Medium-term safety outcomes in patients undergoing tension free vaginal tape obturator for stress urinary incontinence in Murcia, Spain. Historical cohort / Resultados de seguridad a mediano plazo en pacientes intervenidas con el cabestrillo suburetral transobturador dentro-fuera para incontinencia urinaria de esfuerzo en Murcia, España. Cohorte histórica

OBJECTIVE: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery. MATERIALS AND METHODS: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Follow-up was determined for each patient based on the time elapsed between surgery and the time when the research protocol was applied. Complications were stratified according to the modified Clavien-Dindo classification; also we evaluated subjective cure rate, quality of life using the ICIQ-SF score, before and after surgery. RESULTS: The mean age was 52.6 (SD± 10.5) years and 80.1% of patients were at least overweight. The incidence of complications at 12 months was: 8.3% (12/144). We did not detect complications after this period in the followed patients at 24, 36 and 48 months. The subjective cure determined at 12, 24, 36 and 48 months was 62.5% (90/144), 59.09% (55/88), 50.81% (31/61) and 50% (7/14), respectively. There was a significant improvement in quality of life, as determined by the ICQ-SF mean score before and after surgery (13.76[6,34] vs 3.84[5.76]; p<0.05). CONCLUSIONS: The TVT-O surgery is a safe therapy associated with a low complication incidence at 12 months, an acceptable subjective cure rate in stress urinary incontinence, and quality-of-life improvement. Classifications of complications related to the insertion of the prosthesis and of those inherent to surgery, such as urinary tract infection, are required.

Objetivo: describir la seguridad a mediano plazo del procedimiento con el cabestrillo suburetral transobturador dentro-fuera (en inglés: tension free vaginal tape obturator TVT-O) en términos de: complicaciones, cura y cambios en la calidad de vida después de la cirugía. Materiales y métodos: cohorte histórica descriptiva que incluye mujeres mayores de 18 años intervenidas de TVT-O por incontinencia urinaria de esfuerzo (IUE) objetivamente comprobada, hipermovilidad uretral o incontinencia urinaria mixta en la que predominó el componente de esfuerzo, confirmada en prueba urodinámica entre julio del 2013 y abril del 2017 en un hospital de referencia ubicado en la ciudad de Murcia, España. Se excluyeron mujeres con cirugía previa de incontinencia, cirugía vaginal concomitante y planificación del embarazo. El seguimiento se determinó para cada paciente por el tiempo transcurrido desde la cirugía hasta el momento en que se aplicó el protocolo de investigación. Las complicaciones se estratificaron según la clasificación de Dindo-Clavien modificada, además, se evaluaron la tasa de curación subjetiva y la calidad de vida mediante el International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) antes y después de la cirugía. Resultados: la edad media de las pacientes fue de 52,59 (DE±10,46) años, el 80,1 % tenía al menos sobrepeso. La incidencia de complicaciones en los primeros 12 meses fue del 8,3%. No detectamos complicaciones después de este periodo en las pacientes seguidas a 24, 36 y 48 meses. La curación subjetiva determinada a los 12, 24, 36 y 48 meses fue del 62,5% (90/144), 59,09% (55/88), 50,81% (31/61) y 50% (7/14), respectivamente. Hubo una mejoría significativa en la calidad de vida, en términos de puntuación media ICQ-SF antes y después de la cirugía (13,76 [6,34] vs 3,84 [5,76]; p < 0,05). Conclusiones: el TVT-O es una terapia segura, con baja tasa de complicaciones a los 12 meses, aceptable tasa de curación subjetiva de la IUE y una mejora en la calidad de vida. Se necesitan clasificaciones de complicaciones relacionadas con la inserción de la prótesis y que incluyan complicaciones inherentes a la cirugía, como la infección del tracto urinario.

Medium-term safety outcomes in patients undergoing tension free vaginal tape obturator for stress urinary incontinence in Murcia, Spain. Historical cohort / Resultados de seguridad a mediano plazo en pacientes intervenidas con el cabestrillo suburetral transobturador dentro-fuera para incontinencia urinaria de esfuerzo en Murcia, España. Cohorte histórica

ABSTRACT Objective: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery. Materials and methods: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Follow-up was determined for each patient based on the time elapsed between surgery and the time when the research protocol was applied. Complications were stratified according to the modified Clavien-Dindo classification; also we evaluated subjective cure rate, quality of life using the ICIQ-SF score, before and after surgery. Results: The mean age was 52.6 (SD± 10.5) years and 80.1% of patients were at least overweight. The incidence of complications at 12 months was: 8.3% (12/144). We did not detect complications after this period in the followed patients at 24, 36 and 48 months. The subjective cure determined at 12, 24, 36 and 48 months was 62.5% (90/144), 59.09% (55/88), 50.81% (31/61) and 50% (7/14), respectively. There was a significant improvement in quality of life, as determined by the ICQ-SF mean score before and after surgery (13.76[6,34] vs 3.84[5.76]; p<0.05). Conclusions: The TVT-O surgery is a safe therapy associated with a low complication incidence at 12 months, an acceptable subjective cure rate in stress urinary incontinence, and quality-of-life improvement. Classifications of complications related to the insertion of the prosthesis and of those inherent to surgery, such as urinary tract infection, are required.

RESUMEN Objetivo: describir la seguridad a mediano plazo del procedimiento con el cabestrillo suburetral transobturador dentro-fuera (en inglés: tension free vaginal tape obturator TVT-O) en términos de: complicaciones, cura y cambios en la calidad de vida después de la cirugía. Materiales y métodos: cohorte histórica descriptiva que incluye mujeres mayores de 18 años intervenidas de TVT-O por incontinencia urinaria de esfuerzo (IUE) objetivamente comprobada, hipermovilidad uretral o incontinencia urinaria mixta en la que predominó el componente de esfuerzo, confirmada en prueba urodinámica entre julio del 2013 y abril del 2017 en un hospital de referencia ubicado en la ciudad de Murcia, España. Se excluyeron mujeres con cirugía previa de incontinencia, cirugía vaginal concomitante y planificación del embarazo. El seguimiento se determinó para cada paciente por el tiempo transcurrido desde la cirugía hasta el momento en que se aplicó el protocolo de investigación. Las complicaciones se estratificaron según la clasificación de Dindo-Clavien modificada, además, se evaluaron la tasa de curación subjetiva y la calidad de vida mediante el International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) antes y después de la cirugía. Resultados: la edad media de las pacientes fue de 52,59 (DE±10,46) años, el 80,1 % tenía al menos sobrepeso. La incidencia de complicaciones en los primeros 12 meses fue del 8,3%. No detectamos complicaciones después de este periodo en las pacientes seguidas a 24, 36 y 48 meses. La curación subjetiva determinada a los 12, 24, 36 y 48 meses fue del 62,5% (90/144), 59,09% (55/88), 50,81% (31/61) y 50% (7/14), respectivamente. Hubo una mejoría significativa en la calidad de vida, en términos de puntuación media ICQ-SF antes y después de la cirugía (13,76 [6,34] vs 3,84 [5,76]; p < 0,05). Conclusiones: el TVT-O es una terapia segura, con baja tasa de complicaciones a los 12 meses, aceptable tasa de curación subjetiva de la IUE y una mejora en la calidad de vida. Se necesitan clasificaciones de complicaciones relacionadas con la inserción de la prótesis y que incluyan complicaciones inherentes a la cirugía, como la infección del tracto urinario.

Hydroxytyrosol and its complex forms (secoiridoids) modulate aorta and heart proteome in healthy rats: Potential cardio-protective effects.

SCOPE: Hydroxytyrosol (HT) is the major phenolic compound in virgin olive oil (VOO) in both free and complex forms (secoiridoids; SEC). Proteomics of cardiovascular tissues such as aorta or heart represents a promising tool to uncover the mechanisms of action of phenolic compounds in healthy animals. METHODS AND RESULTS: Twelve female Wistar rats were separated into three groups: a standard diet and two diets supplemented in phenolic compounds (HT and SEC) adjusted to 5 mg/kg/day during 21 days. Proteomic analyses of aorta and heart tissues were performed by nano-LC and MS. Ingenuity Pathway Analysis was used to generate interaction networks. HT or SEC modulated aorta and heart proteome compared to the standard diet. The top-scored networks were related to Cardiovascular System. HT and SEC downregulated proteins related to proliferation and migration of endothelial cells and occlusion of blood vessels in aorta and proteins related to heart failure in heart tissue. SEC showed higher fold change values compared to HT, attributed to higher concentration of HT detected in heart tissue. CONCLUSION: Changes at proteomic level in cardiovascular tissues may partially account for the underlying mechanisms of VOO phenols cardiovascular protection being the SEC effects higher than free HT.

Foodomics imaging by mass spectrometry and magnetic resonance.

This work explores the use of advanced imaging MS (IMS) and magnetic resonance imaging (MRI) techniques in food science and nutrition to evaluate food sensory characteristics, nutritional value and health benefits. Determining the chemical content and applying imaging tools to food metabolomics offer detailed information about food quality, safety, processing, storage and authenticity assessment. IMS and MRI are powerful analytical systems with an excellent capability for mapping the distribution of many molecules, and recent advances in these platforms are reviewed and discussed, showing the great potential of these techniques for small molecule-based food metabolomics research.

Analytical methods in sphingolipidomics: Quantitative and profiling approaches in food analysis.

In recent years, sphingolipidomics has emerged as an interesting omic science that encompasses the study of the full sphingolipidome characterization, content, structure and activity in cells, tissues or organisms. Like other omics, it has the potential to impact biomarker discovery, drug development and systems biology knowledge. Concretely, dietary food sphingolipids have gained considerable importance due to their extensively reported bioactivity. Because of the complexity of this lipid family and their diversity among foods, powerful analytical methodologies are needed for their study. The analytical tools developed in the past have been improved with the enormous advances made in recent years in mass spectrometry (MS) and chromatography, which allow the convenient and sensitive identification and quantitation of sphingolipid classes and form the basis of current sphingolipidomics methodologies. In addition, novel hyphenated nuclear magnetic resonance (NMR) strategies, new ionization strategies, and MS imaging are outlined as promising technologies to shape the future of sphingolipid analyses. This review traces the analytical methods of sphingolipidomics in food analysis concerning sample extraction, chromatographic separation, the identification and quantification of sphingolipids by MS and their structural elucidation by NMR.

Ultrasensitive aptamer based detection of ß-conglutin food allergen.

Lupine has been increasingly used in food applications due to its high nutritional value and excellent functional properties. However, there has been a response to the increasing number of severe cases of lupine allergies reported during the last decade, and as a result lupine was recently added to the list of substances requiring mandatory advisory labelling on foodstuffs sold in the European Union. In this paper we report the robust and ultrasensitive detection of the anaphylactic ß-conglutin allergen using Apta-PCR achieving a detection limit of 85 pM (25 ng mL(-1)). No cross-reactivity with other conglutins or plant species potentially used in lupine containing foodstuffs was observed. This robust method provides an effective analytical tool for the detection and quantification of the toxic ß-conglutin subunit present in lupine flour.

Penile paraffinoma after subcutaneous injection of paraffin. Treatment with a two step cutaneous plasty of the penile shaft with scrotal skin.

OBJECTIVE: To report a rare case of penile paraffinoma caused by the subcutaneous or intra-urethral injection of foreign substances containing long-chain saturated hydrocarbons. These were injected in order to increase the penis size which generated a chronic granulomatous inflammatory reaction. This is a rare practice in the western world. METHODS: We present the case of a 32-year-old Bulgarian male who presented with a two-year history of elastic, slightly painful penis swelling after subcutaneous liquid paraffin injection. The proposed treatment was excision of the affected tissue and penile reconstruction in a two-stage procedure. RESULTS: The operative procedure was successful and the patient had good aesthetic and functional results. Paraffin and other materials injected into the penis can produce many complications. Foreign body granuloma, skin necrosis, penile deformity, chronic and unhealed ulcer, painful erection, and the inability to achieve a satisfactory sexual relationship are some of the resulting complications. Intralesional or systemic steroids have been used in primary sclerosing lipogranuloma resulting in the disappearance of the granuloma, but in our opinion the treatment of choice should be radical excision, and, if necessary, secondary reconstruction of the penis. CONCLUSION: The injection of foreign substances to enhance penis size is currently an unjustifiable practice. However, it is still carried out, especially in Eastern Europe and Asia. In most cases surgical treatment is needed to treat the complications and the best modality seems to be radical excision together with follow-up.

Parafinoma peneano tras inyección de parafina subcutánea. Tratamiento con plastia cutánea de diáfisis peneana con piel de escroto en dos tiempos / Penile paraffinoma after subcutaneous injection of paraffin. Treatment with a two step cutaneous plasty of the penile shaft with scrotal skin

OBJETIVO: Presentar un caso infrecuente de parafinoma peneano. Este es el resultado de la inyección subcutánea o intrauretral de sustancias que contienen hidrocarburos saturados de cadena larga que generan una reacción inflamatoria crónica granulomatosa. Se trata de una práctica poco común en nuestro entorno. MÉTODO: Descripción de un caso clínico y revisión de lo publicado. Varón de 32 años que consultó por aumento doloroso del tamaño y consistencia del pene a raíz de la inyección subcutánea de parafina líquida dos años antes. RESULTADO: Se realizó escisión y reconstrucción peneana en dos tiempos, con buen resultado estético y funcional. Macroscópicamente se genera inflamación, necrosis, cicatrices deformantes, ulceraciones, abscesos estériles, erección dolorosa e incluso imposibilidad para mantener relaciones sexuales. Aunque se han ensayado diversos tratamientos con esteroides intralesionales y sistémicos, el único recurso terapéutico efectivo es la extirpación quirúrgica del material inyectado seguida de cirugía reconstructiva en caso necesario. CONCLUSIÓN: La inyección subcutánea de parafina en el pene es una práctica no justificable cuyo tratamiento es la escisión quirúrgica del tejido afectado(AU)

OBJECTIVE: To report a rare case of penile paraffinoma caused by the subcutaneous or intra-urethral injection of foreign substances containing long-chain saturated hydrocarbons. These were injected in order to increase the penis size which generated a chronic granulomatous inflammatory reaction. This is a rare practice in the western world. METHODS: We present the case of a 32-year-old Bulgarian male who presented with a two-year history of elastic, slightly painful penis swelling after subcutaneous liquid paraffin injection. The proposed treatment was excision of the affected tissue and penile reconstruction in a two-stage procedure. RESULTS: The operative procedure was successful and the patient had good aesthetic and functional results. Paraffin and other materials injected into the penis can produce many complications. Foreign body granuloma, skin necrosis, penile deformity, chronic and unhealed ulcer, painful erection, and the inability to achieve a satisfactory sexual relationship are some of the resulting complications. Intralesional or systemic steroids have been used in primary sclerosing lipogranuloma resulting in the disappearance of the granuloma, but in our opinion the treatment of choice should be radical excision, and, if necessary, secondary reconstruction of the penis. CONCLUSION: The injection of foreign substances to enhance penis size is currently an unjustifiable practice. However, it is still carried out, especially in Eastern Europe and Asia. In most cases surgical treatment is needed to treat the complications and the best modality seems to be radical excision together with follow-up(AU)

DNA aptamers against the Lup an 1 food allergen.

Using in vitro selection, high affinity DNA aptamers to the food allergen Lup an 1, ß-conglutin, were selected from a pool of DNA, 93 bases in length, containing a randomised sequence of 49 bases. ß-conglutin was purified from lupin flour and chemically crosslinked to carboxylated magnetic beads. Peptide mass fingerprinting was used to confirm the presence of the ß-conglutin. Single stranded DNA was generated from the randomised pool using T7 Gene 6 Exonuclease and was subsequently incubated with the magnetic beads and the captured DNA was released and amplified prior to a further round of Systematic Evolution of Ligands by Exponential Enrichment (SELEX). Evolution was monitored using enzyme linked oligonucleotide assay and surface plasmon resonance. Once a plateau in evolution was reached, the isolated DNA sequences were cloned and sequenced. The consensus motif was identified via alignment of the sequences and the affinities of these sequences for immobilised ß-conglutin were determined using surface plasmon resonance. The selected aptamer was demonstrated to be highly specific, showing no cross-reactivity with other flour ingredients or with other conglutin fractions of lupin. The secondary structures of the selected aptamers were predicted using m-fold. Finally, the functionality of the selected aptamers was demonstrated using a competitive assay for the quantitative detection of ß-conglutin. . Future work will focus on structure elucidation and truncation of the selected sequences to generate a smaller aptamer for application to the analysis of the Lup an 1 allergen in foodstuffs.

Extraction, isolation, and characterization of globulin proteins from Lupinus albus.

Lupin has recently been added to the list of allergens requiring mandatory advisory labeling on foodstuffs sold in the European Union, and since December 2008, all products containing even trace amounts of lupin must be labeled correctly. Lupin globulins consist of two major globulins called α-conglutin (11S and "legumin-like") and ß-conglutin (7S and "vicilin-like") and another additional two globulins, γ-conglutin and δ-conglutin, which are present in lower amounts. We report on a methodology to facilitate the extraction of each of these proteins using centrifugation and isolation by anion-exchange chromatography followed by size-exclusion chromatography. The isolated subunits were characterized using reducing and non-reducing polyacrylamide gel electrophoresis, western blotting, and peptide mass fingerprinting, all of which revealed that the individual protein subunits are highly pure and can be used as immunogens for the production of antibodies specific for each of the conglutin fractions, as well as standards, and the extraction protocol can be used for the selective extraction of each of the subunits from foodstuffs, thus facilitating a highly accurate determination of the lupin concentration. Furthermore, the subunits can be used to elucidate information regarding the toxicity of each of the subunits, by looking at their interaction with the IgE antibodies found in the serum of individuals allergic to lupin, providing critical information for the definition of the requirements of analytical assays for the detection of lupin in foodstuffs.

[Infiltrating bladder carcinoma and adrenal incidentaloma. Report of one case. Bibliographic review]. / Carcinoma vesical infiltrante e incidentaloma suprarrenal. A propósito de un caso. Revisión de la literatura.

OBJECTIVES: We report one case of left adrenal tumor discovered during the study of an infiltrating bladder carcinoma. We discuss the diagnostic and therapeutic implications of the clinical case. METHODS: Surgical procedure was undertaken with radical cystectomy and Bricker's type urinary diversion, plus adenomectomy by anterior approach. RESULTS: The pathologic report showed a myelolipoma. CONCLUSIONS: Most adrenal tumors are benign, mainly if they are small and non-functioning. The protocol of hormonal study should include potassium and catecholamines. Tumors greater than 6 cm and functioning masses are indications for surgery. For oncological patients, surgical approach of the lesion is indicated if there is not evidence of dissemination.

Fiebre alta dos semanas después de un traumatismo hepático / High fever two weeks after liver trauma

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Carcinoma vesical infiltrante e incidentaloma suprarrenal. A propósito de un caso. Revisión de la literatura / Infiltrating bladder carcinoma and adrenal incidentaloma. Report of one case. Bibliographic review

OBJETIVO: Presentamos un caso de un tumor suprarrenal izquierdo descubierto en el estudio de extensión de un carcinoma vesical infiltrante. Se discuten las implicaciones diagnóstico-terapéuticas del caso clínico. MÉTODO: Se realizó abordaje quirúrgico y se practicó, por un lado, cistectomía radical más derivación urinaria según técnica de Bricker, y por otro, suprarrenalectomía por vía anterior. RESULTADO: El estudio anatomopatológico de la pieza suprarrenalinformó de un mielolipoma. CONCLUSIONES: La mayoría de los tumores suprarrenales son benignos, especialmente si son pequeños y no funcionantes. El protocolo de estudio hormonal debe incluir potasio y catecolaminas. Son quirúrgicos, los mayores de 6 cms. y los funcionantes. En el paciente oncológico, si no existe evidencia de diseminación, está indicado el abordaje quirúrgico de la lesión (AU)

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[Controversies in the evaluation of asymptomatic microhematuria]. / Controversias en la evaluación de la microhematuria asintomática.

OBJECTIVE: Asymptomatic microhematuria continues to be a problem. It has a prevalence of 16% and numerous conditions can present this clinical manifestation. METHODS: A prospective study was carried out on all patients that consulted at the urological services during 2000 for asymptomatic hematuria. Patients presenting with irritative symptoms, urethral secretion, perineal or suprapubic pain, urinary tract infections, renal lithiasis or history of trauma were not included in the study. RESULTS: None of the patients presented tumors. Two patients presented renal lithiasis, 5 simple renal cysts, 8 hypercalciuria and 3 hyperuricosuria. None of the 11 patients with hypercalciuria or hyperuricosuria had a history of lithiasis. CONCLUSIONS: Although the size of the study is small, the incidence of tumors in patients with asymptomatic microhematuria appears to be far from the 12.5% incidence reported by some authors and might probably be closer to the 0.5% incidence reported by others. Furthermore, the significant pathology (renal lithiasis), which requires treatment, is also infrequent.

Controversias en la evaluación de la microhematuria asintomática / Controversies in the study of asymptomatic microhematuria

INTRODUCCIÓN: La hematuria microscópica sigue siendo en la actualidad un problema para el urólogo: se trata de una entidad que afecta hasta al 16 por ciento de la población general, siendo numerosas las enfermedades nefro y urológicas que pueden cursar con esta manifestación clínica.MÉTODOS: Hemos realizado un estudio prospectivo sobre los 98 pacientes que han acudido durante el año 2000 a nuestra consulta de urología, remitidos por presentar microhematuria asintomática. No hemos incluido a los pacientes que presentaban clínica irritativa, secreción uretral, dolor perineal o suprapúbico, infecciones urinarias, litiasis renal o antecedente de traumatismos.En todos ellos se ha practicado urocultivo, radiografía simple de abdomen, ecografía renovesical, citología urinaria (para filiar a la hematuria como glomerular o extraglomerular, así como para descartar la existencia de células sugerentes de tumoración urotelial), y se ha determinado calciuria y uricosuria en orina de 24 horas.En algunos pacientes, a juicio del facultativo, se ha practicado así mismo urografía intravenosa.RESULTADOS: Ninguno de los pacientes presentaba enfermedad tumoral. Dos pacientes presentaron litiasis renal, 5 pacientes quistes renales simples, 8 pacientes hipercalciuria y 3 hiperuricosuria (ninguno de estos 11 pacientes con hipercalciuria o hiperuricosuria presentaba antecedentes litiásicos) y en 8 pacientes el origen de la hematuria era glomerular, y fueron remitidos a estudio nefrológico.CONCLUSIONES: Aunque lo reducido de nuestra muestra no permite avanzar conclusiones relevantes, sí parece evidenciarse que la incidencia de patología tumoral en los pacientes con microhematuria no sintomática debe estar alejada de la cifra del 12,5 por ciento que indican algunos autores, estando probablemente más cerca del 0,5 por ciento que refieren otros. Por otra parte, la patología significativa, tributaria de tratamiento (litiasis renal) también es poco frecuente (AU)

Melanoma maligno de pene / Mligmant melanoma of penis

OBJETIVO: El melanoma maligno de pene es una rara neolplasia con un agresivo comportamiento que le confiere un mal pronóstico. MÉTODO: Se presenta el caso de un varón de 58 años que consulta por lesión pigmentada y sobreelevada a nivel de surco balanoprepucial. La biopsia fue positiva para melanoma. El estudio de extensión no revela la presencia de enfermedad diseminada. RESULTADOS: Se realiza penectomía parcial más linfadenectomía inguinal bilateral. La histología informa de dos ganglios positivos en la misma cadena ganglionar. Se administra interferón durante 6 meses. Tras un seguimiento de 35 meses el paciente permanece libre de enfermedad. CONCLUSIÓN: Aunque la cirugía es el tratamiento electivo, las terapias adyuvantes (quimioterapia e inmunoterapia) deben considerarse en aquellos pacientes con enfermedad no localizada (AU)

Absceso de vesícula seminal: tratamiento conservador / Seminal vesicle abcess: conservative management

OBJETIVO: Aportar un nuevo caso de absceso primario de vesícula seminal, resaltando la posibilidad de tratamiento conservador. MÉTODO: Tratamiento médico antibiótico, según urocultivo y antibiograma, durante cuatro semanas. Control ambulatorio: tacto rectal, urocultivo y ecografía. RESULTADOS: Respuesta clínica favorable desde el tercer día. Alta hospitalaria el séptimo día. Tacto rectal, urocultivo y ecografía normales después de cuatro semanas. CONCLUSIONES: El absceso primario de vesícula seminal puede ser tratado con éxito a base de antibióticos. En tal caso, el drenaje percutáneo del mismo debería reservarse para casos de mala evolución (AU)

Siringocele simple de la glándula de Cowper / Simple syringocele of Cowper's glands

OBJETIVOS: La presentación de un nuevo caso de siringocele simple de la glándula de Cowper y realizar una completa revisión de la bibliografía. MÉTODOS: Descripción del nuevo caso clínico y revisión bibliográfica de los últimos 10 años. RESULTADOS Y CONCLUSIONES: El tratamiento más comúnmente empleado es la marsupialización a uretra por vía endoscópica, tratamiento al que fue sometido nuestro paciente con resultados satisfactorios (AU)

Pólipo fibroepitelial gigante del uréter / Giant fibroepithelial polyip of the ureter

OBJETIVO: El pólipo fibroepitelial del uréter es una patología benigna de baja incidencia. Aportamos un nuevo caso con revisión de la literatura, y realizamos una valoración de las exploraciones complementarias a realizar y las posibilidades terapéuticas. MÉTODO: Se presenta el caso de un joven con anulación funcional de riñón izquierdo por la presencia en el interior del uréter de un pólipo fibroepitelial benigno gigante. Se analizan las distintas exploraciones realizadas y las posibilidades terapéuticas. RESULTADOS: Tras el diagnóstico de uropatía obstructiva con pérdida de la unidad renal izquierda, el paciente fue sometido a nefroureterectomía izquierda encontrando la gran formación polipoidea. CONCLUSIONES: Se trata de una patología benigna, de fácil diagnóstico con las exploraciones endoscópicas que disponemos en la actualidad. En el caso de no producir una anulación funcional El pronóstico de los pacientes con carcinoma de células escamosas no es favorable, con una supervivencia a los 5 años de un 57 por ciento (5). irrecuperable de la unidad renal, el tratamiento endoscópico debe ser la primera opción terapéutica (AU)