Tratamiento endovascular de un caso de priapismo de alto flujo / Endovascular treatment of a case of high-flow priapism

Objetivo. Presentar nuestra experiencia en un caso de priapismo de alto flujo tratado con éxito mediante laembolización selectiva de la arteria cavernosa. Caso clínico. Varón de 43 años con priapismo de alto flujo secundario aun traumatismo perineal. El tiempo desde la presentación de la sintomatología hasta el momento del tratamiento fue de157 días. El diagnóstico se confirmó mediante ecografía Doppler del pene y angiorresonancia aortoilíaca. En el primermomento fue tratado con una embolización supraselectiva y se utilizó un coágulo autólogo. Tres semanas después de laprimera intervención, el priapismo reapareció. La segunda embolización se realizó con micropartículas de polivinilo y microcoils.A corto plazo, el paciente recuperó la flacidez y la erección del pene. A largo plazo mostró como única secuela unamoderada fibrosis de los cuerpos cavernosos. Conclusiones. La embolización de la arteria lacerada es un procedimientoseguro para tratar el priapismo de alto flujo y proporciona excelentes resultados

Aim. To present our experience in a case of high-flow priapism successfully treated by superselectiveembolization of the internal pudendal artery. Case report. A 43 year-old male with high-flow priapism secondary to aperineal trauma. The time from the filing of the symptoms until the time of treatment was 157 days. The diagnosis wasconfirmed by Doppler ultrasound of the penis and aorto-iliac angioresonance. The first time, it was treated bysupraselective embolization with autologous blood clot. Three weeks after the first intervention, priapism reappeared.The second embolization was performed using polyvinyl microparticles and microcoils. In the short term, the patientregained flaccidity and the erection of the penis. In the long term, the only sequel was a moderate fibrosis of the corporacavernosa. Conclusions. The embolization of the lacerated artery is a safe procedure for treating the high flow priapismand provides excellent results

[Bladder amyloidosis: report of 2 cases]. / Amiloidosis vesical: presentación de dos casos.

Two cases of amyloidosis of the bladder are reported: 1) a 45 year old man with haematuria. Cystoscopic examination reveals several tumours in the wall of the bladder. Transuretral resection was performed and histopathological examination revealed primary amyloidosis. Systemic amyloidosis was excluded. He was treated with oral colchicine with success. 2) a 71 year old male with diagnosis of rheumatoid arthritis and systemic amyloidosis visited our hospital with massive haematuria. Transuretral resection was unsuccessful and was necessary surgical ligation of hypogastric arteries.

Amiloidosis vesical: presentación de dos casos / Amyloidosis of the bladder: report of two cases

Presentamos dos casos de amiloidosis vesical: 1) varón de 45 años con clínica de hematurias y hallazgo endoscópico de formaciones tumorales vesicales. Se practicó resección transuretral con el diagnóstico histológico de amiloidosis vesical. Se excluyó mediante biopsia la afectación de otros órganos, siendo tratado con colchicina oral con buen resultado; 2) mujer de 71 años afecta de ami-loidosis sistémica con artritis reumatoide que presentó hematuria masiva tratada con RTU hemos-tática sin éxito, practicándose ligadura quirúrgica de arterias hipogástricas (AU)

[Transplantectomy today: indications and complications]. / La transplantectomía hoy: indicaciones y complicaciones.

Analysis of the indications for transplantectomy and its complications over a 12-year period. Over a total of 159 failure grafts, we performed 53 transplantectomies (33.3%). The percentage of complications was 16.9%. Three patients died (5.6%) during the more or less immediate post-operative period. In our experience, consistent and prolonged maintenance of immunosuppression should avoid the need for transplantectomy in a high percentage of grafts. Only 15 transplantectomies were made on 104 failure grafts after 6 months (14.4%). Our short but successful experience with embolization of 2 rejected grafts confirms the validity of this conservative alternative versus conventional surgical transplantectomy in selected cases.

[Treatment of ureterocele in the adult]. / Tratamiento del ureterocele en el adulto.

Review of 18 cases of ureterocele in the adult. The first clinical symptoms are unspecific, with a long-term evolution, and were found while carrying out routine urological examinations. The association to secondary lithiasis in over 60% cases and the presence of complete duplicity in 44% cases is highlighted. The choice treatment is by endoscopy in the simple cases without hydronephrosis or associated reflux. The technique of transversal incision in 'smiling mouth' at the base of the ureterocele produces good results.

[Kidney preservation]. / Preservación renal.

Extensive literature review on the current state of organs preservation; solutions and methodology. Major advances in immunosuppression methods and the ongoing increase in the number of renal transplants encourage the search and investigation of better preservation techniques. Continuous pulsatile perfusion and perfusion plus hypothermal storage represent the two most frequently used techniques nowadays. In spite of the advantages shown by the former in the case of prolonged cold ischemia, hypothermal storage remains as a practical technique widely used in our environment.