[Clinical significance of sperm presence in post-vasectomy seminograms. Analysis of a 2,168 patients serie]. / Significación clínica de la presencia de espermatozoides en los seminogramas posvasectomía. Análisis de una serie de 2.168 pacientes.

INTRODUCTION: Vasectomy is a safe and effective technique to achieve azoospermia, although the failure rate of the technique is less than 1%. Sterility is not immediate so the post-vasectomy seminogram continues o be essential to ensure the success of the technique. The aim of this trial is to establish the attitude when dealing with immobile residual sperm patients. MATERIAL AND METHODS: Cross-sectional analysis of 2,168 vasectomies performed between January 2010 and March 2017. The first post-vasectomy seminogram was performed at 3 months. Those patients with azoospermia did not undergo further controls. Patients with immobile sperm (<100,000/ml o>100,000/ml) were considered potentially fertile and were followed with monthly seminograms until azoospermia was obtained. RESULTS: Of a total of 1,807 patients were included; 1,297 of these had azoospermia at 3 months seminogram and 501 patients had immobile residual sperm. Only 24 patients of this last group showed more than 100.000 sperm/ml; 9 cases showed mobile sperm. All patients who presented immobile residual sperm underwent serial seminograms. Azoospermia was achieved in an average time of 4,5 months in a rage of 4-10 months, regardless of the initial sperm count. An average of 2,5 tests were performed on each patient. All of the patients with mobile sperm required a reintervention. CONCLUSION: All patients with immobile sperm on the first post-vasectomy seminogram will achieve azoospermia regardless of the initial count. Therefore, serial controls until a negative seminogram is obtained are unnecessary.

Seudopriapismo secundario a invasión linfática en paciente con adenocarcinoma de rete testis / Secondary pseudopriapism after lymphatic invasion in a patient with adenocarcinoma of the rete testis

Presentamos el primer caso clínico publicado de metástasis peneana de carcinoma de la rete testis. Varón de 62 años de edad sometido a orquiectomía por tumoración testicular izquierda con resultado anatomopatológico de carcinoma de la rete testis. Diez meses tras quimioterapia, desarrolló un cuadro de seudopriapismo secundario a infiltración linfática de un carcinoma pobremente diferenciado en muestras tomadas en glande y prepucio durante cirugía de shunt según técnica de Winter y circuncisión. El estudio inmunohistoquímico confirmó que se trataba de una metástasis del tumor testicular primario, con positividad para EMA y negatividad para AFP, PLAP y CD117, además de la negatividad para CD30 que excluían el diagnóstico de otros tumores y apoyaban el carcinoma de la rete testis metastásico. Tumor poco frecuente pero altamente agresivo, con mala evolución por su diagnóstico tardío y mala respuesta a las opciones terapéuticas habituales. Nuestro paciente falleció al mes de la cirugía

We present a case, the first ever published to our knowledge, of penile metastasis from rete testis adenocarcinoma. 62 years old male, who underwent orchiectomy for left testicular mass. Pathology results reveal rete testis adenocarcinoma. Ten months after chemotherapy, show up a pseudopriapism as a consequence of lymphatic infiltration from low differentiated carcinoma in the biopsy of the glans and foreskin taken during shunt surgery and circumcision. Immunohistochemistry revealed that was a primary testicular tumor metastasis, positivity for EMA, negativity for AFP, PLAP, CD117 and CD30 was seen, supporting the diagnosed of metastatic rete testis adenocarcinoma and excluding other tumors. Rare but highly aggressive tumor, poor prognosis because late diagnosis and bad response to adjuvant surgical or chemotherapeutic treatment. The patient dies one month after the surgery

[Secondary pseudopriapism after lymphatic invasion in a patient with adenocarcinoma of the rete testis]. / Seudopriapismo secundario a invasión linfática en paciente con adenocarcinoma de rete testis.

We present a case, the first ever published to our knowledge, of penile metastasis from rete testis adenocarcinoma. 62 years old male, who underwent orchiectomy for left testicular mass. Pathology results reveal rete testis adenocarcinoma. Ten months after chemotherapy, show up a pseudopriapism as a consequence of lymphatic infiltration from low differentiated carcinoma in the biopsy of the glans and foreskin taken during shunt surgery and circumcision. Immunohistochemistry revealed that was a primary testicular tumor metastasis, positivity for EMA, negativity for AFP, PLAP, CD117 and CD30 was seen, supporting the diagnosed of metastatic rete testis adenocarcinoma and excluding other tumors. Rare but highly aggressive tumor, poor prognosis because late diagnosis and bad response to adjuvant surgical or chemotherapeutic treatment. The patient dies one month after the surgery.

Female urethra adenocarcinoma: report of two cases and bibliographic review.

OBJECTIVE: Primary cancer of female urethra is rare and represents about 0.02% of all neoplasias found in women and the majority of them are squamous cell carcinomas. Diagnosis is difficult due to the fact that the disease has usually reached advanced stage. We report our experience with two patients with urethral adenocarcinoma. METHODS: We describe clinical-pathological findings and treatment carried out in two patients with urethral adenocarcinoma. We review the literature focusing on the origin of these tumors and available treatment options. RESULTS: After diagnosis, radical surgery was performed in both patients. Despite this, one patient died of local progression. The other patient is still alive and free of recurrence. CONCLUSIONS: Adenocarcinoma of the female urethra is a rare tumor of difficult diagnosis. Surgery is the only curative treatment. Chemotherapy (CT ) and radiotherapy (RT ) must be used in patients in whom surgery is not possible, although there is no consensus on the best therapeutic approach. Prognosis tends to be poor due to delay in diagnosis.