[Embryonal rhabdomyosarcoma of spermatic cord and prostatic adenocarcinoma. Case report and review of the literature]. / Rabdomiosarcoma embrionario del cordón espermático asociado a adenocarcinoma prostatico. Presentación de un caso y revisión de la literatura.

We present a tumor developed from spermatic cord structures. The histology (rhabdomyosarcoma), the age of the patient and its association with a prostatic adenocarcinoma has developed this case report. Histopathological singularity and regional treatment choice are the two key points of this case.

Medical professional responsibility for postvasectomy pregnancy. / Responsabilidad profesional médica en embarazo posvasectomía.

BACKGROUND: The follow-up of patients postvasectomy is frequently limited to a seminogram at 3months if azoospermia is observed. This study evaluates a series of cases of complaints for postvasectomy pregnancy to establish follow-up recommendations that increase the clinical safety and reduce the risk of complaints. MATERIAL AND METHODS: We reviewed the database of the Department of Professional Responsibility of the Council of the College of Physicians of Catalonia, finding 28 complaints for postvasectomy pregnancy between 1992 and 2011. We analysed the clinical and legal variables of the cases. RESULTS: A total of 13 extrajudicial complaints (46.43%), 13 civil lawsuits (46.43%) and 2 criminal lawsuits (7.14%) were recorded. Only 10 cases had a signed document of informed consent specific to vasectomy. In 26 cases, the data from the spermogram was available. A single spermogram was conducted in 20 cases (76.92%), 2 spermograms were conducted in 4 cases (15.38%) and none were performed in 2 cases (7.69%). For 9 of the cases (45%) where only a single spermogram was performed, the test was performed before 3months postvasectomy. In 17 cases (65.38%), the result of the last spermogram was azoospermia, and 3 cases had oligospermia (11.54%). There were 2 failures of interpretation of the spermogram (7.69%) and 2 of normospermia (7.69%). In 2 cases, a spermogram was not performed (7.69%). Pregnancy occurred between 4 and 50 months after the intervention. In 12 cases (42.86%), it was considered that the practitioner was responsible. DISCUSSION: It is recommended that physicians emphasise (during the patient information stage) the possibility of spontaneous recanalisation and to request 2 spermograms, whose result should be azoospermia. Performing the test in the 3months after vasectomy is risky, as is basing the waiting time on the number of ejaculations.

[Sudden anuria secondary to migration of aortic stent in a single kidney patient]. / Anuria súbita en paciente monorreno secundaria a migración de endoprótesis aórtica.

Percutaneous acces to manage infrarenal aortic aneurysm is a less aggressive technique, but it's not entirely risk free. The migration of stents isn't a frequent complication in that percutaneous technique. Urgent left renal revascularition, when anterior approach or autologous transplantation is not possible, is feasibily by a splenorenal shunt through a lumbar approach.

[Bladder leiomyoma]. / Leiomioma vesical.

A new case of leiomyoma of the bladder is presented in a patient with unspecific symptoms and the preoperatives patterns don't give to a certainty diagnosis. The conclusive diagnosis was obtained with pathoanatomical study of the quirurgic piece.

Responsabilidad profesional médica en embarazo posvasectomía / Medical professional responsibility for postvasectomy pregnancy

Introducción: El seguimiento de los pacientes posvasectomía queda frecuentemente limitado a un seminograma a los 3 meses si se objetiva azoospermia. Este trabajo evalúa una serie de casos de reclamaciones por embarazo posvasectomía, con el objetivo de establecer recomendaciones de seguimiento que aumenten la seguridad clínica y disminuyan el riesgo de reclamaciones. Material y métodos: Se revisó la base de datos del Servicio de Responsabilidad Profesional del Consejo del Colegio de Médicos de Cataluña, localizándose 28 reclamaciones por embarazo posvasectomía entre 1992 y 2011. Se analizaron las variables clínicas y jurídicas de los casos. Resultados: Se registraron 13 reclamaciones extrajudiciales (46,43%), 13 demandas civiles (46,43%) y 2 penales (7,14%). Únicamente en 10 casos constaba la firma de un documento de consentimiento informado específico para vasectomías. En 26 casos se dispuso de los datos correspondientes al espermiograma. En 20 casos (76,92%) se realizó un único espermiograma, en 4 se realizaron 2 (15,38%) y en 2 casos no se realizó ninguno (7,69%). Cuando solo se llevó a cabo un único espermiograma, en 9 casos (45%) este se realizó antes de los 3 meses. En 17 casos (65,38%) el resultado del último espermiograma fue de azoospermia, 3 casos de oligospermia (11,54%), hubo 2 fallos de interpretación del espermiograma (7,69%), 2 de normospermia (7,69%) y en 2 casos no se realizó espermiograma (7,69%). El embarazo se produjo entre los 4 y los 50 meses de la intervención. En 12 casos (42,86%) se consideró que existía responsabilidad profesional. Discusión: Se recomienda enfatizar en la información al paciente la posibilidad de la recanalización espontánea y solicitar 2 espermiogramas con resultado de azoospermia, resultando de riesgo su realización antes de los 3 meses o basar el tiempo de espera en un número de eyaculaciones

Background: The follow-up of patients postvasectomy is frequently limited to a seminogram at 3 months if azoospermia is observed. This study evaluates a series of cases of complaints for postvasectomy pregnancy to establish follow-up recommendations that increase the clinical safety and reduce the risk of complaints. Material and methods: We reviewed the database of the Department of Professional Responsibility of the Council of the College of Physicians of Catalonia, finding 28 complaints for postvasectomy pregnancy between 1992 and 2011. We analysed the clinical and legal variables of the cases. Results: A total of 13 extrajudicial complaints (46.43%), 13 civil lawsuits (46.43%) and 2 criminal lawsuits (7.14%) were recorded. Only 10 cases had a signed document of informed consent specific to vasectomy. In 26 cases, the data from the spermogram was available. A single spermogram was conducted in 20 cases (76.92%), 2 spermograms were conducted in 4 cases (15.38%) and none were performed in 2 cases (7.69%). For 9 of the cases (45%) where only a single spermogram was performed, the test was performed before 3 months postvasectomy. In 17 cases (65.38%), the result of the last spermogram was azoospermia, and 3 cases had oligospermia (11.54%). There were 2 failures of interpretation of the spermogram (7.69%) and 2 of normospermia (7.69%). In 2 cases, a spermogram was not performed (7.69%). Pregnancy occurred between 4 and 50 months after the intervention. In 12 cases (42.86%), it was considered that the practitioner was responsible. Discussion: It is recommended that physicians emphasise (during the patient information stage) the possibility of spontaneous recanalisation and to request 2 spermograms, whose result should be azoospermia. Performing the test in the 3 months after vasectomy is risky, as is basing the waiting time on the number of ejaculations

Rabdomiosarcoma embrionario del cordón espermático asociado a adenocarcinoma prostatico. Presentación de un caso y revisión de la literatura / Embryonal rhabdomyosarcoma of spermatic cord and prostatic adenocarcinoma. Case report and review of the literature

Presentamos el caso de una tumoración derivada de estructuras del cordón espermático. La histología (rabdomiosarcoma), la edad de presentación (adulta) y la asociación con un cáncer de próstata motivó esta nota clínica. La especificidad del estudio anatomopatológico e inmunohistoquímico y el planteamiento del tratamiento regional son los dos aspectos claves del caso (AU)

We present a tumor developed from spermatic cord structures. The histology (rhabdomyosarcoma), the age of the patient and its association with a prostatic adenocarcinoma has developed this case report. Histopathological singularity and regional treatment choice are the two key points of this case (AU)

Anuria súbita en paciente monorreno secundaria a migración de endoprótesis aórtica / Sudden anuria secondary to migration of aortic stent in a single kidney patient

El manejo percutáneo de los aneurismas de aorta infrarrenal es una técnica menos agresiva, pero no está exenta de riesgos. La migración craneal de las endoprótesis es un proceso infrecuente en dicha técnica. Ante una revascularización renal izquierda de urgencia en que no se pueda tener acceso a una vía anterior o la posibilidad de un autotrasplante, una buena alternativa es la realización de unshunt esplenorrenal mediante un acceso lumbar (AU)

Percutaneous acces to manage infrarenal aortic aneurysm is a less aggressive technique, but it’s not entirely risk free. The migration of stents isn’t a frequent complication in that percutaneous technique. Urgent left renal revascularition, when anterior approach or autologous transplantation is not possible, is feasibily by a splenorenal shunt through a lumbar approach (AU)

Leiomioma vesical / Leiomyoma of the bladder

Presentamos un nuevo caso de leiomioma vesical en una paciente con clínica inespecífica, y en la que las pruebas de imagen preoperatorias no lo orientaron. El diagnóstico definitivo lo dio el estudio anatomopatológico de la pieza quirúrgica (AU)