[A Spanish multicenter trial of TVT for female urinary incontinence]. / TVT para la incontinencia urinaria femenina: estudio multicéntrico español.

OBJECTIVE: The purpose of this study was to evaluate results and complications of TVT in a large series from different hospital centers in Spain. METHOD: We retrospectively studied the results of TVT placement from 6 centers with 272 consecutive patients (median follow-up was 636 days). All types of stress urinary incontinence with a surgical indication were included and no previous conditions were established regarding the indication. No protocol was used for either the intervention or postoperative support measures. Data collection was protocolized and carried out using a common questionnaire that was completed by an urologist at each center from 3 to 6 months after the intervention and then annually. All patients who underwent intervention were asked about their satisfaction with the outcome. Multivariate studies were made to identify the factors that influenced the recovery of continence and the occurrence of complications. RESULTS: 92.1% of patients were continent and 2.4% have not shown any improvement. 91.6% of the patients claimed to be satisfied whereas only 2.7% were dissatisfied. After four years only 2.8% of patients showed mild incontinence with time and 0.4% had moderate incontinence. Only previous surgery for incontinence was found to be significantly unfavorable factor for achieving postoperative continence. CONCLUSION: We have reproduced a scenario closer to daily clinical reality than the results of series from a single institution or analyses using stricter selection criteria. This multicenter study verifies the viability and reproducibility of TVT with minimal complications in centers where patients are not selected and where not all urologists are specialized in urinary incontinence.

[Signet-ring cell neoplasm. Unusual histologic variety as primary bladder tumor]. / Neoplasia de células en anillo de sello. Una variedad histológica rara como tumor vesical primario.

We report a case of primary signet-ring cell adenocarcinoma of the urinary bladder. It is a extremely rare tumor. Gross hematuria is the commonest clinical presentation as well as this case. Our patient presented with advanced tumour invasion into perivesical fat at dome. The treatment was partial cystectomy together with quimiotherapy. Medical literature are reviewed with special remark on histopathology and its bladder origin.

[Neoplastic pathology of the urothelium]. / Patologia neoplásica del urotelio.

Bladder cancer is one of the most common diseases treated by urologists. In this article, we will try to review some of the controversies and all the available data which come from the systematic review and meta-analysis.

[Second resection in patients with Ta-T1 bladder tumors]. / Segunda resección en pacientes con tumores vesicales Ta-T1.

OBJECTIVES: To study the incidence of "residual/recurrence" tumor after a second bladder resection (2nd TUR). METHODS: 40 patients with new or recurrent superficial bladder tumor underwent repeat transurethral resection within 3 months after the initial resection. 37 patients were staged as Ta-T1. We study the incidence of tumor after the 2nd TUR both macroscopically detected or included in the bladder scar. We also study the influence of possible factors as the time between both resections, stage, grade, number of tumor size, localization in the bladder, primary or recurrent tumor and tumor pattern. RESULTS: After the 2nd TUR we found tumor in 14 of 37 (37.8%) Ta-T1 bladder tumors. Among the 14 tumors, 10 (71.5%) were macroscopically visible tumors and 4 cases the tumor were found after resection of the bladder scar of the first resection. We did not find relation between the presence of tumor in the 2nd TUR and any of the variables. CONCLUSIONS: After a TUR of superficial bladder tumor the complete removal of tumor is not always achieved. The early 3 months cystoscopy may not find residual tumor. Although we have found tumor in 37.8% in the 2a TUR we can not recommend routine 2nd TUR in superficial bladder cancer.