Favourable impact of regular swimming in young people with haemophilia: experience derived from 'Desafio del Caribe' project.

Swimming is beneficial for persons with haemophilia (PWH) providing good maintenance of the cardiovascular and musculoskeletal system and improving many psychological characteristics. In the Desafío del Caribe Project, young PWH from Venezuela and Mexico took part in an open water competition in the Gulf of Mexico under a multidisciplinary team supervision. Eight severe haemophilia A, two moderate haemophilia A, one severe haemophilia B and two moderate haemophilia B subjects were included. Haematological, musculoskeletal and psychological evaluations were carried out before and during training for the competition. Training program included physical exercise routines and swimming practices that alternated between pools and open water. Swimmers had coverage with factor concentrates before pool and open water trainings. In physiatric evaluations, the Hemophilia Joint Health Score (HJHS) was used. The objective of the psychology area was to analyse self-esteem, precompetition anxiety, coping mechanisms and relaxation levels. The need of factor prophylaxis before intense trainings was confirmed. In the musculoskeletal system a decrease of elbow pain as well as an increase of muscle strength in the ankles were observed. In the psychological area significant differences between the first and second test in self-esteem levels, cognitive anxiety and group cohesion were found. PWH must be provided with orientation and encouragement to practice swimming regularly. High competition exercise must be supervised by a multidisciplinary team which must evaluate the pros and cons of the activity to make relevant recommendations.

[Ureteral obstruction secondary to Rosai-Dorfman disease]. / Obstrucción ureteral secundaria a enfermedad de Rosai-Dorfman.

Ureteral obstruction can be secondary to a lot of reason. We present a uncommon case report of ureteral obstruction to Rosai-Dorfman disease. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management.

[Calcified retroperitoneal liposarcoma]. / Liposarcoma retroperitoneal calcificado.

Case report of a retroperitoneal liposarcoma pleomorfico with calcification in diagnosed in our hospital. We comment on its clinical characteristics, diagnostic methods and treatment. We likewise comment the possible differential diagnoses.

[Adult polycystic disease in horseshoe kidney]. / Enfermedad poliquística del adulto en riñón en herradura.

A case report of kidney polycystic and horseshoe kidney coincidence in the same patient. They are two congenital associated renal diseases uncommon for urologists. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management.

[Primary enuresis. Presentation of a series of 93 cases]. / Comentarios sobre la enuresis primaria. Presentación de una casuística de 93 casos.

The present study was conducted at the outpatient service of Urology. It comprised 93 patients diagnosed as having primary enuresis exclusively. All patients with underlying urological or extraurological conditions were excluded from the study. All the available material on this subject indicate that primary enuresis may be a clinical manifestation of delayed maturation of control of micturition at the level of the CNS. It is important to consider the family history, especially the paternal. Other factors; i.e., social, school, environment, etc., may be relatively important in the presentation of primary enuresis. All the patients in this series received the same treatment. The dose was adjusted according to patient age and sex. The results and the adverse effects of treatment are presented.

[Double tumor pathology: simultaneous renal oncocytoma and colonic carcinoma]. / Doble patología tumoral: oncocitoma renal y carcinoma de colon simultáneos.

We report a case of renal oncocytoma associated with adenocarcinoma of the colon. Although the preoperative evaluation had disclosed a mass in the superior pole of the left kidney, renal oncocytoma had not been suspected and the foregoing was diagnosed pathologically from the intraoperative biopsy. The association of renal oncocytoma and other extraurological tumors reported in the literature are reviewed and the diagnostic and therapeutic aspects are discussed.

[Surgical repair of vesico-vaginal fistulae with abdominal-transvesical approach. Comments on this technique and long-term results]. / Corrección quirúrgica de fístulas vésico-vaginales mediante abordaje abdominal-transvesical. Comentarios a esta técnica y resultados a largo plazo.

OBJECTIVES: We reviewed our series of vesicovaginal fistula that had been treated by the abdominal-transvesical approach, which we have also utilized in complex relapsed fistulas of the posterior aspect of the bladder in all but one case of triple fistula associated with lithiasis of the bladder. METHODS: 6 patients with vesicovaginal fistula secondary to pelviogynecological surgery were treated by the abdominal-transvesical approach. One patient had been referred to our hospital for a triple fistula that had relapsed for the fifth time. This patient was submitted to cystolithotomy during the same session. Another patient with urinary incontinence and cystocele prior to the fistula underwent unrethrocervicopexy following the Marshall-Marchetti-Krantz technique after fistula repair. All the cases were treated by the same surgeon without omental interposition. RESULTS: Excellent results were achieved in all 6 cases, with no fistula relapse. The urinary infection disappeared in those patients with this complication prior to fistula repair. Patient control evaluation was performed 6-12 months postoperatively and at 4 years. All 6 patients are currently urologically asymptomatic and continent. CONCLUSIONS: In our view, vesicovaginal fistula repair can be done via the vaginal, abdominal or combined approach. We do not believe that one technique is superior over the other. Although the 6 cases described herein are not significant statistically, the abdominal-transvecial approach has been successful in these 6 cases, despite the difficulty that is always encountered in some cases of vesicovaginal fistula, regardless of the technique utilized. Omental interposition may be useful in those cases with a large fistulous defect. Some advocate fistulectomy in all cases. The time to surgical correction following diagnosis was always more than three months. The crossed or x-shaped suture achieves minimal superpositioning. Postoperative bladder drainage should not lie on the suture of the bladder mucosa to prevent decubitus through placement of a cystostomy tube. The foregoing points are essential in this procedure.

[Oat cell bladder carcinoma. Report of a case]. / Carcinoma vesical de células pequeñas (oat cell). Aportación de un caso.

OBJECTIVE: To report an additional case of small cell (oat cell) carcinoma of the bladder. METHODS/RESULTS: A 78-year-old patient who consulted for hematuria is described. A TUR biopsy demonstrated small cell undifferentiated carcinoma. The patient received neoadjuvant chemotherapy and subsequently underwent surgery, but died 6 months postoperatively. CONCLUSIONS: Regardless of the treatment utilized, this tumor type maintains its aggressive behaviour and can be associated with other carcinomatous components (papillary transitional cell carcinoma and carcinoma in situ). However, after treatment with CDDP + VP-16 and partial cystectomy, our patient was asymptomatic for 5 months.

[Current role of the Zeiss extractor catheter. Comparative study with other methods. Presentation of 80 personal cases and a comprehensive review]. / Lugar del catéter extractor de Zeiss en la actualidad. Estudio comparativo con otros métodos. Presentación de una casuística personal de 80 casos y revisión global.

The present study compared the Zeiss and Dormia type extractors for ureteral calculi with the new methods of treatment (shock waves and laser) to determine the place of these extractors in our urological armamentarium today. The results and the complications in our series comprised of 80 cases are presented and the literature available on this subject reviewed. We discuss briefly the methods commonly used today, i. e., shock waves and laser, with special reference to the good results and scant complications. We can conclude from this study that these catheters continue to be useful in current urological practice.

[Eosinophilic cystitis]. / Cistitis eosinófilica.

Eosinophilic cystitis is an uncommonly diagnosed disease entity whose etiology is unknown, although factors favoring its presentation such as disorders due to hypersensitivity and associated vesico-prostatic disease have been mentioned. Four cases are presented. The clinical features, complementary tests, treatment, and course are discussed and the literature reviewed.

[Inverted papilloma of the bladder]. / Papiloma invertido de vejiga.

We report a case of inverted papilloma in a patient submitted to TUR of a polypoid mass in the bladder neck, highlighting the coincident clinical features of the cases reported in the literature.

[Inverted carcinoma of kidney pelvis coexisting with transitional cell carcinoma of the bladder. A therapeutic alternative]. / Carcinoma invertido de pelvis renal coexistente con carcinoma de células transicionales de vejiga. Una opción terapéutica.

OBJECTIVE: To describe a case of inverted carcinoma of the right renal pelvis associated with transitional cell carcinoma of the bladder. The unusual nature of this condition and the incidence of tumor recurrence in some patients with bladder cancer and, at least initially, no histopathological evidence of infiltrating tumor prompted us to report this case. METHODS/RESULTS: A 65-year-old male consulted for prostatism. Several months earlier he had had an episode of hematuria. The difficulty in making the diagnosis is underscored and the possibility of conservative surgical management is discussed. Tumor recurrence at two sites distinct from that of the bladder tumor warranted TUR. Two years after the first surgical procedure the patient is disease-free. CONCLUSION: Like most authors, we usually perform radical surgery in these cases. However, in the case described herein, the difficulty in making the diagnosis prompted us to use a conservative approach which, at the present time, appears to have been effective for the renal tumor. New treatment options, like endourological surgery, may have an important place in the management of this tumor type in carefully selected cases.

[Sertoli cell tumor of the testis. Report of a case]. / Tumor testicular de células de Sertoli. Aportación de un caso.

OBJECTIVE: To describe an additional case of Sertoli cell testicular tumor. Although more cases have been reported in the world literature, only one case with bilateral involvement has been described in the Spanish literature over the last 18 years. METHODS: A 34-year-old male consulted for a testicular mass which he had detected a few weeks earlier. US and CT evaluation disclosed a tumor in the right testis and no evidence of metastasis. The patient underwent right radical orchidectomy via the inguinal approach and insertion of a testicular prosthesis. RESULTS: Histopathological analysis of the surgical specimen disclosed a Sertoli cell testicular tumor. Patient control follow-up at 3 and 9 months postoperatively showed no changes in tumor markers or CT findings. CONCLUSION: The benign or malignant nature of Sertoli cell testicular tumor is currently defined by the presence or absence of metastasis, although there are histopathological criteria that might indicate a certain degree of aggressiveness.

[Perineo-scrotal gangrene (Fournier's gangrene)]. / Gangrena perineoescrotal (gangrena de Fournier).

Four cases of perineoscrotal gangrene are reported herein. All were immune-suppressed and three were diabetics. Its primary focus was in the GU tract or intestine. Culture was positive for Gram-negative aerobes and anaerobes. Early aggressive surgery and adjuvant antibiotic therapy achieved an excellent survival rate.

Obstrucción ureteral secundaria a enfermedad de Rosai-Dorfman / Ureteral obstructin secondary to Rosai-Dorfman disease

La obstrucción ureteral puede ser secundaria a múltiples causas. Presentamos un caso poco común dentro de la práctica urológica habitual, consistente en una forma de Histiocitosis denominada Enfermedad de Rosai-Dorfman, como origen de obstrucción ureteral extrínseca. En la presente comunicación describimos la forma de presentación, la metodología diagnóstica utilizada y el tratamiento propuesto (AU)

Ureteral obstruction can be secondary to a lot of reason. We present a uncommon case report of ureteral obstruction to Rosai-Dorfman disease. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management

Liposarcoma retroperitoneal calcificado / Retroperitoneal liposarcoma uit calcification

Se presenta un caso acontecido en nuestro centro correspondiente a un liposarcoma retroperitoneal pleomórfico calcificado en forma de cáscara. Se describe la forma de presentación, los síntomas por los que consulta el paciente, los métodos diagnósticos utilizados y la alternativa terapéutica tomada ante este caso. Se discuten los posibles diagnósticos diferenciales a los que obliga este caso clínico (AU)

Case report of a retroperitoneal liposarcoma pleomorfico with calcification in diagnosed in our hospital. We comment on its clinical characteristics, diagnostic methods and treatment. We likewise comment the possible differential diagnoses (AU)

Enfermedad poliquística del adulto en riñón en herradura / Adult polycistic kidney in horseshoe kidney

Presentamos un caso poco común dentro de la práctica urológica habitual, consistente en la coincidencia en un mismo paciente de dos enfermedades renales congénitas asociadas: riñón poliquístico y riñón en herradura. Se describe la forma de presentación clínica, los métodos diagnósticos utilizados y el manejo terapéutico que se está realizando en este paciente (AU)

A case report of kidney polycistic and horseshoe kidney coincidence in the same patient. They are two congenital associated renal diseases uncommon for urologists. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management (AU)