Infección vesical por esquistosoma: una causa inhabitual de hematuria / Bladder infection by shictosoma: un uncommon cause of haematuria

La inmigración es un fenómeno real en nuestro país que repercute directamente en la sanidad. En la atención a estos pacientes no debemos olvidar la existencia de enfermedades inusuales en nuestro medio. Presentamos el caso clínico de un paciente con hematuria por una esquistosomiasis vesical (AU)

Immigration is a real phenomenon in our country with direct consequences into the public health system. In the attendance to these patients we do not have to forget the existence unusual diseases in our setting. We presented the clinical case of a patient with hematuria caused by bladder schistosomiasis (AU)

[Comparison of diferents suburethral slings for the treatment of stress urinary incontinence]. / Estudio comparativo de diferentes procedimientos de sling suburetral para el tratamiento de la incontinencia urinaria de esfuerzo.

OBJECTIVES: To compare the results of the different procedures of sling suburetral used in our service (TVT, Sparc, IVS, Obtape and Monarc) for the treatment of the female urinary incontinence. MATERIAL AND METHODS: 96 patients retrospective analysis affects of female urinary incontinence and subjected to different procedures of sling suburethral without tension. The half age: 56.1 +/- 10.7 years. 75 patients were intervened by means of procedures retropubics (48 TVT, 17 Sparc, 10 IVS) and 21 with obturators (10 Obtape, 11 Monarc). The half time of pursuit: 26.3 +/- 12.7 months (29.4 months for the methods retropubics and 11.7 for the obturators). The analyzed variables were: age, obesity, grade of previous incontinence, type of used procedure, time of pursuit, and previous surgical procedures. We compare the complications and the results obtained with the different ones technical. RESULTS: the cure percentage was of 95.7%. 7 patients presented complications: one intestinal perforation, two bladders perforations, one erosion of vaginal wall, three incontinences of novo urgency. In 6 cases the stress incontinence persists. When analyzing the association between the diverse variables and the success, we appreciate that the variables with value presage were the age and the obesity (P < 0.05) not observing relationship with the technique employeed. CONCLUSIONS: The existence of multiple surgical approachs and a varied auxiliary materials allow each surgeon to choose that with the one that is more familiarized and comfortable without, seemingly, influence it in the results.

[Treatment of males with post-prostatectomy stress urinary incontinence by a mesh anchored to the ischio-pubic bones]. / Tratamiento de la incontinencia urinaria de esfuerzo post-prostatectomía radical mediante malla anclada a ramas isquiopubianas.

We presented the results of an alternative in the treatment of the stress urinary incontinence of male radical postprostatectomy. Is a technique of renewed interest in the last years, cradle in the procedure of Stamey, consisting of placing an on guard suburetral polypropylene mesh, anchored by means of screws to the isquiopubian branches. We have applied the procedure in 4 patients and with stress urinary incontinence of long evolution. After an average pursuit of 12.5 months, two patients present total continence, one has improved significantly and in the other the incontinence persists. There have been no postoperating complications nor rejection of the mesh. From these preliminary results and the reviewed bibliography, we thought that this technique can constitute an alternative to the artificial urinary sphincter, dices its clinical results, its facility of execution, the good tolerance and his low cost.

Estudio comparativo de diferentes procedimientos de sling suburetral para el tratamiento de la incontinencia urinaria de esfuerzo / Comparison of diferents suburethral slings for the treatment of stress urinary incontinence

Objetivos: Comparar los resultados de los diferentes procedimientos de sling suburetral utilizados en nuestro servicio (TVT(R), Sparc(R), IVS(R), Obtape(R) y Monarc(R) para el tratamiento de la IUE femenina. Material y métodos: Análisis retrospectivo de 96 pacientes afectas de IUE y sometidas a diferentes procedimientos desling suburetral sin tensión. La edad media: 56,1 +/- 10,7 años. 75 pacientes se intervinieron mediante procedimientos suprapúbicos (48 TVT, 17 Sparc, 10 IVS) y 21 con transobturatrices (10 Obtape, 11 Monarc). El tiempo medio de seguimiento: 26,3 +/- 12,7 meses (29,4 meses para los métodos suprapúbicos y 11,7 para los transobturarices). Las variables analizadas fueron: edad, obesidad, grado de incontinencia previa, tipo de procedimiento empleado, tiempo de seguimiento, y procedimientos quirúrgicos previos. Comparamos las complicaciones y los resultados obtenidos con las diferentes técnicas. Resultados: el porcentaje de curación fue del 95,7%. 7 pacientes presentaron complicaciones: una perforación intestinal, dos perforaciones vesicales, una erosión de pared vaginal, tres incontinencias de urgencia de novo. En 6 casos persiste la incontinencia de esfuerzo. Al analizar la asociación entre las diversas variables y el éxito postquirúrgico, apreciamos que las variables con valor pronóstico fueron la edad y la obesidad (P <0.05) no observando relación con la técnica empleada. Conclusiones: La existencia de múltiples abordajes quirúrgicos y un variado utillaje auxiliar permiten que cada cirujano pueda escoger aquel con el que esté más familiarizado y cómodo sin que, aparentemente, ello influya en los resultados (AU)

Objectives: To compare the results of the different procedures of sling suburetral used in our service (TVT(R), Sparc(R),IVS(R), Obtape(R) and Monarc(R)) for the treatment of the female urinary incontinence. Material and methods: 96 patients retrospective analysis affects of female urinary incontinence and subjected to different procedures of sling suburethral without tension. The half age: 56,1 +/- 10,7 years. 75 patients were intervened by means of procedures retropubics (48 TVT, 17 Sparc, 10 IVS) and 21 with obturators (10 Obtape, 11 Monarc). The halftime of pursuit: 26,3 +/- 12,7 months (29,4 months for the methods retropubics and 11,7 for the obturators). The analyzed variables were: age, obesity, grade of previous incontinence, type of used procedure, time of pursuit, and previous surgical procedures. We compare the complications and the results obtained with the different ones technical. Results: the cure percentage was of 95.7%. 7 patients presented complications: one intestinal perforation, two bladders perforations, one erosion of vaginal wall, three incontinences of novo urgency. In 6 cases the stress incontinence persists. When analyzing the association between the diverse variables and the success, we appreciate that the variables with value presage were the age and the obesity (P <0.05) not observing relationship with the technique employeed. Conclusions: The existence of multiple surgical approachs and a varied auxiliary materials allow each surgeon to choose that with the one that is more familiarized and comfortable without, seemingly, influence it in the results (AU)

Tratamiento de la incontinencia urinaria de esfuerzo post-prostatectomía radical mediante malla anclada a ramas isquiopubianas / Treatment of the stress urinary incontinence of male radical postprostatectomy anchored by means of screws to the isquiopubian branches

Presentamos los resultados de una alternativa en el tratamiento de la incontinencia urinaria de esfuerzo masculina post-prostatectomía radical. Se trata de una técnica de renovado interés en los últimos años, basada en el procedimiento de Stamey, consistente en colocar una malla de polipropileno en posición suburetral, anclada mediante tornillos a las ramas isquiopubianas. Hemos aplicado el procedimiento en 4 pacientes oncológicamente estables y con incontinencia urinaria de larga evolución. Tras un seguimiento medio de 12,5 meses, dos pacientes presentan continencia total, uno ha mejorado significativamente y en el otro persiste la incontinencia. No ha habido complicaciones postoperatorias ni rechazo de la malla. A partir de estos resultados preliminares y la bibliografía revisada, pensamos que esta técnica puede constituir una alternativa al esfínter urinario artificial, dados sus resultados clínicos, su facilidad de realización, la buena tolerancia y su bajo coste (AU)

We presented the results of an alternative in the treatment of the stress urinary incontinence of male radical postprostatectomy. Is a technique of renewed interest in the last years, cradle in the procedure of Stamey, consisting of placing an on guard suburetral polypropylene mesh, anchored by means of screws to the isquiopubian branches. We have applied the procedure in 4 patients and with stress urinary incontinence of long evolution. After an average pursuit of 12.5 months, two patients present total continence, one has improved significantly and in the other the incontinence persists. There have been no postoperating complications nor rejection of the mesh. From these preliminary results and the reviewed bibliography, we thought that this technique can constitute an alternative to the artificial urinary sphincter, dices its clinical results, its facility of execution, the good tolerance and his low cost (AU)

[Urological attendance in the Integral Health Center "Alto Palancia": model of primary-specialized integration and unique consultation]. / La asistencia urológica en el Centro Sanitario Integral "Alto Palancia": modelo de integración primaria-especializada y consulta única.

INTRODUCTION AND OBJECTIVE: The progressive increase in the demand of urological attendance demands to establish new welfare models that avoid the saturation of consultations and improve the quality in the attention to the user. The objective of this work is to analyze the improvement of the welfare activity developed in Integral the Sanitary Center Alto Palancia, after the restoration of new welfare models based on integration between Attention Primary and Specialized and the putting in practice of the denominated Unique Consultation. MATERIAL AND METHODS: We analyzed the characteristics of the Center, functions and activity of the specialty developed during year 2002. We described to the application of the model of Unique Consultation and the elements of integration with Primary Attention. We analyzed the improvement of the activity through indicators, that we compared with preceding years. In order to determine the degree of satisfaction of the users we made a survey of opinion of patients and/or taken care of relatives in the Center under the new welfare models. Finally we analyzed the advantages that the applied process presents for the patient and the own sanitary institution. RESULTS: 42% of patients have been taken care of by means of the model of Unique Consultation, being the predominant pathology the HBP in the man and the ITUs in the woman. The time of delay for first visit has been reduced from 49 days in single December 2001 to 3 in December 2002. Single 7.7% of patients discharged from the hospital for pursuit by Primary Attention have been sent again to the specialist. The time that the urólogo dedicates to consultations has reduced in a 29%, being this time dedicated to the accomplishment smaller surgery and final reconnaissances (echography, urodynamic studies and others). The opinion survey has shown a satisfaction of the user very elevated. CONCLUSION: The model of Integral Attention Primary-Specialized and the putting in practice of Unique Consultation applicable to the specialty of Urology, increasing the quality perceived by the user and with evident advantages for the Sanitary Organization.

La asistencia urológica en el Centro Sanitario Integral “Alto Palancia”: modelo de integración Primaria-Especializada y Consulta Única / Urological attendance in integral center Sanitari

Introducción y objetivos: El progresivo incremento en la demanda de asistencia urológica exige establecer nuevos modelos asistenciales que eviten la saturación de consultas y mejoren la calidad en la atención al usuario. El objetivo de este trabajo es analizar la mejora de la actividad asistencial desarrollada en el Centro Sanitario Integral “Alto Palancia”, tras la instauración de nuevos modelos asistenciales basados en la integración entre Atención Primaria y Especializada y la puesta en práctica de la denominada Consulta Única. Material y métodos: Analizamos las características del Centro, funciones y actividad de la especialidad desarrollada durante el año 2002. Describimos la aplicación del modelo de Consulta Única y los elementos de integración con Atención Primaria. Analizamos la mejora de la actividad a través de indicadores, que comparamos con años precedentes. Para determinar el grado de satisfacción de los usuarios realizamos una encuesta de opinión de pacientes y/o familiares atendidos en el Centro bajo los nuevos modelos asistenciales. Finalmente analizamos las ventajas que el proceso aplicado presenta para el paciente y para la propia institución sanitaria. Resultados: El 42% de pacientes han sido atendidos mediante el modelo de Consulta Única, siendo la patología predominante la HBP en el varón y las ITUs en la mujer. El tiempo de demora para primera visita se ha reducido desde 49 días en diciembre 2001 a solo 3 en diciembre 2002. Solo el 7,7% de pacientes dados de alta para seguimiento por Atención Primaria han sido remitidos de nuevo al especialista. El tiempo que el urólogo dedica a consultas se ha reducido en un 29%, siendo este tiempo dedicado a la realización cirugía menor y exploraciones complementarias (ecografias, estudios urodinámicos, etc.). La encuesta de opinión ha puesto de manifiesto una satisfacción del usuario muy elevada. Conclusiones: El modelo de Atención Integral Primaria-Especializada y la puesta en práctica de la Consulta Única son aplicables ala especialidad de Urología, incrementando la calidad percibida por el usuario y con evidentes ventajas para la Organización Sanitaria (AU)

Introduction and objective: The progressive increase in the demand of urological attendance demands to establish new welfare models that avoid the saturation of consultations and improve the quality in the attention to the user. The objective of this work is to analyze the improvement of the welfare activity developed in Integral the Sanitary Center Alto Palancia, after the restoration of new welfare models based on integration between Attention Primary and Specialized and the putting in practice of the denominated Unique Consultation. Material and methods: We analyzed the characteristics of the Center, functions and activity of the specialty developed during year 2002. We described to the application of the model of Unique Consultation and the elements of integration with Primary Attention. We analyzed the improvement of the activity through indicators, that we compared with preceding years. In order to determine the degree of satisfaction of the users we made a survey of opinion of patients and/or taken care of relatives in the Center under the new welfare models. Finally we analyzed the advantages that the applied process presents for the patient and the own sanitary institution. Results: 42% of patients have been taken care of by means of the model of Unique Consultation, being the predominant pathology the HBP in the man and the ITUs in the woman. The time of delay for first visit has been reduced from 49 days in single December 2001 to 3 in December 2002. Single 7.7% of patients discharged from the hospital for pursuit by Primary Attention have been sent again to the specialist. The time that the urólogo dedicates to consultations has reduced in a 29%, being this time dedicated to the accomplishmentsmaller surgery and final reconnaissances (echography, urodynamic studies and others). The opinion survey has shown a satisfaction of the user very elevated. Conclusion: The model of Integral Attention Primary-Specialized and the putting in practice of Unique Consultation applicable to the specialty of Urology, increasing the quality perceived by the user and with evident advantages for the Sanitary Organization (AU)

[Unusual bladder tumors: primary epidermoid carcinoma, adenocarcinoma, and sarcoma. Clinical behavior. Our experience]. / Tumores vesicales inusuales: carcinoma epidermoide, adenocarcinoma y sarcoma primarios. Comportamiento clínico. Nuestra experiencia.

INTRODUCTION AND OBJECTIVES: Non-transitional cell tumours of the bladder are both a diagnostic challenge for the pathologist and a therapeutic challenge for the urologist, because although uncommon (less than 5% of all malignancies of the bladder) they show different biological behaviours each requiring a unique approach. The most significant pathoanatomical types are: primary epidermoid carcinoma, primary adenocarcinoma and primary sarcoma. This paper presents an analysis of our experience in these types of tumours. MATERIAL AND METHODS: A retrospective study of unusual cases of cancer of the bladder seen in our hospital between 1988-2001. Their biological behaviour and the therapies applied are analysed. The extravesical origin of the tumour was ruled out in all cases. RESULTS: We found 21 cases of the following pathoanatomical varieties: 13 epidermoid carcinomas, 7 adenocarcinomas (3 urachal) and 1 sarcoma. Mean age was very different between epidermoid carcinomas (69.2 +/- 9.1 years) and adenocarcinomas (50.3 +/- 8.1). Tumour behaviour was very aggressive in all three histological varieties. At the time of diagnosis 19 patients had locally advanced stages (> or = T2). Although elective therapy was cystectomy, this was only feasible in 10 cases. Systemic chemotherapy (most frequently M-VAC) and/or local radiotherapy was used in 7 cases. 14 patients have died after a mean survival of 15.7 +/- 11.6 months. CONCLUSIONS: Late diagnosis of these tumours and their aggressive biological behaviour involve a gloomy prognosis. Only early diagnosis and radical therapy could improve the prognosis.

Tumores vesicales inusuales: carcinoma epidermoide, adenocarcinoma y sarcoma primarios.Comportamiento clínico. Nuestra experiencia / Unusual tumours of the bladder: primary epidermoid carcinoma, adenocarcinoma and sarcoma. Clinical behaviour. Our experience

INTRODUCCIÓN Y OBJETIVOS: Los tumores vesicales con un patrón morfológico no transicional, constituyen un reto diagnóstico al patólogo y terapéutico al urólogo, pues aunque son poco frecuentes (menos del 5 por ciento de los tumores malignos de vejiga), presentan un comportamiento biológico diferente que obliga a un abordaje terapéutico particular. Las variedades anatomopatológicas más importantes son: el carcinoma epidermoide, el adenocarcinoma y el sarcoma primarios. Analizamos nuestra experiencia en este tipo de tumores. MATERIAL Y MÉTODOS: Estudio retrospectivo de los tumores vesicales inusuales tratados en nuestro Hospital entre 19882001. Analizamos su comportamiento biológico y tratamiento aplicado. En todos ellos se descartó el origen extravesical de la tumoración. RESULTADOS: Encontramos 21 casos, cuyas variedades anatomopatológicas fueron: 13 Carcinomas Epidermoides, 7 Adenocarcinomas (3 de Uraco) y un Sarcoma. La edad media fue muy diferente entre los carcinomas epidermoides (69,2 ñ 9,1 años) y los adenocarcinomas (50,3 ñ 8,1). En las tres variedades histológicas el comportamiento fue muy agresivo. En el momento del diagnóstico 19 pacientes presentaban estadios locales avanzados (T2). Aunque el tratamiento electivo fue la cistectomía, sólo se pudo realizar en 10 casos. Quimioterapia sistémica (la más frecuente M-VAC) y/o RT local se aplicó en 7 casos. 14 pacientes han fallecido, con una supervivencia media de 15,7 ñ 11,6 meses. CONCLUSIONES: El diagnóstico tardío de estos tumores y su agresivo comportamiento biológico comportan un pronóstico sombrío. Sólo un diagnóstico precoz y un tratamiento radical podrían mejorar su pronóstico (AU)

[Anterograde insertion of ureteral catheter]. / Inserción anterógrada de catéter ureteral.

We report twenty-four patients with urinary obstruction, in which twenty-seven antegrade ureteral stent (double J) insertions were attempted (in six patients the obstruction was bilateral and in three other patients we failed). In all of them access to the urinary tract was through a nephrostomy catheter, in seventeen cases we proceeded to insert the antegrade catheter immediately after percutaneous nephrostomy and in ten remaining cases we achieved in a second try after carrying nephrostomy and failing a conventional retrograde approach to ureteral stent insertion. We got a 90-per cent success rate. A case of perirrenal hematoma occurred after applying a nephrostomy. It was the only relevant complication. In conclusion we consider that the antegrade ureteral stent insertion is a good alternative when, under several circumstances, the conventional retrograde insertion fails.

[Tuberous angioma of the glans penis: treatment with laser and local anesthesia]. / Angioma tuberoso del glande del pene: tratamiento con láser y anestesia local.

A case of angioma tuberous of the glans penis treated with Neodymiun:Yag laser under local anesthesia in a eleven-years-old outpatient is reported. These lesions are extremely rare. Local excision of this tumor was accepted treatment, but we think that laser treatment (Neodymiun:Yag) is far superior to surgical excision and we think this treatment of choice. The particularity of the case we report, is aside the rarity, the possibility of treatment in an outpatient child, with local anesthesia and excellent tolerance.

Inserción anterógrada de catéter ureteral / Antegrade ureteral stent insertion

Presentamos 24 pacientes con patología obstructiva urinaria, en los que se realizaron 27 procedimientos de colocación de un catéter doble J vía anterógrada (en 6 la obstrucción era bilateral y en 3 pacientes no se consiguió pasar el catéter).En todos los casos el acceso a la vía urinaria fue a través de un catéter de nefrostomía, en 17 casos en el mismo acto se decidió colocar el catéter doble J y en los 10 restantes se realizó en un segundo tiempo, tras llevar la nefrostomía y haber fracasado un abordaje retrógrado convencional para la colocación del catéter de doble J. El éxito de la técnica fue en el 90 por ciento de los casos. Hemos tenido una complicación reseñable por la formación de un hematoma subcapsular, tras la realización de la nefrostomía. Como conclusión, consideramos que el abordaje anterógrado para la colocación de un catéter doble J es una buena alternativa cuando, por diversos motivos, se fracasa en la colocación retrógrada convencional. (AU)

Angioma tuberoso del glande del pene: tratamiento con láser y anestesia local / Angioma tuberous of the glans penis: treatment with laser and local anesthesia

Presentamos un caso de angioma tuberoso del glande del pene tratado con láser Neodimio: YAG, bajo anestesia local en un paciente ambulatorio de once años. Estas lesiones son extremadamente raras. La excisión local de este tumor es el tratamiento comúnmente aceptado, no obstante nosotros creemos que el tratamiento con láser Neodimio: YAG ofrece más beneficios que la extirpación quirúrgica, y pensamos que este es el tratamiento de elección. La particularidad de este caso que presentamos es, además de su rareza, la posibilidad de tratamiento ambulatorio en un niño con anestesia local y excelente tolerancia (AU)

[Studer-type orthotopic urinary bladder: our experience]. / Vejiga urinaria ortotópica tipo Studer: nuestra experiencia.

OBJECTIVE: To analyze the outcome, complications and functional results in patients undergoing bladder substitution with the Studer continent urinary pouch. METHODS: The clinical records of 6 male patients who underwent radical cystectomy for invasive bladder cancer and bladder substitution with the Studer reservoir at our hospital from January 1996 to February 2000 were reviewed. Patient mean age was 54.2 years and mean follow-up was 14 months. Follow-up evaluation included abdominopelvic CT, chest x-ray, urinalysis, blood biochemistry, venous gasometry and ultrasonography with evaluation of postvoid residual urine. RESULTS: Transitional cell carcinoma was found to be the most frequent histopathological type. Distribution by grade and pathological stage showed they were all high grade infiltrating tumors localized to the bladder. Four patients are free of disease, one died from metastatic disease and one patient with tumor progression and multiple lung metastases at two months' follow-up is currently on chemotherapy. The mean operating time was significantly longer for this procedure than for the non-continent Bricker urinary diversion (mean 7.2 hours vs 3.5 hours, respectively). The immediate postoperative complications were: ileus (> 7 days) in two patients, diarrhea (> 3 days) in two, occlusive ileus due to fecaloma in one, metabolic acidosis in one, wound seroma in one, and wound infection in two patients. The early and late postoperative complications were: incontinence for up to one month after removing the urethral catheter in three patients (two of these patients are still incontinent at two months' follow-up), wound infection in two and impotence in 6 patients. CONCLUSION: Reservoir function in the medium-term is good; spontaneous urethral micturition and continence are maintained. To achieve good results, patients should be followed carefully and should be given detailed information about postoperative care and management.

[Retroperitoneal germ cell tumor]. / Tumor de células germinales retroperitoneal.

We report a case of retroperitoneal extragonadal germ-cell tumor in an 17 years old patient who presented with aedema and pain in left inferior extremity asociated with hemopthysis caused by pulmonar metastasis, who was treated with chemotherapy and resection of residual mass and pulmonary nodes. Dyagnosis was stableshed by fine neadle aspiration biopsy of the wass. We comment on the difficult of stableshing differential dyagnosis between retroperitoneal extragonadal germ-cell tumor and metastasis of a testicular tumor. Dyagnosis is stableshed by the finding of a histologically malignant germ-cell tumor with normal testis. We considered physical examination and ecographyc exploration enough for a correct dyagnosis.

[Cystic lymphangioma of the adrenal gland in adults. Review of the literature and report of a new case]. / Linfangioma quístico de la glándula suprarrenal del adulto. Revisión de la literatura y aportación de un nuevo caso.

Presentation of one case of cystic lymphangioma of the suprarenal gland in a 34-year-old female patient with a background of lower urinary tract infections, presenting with continuous and aggravating pain in left lumbar area and with no other associated symptomatology, diagnosed with ultrasound, IVU and CAT. A review of the literature is made. The present study pretends to give an overall view of a rare and benign disease, commenting upon the difficulties found in its diagnosis and the different therapeutical options.

[Bladder leiomyoma. Review and report of a case]. / Leiomioma vesical. Revisión y presentación de un caso.

OBJECTIVE: The present study reviews bladder leiomyoma, an uncommon pathology. The problems of differential diagnosis and the therapeutic options are discussed and the literature reviewed. METHODS/RESULTS: A 33-year-old female with anterolateral intramural leiomyoma of the bladder is described. Patient evaluation included US, cystography, CT, cystoscopy and ultrasound-guided suprapubic puncture. CONCLUSIONS: Leiomyoma is an uncommon benign tumor of the bladder. To our knowledge, only 235 cases have been reported in the literature. We advocate the use of ultrasound-guided suprapubic puncture, a simple procedure that is frequently diagnostic, in the evaluation of this tumor type.

[Acquired enterovesical fistulas]. / Fístulas enterovesicales adquiridas.

We report on 23 patients with acquired vesicoenteric fistula treated during the past 12 years: 48% of these were of inflammatory etiology (11 cases), 35% were caused by neoplasms (8 cases) and 17% were iatrogenic (4 cases). The most frequent symptoms were pneumaturia and fecaluria (78% of cases). Cystoscopy was the most useful diagnostic procedure in detecting fistula (13 of 18 cases). Other imaging techniques, though less effective for diagnosis, were useful in assessing the status of the GI tract and, at times, in determining the etiology of the fistulae. Treatment depends on the etiology, localization and patient general condition. The technique most frequently applied in our series was resection of the fistulous tract, together with the compromised intestinal segment, and bladder suture.

[Malignant mesothelioma of the tunica vaginalis of the testis]. / Mesotelioma maligno de la túnica vaginal del testículo.

We report a case of malign mesothelioma of the tunica vaginalis of testis in a 84 years-old male. Clinical presentation was hydrocele. Special attention is given to differential diagnosis and therapeuticals possibilities.