES: Current trends in the treatment of varicocele are focused on outpatient procedures of high and complete ligature of the spermatic vascular pedicle or percutaneous embolization. Laparoscopic varicocelectomy competes with them and other minimally invasive techniques such as chemical or thermal sclerosing therapy of the spermatic veins. METHODS: We perform a bibliographic review of the Spanish and Anglo-Saxon literature with the aim of evaluating the real weight of the laparoscopic technique, and at the same time show our personal experience. RESULTS: We found 8 papers in Spanish and 187 in English. Although the interest for laparoscopic varicocelectomy among Spanish urologists is very low, in other countries there is moderate interest for it, being in competition, though in disadvantage, with other outpatient minimally invasive techniques performed under local or regional anesthesia. CONCLUSIONS: Microlaparoscopy improves the overall position of this technique, mainly in cases of bilateral varicocele whenever an "en bloc" ligature of the spermatic artery and vein is performed.

[Intraurethral foreign bodies]. / Cuerpos extraños intrauretrales.

OBJECTIVES: We report a case of urethral foreign bodies in a patient with posttraumatic psychiatric disorders. METHODS: The patient presents with clinical signs of scrotal abscess. Many foreign bodies were removed from the bulbar urethra; one urinary stone formed around one of them required lithotripsy. RESULTS: Treatment included removal of the foreign bodies, abscess drainage, and administration of wide spectrum antibiotics. CONCLUSIONS: Urethral foreign bodies are exceptional, and may present with many symptoms making diagnosis difficult. We noted symptoms and diagnosis in our case, and additionally the therapeutic options proposed in the literature.

[Laparoscopic nephroureterectomy for upper urinary tract urothelial tumors]. / Nefroureterectomía laparoscópica en tumores de uroteuo alto.

OBJECTIVES: We present our 11 year experience with 15 laparoscopic nephroureterectomy procedures for upper urinary tract urothelial tumor. METHODS/RESULTS: The tumor site was pyelocalyceal in 9 cases, ureteral in 4, and multifocal in one. All cases were urothelial tumors grade II or III; stage was Ta-T1 in 9 cases, T2 in three, T3 in two, and T4 in one. Transperitoneal approach was performed in 14 cases, whereas only one retroperitoneal. Hand assisted laparoscopy was performed in five cases. Seven specimens were extracted after morcellation without any recorded tumor seeding attributable to this manoeuvre. We recorded one case of sudden death due to pulmonary embolism 48 hours after the procedure, one case of intestinal obstruction secondary to an ileal loop hernia through the parietal orifice of one of the trocars, and one case of unstable angina pectoris. Two patients died because of disease progression, one of them after bladder recurrence. CONCLUSIONS: We think that hand assisted laparoscopy is a good indication for nephroureterectomy for upper urinary tract urothelial tumor. We propose a new procedure to avoid possible tumor cell spilling at the time of ureterectomy, which simplifies the operation very much at the same time.