[Intestinal obstruction caused by transitional carcinoma]. / La obstrucción intestinal por carcinoma transicional.

OBJECTIVES: To draw attention to the possibility that distant intestinal metastasis can arise from transitional urothelial carcinoma located in the bladder. METHODS: Two female patients developed distant metastasis during treatment of the tumor by transurethral resection of the bladder. RESULTS: Following complicated transurethral resection with perforation of the peritoneal cavity, the patients developed intestinal obstruction from metastatic transitional cell carcinoma. CONCLUSIONS: Direct or distant seeding of tumor cells on previously undamaged peritoneal serosa produced with the resectoscope may not be exceedingly unlikely.

[Renal cystic mass: the diagnostic dilemma]. / Masa quística renal: el dilema diagnóstico.

OBJECTIVE: To determine the best diagnostic approach and management of cystic renal mass. METHODS: Four cases are described and the literature reviewed. RESULTS: Of the 4 cases of cystic renal mass, 2 had a previous history of renal trauma. Puncture and aspiration of the cystic content were performed in three cases; cytology was positive for malignancy in one, which was confirmed by the histologic analysis. Two cases underwent nephrectomy although one of the post-traumatic cases had a preoperative diagnosis of pararenal pseudocyst. The literature review showed a significant controversy exists concerning the diagnostic approach and treatment. CONCLUSIONS: We advocate an approach free from tenets, where all the appropriately chosen diagnostic tools may be valid. If doubts persist after diagnostic evaluation, nephrectomy should be performed.

[Inverted Y ureteral duplication]. / Duplicación ureteral en Y invertida.

We report a case of inverted Y duplication of the ureter, incidentally found in a man consulting for hematuria. The diagnostic and therapeutic aspects are briefly discussed.

[Prostate-bladder rhabdomyosarcoma: therapeutic approaches]. / Rabdomiosarcoma prostatovesical: actitudes terapéuticas.

We describe the unusual case of a young male who presented lower urinary tract obstruction secondary to a bladder-prostate embryonal rhabdomyosarcoma. Initially he was treated with multiagent chemotherapy and radiotherapy in an attempt to preserve bladder function, but eventually radical cystoprostatectomy was warranted to control tumor growth. The objectives of chemotherapy and radiotherapy, partial and/or radical surgery and the main prognostic factors are briefly discussed.

[Does hyponatremia predict post-transurethral resection of the prostate syndrome?]. / Predice la hiponatremia el síndrome post-RTU?

The florid post-TUR syndrome observed in one of our patients prompted us to conduct a prospective study on 100 males undergoing TUR to determine the natremia levels that could herald the presentation of this syndrome. Several parameters were evaluated, including pre- and post-operative serum sodium levels, total volume of irrigant used, and the weight of the resected prostate. Although the natremia levels dropped significantly in 4 patients, only the patient who had motivated this study developed symptoms and evidently no conclusions can be drawn on the basis of a single observation.

[Digestive hemorrhage in renal cell carcinoma]. / Hemorragia digestiva en el carcinoma de células renales.

We report a rare case of a young male patient with a single duodenal metastasis from a renal cell tumor nine years after nephrectomy that presented as upper GI tract hemorrhage. The clinical and pathological aspects of this uncommon intestinal metastasis are briefly discussed.

[Von Hippel Lindau disease in urologic patients]. / La enfermedad de von Hippel Lindau en pacientes urológicos.

A case of von Hippel Lindau disease in a young female is described. Currently, surgery is unwarranted, since these patients only present cystic disease. However, subsequent control evaluations may indicate surgery since these cysts can easily progress to a carcinoma. The literature is briefly reviewed, with special reference to the therapeutic aspects of current day patient management.

[The psoas bladder-hitch. An illustrative case]. / Vejiga psoica. Caso ilustrativo.

The psoas bladder hitch is an invaluable surgical procedure in the treatment of lesions of the lower ureteral third and transplantation with short ureters. We briefly review this procedure and describe an illustrative case of ureteroneocystostomy of the right lumbar ureter.

[Testicular metastasis of renal adenocarcinoma. Report of a case]. / Metástasis testicular de adenocarcinoma renal. Presentación de un caso.

Metastatic tumors of the testis are extremely rare, if we exclude leukemias and lymphomas. The present article reports a case of renal adenocarcinoma metastatic to the testis that presented with paraneoplastic syndrome, hematuria and a palpable testicular mass. The literature on metastatic tumors of the testis is briefly reviewed.

[Retroaortic renal vein. Report of a case]. / Vena renal retroaórtica. Presentación de un caso.

The retroaortic renal vein is a malformation characterized by the presence of a vessel that drains the left renal blood up to the inferior vena cava crossing behind the aortic artery. Unfamiliarity with this condition may lead to an incorrect diagnosis of adenopathy in patients with testicular and/or renal neoplasia and increases the number of complications of surgery of the left renal pedicle. Herein we describe a 71-year-old male with a retroaortic renal vein that had been detected during radical surgery for a left renal tumor.

[Spontaneous retroperitoneal hemorrhage]. / Hemorragia retroperitoneal espontánea.

We report three cases of spontaneous retroperitoneal hemorrhage; two patients had a ruptured angiomyolipoma and one had a Wünderlich's syndrome. They had presented with the so called Lenk's triad. The definitive diagnosis was made on the CT findings and treatment was by nephrectomy (cases 1 and 2) and simple evacuation of the hematoma (case 3). The clinical, diagnostic and therapeutic aspects are briefly discussed.

[Fournier's gangrene. Presentation of 11 cases and review of the literature]. / Gangrena de Fournier. Presentación de 11 casos y revisión de la literatura.

Fournier's gangrene is an infectious necrotizing cellulitis of the penis and/or perineoscrotal region, which rapidly progresses and carries a high mortality. Eleven cases of Fournier's gangrene that had undergone an emergency procedure from 1985 to 1992 are described. Excellent results were achieved, with a survival rate of 91%. In our view, treatment of this disease entity is fundamentally based on early diagnosis, wide radical debridement of the affected area, frequent local treatment, debridement at the least sign of recurrence and early antibiotic therapy with three agents.

[Impotence caused by venous leakage: surgical treatment. Short- and mid-term results]. / Impotencia por fuga venosa: tratamiento quirúrgico. Resultados a corto y medio plazo.

We reviewed the results achieved by ligation of the deep dorsal vein of the penis in 14 males with erectile dysfunction secondary to venous leakage. Prostaglandin E1 injection, echo Doppler and cavernosometry were utilized for the diagnosis. Surgical correction was performed when the cavernosometric flow required for erection was more than 200 cc/minute. The patients had a follow-up evaluation at 3, 6 and 12 months postoperatively. At one year, 4 (28.5%) patients showed good results and 10 (71.4%) poor. The factors that may influence the short, medium and long-term results are briefly described.

[Verrucous carcinoma of the penis: our caseload]. / Carcinoma verrucoso de pene: nuestra casuística.

Verrucous carcinoma, a tumor that encompasses approximately 5% of all penile neoformations, is a variant of squamous cell carcinoma which is benign and has a peculiar histological behaviour. We report on three patients aged 57, 80 and 84 years with this tumor type who underwent surgery (circumcision in one case and partial penectomy in the remaining two cases). The literature is briefly reviewed and the epidemiological, clinical, diagnostic and therapeutic aspects are discussed.

[Simultaneous presentation of bilateral renal adenocarcinoma. Therapeutic possibilities]. / Presentación simultánea de adenocarcinoma renal bilateral. Posibilidades terapéuticas.

Bilateral renal adenocarcinoma accounts for 1.4% to 5% of all renal adenocarcinomas. Currently, an increased incidence of synchronous bilateral renal adenocarcinoma has been observed, which can be ascribed to the availability of more sophisticated high resolution ultrasound and computed tomography. Several surgical options exist, such as bilateral radical resection, radical surgery combined with partial nephrectomy or tumor enucleation for the contralateral side, and partial nephrectomy or tumor enucleation for both sides. Two cases of synchronous bilateral renal adenocarcinoma are described. One case was submitted to a left superior partial nephrectomy and enucleation of the tumor in the right kidney. The other patient underwent a left radical nephrectomy and excision of the inferior pole of the right kidney.