[Nd-YAG laser photocoagulation of scrotal sebaceous cysts]. / Fotocoagulación con láser de Nd-YAG de quistes sebáceos escrotales.

Scrotum's sebaceous cyst is an usual pathology, not life threatening, but susceptible of infection, producing abscess with their associated cosmetic and psychological disturbance. The classical management is the complete excision, under local anaesthesia, to prevent its recidive. Until today, the use of de Nd-YAG laser for the management of the scrotum's sebaceous cysts as not been reported. We report a case of a young man with several scrotum's sebaceous cysts, treated successfully with the use of a Nd-YAG laser.

Fotocoagulacion con láser de Nd-YAG de quistes sebaceos escrotales / Phtocoagulation with Nd-YAG Laser of scrotum's sebaceous cysts

Los quistes sebáceos escrotales constituyen una frecuente patología, que si bien no es importante por sí misma, pueden infectarse ocasionando pequeños abscesos, con repercusión estética y psicológica en el paciente. El tratamiento clásico de los mismos es su exéresis con anestesia local, procurando extirpar la totalidad de los mismos, ya que de no actuar así, la recidiva es la norma. Hasta la fecha, el uso del láser de Nd-YAG en el tratamiento de los quistes sebáceos escrotales no ha sido descrito. Presentamos el caso de un paciente joven, con multitud de quistes sebáceos escrotales, que con la aplicación complementaria del láser de Nd-YAG se pudo controlar el problema de forma sencilla (AU)

[Kidney annulment and bladder lithiasis secondary to ureteral catheter]. / Anulación renal y litiasis vesical secundaria a catéter ureteral.

We reported a case of a kidney annulment and bladder stone secondary a foreign body (ureteral stent). We review all the cases of urinary stone secondary a foreign bodies.

Anulación renal y litiasis vesical secundaria a catéter ureteral / Kidney annulment and bladder stone secondary and ureteral stent

Presentamos un caso de anulación renal y litiasis vesical secundaria a la presencia prolongada de un catéter ureteral.Revisamos los casos de litiasis urinaria secundaria a cuerpos extraños (AU)

Barcelona retrograde urethrography: a new device and technique.

PURPOSE: We describe a new device and technique for retrograde urethrography without instrumentation of the male urethra. MATERIALS AND METHODS: We performed retrograde urethrography with a vacuum uterine cannula in 160 patients. Stricture of the distal tip of the urethra and iatrogenic damage to the urethra were evaluated. RESULTS: No patient sustained iatrogenic damage to the urethra and stricture of the distal tip of the urethra was visualized in 12 patients. CONCLUSIONS: We recommend the use of this technique of retrograde urethrography without instrumentation to determine urethral disease when manipulation of the urethra must be avoided or is impossible due to meatal stenosis.

[Expression of the tumor suppressor gene p53 in superficial transitional carcinoma of the bladder]. / Expresión del gen supresor tumoral p53 en los carcinomas transicionales superficiales de vejiga.

Presentation of 113 cases of transitional cells surface tumours of the bladder where p53 protein expression has been used and compared to known prognostic factors. The existence of a statistically significant relationship between this expression and the tumoral grade and stage in all studied groups has been noticed. It can be concluded that the expression of this protein can be useful as a new prognostic factor, even though it is still necessary to conduct more studies, basically prospective.

[High incidence of chromosome 8 monosomy and chromosome 7 trisomy in prostatic primary tumor and its related lymphatic metastasis. Preliminary results]. / Alta incidencia de la monosomia del cromosoma 8 y la trisomia del cromosoma 7 en el tumor primario prostático y su metástasis ganglionar asociada. Resultados preliminares.

INTRODUCTION: The research on tumoral aggressivity parameters in prostate cancer, such DNA ploidy detected by fluorescence in situ hybridization, has significant relevance to refine prognostic on an individualized patient. OBJECTIVES: To identify chromosome numeric alterations by FISH in primary prostate cancer focus and its corresponding lymph node metastases. b) To describe a cytogenetic tumoral progression pathway. METHODS: So far, we have retrospectively studies eight patients with prostate cancer and lymph node metastases performing FISH analysis on the primary prostate cancer focus and its metastatic lymph node. DNA probes for chromosomes 7, 8, 10 and 12 have been used for FISH analysis. RESULTS: a) Seven out of eight tumours (85%) were aneuploid when studied by FISH and the most frequent chromosome alterations found were monosomy 8 (100%) and trisomy 7 (85.7%). All the lymph nodes were aneuploid being monosomy 8 (87.5%) and trisomy 7 (62.5%) the most common chromosome alterations. b) Monosomy 8 and trisomy 7 appeared to be in the same cytogenetic tumoral progression pathway. CONCLUSION: Although we report about a preliminary study, monosomy of chromosome 8 and trisomy 7 are related with poor evolution, probably because of the loss of a suppressor gene or a proto-oncogen overexpression. The presence of any of them in a prostate cancer focus is related with poor prognosis.

[Renopancreatic transplant. Urologic complications]. / Transplante renopancreático. Complicaciones urológicas.

OBJECTIVE: Retrospective study of urological complications in our series of reno-pancreatic transplants. MATERIAL AND METHODS: Between February 1983 and May 1994 our group has conducted 93 RPT, 80 of which, mean age 36 +/- 6 years (24-54 years), are studied in this paper: 57 male and 23 female with an average time in dialysis of 20 +/- 15 months (0-84 months) and diabetes evolution of 21 +/- 5 years (11-37 years). RESULTS: Actuarial annual survival of patient, renal graft and pancreatic graft has been 85%, 79% and 74% respectively. Haematuria: 25% incidence, with graft pancreatitis etiology in 16 cases, rejection in 8 and urinary fistula in 6. Urinary infection: 85% incidence, symptomatic in 23 patients (29%) and asymptomatic in the remaining cases. Dysuria, urethritis and urethral stenosis: 14 patients, all male, most with both conditions associated. Reconversion of pancreatic exocrine secretion by intestinal route was performed in 7 patients. Urinary fistula: secondary to surgery in 9 cases and rejection in 4. Etiology of one case remained unknown. In 4 cases it was resolved with conservative treatment, and with surgical correction in 8. One patient required pancreatic transplantectomy and one patient died of AMI. CONCLUSIONS: Urological complication in RPT account for a significant morbidity, urinary fistula being the one with greater repercussion on the patient and pancreatic graft survival.

[Is there an age limit for cadaveric kidney donors currently?]. / Existe actualmente un límite de edad en el donante renal de cadáver?

OBJECTIVES: The insufficient number of kidney transplants has gradually raised the age limit to the cadaver kidney donor. The use of grafts harvested from older donors has been debated due to the existing structural and functional changes that might influence renal function and long-term graft survival. The foregoing aspects are discussed herein. METHODS: The anatomical, histological and functional changes in the kidney associated with ageing are analyzed. The clinical experience with renal grafts from older donors before and after cyclosporine became available are reviewed. The ethical issues on whether grafts from very old donors should be used and who should receive these grafts are discussed. RESULTS: The use of grafts from donors over 60 years old had no significant short and medium term differences in comparison with younger donors in terms of graft survival, although a higher incidence of acute tubular necrosis and poor renal function have been observed. There are no conclusive studies on the long-term effects on graft survival when kidneys from donors aged over 65 are utilized. In our experience, the results achieved with grafts from donors over 70 has been unsatisfactory. The guidelines utilized in the selection of grafts derived from older donors are presented. CONCLUSIONS: Grafts from donors aged 60 to 70 may be utilized in renal transplantation following precise selection criteria. Graft survival has been satisfactory, although a higher incidence of acute tubular necrosis and higher creatinine levels have been observed. We do not advocate the use of grafts from donors over 70, except in very exceptional cases. Long-term multicenter studies on grafts from very old donors and trials using alternative immunosuppressor modalities that might permit optimal use of these grafts are warranted.

[Leiomyosarcoma originating in the renal vein. A special case]. / Leiomiosarcoma originado en vena renal. Un caso especial.

OBJECTIVES: An additional case of leiomyosarcoma of the renal vein is presented and the literature reviewed. METHODS/RESULTS: The patient had a history of hypertension. He and his brother were the first case of twins with bilateral retinoblastoma reported in the literature. The pathological findings were diagnostic of leiomyosarcoma of the renal vein. The clinical features, diagnosis and treatment are discussed. CONCLUSIONS: Leiomyosarcoma of the renal vein is an uncommon tumor which presents difficulties in making the preoperative diagnosis. A possible relationship may exist between this tumor type and the radiotherapy administered during childhood due to retinoblastoma.

[Transperineal drainage of prostatic abscess]. / Drenaje transperineal de un absceso prostático.

The availability of antibiotics has made prostatic abscess an uncommon disease. A case of prostatic abscess is described. The etiopathogenesis, clinical features, diagnosis and treatment of this disease entity are discussed.

[Cystolysis. Supratrigonal denervation]. / Cistolisis. Denervación supratrigonal.

CI is an entity with obscure etiopathogenesis and difficult to manage. This essay contributes three cases, out of a series of 25, were cytolisis was performed. Results after six months follow-up are very encouraging, since pain has disappeared in all cases and pollakiuria has been radically reduced.

Correlation between serum values of prostatic acid phosphatase and morphometric analysis in the cytologic diagnosis of prostatic carcinoma.

We studied 78 men with suspicion of prostatic carcinoma, who underwent transrectal aspiration biopsy, diagnosing 46 adenocarcinoma, 13 chronic prostatitis and 19 benign prostatic hyperplasia. Moreover, we determined prostatic acid phosphatase (PAP) by enzyme immunoanalysis, resulting in 9/78 false-positives and 18/78 false-negatives. Also, we carried out a morphometric analysis of the cytologic samples which showed good correlation with the cytologic diagnosis except in the moderately differentiated carcinomas. We found a good correlation between PAP values, cytologic diagnosis and nuclear size as well as the percentage of the binucleolated cells.

[Morphological study of the trigonal epithelium in male hyperestrogenism]. / Estudio morfológico del epitelio trigonal en los hiperestrogenismos masculinos.

The histological changes caused by endocrinological action on the female epithelium are known and well-documented. These have been described in the bladder and attention has been focussed to the anatomo-clinical implications. A review of the literature with special reference to organogenetic, clinical and hormonal aspects prompted us to consider the cervico-trigonal epithelium as being particularly interesting in determining the histological changes arising from endocrine action. With hormonal influence as our working hypothesis, a morphological study of the trigonal epithelium was conducted in males with hyperestrogenism. Light and scanning electron microscopy revealed the presence of new glandular-like structures resembling the female endometrium with clearly evident metaplastic etiology and dynamics mediated by hormonal action.

[Malignant hemangiopericytoma: a rare primary retroperitoneal tumor]. / Hemangiopericitoma maligno: un raro tumor retroperitoneal primario.

A case of malignant retroperitoneal hemangiopericytoma is described. The infrequency of the retroperitoneal mesenchymatous origin, specific anatomopathological criteria of malignity, constant hypervascularization as well as clinico-radiological, surgical and prognostic characteristics found in the literature are highlighted.

[The Ask-Upmark kidney: a form of reflux nephropathy]. / El riñón de ASK-Upmark: una forma de nefropatía del reflujo.

We present six female patients aged 14 to 47, all diagnosed histopathologically as suffering from Ask-Upmark Kidney and who had clinical manifestations of severe arterial tension associated with urinary infection in four cases. Mictional Cystourethrography was carried out in all cases, and four of them displayed vesicoureteral reflux in the small kidney. Although this pathology has classically been considered a congenital malformation in the context of renal hypoplasias (segmental hypoplasia), the observation of glomerular traces with PAS staining in the renal segments regarded classically as "aglomerular" and the frequent association of this pathology with vesicoureteral reflux point significantly towards Ask-Upmark Kidney being a form of reflux nephropathy. Nephrectomy cured the arterial hypertension in half the cases, and the factors with prognostic importance in this respect are commented upon.

[Effects of urologic surgery on lymphocyte blastogenic response to phytohemagglutinin]. / Efectos de la cirugía urológica sobre la respuesta blastogénica linfocitaria a la PHA.

In order to study the effect of urological surgery on the defence system, we have evaluated the postoperative evolution of the lymphocyte blastogenic response to phytohemagglutinin (PHA) in 45 patients. 25 of them were subjected to a transurethral resection (TUR) of a vesical tumour, 10 to a transvesical prostatectomy, 6 to a pyelolithotomy and 4 to a nephrectomy due to renal atrophy secondary to lithiasis. We verified a significant drop in the lymphocyte blastogenic response to PHA at 2-4 hours of transvesical prostatectomy (p less than 0.001) and of pyelolithotomy and nephrectomy (p less than 0.001) which was sustained until the fourth and second day after operation respectively, with subsequent return to normal. However, lymphocyte blastogenic response to PHA did not vary significantly during the postoperative of patients subjected to a TUR of vesical tumours. On the whole, the degree and duration of postoperative immunodepression was dependent on the intensity of the surgical traumatism.

[Fistulization in xanthogranulomatous pyelonephritis. Presentation of 6 clinical cases and review of the literature]. / Fistulización en la pielonefritis xantogranulomatosa. Presentación de 6 casos clínicos y revisión de la literatura.

Fistulization is an uncommon complication in Xanthogranulomatous Pyelonephritis, but harmful for the adjacent organs. Owing to their rare localization we present 6 cases with scrotal skin, bronchi, colon and spleen fistulization.