[Nephritic colic caused by periureteral fibrosis resulting from metastasis from lobular carcinoma of the breast]. / Cólico nefrítico por fibrosis periureteral de metástasis de carcinoma lobulillar de mama.

OBJECTIVE: To report a rare case of renoureteral colic in a patient with a solitary left kidney, due to fibrosis around the renal pelvis and ureter from metastatic lobular carcinoma of the breast. METHODS/RESULTS: A 45-year-old patient consulted at the emergency services for pain in the left renal fossa that irradiated to the genital organs. Patient evaluation showed lid edema and oliguria. An abdominal ultrasound scan demonstrated left hydronephrosis. The cause of the obstruction could not be determined by imaging techniques. Exploratory lumbotomy was performed and the pelvis and ureter were released from the fibrotic covering. The histological analysis showed infiltration of the ureteral adventitia arising from lobular breast carcinoma. CONCLUSIONS: Retroperitoneal metastases that cause ureteral obstruction usually occur two years following diagnosis of the primary tumor. This is one of the few cases of ureteral obstruction from metastatic lobular carcinoma of the breast reported in the literature. Unlike the other cases, however, our patient showed a complicated genitourinary malformation.

[Endoscopic anterior commissurotomy (EAC) versus TUR as the treatment for the neck obstruction syndrome. Our experience. The results]. / La comisurotomía anterior endoscópica (CAE) versus RTU como tratamiento del síndrome obstructivo cervical. Experiencia. Resultados.

OBJECTIVE: 30 patients were included over a 5-year period in a protocol divided into two uniform cohorts (age, surgical risk, prostatic volume, etc.). Both groups are compared based on morphological effectiveness, functionality, quality of life parameters, etc. Also a comparison on the efficacy of anterior commissurotomy vs. conventional TUR is carried out. METHOD: After 12 hours, a cohort of 15 patients had a Collins' loop section of the vesical neck anterior aspect, a technique described by Keitzer (1969). RESULTS: Results were optimal and superior to those obtained with TUR. We conclude this technique is effective, and emphasize the validity of the concepts described by Gil Vernet in 1956.

[Usefulness of posterior capsulectomy in the treatment of bladder neck disease]. / Utilidad de la capsulectomía posterior como tratamiento de la enfermedad de cuello vesical.

RATIONALE: Presentation of 12-year experience accrued in the surgical treatment of the acquired bladder neck disease. Based on Riches' experience (1961), posterior capsulotomy, although exceptional in terms of indication, was effective in the treatment of 26 patients with early failure of standard endoscopic techniques. MATERIALS AND METHOD: Over a 12-year period, 945 prostatectomies were entered in a protocol, 305 (32.2%) open surgery and 640 (67.8%) transurethral resections. Incidence of sclerosis was 5.03% (48 patients). Treatment of second group with TUR and/or cervicotomy failed in 26 (45-58%) patients. Posterior capsulotomy was effective in 100% patients. RESULTS: Mean follow-up has been productive, and exceeds 4 years based on clinical, radiologic, endoscopic and urodynamic parameters.

[Eosinophilic cystitis in children. Study of 4 cases]. / Cistitis eosinofílica en el niño. Estudio de 4 casos.

OBJECTIVE: To present our experience in the diagnosis and treatment of 4 children with eosinophilic cystitis. METHODS: 4 children (3 boys and 1 girl) with eosinophilic cystitis are described. The mean follow-up since diagnosis was 30 months, the mean age was 7 years and the main symptom was hematuria. The clinical features, etiology, course of the disease, pathological findings and diagnostic methods are reviewed. The definitive diagnosis was established by the pathological findings. None of the patients had a recurrence. CONCLUSIONS: The diagnosis of eosinophilic cystitis is exclusively based on the histological findings. There are no clinical or complementary pathognomonic signs. Like most authors, we believe that the immune system plays a decisive role in the appearance of this disease.

[A retrospective study of surgery for tumors of the renal parenchyma in adults]. / Estudio retrospectivo sobre la cirugía de los tumores del parénquima renal en el adulto.

OBJECTIVES: To determine the incidence of renal parenchymal tumors in adult patients over the last 30 years, analyze the therapeutic approach and compare radical vs conservative surgery, the surgical principles involved and the survival rates achieved. METHODS/RESULTS: We have reviewed 260 cases of renal parenchymal tumors in adults and the utilization of conservative vs radical surgery over the last 30 years. This tumor type has been significantly influenced by the availability of US for routine evaluation, which has led to changes in the clinical features of this condition and the surgical expectations. CONCLUSIONS: Although the techniques of conservative surgery of the kidney have remained unchanged over the last 50 years, the indications have changed. The incidence of nononcological conditions has decreased while the number of incidentally discovered tumors has increased. The tumor is diagnosed earlier, of smaller size and lower histological grade and stage.