[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.

[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.

[Surgical treatment of hypospadias. Apropos of 700 hypospadias surgically treated (1966-1988). Indications and results. Current trends of the surgical treatment]. / Consideraciones sobre el tratamiento quirúrgico del hipospadias. A propósito de 700 hipospadias intervenidas (1966-1988). Indicaciones y resultados. Tendencias actuales del tratamiento quirúrgico.

The surgical treatment of hypospadias is very complex. The objective is to obtain a satisfactory urinary and genital function with an equal morphological, anatomical and aesthetic result. Our contribution covers 22 years of surgical multicentre experience (700 cases). We evaluate the surgical indication, results, complications, associated malformations and study protocols. The anterior forms 590 (82%) were treated using the Duckett Magpi, Mathieu, Duplay and Leveuf techniques. Posterior forms 110 (18%) with a wide variety of techniques. Results have been encouraging in both. We have objectively evaluated the evolution of the indications, as well as the application of different techniques depending on the extent of urethral malformation.

[Prostate cyst at the midline in a patient with a renal transplantation]. / Quiste prostático de línea media en paciente trasplantado renal.

Cystic lesions at the midline of the prostate are uncommon and they are considered as congenital disorders. Is generally accepted that active treatment should be instituted only in symptomatic patients and watchful waiting in asymptomatic ones. The most common active treatment is minimally invasive surgery by puncture-aspiration or endoscopic unroofing. We are attaching an inmunosupressed patient because of a renal transplantation in which we provided an active treatment by puncture-aspiration of the cystic lesion in spite of being asymptomatic.

[Bivalve transinusal anatrophic nephrolithotomy. Anatomic considerations. New technique]. / Nefrolitotomía anatrófica transinusal bivalva. Consideraciones anatómicas. Nueva tecnica.

The paper describes the experience accumulated over a 9- year period on surgical treatment of coralliform lithiasis. The treatment implied the use of an original technique inspired in the surgical concepts divulged by Gil-Vernet, Kelly and Dufour. Ninety-four patients have been effectively treated with this technique, known as the Bivalve Transinusal Anathropic Nephrothomy. The surgical technique applied is described and analyzed.

[Vestibular approach in urinary incontinence in women. Original technic. Experience. Results]. / La vía de abordaje vestibular en la incontinencia de orina en la mujer. Técnica original. Experiencia. Resultados.

Presentation of an original technique to treat S.U.I. in women. This technique contains in itself many others, both in terms of the conceptual anatomical base on which it is inspired, and in the possibilities of its surgical application. Lisfranc's approach, supra-meatic and infra-clitoridean, allows to section both the pubo-urethral ligament and Colles fascia thus reaching into the Retzius. It makes possible the use of solid anatomical elements (pelvian fascia, elevator, urethro-vaginal septum, etc...) thus allowing to suspend the pelvian base from fascia ligaments or from the abdominal wall muscles. Sixty patient who had simple S.U.I. received treatment, with a 95% efficacy index based on the evaluation of the urodynamic, bacteriological and clinical studies. We conclude with an evaluation on the validity of the results obtained by emphasizing the high efficacy index, simplicity, low morbidity and short hospital stay.

[Complete testicular feminization syndrome. Report of a case]. / Síndrome de feminización testicular completa. A propósito de un caso.

A case of complete testicular feminization (Morris syndrome) in a male pseudohermaphrodite is described. The results of the hormone analyses and the histological features of the resected gonad are presented. The literature is reviewed with special reference to whether gonadectomy should be performed in the pre or post-pubertal period. We advocate early castration because of the high incidence of germ cell neoplasia and the possibility of virilization in case of incomplete androgenic resistance. Our approach is based on the satisfactory feminization achieved by exogenous estrogen therapy.

[Ureteral stenosis. Complication of the urinary tract in renal transplantation. Experience. Comments]. / La estenosis ureteral. Complicación de la vía urinaria en el trasplante renal. Experiencia. Comentarios.

Our experience in stenosis of the urinary tract after renal transplantation is described. We reviewed the records of 160 consecutive cases of renal transplantation. The data gleaned over a period of 10 years (1982-1992) show a stenosis rate of 4.37%. All the cases were successfully treated by surgery.

[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.

[Anatomical and technical foundations of the non-hemorrhagic treatment of simple hydrocele. Technical contributions]. / Fundamentos anatómicos y técnicos del tratamiento no hemorrágico del hidrocele simple. Aportaciones técnicas.

The efficacy of the conventional surgical techniques in the treatment of simple hydrocele has been well-established. However, further insights into the embryological anatomy of the testis and its layers have led to the development of new surgical concepts. We have conducted a retrospective study after using an "avascular" technique (extravaginalization-marsupialization) with optimum results. 120 patients treated by the Wilkinson vaginal reversal were assessed for efficacy and complications. The working hypothesis and the principles based on embryological anatomy are discussed. The results and relevant data of the treated group of patients are presented.

[Surgical complications after 160 renal transplantations. Experience. Comments]. / Complicaciones quirúrgicas tras 160 transplantes renales. Experiencia. Comentarios.

The present study reviewed the complications observed in 160 renal transplants that had been performed from 1982 to 1992. Complications were observed in 27 cases (16.87%), which falls within reasonable limits and is similar to the complication rate reported elsewhere. The treatment utilized in these cases was highly effective and only 3 grafts (1.87%) were lost. The following complications were observed: obstructive uropathy (7 cases, 4.37%), fistula (18 cases, 11.25%), vascular complications (1 case, 0.62%) and other complications (1 case, 0.62%).

[Gonadal stromal tumor in childhood. Report of a case. Comments]. / Tumor de estroma gonadal en la infancia. Aportación de un caso. Comentarios.

A case of testicular gonadal stromal tumor in an 8-month-old boy is described. Patient evaluation revealed no hormonal alterations. The patient underwent orchidectomy and has remained tumor-free at two years follow-up, which meets the well-established criteria for benign tumors. A detailed anatomopathological description is presented.

[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.

[The endourological treatment of distal ureteral fistulae in the kidney transplant. The exclusion or "dry" technic]. / Tratamiento endourológico de las fístulas de uréter distal en el trasplante renal. Técnica de exclusión o "seca".

The present study reports our experience in the endourological treatment of fistulas of the distal ureter in renal transplant patients. The temporary urinary exclusion or dry technique was effective in 8 of the 10 patients. We advocate the use of this simple and safe technique which achieves excellent results.