BCL-2, TP53 and BAX protein expression in superficial urothelial bladder carcinoma.

Whether TP53, BCL-2 and BAX expressions add independent prognostic information in patients with Ta/T1 bladder urothelial carcinoma remains unclear. TP53 overexpression correlated with high tumor grade (p=0.004), WHO grading categories (0.045), BAX expression (p=0.043) and pathologic stage (p=0.05). BCL-2 immunostaining was inverse associated with tumor grade (p=0.008). Lack of BAX expression was related to reduced patient's survival (p=0.028). Mortality was higher in patients with BCL-2+/TP53+ (p=0.023) or TP53+/BAX- (p=0.027) phenotype. BAX and pathologic stage were independent predictors of progression-free and overall survival, respectively. Therefore, BAX expression might be relevant in patient's prognosis.

[Our experience with the Nesbit technique for the treatment of Peyronie's disease]. / Nuestra experiencia en la enfermedad de Peyronie con la técnica de Nesbit.

OBJECTIVES: The Nesbit technique is the reference technique for the surgical correction of the penile incurvation of Peyronie's disease. We report our experience at the Centro Urológico San Ignacio. METHODS: 68 patients with stable penile incurvation who requested surgical correction. Correction of the curvature is defined as > or = 80% rectification of the pathologic angle. Mean patient age was 44 years (31-77). 53% of the patients presented difficulties for penetration, 20% partner's discomfort on intercourse, and 27% requested surgery for aesthetic reasons. Penile deviation was dorsal in 42% of the patients, to the left in 46% and to the right in 12%. The curvature angle was less than 30 degrees in 28%, between 30 degrees-45 degrees in 36%, between 45 degrees-60 degrees in 37% and > 60 degrees in 7%. RESULTS: Mean follow-up of the series was 36 months. 20% of the patients had a penile shortening longer than 1.5 cm. 85% of the patients are satisfied with the results. The most frequent complaint was penile shortening. Correction was achieved in 92% of the patients. Four patients were reoperated: two of them for significant phimosis three months after surgery, and the other two for curvature recurrence. CONCLUSIONS: The Nesbit technique is a simple technique, with a low complication rate, and good results both in curvature correction and patient satisfaction.

Nuestra experiencia en la enfermedad de Peyronie con la técnica de Nesbit / Our experience with the Nesbit technique for the treatment of Peyronie´s disease

OBJETIVO: La técnica de Nesbit esa la técnica de referencia en la cirugía correctora de la incurvaciónpenenana en la enfermedad de Peyronie. Presentamos nuestra experiencia en el Centro Urológico san Ignacio.MÉTODO: 68 pacientes con incurvación peneana establey que deseaban corrección quirúrgica de la misma. Se considera corrección de la curvatura cuando la rectificaciónes igual o superior al 80% de la angulación patológica. La edad media de los pacientes es de 44 años (31-77). Un 53% presentaban dificultad para la penetración, un 20% molestias en su pareja, un 27% se intervinieron por razones estéticas. La desviación peneanaera dorsal en el 42%, izquierda en el 46% y derecha en el 12%. El ángulo de incurvación medido en grados era menor de 30º en el 28%, entre 30 y 45 en el 36%, entre 45 y 60 en el 37% y mayor de 60% en el 7%.RESULTADOS: El seguimiento medio de la serie es de 46 meses. Acortamiento peneano superior a 1,5 cm en el 20% de los enfermos. El 85% de los enfermos están satisfechos con los resultados obtenidos. La queja más frecuente es el acortamiento peneano. Se ha corregidola desviación en el 92% de los pacientes. Hemos reintervenido a cuatro pacientes, A dos por fimosis marcadaa los tres meses de la intervención, los otros dos enfermos presentaron recidiva de la curvatura.CONCLUSIONES: La técnica de Nesbit es una técnica sencilla, con escasas complicaciones y buenos resultadostanto en corrección de curvatura como en satisfaccióndel enfermo

OBJECTIVES: The Nesbit technique is the reference technique for the surgical correction of the penile incurvation of Peyronie’s disease. We report our experience at the Centro Urológico San Ignacio.METHODS: 68 patients with stable penile incurvation who requested surgical correction. Correction of the curvature is defined as ≥ 80% rectification of the pathologic angle. Mean patient age was 44 years (31-77). 53% of the patients presented difficulties for penetration, 20% partner`s discomfort on intercourse, and 27% requested surgery for aesthetic reasons. Penile deviation was dorsal in 42% of the patients, to the left in 46% and to the right in 12%. The curvature angle was less than 30 ° in 28%, between 30º-45 ° in 36%, between 45 °-60 ° in 37% and > 60 ° in 7%.RESULTS: Mean follow-up of the series was 36 months. 20% of the patients had a penile shortening longer than 1.5 cm. 85% of the patients are satisfied with the results. The most frequent complaint was penile shortening.Correction was achieved in 92% of the patients. Four patients were reoperated: two of them for significantphimosis three months after surgery, and the other two for curvature recurrence.CONCLUSIONS: The Nesbit technique is a simpletechnique, with a low complication rate, and good results both in curvature correction and patient satisfaction

Apoptotic and proliferation indexes in primary superficial bladder tumors.

Whether apoptotic index [AI] and/or Ki-67 labeling index [Ki-67LI] add prognostic information in bladder cancer remains unclear. Mean AI and Ki-67 LI increased with grade and stage in 147 superficial bladder tumors. AI (>1.7%) correlated with tumor size, grade and proliferation. Ki-67 LI (>10%) correlated with higher grade and stage. Tumor size and Ki-67 LI were independent predictors of disease-free and progression-free survival, respectively. Tumor size, patient's age and tumor's recurrence predicted overall survival. We conclude that conventional clinical parameters and Ki-67 LI define risk groups of bladder tumors, while AI has limited value.

Leiomioma vesical en paciente varón de diecisiete años / Bladder leiomyoma in a 17-year-old male patient

OBJETIVO: El leiomioma vesical es untumor de presentación rara, cifrándose su frecuencia enla literatura en menos de un 1% MÉTODO: Presentamos el caso de un varón de 17años, con dos pequeñas neoformaciones vesicales descubiertaspor hematuria y clínica irritativa miccional.RESULTADOS: Tras RTU de la lesión es diagnosticadode leiomioma vesical, sin recidiva en el periodo deseguimiento.CONCLUSIONES: El leiomioma vesical es un tumorbenigno, por lo que hay que realizar cirugía lo másconservadora posible. En la revisión realizada de lasrevistas urológicas españolas, es el caso más joven presentadohasta ahora

OBJECTIVES: Bladder leiomyoma is a rare tumor, its frequency being estimated below 1%. METHODS: We report the case of a 17-year-old male patient presenting with hematuria and lower urinary tract irritative symptoms whose work up discovered two small bladder tumors. RESULTS: After TUR of the lesions the diagnosis of bladder leiomyoma was established; no recurrences have appeared on follow-up. CONCLUSIONS: Bladder leiomyoma is a benign tumor, therefore surgery should be the most conservative. Bibliographic review of the Spanish urologic journals shows that this is the youngest patient reported to date

[Bladder leiomyoma in a 17-year-old male patient]. / Leiomioma vesical en paciente varón de diecisiete años.

OBJECTIVES: Bladder leiomyoma is a rare tumor, its frequency being estimated below 1%. METHODS: We report the case of a 17-year-old mole patient presenting with hematuria and lower urinary tract irritative symptoms whose work up discovered two small bladder tumors. RESULTS: After TUR of the lesions the diagnosis of bladder leiomyoma was established; no recurrences have appeared on follow-up. CONCLUSIONS: Bladder leiomyoma is a benign tumor, therefore surgery should be the most conservative. Bibliographic review of the Spanish urologic journals shows that this is the youngest patient reported to date.

[Ambulatory ureteroscopy and pneumatic lithotripsy. Our experience after 1803 ureteral stones]. / Ureteroscopia y litotricia neumática ambulatoria. Nuestra experiencia en 1803 litiasis ureterales.

OBJECTIVES: Ureteroscopy with endoscopical stone fragmentation is effective in the treatment of ureteral lithiasis. We report our experience, as well as our methods. METHODS: 1803 cases of ureteral stones were treated as outpatient. 44% were located in the lumbar ureter, 11% in the iliac ureter, and 45% in the pelvic ureter. Average size was 0.87 (0.4-2.2) cm. A 7 Fr Wolf rigid ureteroscope and a lithoclast type pneumatic lithotripter were employed. Lithotripsy was performed to an extent that small fragments might be spontaneously passed. RESULTS: 98% of the stones were solved. 16% required additional ESWL. 16% of the patients required the insertion of a double J stent. 12% of the patients required more than one session. Complications appeared in 8% of the patients. CONCLUSIONS: Good results: 98% success rate. It can be performed as outpatient. The support of an ESWL unit is basic.