[Recurrent urinary tract infections: prevention of recurrence with intravesical instillations of chondroitin sulfate and hyaluronic acid.] / Infecciones urinarias de repetición: prevención de recidivas con instilaciones intravesicales de condroitin sulfato sódico y ácido hialurónico.

OBJECTIVE: The aim of our study is to demonstrate that intravesical administration of the association chondroitin sulfate (CS) and hyaluronic acid (HA), according to our treatment schedule, is a benefit for women with recurrent urinary tract infections (RUTI), not only from a clinical point of view, but also reducing recurrences. METHODS: This is a study of 28 women diagnosed with RUTI, with a positive culture, and compatible symptoms;frethey underwent treatment according to the protocol of intravesical instillations of the combination CS 2%-1 gr + HA 1.6%-800 mg. To evaluate the effectiveness of the treatment, symptoms improvement, reduction of the number of episodes of urinary tract infection and quality of life were considered. RESULTS: In our series, we can observe an improvement of the quality of life assessed by PG-I, 66% after 12 months. It was seen that 55.6% of the patient's urine cultures became negative, while 44.4% had episodes of urinary infection, but with lower baseline symptoms intensity. DISCUSSION: Patients included in the protocol of instillation improved significantly their quality of life; in addition, to a considerable extent new urinary infections were not presented, being milder when they presented.

Infecciones urinarias de repetición: prevención de recidivas con instilaciones intravesicales de condroitin sulfato sódico y ácido hialurónico / Recurrent urinary tract infections: prevention of recurrence with intravesical instillations of chondroitin sulfate and hyaluronic acid

OBJETIVO: El objetivo de nuestro estudio es demostrar, que la administración intravesical de la asociación condroitin sulfato sódico (CS) y ácido hialurónico (AH) según nuestro esquema de tratamiento, supone un beneficio en mujeres pre/post menopáusicas con infecciones urinarias de repetición (IUR), no sólo desde el punto de vista clínico, sino que también disminuyen las recurrencias. MÉTODOS: Se presenta un estudio con 28 mujeres diagnosticadas de IUR con cultivo positivo y síntomas compatibles, siguieron tratamiento según protocolo de instilaciones intravesicales de la combinación CS 2%-1 gr + AH 1,6%-800 mg (IALURIL®). Para comprobar la eficacia del tratamiento se evaluó: mejoría de síntomas, reducción del número de episodios de infección urinaria y la calidad de vida. RESULTADOS: En nuestra serie se apreció una mejoría de la calidad de vida, valorada por la escala de impresión de mejoría global del paciente (PG-I), a los 12 meses del 66%. Se apreció que el 55,6% (15/27) de las pacientes negativizaron sus cultivos, mientras que el 44,4% (12/27) presentaron un solo episodio de infección urinaria pero con menor intensidad de síntomas que al inicio del estudio. CONCLUSIONES: Los pacientes incluidos en el protocolo de instilación mejoraron de forma significativa su calidad de vida, además en un porcentaje considerable no se presentaron nuevas infecciones urinarias; en los casos que se presentaron estas fueron menos frecuentes y afectaron menos el estado general de las pacientes que pretratamiento

OBJECTIVE: The aim of our study is to demonstrate that intravesical administration of the association chondroitin sulfate (CS) and hyaluronic acid (HA), according to our treatment schedule, is a benefit for women with recurrent urinary tract infections (RUTI), not only from a clinical point of view, but also reducing recurrences. METHODS: This is a study of 28 women diagnosed with RUTI, with a positive culture, and compatible symptoms; frethey underwent treatment according to the protocol of intravesical instillations of the combination CS 2%-1 gr + HA 1.6%-800 mg. To evaluate the effectiveness of the treatment, symptoms improvement, reduction of the number of episodes of urinary tract infection and quality of life were considered. RESULTS: In our series, we can observe an improvement of the quality of life assessed by PG-I, 66% after 12 months. It was seen that 55.6% of the patient`s urine cultures became negative, while 44.4% had episodes of urinary infection, but with lower baseline symptoms intensity. DISCUSSION: Patients included in the protocol of instillation improved significantly their quality of life; in addition, to a considerable extent new urinary infections were not presented, being milder when they presented

Alternativa terapéutica para el dolor pélvico crónico de origen vesical / New approach in treatment of pelvic chronic pain syndrome (CPPS)

Introducción: El dolor pélvico crónico (DPC) es un problema complejo e importante tanto por su frecuencia como por sumorbilidad. Cuando se presenta asociado con síntomas miccionales deberemos pensar en un origen vesical. Objetivo: Evaluar la respuesta a un tratamiento intravesical, al que denominamos Formula Sedante, en pacientes con dolor pélvico crónico de origen vesical, refractarios a otros tratamientos. Material y métodos: Entre junio 2005 y septiembre de 2008, 14 pacientes (edad media de 59 años), 12 mujeres y 2 hombres, con DPC de origen vesical siguieron un tratamiento intravesical con “Formula Sedante”, como terapia de segunda línea. Su composición es Dexametasona, Nitrofurantoína, Lidocaína y Suero salino. Evaluamos el dolor (escala 0-10), la frecuencia miccional y la mejoría subjetiva del paciente. Resultados: El dolor global medio fue de 6’4 de base, al mes y a los 6 meses fue de 4’7 y 3’5 respectivamente. El 75% de los pacientes mostró una disminución de los valores en la escala de dolor. La frecuencia miccional diurna mejoró un 28%al mes del tratamiento y un 40% a los 6 meses. Un 70 % de los pacientes refirió sentir mejoría tras la pauta de instilaciones, de los cuales en torno a un 80% la evaluó como “moderadamente mejor” o “mucho mejor”, tanto al mes como a los 6 meses del tratamiento. Ninguno de los pacientes presento efectos secundarios reseñables. Conclusiones: Consideramos el tratamiento de instilación intravesical con “Formula Sedante” una opción útil y segura, como segunda línea de tratamiento, para el dolor pélvico crónico de origen vesical (AU)

Introduction: Chronic pelvic pain syndrome (CPPS) is a complex problem that is a major cause of morbidity and disability. Objetive: To evaluate the feasibility, safety and efficacy of intravesical instillation of a new therapeutic tool in patients suffering from CPPS. Methods: Between june 2005 and september 2008 we recruited 14 patients (mean age 59) who had been diagnosed with CPPS, and refractory to previous treatments. The intravesical solution consisted of steroids, local anaesthetic, antibiotic and saline solution. Was evaluated the intensity of pain; voiding frequency and subjective improvement (with patient global improvement impression PGI-I).Results: Global pain at baseline was 6,4, at 1 month and 6 months 4,7 and 3,5. 75% of the patients showed improvement in the reduction of pain. Voiding frequency at baseline was 22’5 daily. At one and six months, voiding frequency was 16,2and 13,5 respectively. According to the PGI-I test 30% of patients were much better, 30% moderate improvement, 10%slight improvement and 30% with no changes at 1 month. At 6 months, 15% of patients were much better, 40% moderated improvement, 15% slight improvement and 30% with no changes. None of the patients felt worse than before treatment. Conclusions: Therapeutic results of our intravesical solution traduces in an improvement of pain and voiding frequency reduction with no side-effects. Patients benefit of this improvement in the PGI-I test that reflects an improvement in quality of life. We consider this treatment a second-line approach for CPPS in which gold standard management is still a challenge (AU)

[The Spanish participation in the Congresses of the International Society of Urology during the 20th century]. / Participación española en los Congresos de la Sociedad Internacional de Urología en el siglo XX.

OBJECTIVES: With the occasion of the Centenary of the Constitution in 1907 of the International Society of Urology, initially named Association, we point at the topics treated and analyze the presence of the Spanish urologists in the foundation act as well as their role and contributions in the meetings during the 20th century. METHODS: We obtained the data from the information in various periodic publications, from the memories of some participant urologists and from the meeting records. RESULTS: We obtained notes from the foundation meeting of the International Association and two congresses, and also from the 25 congresses of the Society. We mainly extract data from the records edited by the meeting secretary, about the assistance of Spanish urologists and their contribution with conferences or communications and also about the relevance they have had holding positions within the organization. CONCLUSIONS: From 1907 the presence of Spanish urologists both in the Association and the International Society of Urology has been a constant. During the first half of the century, a time when our Urology was in a period of consolidation, the people in charge of the main urology departments in big hospitals in our country where the ones that could transmit their experience, with a level and quality comparable with the rest of Europeans. During the second half, once the nations recovered from wars, the scientific activity continued with an increasing Spanish contribution, which extended all over the country with the creation of the net of Social Security hospitals. They had hierarchical urology departments that performed study and analysis of their case series and started clinical and experimental research, significantly increasing the number of Spanish communications, mainly in congresses celebrated in Spanish speaking or European cities. As a consequence of their participation, three of the 25 meetings organized during the 20th century have been held in Spain. The Spanish presence in the directing boards of the society was favoured by the presence of Dr. Salvador Gil Vernet to consecutive periods.

[Penile sarcoma: a rare tumor]. / Sarcoma de pene: un tumor raro y agresivo.

OBJECTIVE: We report the case of a penile tumor presenting with lung and lymph node metastasis, with fatal evolution after the absence of response to surgery and adjuvant treatment. METHODS: Male patient presenting with a penile mass appearing progressively, with metastases. RESULTS: Partial penectomy and adjuvant chemotherapy were performed, with the appearance of a rapidly growing local recurrence which led to death of the patient in a few months. The tumor was a penile sarcoma with osteosarcomatous differentiation. CONCLUSIONS: Penile sarcoma is an unfrequent tumor that has a very aggressive behavior, requiring early diagnosis and aggressive management. It has tendency to local recurrence, and when it presents with distant metastases is lethal within a few months.

[Bilateral renal lymphangiomatosis: conservative management]. / Linfangiomatosis renal bilateral: actitud conservadora.

OBJECTIVE: Lymphangiomatosis is a benign disease of difficult diagnosis. The bilateral form is very rare, being in some cases an incidental finding. METHODS: We report the case of a female patient with the incidental radiological diagnosis of bilateral lymphangiomatosis, who did not present symptoms in relation to the disease. RESULTS: After a meticulous study with ultrasound, abdominal CT scan and the MRI the diagnosis was asymptomatic bilateral lymphangiomatosis and expectant management was decided with good outcome. CONCLUSIONS: Most cases reported have been treated by nephrectomy for diagnosis, but in our case it was possible to do precise diagnosis adding the experience of the radiologist and the urologist and she had a good outcome with conservative management.

Participación española en los congresos de la Sociedad Internacional de Urología en el siglo XX / The spanish participation in the Congresses of the International Society of Urology during the 20th Century

OBJETIVO: Con ocasión del centenario de la constitución en 1907 de la denominada primero Asociación y, más tarde, Sociedad Internacional de Urología, señalamos los temas tratados y analizamos la presencia de urólogos españoles en el acto fundacional así como el papel desempeñado y sus aportaciones en los congresos de la Sociedad celebrados en el siglo XX. MÉTODOS: Entresacamos datos de la información recogida en diferentes publicaciones periódicas, de las memorias de algunos de los participantes y de las actas de los congresos. RESULTADOS: Hemos obtenido notas de la reunión constitutiva de la Asociación Internacional y de sus dos congresos y luego de los veinticinco de la Sociedad. Extraemos, principalmente de las actas editadas por el secretario de la reunión, la asistencia de los urólogos españoles y su contribución con ponencias o comunicaciones así como la relevancia que han tenido al desempeñar cargos en el seno de la organización. CONCLUSIONES: Desde 1907 la presencia de urólogos españoles tanto en la Asociación como en la Sociedad Internacional de Urología ha sido constante. En la primera mitad del siglo, años en los que nuestra Urología se encontraba en un periodo de consolidación, fueron los responsables de los principales servicios urológicos de los grandes hospitales del país los que podían transmitir su experiencia con un nivel y calidad equiparables a los del resto de los europeos. En la segunda, una vez recuperadas las naciones de los episodios bélicos, prosigue la actividad científica con una creciente aportación española conforme se extiende por todo el país la creación de los Hospitales de la Seguridad Social con servicios jerarquizados de Urología en los que se realiza el estudio y el análisis de sus casuísticas y se inician la investigación clínica y experimental, lo que permite que las comunicaciones españolas se incrementen de modo notable sobre todo en los congresos celebrados en poblaciones de habla castellana o en los europeos. Como consecuencia de su participación, en España se han desarrollado tres de los veinticinco congresos organizados en el siglo XX. La presencia española en los órganos rectores de la Sociedad se vio favorecida con la presidencia del profesor D. Salvador Gil Vernet por dos periodos consecutivos

OBJECTIVES: With the occasion of the Centenary of the Constitution in 1907 of the International Society of Urology, initially named Association, we point at the topics treated and analyze the presence of the Spanish urologists in the foundation act as well as their role and contributions in the meetings during the 20th century. METHODS: We obtained the data from the informationin various periodic publications, from the memories of some participant urologists and from the meeting records. RESULTS: We obtained notes from the foundation meeting of the International Association and two congresses, and also from the 25 congresses of the Society. We mainly extract data from the records edited by the meeting secretary, about the assistance of Spanish urologists and their contribution with conferences or communications and also about the relevance they have had holding positions within the organization. CONCLUSIONS: From 1907 the presence of Spanish urologists both in the Association and the International Society of Urology has been a constant. During the first half of the century, a time when our Urology was in a period of consolidation, the people in charge of the main urology departments in big hospitals in our country where the ones that could transmit their experience, with a level and quality comparable with the rest of Europeans. During the second half, once the nations recovered from wars, the scientific activity continued with an increasing Spanish contribution, which extended all over the country with the creation of the net of Social Security hospitals. They had hierarchical urology departments that performed study and analysis of their case series and started clinical and experimental research, significantly increasing the number of Spanish communications, mainly in congresses celebrated in Spanish speaking or European cities. As a consequence of their participation, three of the 25 meetings organized during the 20th century have been held in Spain. The Spanish presence in the directing boards of the society was favoured by the presence of Dr. Salvador Gil Vernet to consecutive periods

Sarcoma de pene: un tumor raro y agresivo / Penile sarcoma: a rare tumor

OBJETIVO: Presentamos el caso de un tumor de pene que debutó con metástasis pulmonares y ganglionares con evolución fatal sin respuesta a cirugía y terapia adyuvante. MÉTODOS: Varón que se presenta con masa peneana de aparición progresiva con metástasis. RESULTADOS: Se practica penectomía parcial y quimioterapia adyuvante, apareciendo recidiva local de crecimiento rápido provocando la muerte del paciente en pocos meses. El tumor resultó ser un sarcoma de pene con diferenciación osteosarcomatosa. COINCLUSIONES: El sarcoma de pene es un tumor infrecuente pero de comportamiento muy agresivo que requiere un diagnóstico precoz y una actitud agresiva en su manejo. Tiene tendencia a la recurrencia local y cuando debuta con metastasis a distancia es letal en pocos meses

OBJECTIVE: We report the case of a penile tumor presenting with lung and lymph node metastasis, with fatal evolution after the absence of response to surgery and adjuvant treatment. METHODS: Male patient presenting with a penile mass appearing progressively, with metastases. RESULTS: Partial penectomy and adjuvant chemotherapy were performed, with the appearance of a rapidly growing local recurrence which led to death of the patient in a few months. The tumor was a penile sarcoma with osteosarcomatous differentiation. CONCLUSIONS: Penile sarcoma is an unfrequent tumor that has a very aggressive behavior, requiring early diagnosis and aggressive management. It has tendency to local recurrence, and when it presents with distant metastases is lethal within a few months

Linfangiomatosis renal bilateral: actitud conservadora / Bilateral renal lymphangiomatosis: conservative management

OBJETIVO: La linfangiomatosis es una enfermedad benigna pero de difícil diagnóstico. La forma bilateral es muy rara, pudiendo tratarse en algún caso de un hallazgo casual. MÉTODOS: Presentamos el caso de una paciente diagnosticada radiológicamente de linfangiomatosis bilateral de forma casual pues no presentaba síntomas derivados esta patología. RESULTADOS: Después de un estudio minucioso con ecografía, TAC-abdominal y RNM y con el diagnóstico de linfangiomatosis bilateral asintomática, se decidió actitud expectante con buena evolución posterior. CONCLUSIONES: La mayoría de casos descritos han recurrido a la nefrectomía para su diagnóstico, pero como en nuestro caso, es posible un diagnóstico certero con la experiencia del radiólogo y urólogo y un manejo conservador con buena evolución

OBJECTIVE: Lymphangiomatosis is a benign disease of difficult diagnosis. The bilateral form is very rare, being in some cases an incidental finding. METHODS: We report the case of a female patient with the incidental radiological diagnosis of bilateral lymphangiomatosis, who did not present symptoms in relation to the disease. RESULTS: After a meticulous study with ultrasound, abdominal CT scan and the MRI the diagnosis was asymptomatic bilateral lymphangiomatosis and expectant management was decided with good outcome. CONCLUSIONS: Most cases reported have been treated by nephrectomy for diagnosis, but in our case it was possible to do precise diagnosis adding the experience of the radiologist and the urologist and she had a good outcome with conservative management

[Cavernous hemangioma of the bladder]. / Cavernomatosis vesical: una patologia infrecuente.

OBJECTIVE: Certain pathologic entities should be ruled out in the diagnostic work up of hematuria, because they are so rare that if they would not share diagnostic tests with more frequent urological diseases they could be missed. The cavernous haemangioma of the bladder is one of them. METHODS: We report the case of a male patient presenting with rectal bleeding and hematuria with the diagnosis of rectal-vesical cavernous haemangioma. RESULTS: After 8 years of follow-up he did not need surgical treatment, only blood transfusions at the time of diagnosis. He has self limited episodes of hematuria not requiring aggressive therapy. CONCLUSIONS: The cavernous haemangioma of the bladder is a rare disease presenting as bleeding bladder excrecent lesions that do not require surgery as first treatment option if the bleeding is not life-threatening.

Cavernomatosis vesical: una patología infrecuente / No disponible

OBJETIVO: Existen ciertas patologías a tener en cuenta en el estudio de una hematuria, que por su infrecuencia pasarían desapercibidas de no ser porque comparten pruebas diagnosticas con las patologías urológicas más comunes; una de ellas es la cavernomatosis vesical. MÉTODO: Presentamos el caso de un paciente que debutó con rectorragias y hematuria y fue diagnosticado de cavernomatosis rectovesical. RESULTADOS: Después de 8 años de seguimiento de su hematuria no ha requerido tratamiento quirúrgico alguno y solamente ha precisado de transfusión al inicio del diagnóstico. Los episodios de hematuria son autolimitados y no requieren maniobras agresivas. CONCLUSIONES: La cavernomatosis vesical es una patología infrecuente que se manifiesta en forma de lesiones vesicales excrecentes que sangran y que no requiere tratamiento quirúrgico de entrada si no compromete la vida del paciente (AU)

OBJECTIVE: Certain pathologic entities should be ruled out in the diagnostic work up of hematuria, because they are so rare that if they would not share diagnostic tests with more frequent urological diseases they could be missed. The cavernous haemangioma of the bladder is one of them. METHODS: We report the case of a male patient presenting with rectal bleeding and hematuria with the diagnosis of rectalvesical cavernous haemangioma. RESULTS: After 8 years of follow-up he did not need surgical treatment, only blood transfusions at the time of diagnosis. He has self limited episodes of hematuria not requiring aggressive therapy. CONCLUSIONS: The cavernous haemangioma of the bladder is a rare disease presenting as bleeding bladder excrecent lesions that do not require surgery as first treatment option if the bleeding is not life-threatening (AU)

[Hand-assisted laparoscopic radical nephrectomy vs. open nephrectomy in the treatment of clinically localized renal cell carcinoma. Comparative study]. / Nefrectomía radical laparoscópica asistida por la mano frente a nefrectomía abierta en el tratamiento del carcinoma de células renales clínicamente localizado. Estudio comparativo.

INTRODUCTION: The description of the first laparoscopic nephrectomy made a revolution in the managing of the benign and malignant renal diseases. Hand-assisted laparoscopy (HAL) was developed with the aim of offering advantages to both patients and surgeons. The aim of the present work is to compare, in our experience, the results offered in the radical nephrectomy by HAL and open surgery, by analysis of surgical time, estimated blood loss during surgery and hospital stay. METHODS: Eleven Hand-assisted laparoscopic (HAL) radical nephrectomies and eight open radical nephrectomies were carried out at our institution during the same period (June 2001 to December 2002). All patients underwent computed tomography and were found to have a clinically localised functioning renal mass in all cases. The size of this renal mass was 4-7 cm (average 5.5 cm) in the HAL group and 4.5-15 cm (average 7.8 cm) in the open group. Patient age, body mass index, and American Society of Anaesthesiologists' score showed no significant difference between groups. RESULTS: The average surgical time in the HAL group was 156.72 minutes, the average blood loss during surgery was of 83.6 ml and the average hospital stay was of 3.09 days. Conversion to open surgery was not necessary in any patient. Average surgical time in the open surgery group was 178.25 minutes, the estimated blood loss during surgery was of 337.75 ml (p < 0.05) and the hospital stay was of 5.37 days (p < 0.05). The comparison of the means by two-tailed student's t test revealed significant differences in estimated blood loss and hospital stay, favoring HAL, and no significant differences in surgical time. CONCLUSIONS: HAL nephrectomy is feasible in almost all nephrectomies and is a safe, reproducible, and minimally invasive technique to perform extirpable renal surgery. HAL offer clear advantages over traditional open surgery, including decreased blood loss and hospital stay.

[Fatal evolution of a renal angiosarcoma]. / Evolución fatal de angiosarcoma renal.

OBJECTIVES: Report a new case of renal angiosarcoma treated by surgery and adjuvant chemotherapy with bad results. METHODS: 72-year-old male undergoing right nephrectomy for renal tumor. Pathology reports renal angiosarcoma. RESULTS: Three months after surgery patient refers lumbar pain and hemoptysis and CT scan reveals the existence of multiple bone and lung metastasis; a regimen of systemic chemotherapy with Doxorrubicine+ Ifosfamide was started without response; he died two months later. CONCLUSIONS: Primary renal angiosarcoma is very rare, with less than 10 cases in the literature before 1998, and it is always associated with bad prognosis. Diagnosis is based on immunohistochemical studies (antibodies against CD31, CD34 and factor VIII related antigen) to define the endothelial differentiation of the tumor. There is no experience to define the best therapeutic strategy against this entity.

[Relation between hypertension and clinical cases of benign prostatic hyperplasia]. / Estudio de la relación entre hipertensión y caso clínico de hiperplasia benigna de próstata.

OBJECTIVES: To confirm the relationship between hypertension and lower urinary tract symptoms (LUTS) in our environment, and to evaluate the association between hypertension and LUTS secondary to benign prostatic hypertrophy (BPH). METHODS: We prospectively studied during 3 months all male patients older than 50 years (163 patients) analysing previous medical history, IPSS, digital rectal examination, urine sediment, basic biochemical profile, PSA, uroflowmetry, and urinary tract ultrasound. Patients with neurological diseases, previous pelvic trauma, diabetes mellitus, suspicious digital rectal examination, abnormal PSA, or under treatment with alpha blockers, antidepressants, finasteride or antipsychotic drugs were excluded. RESULTS: From a total of 163 patients 113 were classified as suffering clinical BPH (LUTS, prostate greater than 30 gm, and uroflowmetry < 15 ml/sec), and 75 as hypertensive. Among 75 hypertensive patients 31 presented IPSS greater than 7 (41.3%) in comparison to 20 out of 88 non hypertensive patients (22.7%), being the difference statistically significant. CONCLUSIONS: Our study confirms what has been previously reported by other authors, that there is a statistically significant relationship between hypertension and LUTS secondary to BPH.

[Urachal cysts during childhood]. / Quistes uracales en la infancia.

OBJECTIVE: To assess diagnosis and treatment of uracal cysts. METHODS: We reviewed the medical records and radiological studies of four patients who were treated for a urachal anomaly: two urachal cysts and two urachal abscesses. Diagnostic evaluation included, ultrasound, computerized tomography and magnetic resonance. RESULTS: Treatment of urachal abscesses involved drainage and secondary excision. The urachal cyst does not require surgical intervention. CONCLUSIONS: Ultrasound is an excellent diagnostic tool for patients with urachal cysts. Infected cysts may present with pain, tenderness and erythema in the infraumbilical region. Extraperitoneal excision is the treatment of choice, although large infected cysts may require an initial drainage procedure.

Estudio de la relación entre hipertensión y caso clínico de hiperplasia benigna depróstata / Clinical study to evaluate the relationship between hypertension and benign prostatic hyperplasia

OBJETIVOS: Confirmar la asociación entre H.T.A.y síntomas del tracto urinario inferior (L.U.T.S.) en nuestro medio y evaluar la asociación entre H.T.A. y síntomas del tracto urinario inferior debidos a Hiperplasia Benigna de la Próstata (H.B.P.). MÉTODOS: Durante tres meses, estudiamos prospectivamente, todos los varones mayores de 50 años (163 pacientes) analizando los antecedentes personales, cuestionario IPSS, tacto rectal, sedimento urinario, bioquímica elemental, P.S.A., flujometría y ecografía renovesical y prostática. Se excluyen los enfermos con alteraciones neurológicas, traumatismo pélvico previo o diabetes mellitas, tacto rectal sospechoso y P.S.A. alterado y consumo habitual de fármacos como alfabloqueantes, antidepresivos, finasteride o antipsicóticos. RESULTADO: De los 163 pacientes, 113 fueron catalogados como "H.B.P. clínica" (presencia de síntomas del tracto urinario inferior, próstata mayor de 30 gramos y flujometría inferior de 15 ml./sg.), y 75 como hipertensos. De los 75 hipertensos, 31 presentó puntuación IPSS superior a 7(41,3 por ciento) frente a los 20 de los 88 no hipertensos (22,7 por ciento), existiendo una diferencia estadísticamente significativa. CONCLUSIONES: Nuestro estudio, reafirma los resultados ya comunicados por otros autores, con relación estadísticamente significativa entre la H.T.A. y síntomas de prostatismo (I.P.S.S.) (AU)

No disponible

Quistes uracales en la infancia / Urachal cysts during childhood

OBJETIVO: Valorar diagnóstico y tratamiento de los quistes uracales. MÉTODOS: Revisamos historia y estudios radiológicos de cuatro pacientes; dos presentaban quistes uracales y los otros dos, abscesos. Los métodos diagnósticos incluyeron ecografía, TAC y en un caso RNM. RESULTADOS: El tratamiento de los abscesos fué quirúrgico en dos tiempos. Los quistes no han sido intervenidos. CONCLUSIONES: La ecografía es un excelente método diagnóstico para el quiste uracal. El quiste infectado se presenta con dolor fiebre y eritema en la región periumbilical. La escisión extraperitoneal es el tratamiento de elección, aunque si el quiste está infectado es preciso realizar un drenaje en un primer tiempo (AU)

Quistes prostáticos de la línea media: manejo y seguimiento / Medial prostatic cysts: management and follow-up

OBJETIVOS: Conocer la forma de presentación clínica y el manejo diagnóstico y terapéutico de una patología tan infrecuente como son los quistes prostáticos de la línea media. MÉTODOS: Entre 1990 y 1999, ocho pacientes fueron diagnosticados en nuestro centro de quiste prostático de la línea media. La ecografía renovesical fue la primera exploración practicada y resultó diagnóstica en la mayoría de los casos. Sólo requirieron ingreso aquellos pacientes que se intervinieron quirúrgicamente. RESULTADOS: La clínica de presentación más frecuente correspondió al síndrome miccional, tanto irritativo como obstructivo. El tratamiento instaurado fue resolutivo o mejoró la clínica. CONCLUSIONES: La ecografía renovesical es la primera opción a tener en cuenta en el diagnóstico de esta patología. Antes de atribuir los síntomas a un quiste de próstata deberemos descartar otras patologías urológicas de mayor relevancia pronóstica El tratamiento debe ser aplicado sólo a los pacientes sintomáticos y se individualizará según las características en cada caso (AU)