Experimental murine model of renal cancer. / Modelo murino experimental de cáncer renal.

INTRODUCTION: The objective of this study was to determine the reproducibility in a murine model of renal tumours of various histological strains that could be useful for investigating the response to target drugs. MATERIAL AND METHODS: Development and analysis of the "in vivo" model: tumour xenograft of renal cell carcinomas with Balb/c nude athymic mice. Nontumourous human renal tissue was implanted in the interscapular region of 5 mice, chromophobe renal cell carcinoma was implanted in 5 mice (which, after checking its growth, was prepared for implantation in another 10 mice) and Fuhrman grade 2 clear cell renal cell carcinoma (CCRCC) was implanted in 5 mice (which was also subsequently implanted in 10 mice). We monitored the tumour size, onset of metastases and increase in size and number of tumours. When the size had reached a point greater than or equal to locally advanced or metastatic carcinoma, the animals were euthanised for a pathological and immunohistochemical study and a second phase of implantation. RESULTS: The subcutaneous xenograft of the healthy tissue did not grow. The animals were euthanised at 6 months and no renal tissue was found. The chromophobe renal cell carcinoma cells grew in the initial phase (100%); however, in the second phase, we observed a chronic lymphomonocyte inflammatory reaction and a foreign body reaction. The CCRCC grew at 5-8 months both in the first and second phase (100%), maintaining the tumour type and grade. CONCLUSIONS: The model with athymic Balb/c nude mice is useful for reproducing CCRCC, with the same histological characteristics and aggressiveness as native human tumours, promoting the development of the second experimental phase.

Hemorrhagic cytitis after bone marrow transplantation.

OBJECTIVES: Hemorrhagic cystitis (HC) presenting with gross hematuria, bladder pain and urinary frequency develops in 13-38% of patients following bone marrow transplantation (BMT). The objective of the study was to study the characteristics of patients suffering hemorrhagic cystitis after hematopoietic stem cell transplantation in our center. METHODS: We conducted a retrospective chart review of all patients who underwent BMT at our institution between January 1996 and August 2012. We recorded the age, sex, diagnosis, conditioning regimen, interval between BMT and development of symptoms of cystitis and treatment instituted. RESULTS: Five hundred patients underwent BMT in the period of time studied. 52 of them developed hemorrhagic cystitis. The mean age of the affected patients was 39 years; there were 34 males and 18 females. The diagnoses include AML (n=11), ALL (n=8), CML (n=6), MDS (n=11), CLL (n=5), NHL (n=1), HD (n=5), MM (n=2), Medular aplasia((n=3). HC appeared 59.48 days after BMT. There were no differences between sexes. Mortality among the 52 patients was 51.14% but HC was not the cause of death in any patient. Polyomaviruses were detected in the urine of 78.94 % of survivors. CONCLUSIONS: Polyomavirus infection with BK and JC types is usually acquired in infancy and the virus remains latent in renal tissue. Immunosuppression facilitates reactivation of the renal infection and replication of the virus responsible for the clinical manifestations of HC. The differential diagnoses include other urinary infections, lithiasis, thrombocytopenia and adverse effects of pharmacological agents. The urologist plays a limited role in the management of this disease.

Evaluation of a therapeutic vaccine for the prevention of recurrent urinary tract infections versus prophylactic treatment with antibiotics.

INTRODUCTION AND HYPOTHESIS: Urinary tract infections (UTIs) are considered the most common bacterial infections, especially in women. The objective of this study was to evaluate the use of the sublingual bacterial vaccine Uromune® in order to prevent recurrent UTIs (RUTIs). METHODS: This study was conceived as a multicenter observational study. The clinical history of 319 women who presented at least 2 episodes of UTI in the last 6 months or 3 in 12 months was reviewed. Data related to treatment and clinical evolution were recorded and analyzed. A total of 159 patients received prophylactic treatment with Uromune® for a period of 3 months (group A) and 160 with sulfamethoxazole/trimethoprim 200/40 mg/day for a period of 6 months (group B). Uromune® contained an inactivated bacterial cell suspension of selected strains of Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris, and Enterococcus faecalis. RESULTS: Patients in group A experienced a highly significant reduction in the number of infections compared to patients in group B. In the first 3 months, the mean number of infections was 0.36 versus 1.60 (P < 0.0001), respectively. A significant reduction was also observed after 9 and 15 months (P < 0.0001). The numbers of patients who did not have any UTI at 3, 9, and 15 months were 101, 90, and 55 in group A versus 9, 4, and 0 in group B (P < 0.0001). CONCLUSIONS: The results obtained in this study favor the use of this bacterial-based therapeutic vaccine as an effective strategy to reduce frequency, duration, severity, and costs of RUTIs.

Clinical profile and epidemiological changes of clear cell renal carcinoma during 12 years in our health area.

OBJECTIVES: To investigate changes in the epidemiology and clinical profile of patients diagnosed with renal clear cell carcinoma in a community health area over 12 years. METHODS: Retrospective analysis of epidemiological characteristics and clinical profile of patients diagnosed with renal clear cell carcinoma in a health area composed of a population of 353.619 inhabitants from January 1999 to December 2010. Descriptive statistical and multivariate analysis, Fisher exact test and Chi-Square were utilized. p<0.05 was accepted as significant. RESULTS: 349 diagnoses of renal mass were reported; 165 of them were clear renal cell carcinoma. Median age was 70.41 years, and the Female/Male rate was 28% and 72%, respectively. 4% women and 30% men smoked ≥20 cigarettes/day, more frequently during the period 1999-2001. 52% women and 30% men had hypertension. Hematuria was the most frequent symptom (23%), more frequent in the period 2007-2010, followed by abdominal pain (16%) and renal colic(13%). Weight loss (12%) was more frequent between 1999-2000. Asthenia appeared as the first symptom in 8% of cases. The tumor was incidentally diagnosed in 20% of cases, more frequently in the period between 2007-2010. Diagnosis was established in the Urology Department in 36% of the cases. Stages T1-2 N0 were more frequent between 2007-2010, and M1 between 1999-2000. G3 was more frequent in the entire series. The relative cancer specific mortality of patients who were surgically treated was less in the last 2 years of the period. CONCLUSIONS: Clear renal cell carcinoma is the most frequent renal cancer and its incidence is increasing in our environment. It affects more frequently males than females, and at an earlier age. The last few years are showing a decrease in the habitual smoker males and an increase in HTN in females. A tendency has been detected to the early stage clinical diagnosis but with a higher histopathological grade. It is most frequent diagnosed by a non-Urology speciality.

Perfil clínico y cambios epidemiológicos del carcinoma renal de células claras a lo largo de 12 años en un área de salud / Clinical profile and epidemiological changes of clear cell renal carcinoma during 12 years in our health area

OBJETIVO: Investigar si se producen cambios en la epidemiología y en el perfil clínico de los pacientes diagnosticados de carcinoma renal de células claras (CRCC) en un área de salud a lo largo de 12 años. MÉTODOS: Se realiza un análisis retrospectivo de las características epidemiológicas y del perfil clínico (sexo, edad, factores de riesgo, estadio tumoral y supervivencia) de los pacientes diagnosticados de CRCC en un área de salud de 353619 habitantes desde enero de 1999 hasta diciembre de 2010. Se utiliza estadística descriptiva, t de Student, test exacto de Fisher y Chi-Square. p<0.05 se aceptó como significativo(AU)

RESULTADOS: Se emitieron 349 diagnósticos de masa renal, de los cuales 165 casos corresponden a CRCC. La edad media fue de 70.41 años, y la distribución mujeres/varones fue 28/72%. El consumo de ≥20 cigarillos/día se presentó en el 4% de las mujeres y en el 30% de los hombres, siendo más frecuente en 1999-2001. El 52% de las mujeres y el 30 % de los hombres padecían hipertensión arterial (HTA). La hematuria fue el síntoma más frecuente, apareciendo en un 23%, más frecuente en 2007-2010 (p<0.034). Los siguientes síntomas en frecuencia fueron el dolor abdominal (16%) y las crisis renoureterales (13%). La pérdida de peso (12%) fue más frecuente entre los años 1999 y 2000. La astenia apareció como síntoma primero en un 8% de casos. El diagnóstico fue incidental en un 20% de los casos, más frecuente entre los años 2007 y 2010 (p<0.0081).Conocido tradicionalmente como el tumor del internista, corroboramos que solo el 36% de estos tumores fueron diagnosticados en Urología y el 64% en otras especialidades. En cuanto al estadio, T1-T2 y N0 fueron más frecuentes en los últimos 4 años respecto a 1999-2006 (p<0.016 y p<0.0002 respectivamente). M1 fue más frecuente que M0 en 1999-2000 (p<0.0021) y M0 más frecuente en 2004-2010 (p<0.0038). G3 fue más frecuente en toda la serie, más acentuado en 2008-2010 (p<0.0186). La mortalidad relativa cáncer-específica de los pacientes tratados quirúrgicamente fue menor en los dos últimos años del periodo (p<0.0314). CONCLUSIONES: El CRCC es el cáncer renal más frecuente y con incidencia en aumento en nuestro medio. Afecta más y a menor edad a hombres que a mujeres. En los últimos años se registra menos tabaquismo severo en hombres y más HTA en mujeres. Existe una tendencia al diagnóstico en estadio clínico más precoz pero con mayor grado histopatológico. El diagnóstico se realiza con mayor frecuencia en especialidad no urológica(AU)

OBJECTIVES: To investigate changes in the epidemiology and clinical profile of patients diagnosed with renal clear cell carcinoma in a community health area over 12 years. METHODS: Retrospective analysis of epidemiological characteristics and clinical profile of patients diagnosed with renal clear cell carcinoma in a health area composed of a population of 353.619 inhabitants from January 1999 to December 2010. Descriptive statistical and multivariate analysis, Fisher exact test and Chi-Square were utilized. p<0.05 was accepted as significant. RESULTS: 349 diagnoses of renal mass were reported; 165 of them were clear renal cell carcinoma. Median age was 70.41 years, and the Female/Male rate was 28% and 72%, respectively. 4% women and 30% men smoked ≥20cigarettes/day, more frequently during the period 1999-2001. 52% women and 30% men had hypertension. Hematuria was the most frequent symptom (23%), more frequent in the period 2007-2010, followed by abdominal pain (16%) and renal colic (13%). Weight loss (12%) was more frequent between 1999-2000. Asthenia appeared as the first symptom in 8% of cases. The tumor was incidentally diagnosed in 20% of cases, more frequently in the period between 2007-2010.Diagnosis was established in the Urology Department in 36% of the cases. Stages T1-2 N0 were more frequent between 2007-2010, and M1 between 1999-2000. G3 was more frequent in the entire series. The relative cancer specific mortality of patients who were surgically treated was less in the last 2 years of the period(AU)

CONCLUSIONS: Clear renal cell carcinoma is the most frequent renal cancer and its incidence is increasing in our environment. It affects more frequently males than females, and at an earlier age. The last few years are showing a decrease in the habitual smoker males and an increase in HTN in females. A tendency has been detected to the early stage clinical diagnosis but with a higher histopathological grade. It is most frequent diagnosed by a non-Urology speciality(AU)

Paraganglioma of prostatic origin.

INTRODUCTION: Paragangliomas are usually benign tumors arising from chromaffin cells located outside the adrenal gland. Prostatic paraganglioma is an unusual entity in adult patients, with only 10 cases reported in the medical literature. CASE REPORT: A 34-year-old male with a history of chronic prostatitis consulted for perineal pain. On digital rectal examination the prostate was enlarged and firm, without nodules. The PSA level was 0.8 ng/mL and the catecholamines in the urine were elevated. On ultrasound a retrovesical 9 cm mass of undetermined origin measuring was present. A PET-CT scan showed a pelvic lesion measuring 9 cm with moderate increase in glucidic metabolism localized in the area of the prostate. A biopsy of the prostate revealed a neuroendocrine tumor, possibly a prostatic paraganglioma. A body scintigraphy with MIBG I-123 ruled out the presence of metastases or multifocal tumor. A radical prostatectomy with excision of the pelvic mass was performed under adrenergic blockade. One year after surgery the patient is asymptomatic and disease free. DISCUSSION/CONCLUSIONS: Prostatic paraganglioma is a rare, usually benign tumor, which should be considered in the differential diagnosis of prostate tumors in young males. Its diagnosis is based on the determination of catecholamine in blood and 24-hour urine and in imaging studies principally scintigraphy with MIBG I-123. Diagnostic confirmation is by histopathological study. The treatment consists of radical resection under adrenergic blockade and volume expansion. Given the limited number of cases reported, it is difficult to establish prognostic factors. Malignancy is defined by clinical criteria, and requires life long follow-up.

Factores de riesgo de fracaso de la corrección quirúrgica de la incontinencia urinaria de esfuerzo mediante cinta suburetral transobturatriz / Risk Factors for Failure After Transobturator Vaginal Tape for Urinary Incontinence

Objetivos: Identificar factores que llevaron al fracaso del tratamiento quirúrgico en 302 mujeres con incontinencia urinaria de esfuerzo (IUE) tratadas mediante cinta suburetral transobturatriz (TOT) con seguimiento de 4 años (rango 1-6).Material y métodos302 mujeres incontinentes de 41-81 años fueron intervenidas mediante TOT entre abril de 2003 y noviembre de 2010. Los datos se recogieron mediante el cuestionario validado para incontinencia de orina, el International Consultation on Incontinence Questionnaire — Short Form (ICIQ-SF), y los registros clínicos de la historia. En 262 se consiguió continencia (grupo A) y 40 siguieron incontinentes (grupo B). Se investigó: edad, tiempo de evolución de IUE, tipo y número de partos (eutócicos, distócicos, nuliparidad, multiparidad) y antecedentes médicos y/ o quirúrgicos. Se empleó el cuestionario ICIQ-SF para asignar si los resultados de la cirugía fueron o no exitosos. Resultados: El grupo A presentó menor edad (p=0,0001), menos tiempo de evolución de IUE (p=0,017) y más partos eutócicos (p=0,00002). El grupo B presentó más partos distócicos (p=0,002), colocación previa de cinta vaginal libre de tensión (TVT) o TOT (p=0,03), tratamiento antidepresivo-ansiolítico (p=0,003), tratamiento antihipertensivo (p=0,0005), DMID (p=0.02), HTA (p=0,0007), trastornos respiratorios (p=0,025). No hubo diferencia en nuliparidad (p=0,7), multiparidad (p=0,4), obesidad (p=0,18), trastornos intestinales (p=0,59), anexectomía (p=0,19), cesárea (p=0,17), colposuspensión (p=0,29), histerectomía (p=0,57), alergias (p=0,48), artritis (p=0,22), artrosis (p=0,44), depresión (p=0,74), DMNID (p=0,44), tabaquismo (p=0,28) o fibromialgia (p=0,47). Conclusiones: Edad avanzada, largo tiempo de evolución de la incontinencia urinaria, antecedentes de partos distócicos y la colocación de TVT o TOT previamente aparecen como los factores independientes más asociados al fracaso del TOT, y pueden hacer aconsejable la indicación de otra técnica quirúrgica (AU)

Objective: To identify risk factors leading to treatment failure in a sample of 302 women with stress urinary incontinence (SUI) treated by transobturator vaginal tape (TOT) with a medium follow-up of 4 years (range 1-6). Material and Methods: A population based cohort study with prospectively data from 302 women, aged 41-81 years underwent TOT between April 2003-November 2010. Data were collected by validated questionnaire on urinary incontinence, the International Consultation on Incontinence Questionnaire — Short Form (ICIQ-SF), and clinical data-records. Continence was achieved in 262 (Group A) and 40 continued with incontinence (Group B). We investigated the relationship between age, SUI evolution time, type and number of childbirths (eutocic, dystocic, nulliparous, multiparous status) and medical and/or surgical backgrounds. The ICIQ-SF questionnaire was used to describe whether the surgery outcomes were successful or not. Results: Group A were younger (p=0.0001), had less SUI evolution time (p=0.017); more eutocic childbirths (p=0.000018). Group B had more dystocic childbirth (p=0.022), previous tension free vaginal tape (TVT) or TOT (p=0.03.), antidepressant-anxiolytic drugs (p=0.003), antihypertensive drugs (p=0.0005), type 1 diabetes (p=0.02), arterial hypertension (p=0.0007), respiratory diseases (p=0.025). Differences were not found with regard to nulliparous (p=0.701), multiparous status (p=0.42), obesity (p=0.18), intestinal disorders (p=0.59), oophorectomy (p=0.19), caesarean (p=0.17), prolapse surgery (p=0.29), hysterectomy (p=0.57), allergies (p=0.48), arthritis (p=0.22), arthrosis (p=0.44), depression (p=0.74), type 2 diabetes (p=0.44), smoking patterns (p=0.28), fibromyalgia (p=0.47). Conclusions: Elderly women, with long evolution SUI, dystocic delivery, previous TVT or TOT appear as independent risk factors associated to TOT failure. These factors may make the indication of another surgical approach recommendable (AU)

[Risk factors for failure after transobturator vaginal tape for urinary incontinence]. / Factores de riesgo de fracaso de la corrección quirúrgica de la incontinencia urinaria de esfuerzo mediante cinta suburetral transobturatriz.

OBJECTIVE: To identify risk factors leading to treatment failure in a sample of 302 women with stress urinary incontinence (SUI) treated by transobturator vaginal tape (TOT) with a medium follow-up of 4 years (range 1-6). MATERIAL AND METHODS: A population based cohort study with prospectively data from 302 women, aged 41-81 years underwent TOT between April 2003-November 2010. Data were collected by validated questionnaire on urinary incontinence, the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and clinical data-records. Continence was achieved in 262 (Group A) and 40 continued with incontinence (Group B). We investigated the relationship between age, SUI evolution time, type and number of childbirths (eutocic, dystocic, nulliparous, multiparous status) and medical and/or surgical backgrounds. The ICIQ-SF questionnaire was used to describe whether the surgery outcomes were successful or not. RESULTS: Group A were younger (p=0.0001), had less SUI evolution time (p=0.017); more eutocic childbirths (p=0.000018). Group B had more dystocic childbirth (p=0.022), previous tension free vaginal tape (TVT) or TOT (p=0.03.), antidepressant-anxiolytic drugs (p=0.003), antihypertensive drugs (p=0.0005), type 1 diabetes (p=0.02), arterial hypertension (p=0.0007), respiratory diseases (p=0.025). Differences were not found with regard to nulliparous (p=0.701), multiparous status (p=0.42), obesity (p=0.18), intestinal disorders (p=0.59), oophorectomy (p=0.19), caesarean (p=0.17), prolapse surgery (p=0.29), hysterectomy (p=0.57), allergies (p=0.48), arthritis (p=0.22), arthrosis (p=0.44), depression (p=0.74), type 2 diabetes (p=0.44), smoking patterns (p=0.28), fibromyalgia (p=0.47). CONCLUSIONS: Elderly women, with long evolution SUI, dystocic delivery, previous TVT or TOT appear as independent risk factors associated to TOT failure. These factors may make the indication of another surgical approach recommendable.

Fisioterapia y personas con discapacidad: papel de la fisioterapia coadyuvante en la discapacidad física y psicosomática causada por la cistopatía intersticial / Physiotherapy and persons with disability: role of coadjuvant physiotherapy in the physical and psychosomatic disability caused by interstitial cystitis

La cistopatía intersticial es un síndrome clínico caracterizado por frecuencia urinaria y/o dolor pelviano de etiología no establecida que excluye otras causas conocidas. Su escaso conocimiento en el ámbito clínico y, en especial, en su repercusión biopsicosocial incentiva hoy en día la realización de estudios específicos entre los que éste aporta una visión terapéutica efectiva mediante biofeedback de suelo pelviano sin electroestimulación partiendo de un protocolo básico de la Asociación Europea de Urología, aplicado a pacientes diagnosticadas de cistopatía intersticial, para producir una mejora en la calidad de vida y una reducción de la discapacidad o de la invalidez temporal en relación con el síndrome(AU)

Interstitial cystitis is a clinical syndrome characterized by urinary frequency and/or pelvic pain with a non-established etiology that excludes any other known causes. The limited knowledge within the clinical fields and especially about its biopsychosocial effects currently encourages the conduction of specific studies. Among these, there are those that provide an effective therapeutic view using pelvic floor biofeedback without electrostimulation, using a basic protocol of the Urology European Association, applied to interstitial cystitis diagnosed patients, that aims to generate an improvement in their quality of life and of reducing the disability or the temporary impairment related to the syndrome(AU)

[Treatment of stress urinary incontinence with perineal biofeedback by using superficial electrodes]. / Tratamiento de la incontinencia urinaria de esfuerzo con biofeedback perineal con electrodos de superficie.

PURPOSE: We analyze the pelvic floor muscles treatment outcomes by using biofeedback (BFB) with electromyography with superficial electrodes in women diagnosed as having stress urinary incontinence (SUI). Besides, we compare this treatment with pelvic floor muscle exercises (PFME) plus vaginal electrostimulation. METHODS: 85 women with stress urinary incontinence, aged 42 - 74 years. We divided the patients in two groups: Group 1 (N = 50): This patients carry out a perineal biofeedback with superficial electrodes without electrostimulation, and Group 2 (N = 35): This patients were treated with pelvis floor muscle exercices and vaginal electrostimulation. All patients carry out two session per week (of 30 minutes each one) during ten weeks. We assess the outcomes through international urinary incontinence questionnaires (IU-5 and ICIQ-SF) and urinary incontinence related quality of life test (King's questionnaire). Student t-test and Fisher Exact test were used, p < 0.05 was considered statistically significant. RESULTS: No difference was found in the age average of both groups. 84% of patients of group 1 and 80% of patients of group 2 were cured with the treatment. We assumed they were cured when incontinence episodes not happened or they do not need to use absorbent materials. In the Group 1, 50% of patients in the fourth week and 84% in the tenth week were cured. In the Group 2, 71.42% of patients in the fourth week and 80% in the tenth week were cured. In the Group 2, eight patients (22.85%) complained side effects. Both groups improved the quality of life similarly. CONCLUSION: Grade 1 and grade 2 stress urinary incontinence treatment by using perineal biofeedback with superficial electrodes electromyography is better or similar to more invasive treatments. Also pelvic floor muscle exercices plus vaginal electrostimulation have good outcomes although some patients complain side effects. Both conservative treatments are effective and feasible.

Tratamiento de la incontinencia urinaria de esfuerzo con Biofeedback perineal con electrodos de superficie / Treatment of stress urinary incontinence with perineal biofeedback by using superficial electrodes

Objetivo: Se analiza el resultado del tratamiento de los músculos perineales mediante biofeedback (BFB) con electrodos de superficie en mujeres diagnosticadas de incontinencia urinaria de esfuerzo (IUE). Además se compara con la reeducación de la musculatura del suelo pélvico (RMSP) más electroestimulación vaginal (EEV). Métodos: 85 mujeres diagnosticadas de IUE; de edades comprendidas entre 42 y 74 años, se dividieron en: Grupo 1 (N=50): tratadas mediante un programa de BFB perineal con electrodos de superficie sin electroestimulación y Grupo 2 (N=35): tratadas con RMSP con EEV. Se realizaron dos sesiones semanales de 30 minutos cada una durante 10 semanas. Se evaluaron los resultados mediante el estudio de los cambios en los índices internacionales de la incontinencia urinaria (IU–5 y el índice ICIQ-SF) y el índice de calidad de vida derivada de los síntomas urinarios (cuestionario de salud King´s). Se emplearon la t de Student y el test exacto de Fisher, p < 0,05 se aceptó como significación estadística. Resultados: La edad de ambos grupos fue comparable. 84% y 80% de pacientes en los grupos 1 y 2 mejoraron respectivamente, entendiendo por mejora la no existencia de episodios de incontinencia y la ausencia de necesidad de usar absorbentes. No hubo diferencia en la mejora de la incontinencia entre ambos grupos. En el Grupo 1 la mejora se produjo en el 50% de pacientes en la semana 4, y en el 84%en la semana 10. En el Grupo 2 la mejoría ocurrió en el 71,42% de pacientes en la semana 4 y en el 80% de pacientes en la semana 10.Ocho pacientes del Grupo 2 (22,85%) presentaron efectos secundarios locales. La mejora en la calidad de vida en ambos grupos arrojó resultados similares. Conclusión: El éxito del tratamiento de la incontinencia urinaria de esfuerzo grados 1 y 2 mediante un programa de biofeedback perineal con electromiografía con electrodos de superficie sin electroestimulación es similar o superior a los publicados en tratamientos más invasivos. El tratamiento con ejercicios del suelo pélvico con electroestimulación vaginal puede conseguir resultados similares, aunque puede presentar efectos secundarios. Ambos tratamientos conservadores son eficaces y factibles (AU)

Purpose: We analyze the pelvic floor muscles treatment outcomes by using biofeedback (BFB) with electromyography with superficial electrodes in women diagnosed as having stress urinary incontinence (SUI). Besides, we compare this treatment with pelvic floor muscle exercises (PFME) plus vaginal electrostimulation. Methods: 85 women with stress urinary incontinence, aged 42 - 74 years. We divided the patients in two groups: Group 1 (N=50): This patients carry out a perineal biofeedback with superficial electrodes without electrostimulation, and Group 2 (N=35): This patients were treated with pelvis floor muscle exercices and vaginal electrostimulation. All patients carry out two session per week (of 30 minutes each one) during ten weeks. We assess the outcomes through international urinary incontinence questionnaires (IU–5 and ICIQ-SF) and urinary incontinence related quality of life test (King´s questionnaire). Student t-test and Fisher Exact test were used, p < 0.05 was considered statistically significant. Results: No difference was found in the age average of both groups. 84% of patients of group 1 and 80% of patients of group 2 we recured with the treatment. We assumed they were cured when incontinence episodes not happened or they do not need to use absorbent materials. In the Group 1, 50% of patients in the fourth week and 84% in the tenth week were cured. In the Group 2, 71,42% of patients in the fourth week and 80% in the tenth week were cured. In the Group 2, eight patients (22,85%) complained side effects. Both groups improved the quality of life similarly. Conclusion: Grade 1 and grade 2 stress urinary incontinence treatment by using perineal biofeedback with superficial electrodes electromyography is better or similar to more invasive treatments. Also pelvic floor muscle exercices plus vaginal electrostimulation have good outcomes although some patients complain side effects. Both conservative treatments are effective and feasible (AU)

[Post-traumatic arterial priapism resolved using supraselective embolization]. / Priapismo arterial postraumático resuelto por embolización supraselectiva.

Presentation of a new case of high flow priapism in a patient with recent background of perineal traumatism. Diagnosis, already inferred through anamnesis, was later suspected from the results of blood gasometry in cavernous bodies, and eventually confirmed by Eco-Doppler. A revision of the related literature revealed a total of 20 patients in whom supraselective embolization has been used as the therapeutical approach, Bucrylate being used in only two of them. Finally, a few considerations are contributed on the therapeutical management of these patients and the relevance of a correct diagnosis of the two distinct groups of priapism, since they differ considerably in terms of treatment.

La uretrotomia bajo visión directa en el tratamiento de la estrechez uretral masculina / Direct vision urethrotomy in the management of strictures of the male urethra

Dentro de la patologia urológica, la estenosis uretral masculina es uno de los capítulos que mayores controversias sucita. Básicamente han sido tres las fórmulas propuestas en su terapéutica: dilataciones periódicas, uretrotomia ciega y numerosisimas técnicas de uretroplastia cruenta. Durante la última década y merced sobre todo a los trabajos desarrollados por Sachse, la uretrotomia interna, bajo visión directa y con corte frio, ha surgido con fuerza mostrándose, cada vez más, como alternativa validad frente a otros procederes más agresivos. . Presentamos en esta revisión, los resultados obtenidos en 45 pacientes tratados con esta técnica

La uretrotomia bajo visión directa en el tratamiento de la estrechez uretral masculina / Direct vision urethrotomy in the management of strictures of the male urethra

Dentro de la patologia urológica, la estenosis uretral masculina es uno de los capítulos que mayores controversias sucita. Básicamente han sido tres las fórmulas propuestas en su terapéutica: dilataciones periódicas, uretrotomia ciega y numerosisimas técnicas de uretroplastia cruenta. Durante la última década y merced sobre todo a los trabajos desarrollados por Sachse, la uretrotomia interna, bajo visión directa y con corte frio, ha surgido con fuerza mostrándose, cada vez más, como alternativa validad frente a otros procederes más agresivos. . Presentamos en esta revisión, los resultados obtenidos en 45 pacientes tratados con esta técnica (AU)

Interes de la ecografía endocavitaria en el cáncer rectal / The interesting of the endocavitary echography in rectum neoplasm

Presentam los autores su experiencia con la ecografía endocavitaria en 18 pacientes portadores de câncer rectal a distintos niveles

Interes de la ecografía endocavitaria en el cáncer rectal / The interesting of the endocavitary echography in rectum neoplasm

Presentam los autores su experiencia con la ecografía endocavitaria en 18 pacientes portadores de cÔncer rectal a distintos niveles (AU)

[Priapism: analysis and results of surgical treatment in 9 cases]. / Priapismo: análisis y resultados del tratamiento quirúrgico en nueve casos.

A review is made of nine cases of priapism, seven of which were idiopathic and two secondary. The different etiological and clinical aspects are analyzed. All the patients underwent surgical treatment, with 42.8% of good, long-term results and the authors always recommend aggressive and early, surgical treatment.