[Giant fecal impaction as a cause of female incontinence (Fecaloma) and bladder instability. Contribution with one case]. / Fecaloma gigante como causa de incontinencia e inestabilidad vesical femenina. Aportación de un caso.

We present a case of a 60 years old female patient, with previous depressive disorders, an attempted suicide with pelvic injuries, who comes showing two years evolution of emergence incontinence. The was diagnosed with a giant fecal impaction occuping almost all the pelvic zone and leading to a bladder displacement and right ureteral ectasis.

[Bladder leiomyosarcoma. Report of a case]. / Leiomiosarcoma vesical. Aportación de un caso.

Presentation of a new case of vesical leiomyosarcoma, a malignant and uncommon tumour. Pre-operative diagnosis is practically impossible. Review of the literature and remarks on management approaches.

[Percutaneous renal surgery]. / Cirugía renal percutánea.

RATIONALE: Analysis of complications resulting from the renal percutaneous approach. METHODS: Between 1990 and 1996, 175 percutaneous surgical procedures were performed by our group. In 69.2% cases, the reason was a lithiasic condition. We also carried out: 35 endopyelotomies, 12 renal cyst resections, 4 stenosis of uretero-ileal anastomosis, 2 diagnostic nephroscopies and 1 pyelic tumour resection. RESULTS: Total rate of complications was 22.2%. Mortality was 0.5% (one case). Surgery had to be terminated in 13 cases for different reasons. Blood transfusions were required in 9 cases. 3 cases of route perforation required extended maintenance of nephrostomy. Infectious problems developed in 9 cases. There were also 2 renocutaneous fistula, one renocolic fistula and one pneumothorax. No significant differences were found between the total number of complications and the type of treatment carried out. There is however a relationship between the lithiasic condition and the haemorrhagic complications and also with the failure of the approach. There are no significant differences between the number of complications and other variables such as age, sex, side, calix approached or duration of surgery. CONCLUSIONS: The percutaneous approach to the kidney can be considered as a technique with a low morbidity-mortality ratio.

[Testicular epidermoid cyst]. / Quiste epidermoide testicular.

Epidermoid cysts are benign tumours that can affect testicles. Incidence is rare, having been described until now in less than 200 cases. Contribution of one study case of testicular epidermoid cyst and discussion of issues on histogenesis, ultrasound diagnosis and therapy approaches.

[Bilateral testicular microlithiasis]. / Microlitiasis testicular bilateral.

OBJECTIVE: To report an uncommon case of testicular microlithiasis that was incidentally discovered. METHODS/RESULTS: A case of bilateral testicular microlithiasis in an 8-year-old boy that presented with a left scrotal cystic mass is described. Testicular microlithiasis was discovered on ultrasound evaluation. CONCLUSIONS: Bilateral testicular microlithiasis is a rare condition that requires control follow-up of tumor markers and by ultrasound since this condition has been associated with tumors.

Improvement of the nutritional condition with hypocaloric peripheral parenteral nutrition (HPPN) in the immediate postoperative period of elective abdominal surgery.

Thirty-one patients scheduled for elective surgery for non-malignant abdominal disease were randomized during the first five postoperative days to two different schedules. Group I received water, electrolytes and glucose. Group II received a standard solution containing crystalline amino acids (3.8 g/l), xylitol (25 g/l) and sorbitol (25 g/l), accounting for a total of 900 cal/day. Evaluation was made with clinical, anthropometric and biochemical parameters. Among others, the following significant differences were observed at the end of the study: retinol bound protein: in group I, 4.25 +/- 1.3 and in group II, 5.38 +/- 1.53 (p less than 0.05); prealbumin: in group I, 18.7 +/- 6.24 and in group II, 24.51 +/- 7 (p less than 0.05). The significantly higher values of short-life plasma proteins observed in group II indicate that with HPPN a higher synthesis of visceral protein is promoted. These data demonstrate that HPPN improves the nutritional state during the postoperative period.