Videolaparoscopic lower pole heminephrectomy for treatment of a duplex kidney.

INTRODUCTION: In a duplicated renal collecting system, or duplex kidney, the most frequent pathology presenting at the lower pole is the vesicoureteral reflux (VUR), which could lead to urinary tract infections (UTI) or even renal dysplasia. Under some circumstances, such as recurrent UTIs or impaired kidney function, heminephrectomy of the pathologic moiety is indicated. However, there are only few academic videos of laparoscopic lower pole heminephrectomy in the pediatric population available in literature. Therefore, we present a descriptive video of this procedure. METHODS: This video exhibits a case report of a 15-month-old male patient who underwent a videolaparoscopic lower pole heminephrectomy as treatment of a refluxing non-functional lower moiety of a right duplex kidney. Moreover, the patient presented a refluxing contralateral ureter which was endoscopically corrected at the same time. RESULTS: A laparoscopic right lower pole heminephrectomy associated with an endoscopic contralateral reflux treatment was performed. No complication occurred during hospital stay or at 30-day follow up. CONCLUSION: Videolaparoscopic lower pole heminephrectomy is a safe and feasible procedure in the pediatric population. Associating an endoscopic correction of the contralateral side reflux at the same moment shows no additional morbidity or complication.

[Complex reconstructive surgery of cervico-urethral sclerosis after radical prostatectomy, due to endoscopic solution failure]. / Cirugía reconstructiva compleja de la esclerosis cervico-uretral tras prostatectomía radical, por fracaso de la solución endoscópica.

The sclerosis of the cervico-urethral union is one of the complications that may arise after a radical prostatectomy, in most cases, the endoscopic treatment usually solves it. We introduce repair by open approach of a sclerosis cervico-urethral after radical prostatectomy that did not respond to endoscopic management. The surgical technique had two times, the first perineal and a second time with hypogastric approach. After six months of this complex surgery an artificial sphincter was placed to patient. The patient is asymptomatic and continent after three years of follow up surgery.

[Transurethral treatment of massive hematuria post retropubic adenomectomy]. / Tratamiento por vía transuretral de la hematuria masiva postadenomectomía retropúbica.

INTRODUCTION AND OBJECTIVES: to evaluate the frequency of reoperation caused by massive hematuria in the postoperation of open prostatectomy in benign prostatic hyperplasia (BHP) at our hospital. At the same time, we also want to evaluate the effectiveness and possible secondary effects of using transurethral approach to solve this surgical complications. MATERIAL AND METHODS: we analyzed retrospectively 540 open surgeries in benign prostatic hyperplasia, carried out from 1998 to 2005. We evaluated effectiveness, average surgery time and complications in case of endoscopic review. RESULTS: a reoperation was necessary in 2.5% of all 540 cases. In all the cases reoperated, hemorrhage was controlled using transurethral approach. Average surgery time was 37 minutes and secondary effects observed were not important. CONCLUSIONS: transurethral approach is a simple and effective technique in the treatment of massive hematuria after open prostatectomy in BPH. Surgery time spent is acceptable, and early and delayed complications observed have been few and cannot, in our opinion, be imputed only to this tech-