[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.

[Dissecting aneurysm of the renal artery in patient with transplantation. Report of a case. Review of the literature]. / Aneurisma disecante de la arteria renal en paciente trasplantado. Presentación de un caso. Revisión de la literatura.

OBJECTIVES: Aneurysmatic processes of the renal artery after transplant are rare entities, generally secondary to technical defects or infectious pictures. Among other presentations, dissecting aneurysm are exceptional, having a particularly difficult diagnosis due to the lack of specific clinical data which could differentiate them from other processes such as graft rejection or acute tubular necrosis, as well as the absence of characteristic representative images. METHODS: We report one case of dissecting aneurysm after a kidney transplant resulting in graft loss. RESULTS: We analyze the presentation form, diagnostic procedures, pathologic studies, and possible therapeutic options. CONCLUSIONS: Dissecting aneurysm of the renal artery is a rare entity of difficult diagnosis due to the poorness of presenting symptoms and the difficulty of finding it in routine tests, being necessary to think of it and to perform angiography as the only diagnostic test. Treatment is carried out by hilar reconstruction or transplant nephrectomy when the former is not possible.

[Relation between hypertension and clinical cases of benign prostatic hyperplasia]. / Estudio de la relación entre hipertensión y caso clínico de hiperplasia benigna de próstata.

OBJECTIVES: To confirm the relationship between hypertension and lower urinary tract symptoms (LUTS) in our environment, and to evaluate the association between hypertension and LUTS secondary to benign prostatic hypertrophy (BPH). METHODS: We prospectively studied during 3 months all male patients older than 50 years (163 patients) analysing previous medical history, IPSS, digital rectal examination, urine sediment, basic biochemical profile, PSA, uroflowmetry, and urinary tract ultrasound. Patients with neurological diseases, previous pelvic trauma, diabetes mellitus, suspicious digital rectal examination, abnormal PSA, or under treatment with alpha blockers, antidepressants, finasteride or antipsychotic drugs were excluded. RESULTS: From a total of 163 patients 113 were classified as suffering clinical BPH (LUTS, prostate greater than 30 gm, and uroflowmetry < 15 ml/sec), and 75 as hypertensive. Among 75 hypertensive patients 31 presented IPSS greater than 7 (41.3%) in comparison to 20 out of 88 non hypertensive patients (22.7%), being the difference statistically significant. CONCLUSIONS: Our study confirms what has been previously reported by other authors, that there is a statistically significant relationship between hypertension and LUTS secondary to BPH.

[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.