[Mixed urogenital schistosomiasis]. / Esquistosomiasis genitourinaria mixta.

Urinary schistosomiasis is a parasitosis caused by Schistosoma Haematobium which affect in a diffuse manner all the genitourinary tract. Presentation of 5 patients (4 male, 1 female) with mixed Bilharziosis that was detected after the study of a young male that came to the clinic with a complaint of haematuria and who underwent transurethral resection under the suspicion of a vesical urothelial neoformation. Sch. Hameatobium eggs were detected in the urine and Sch. Mansoni in the semen of all 4 male. All of them evolved favourably with Praziquantel. Considering the rarity of schistosomiasis in our environment and its increased incidence in endemic areas, this process should be included in the algorithm of differential diagnosis in young patients reporting dysuric syndromes associated to haematuria; the relevance of an epidemiological anamnesis so as to institute early treatment and avoid the consequences of chronic infection is pointed out.

[Synchronous manifestation of bladder inverted papilloma and transitional carcinoma of the renal pelvis]. / Presentación sincrónica de papiloma invertido vesical y carcinoma transicional de pelvis renal.

OBJECTIVE: To review briefly the histological and biological aspects of inverted papilloma and to determine whether it is a benign tumor or low-grade malignant lesion. METHOD/RESULTS: We report a patient with synchronous presentation of bladder inverted papilloma and renal pelvis transitional cell carcinoma. After endoscopic resection of the bladder tumor and left ureteral meatus, a radical nephroureterectomy was carried out with success. The clinical features, diagnostic and therapeutic aspects are briefly reviewed. CONCLUSIONS: Inverted papilloma accounts for 2.2% of all urothelial tumors; the bladder is most commonly involved. It is frequently a single lesion with endophytic growth pattern. The clinical significance remains a controversy. Most investigators consider them as benign neoplastic tumors, although in one third of the patients it may be associated with synchronous urothelial carcinomas, implying a malignant condition. Therapeutic management and follow-up are emphasized.

[Ectopic ureter in prostatic urethra. Unusual discovery in an adult]. / Uréter ectópico en uretra prostática. Descubrimiento inusual en adulto.

OBJECTIVE: Ectopic ureter is a congenital anomaly more frequent in the female, in the pediatric age and is commonly left-sided. The present article reports an uncommon case without the common features of this anomaly. METHODS/RESULTS: We report on a 67-year-old man with complete duplex system and ectopic obstructive megaureter in the prostatic urethra with a silent onset. The diagnostic and therapeutic aspects in the literature are briefly discussed. CONCLUSION: Because this anomaly is asymptomatic and incidentally discovered because of contralateral disease, the approach is conservative.

[Metachronous metastasis in ureteral stump secondary to ipsilateral renal adenocarcinoma]. / Metástasis metacrónica en muñón ureteral secundaria a adenocarcinoma renal ipsilateral.

OBJECTIVES: Ureteral metastasis from renal adenocarcinoma is uncommon. The rarity of this disease prompted us to report on the present case, with special reference to diagnosis. METHODS/RESULTS: A patient with metachronous metastasis in the ureteral stump from clear cell renal adenocarcinoma resected three years earlier is described. The etiopathogenic, clinical, diagnostic and therapeutic aspects are briefly reviewed. CONCLUSIONS: Ureteral metastases, although uncommon, are generally ipsilateral to the renal tumor and arise from aggressive renal carcinomas that are locally advanced with vascular and/or lymphatic spread. We underscore the importance of retrograde pyelography and ureterorenoscopy in the diagnostic workup of all patients with gross hematuria following nephrectomy due to hypernephroma.

[Obstruction of the urethral conduct following implantation of the endoprosthesis Urolume: therapeutic management]. / Obliteración de la luz uretral tras implante de endoprotesis urolume: manejo terapéutico.

The introduction of self-expandable urethral endoprostheses for the management of relapsing urethral stenosis has required the development of a minimally invasive therapeutical approach of widespread acceptance by the urological community. The reason for its success is the simplicity of implantation and the low rate of complications up to date. This paper reports on a patient carrying a ¿Urolume¿ urethral endoprosthesis for a relapsing bulbar urethral stenosis, which two years after implantation presents re-stenosis secondary to endoluminal inflammatory tissue growth. After two failure endoscopic resections, endoscopic removal of the prosthesis was required. Currently the patient carries a ¿Urocoil¿ spiral endoprosthesis to avoid tissular reaction. The therapeutical aspects found in the literature are reviewed, emphasizing the need of follow-up to detect complications, to improve indications and to select those patients that may be candidates for this treatment.

[Ureteral endometriosis]. / Endometriosis del uréter.

OBJECTIVES: Ureteral involvement due to endometriosis is uncommon. Its silent onset and the progression of ureteral obstruction, if undiagnosed, can lead to the loss of the renal unit. The present case is described to underscore the importance of early diagnosis. METHODS/RESULTS: We report on a patient with obstructive uropathy secondary to intrinsic ureteric endometriosis that had undergone nephrectomy due to parenchymal destruction. One year following resection of the endovesical portion, recurrence in the ureteral stump was observed. The clinical features, the diagnostic and clinical aspects are briefly discussed. CONCLUSIONS: Although ureteric involvement is uncommon, renal function of patients with pelvic endometriosis must be followed closely by analyses, ultrasound and/or intravenous urography for early detection of this condition.

[Cystic pyeloureteritis. A diagnosis to keep in mind]. / Pieloureteritis quística. Un diagnóstico a tener en cuenta.

OBJECTIVES: Cystic pyeloureteritis is a disease entity of unknown etiology and unspecific symptoms. It is incidentally detected and is difficult to distinguish from other disorders showing filling defects on urographic evaluation. All the foregoing prompted us to report the present case. METHODS/RESULTS: We report a case of cystic pyeloureteritis that had been diagnosed during ureterorenoscopy in a patient with lithiasis and recurrent urinary tract infection. The etiopathogenesis, diagnostic and therapeutic aspects described in the literature are briefly reviewed. CONCLUSIONS: We underscore the importance of confirming the diagnosis by endoscopic and cytological studies. Conservative management is advocated. Patient follow up should include urinalysis, urine culture and cytology twice yearly and intravenous urography once a year.

[Obstructive uropathy secondary to genitourinary prolapse]. / Uropatía obstructiva secundaria a prolapso genitourinario.

Genital prolapse is associated to a greater concurrence of repeat urinary infections, stress urinary incontinence, arterial hypertension and obstructive uropathy with a higher or lower degree of renal impairment. Incidence of uropathy in the genital prolapse setting ranges between 4 and 13%. This paper presents a female patient with renal insufficiency secondary to bilateral obstructive uropathy caused by a concomitant genital prolapse. A brief revision is made of the pathophysiological, diagnostic and therapeutic aspects in the literature. The need to perform both prone and standing urographic studies is emphasized; also a study of the renal function should be performed in these patients in order to establish the appropriate treatment and avoid major complications and renal function impairment.

[Penile prosthetic implant in the treatment of impotence: our experience]. / Implante de prótesis de pene en el tratamiento de la impotencia: nuestra experiencia.

The aim of this study was to review the current situation of penile prostheses in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in our experience. From 1987 to 1993, 35 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 54 years and the mean duration of erectile dysfunction was 37 months. Diabetes, vascular disease and pelvic surgery were the most common pathologies recorded. We utilized the penoscrotal approach in 97.14% of the cases and implanted the following prostheses: 12 Hydroflex, 7 Uniflate 1000, 6 Acuform, 4 Mark II, 3 Dynaflex and 3 Alpha 1. The mean follow-up was 38 months. Infection of the prosthesis by Staph. epidermidis was observed in 5.71% of the cases. This infectious complication required removal of the prosthesis. Two patients with a Uniflate prosthesis complained of mechanical failure. Eighty percent of the patients and 74.28% of their partners were satisfied with the results. When asked if they would undergo another operation again if it were necessary, 71.42% answered "yes". Penile prostheses have withstood the test of time and continue to be an effective and valid therapeutic alternative in impotent men. Although the complication rate is low, adequate information must be provided to the patient and partner in order to enhance the results.

[Epidermoid carcinoma of the penis]. / Carcinoma epidermoide de pene.

Four cases of Penis Epidermoid Carcinoma, three treated with partial amputation and one with Co60 radiotherapy due to the patient's refusal to undergo surgery, are illustrated. After an average follow-up of 14 months (2-24), patients who underwent surgery have not relapsed. Local relapse was observed in the patient given radiotherapy within 6 months.