[Infrequent cause of bilateral obstructive uropathy]. / Una causa infrecuente de uropatia obstructiva bilateral.

Muscular haematoma of the straight muscles of the abdomen are very rare to observe and, although there is a possibility of the haematoma extending to the retroperitoneum, they very rarely cause oligoanuria by compression of the urinary tract. Presentation of one case of spontaneous haematoma of the straight muscles of the abdomen with urologic damage by ureteral compression inducing oligoanuria and bilateral ureterohydronephrosis.

[Leukemoid reaction and thrombocytosis in bladder sarcoma]. / Reacción leucemoide y trombocitosis en sarcoma de vejiga.

Presentation of one case of a patient with vesical sarcoma with sustained high white blood cells and platelets plasma levels over the course of the disease. In the absence of fever and with a persistently negative blood culture, the situation was rated as a leukaemoid reaction and thrombocytosis of para-renoplastic nature. A brief comment on the features and evolution of this para-neoplastic syndrome and the outcome of the patient with vesical sarcoma is included.

[Paratesticular rhabdomyosarcoma in children. Is retroperitoneal lymphadenectomy necessary in disease limited to the scrotum?]. / Rabdomiosarcoma paratesticular en niños. Es necesaria la linfadenectomía retroperitoneal en enfermedad limitada a escroto?

Between 1970 and 1993, five children with paratesticular rhabdomyosarcoma (PR) and age ranging from 3 to 10 years were treated by our group. Following radical orchidectomy and clinical staging, 4 were rates as Group I-IRS (completely resected local disease) and 1 in Group IV-IRS (distant metastasis). All patients in Group I underwent intensive chemotherapy with vincristine, actynomicin D and cyclophosphamide (VAC) for 18 months, while no case of retroperitoneal lymphadenectomy was performed. Currently, all patients are disease free with a mean follow-up of 8 years and 5 months. The single patient included in Group IV received radiotherapy (800 rads in abdominal field) and chemotherapy with VAC + prednisone (PDR), and retroperitoneal lymphadenectomy of residual masses was performed. The patient developed liver metastasis and died 20 months later. The purpose of this paper is to convey the reader our experience in the treatment of PR in children, making a special reference to the excellent prognosis when the disease is limited to the scrotum and recommending in such cases the use of intensive chemotherapy with VAC after performing radical orchidectomy.

[A vesicoileal fistula secondary to bladder cancer]. / Fístula vésico-ileal secundaria a cáncer de vejiga.

Exposition of one case of vesico-ileal fistula with atypical presentation and infrequent etiology, secondary to transitional cell vesical carcinoma. The incident is exploited to review the etiology of acquired enterovesical fistulae.

[Latex allergy in children with myelomeningocele. Incidence and associated factors]. / Alergia al látex en niños con mielomeningocele. Incidencia y factores asociados.

RATIONALE: The purpose of our work is to know the prevalence of allergies to latex in patients with myelomeningocele (MMC) and to evaluate any potential factors influencing its development. METHODS: The study included 100 children with mean age 7.5 +/- 4.8 years, diagnosed with MMC by skin tests and total and latex-specific IgE determination. The results were compared to those obtained in three "control" groups: atopic patients, patients undergoing their first operation and multi-operated patients. The relationship between the different variables analyzed was assessed using univariant and multivariant statistical studies. RESULTS: 29 were sensitized (15 symptomatic and 14 asymptomatic) and 8 doubtful. Results showed statistically significant (p < 0.05) differences for atopic and first operation groups and non significant differences for the multi-operation group. The multivariant study selected the followed as the most relevant variables: number of surgical interventions, total IgE levels in z units, ventricle-peritoneal by-pass carriers and atopy background. Also in the multivariant study, the following showed statistically significant results: age, Cums' number, inclusion in intermittent catheterism program and total IgE levels. Neither sex or familial background of atopy showed statistical significance. CONCLUSIONS: Allergy to latex in MMC patients is related to multiple antigen contacts, the numerous manipulations and operations undertaken throughout the patient's life plus a personal propensity to allergies. It is essential that this group should adopt certain standards to minimize contact with the antigen and undergo an allergological study so as to detect those who are sensitized, which in nearly half our series has not yet exhibited symptomatology in contact with latex utensils. All diagnostic and therapeutical procedures should be conducted in latex-free environments.

[PSA in women. Evaluation of its determination with polyclonal and monoclonal immunoassay]. / El PSA en mujeres. Evaluación de su dosificación mediante inmunoanálisis policlonal y monoclonal.

PSA concentrations were measured in 421 women. In a first group comprising 309 subjects, the assay was carried out with kits containing polyclonal antibodies (PPSA). In the second group with 112 women, the assays used kits containing polyclonal antibodies (PPSA) and kits containing monoclonal antibodies (MPSA), and results obtained with both assays were compared. In the first group PSA levels higher than 0.4 ng/ml were detected in 47.9%. In the second group concentrations higher than 0.4 ng/ml were detected in 52.7% when using PPSA versus 16.7% when using MPSA. The rate of PSA detectable levels in healthy women, with benignant and malignant conditions was 36.7, 42.1 and 84.4% for PPSA, and 16.7, 14.0 and 21.9 for MPSA. This study shows that it is possible to detect PSA levels in women, and that this is more frequent when using a polyclonal antibodies assay.

[Conservative approach in total multicystic renal dysplasia. Our experience]. / La actitud conservadora en la displasia renal multiquistica total. Nuestra experiencia.

Contribution of 14 patients with Unilateral Total Multicystic Renal Dysplasia treated with conservative criteria, with particular emphasis in the absence of clinical complications, as well as the natural tendency to involution of the affected organs. Five dysplastic kidneys disappeared in the ultrasound, 4 decreased in size, 3 remained the same and 2 have been removed. Review of the literature and discussion of all the reasons why nephrectomy was traditionally indicated, explaining the reasons why we support an expecting attitude.

[Spontaneous bladder rupture secondary to urinary tuberculosis]. / Rotura vesical espontánea secundaria a tuberculosis urinaria.

Atraumatic spontaneous vesical fracture is an uncommon occurrence. Here we present the case of a female patient with spontaneous vesical fracture secondary to urinary tract tuberculosis. A review of current literature showed another published case similar to ours. A brief comment is made on presentation signs and symptoms and picture evolution, as well as a discussion on the predisposing factors of spontaneous vesical fracture and its treatment.

[Ureteral endometriosis. Review of the literature]. / Endometriosis ureteral. Revisión de la literatura.

Ureteral endometriosis is an uncommon process. It should be suspected, however, in patients with known pelvian disease presenting urological sings and symptoms. It is important to establish early diagnosis which does not delay a conservative therapeutical approach, so as to avoid the progressive decline of renal function and, eventually, nephrectomy. Contribution of one case of extraluminar ureteral endometriosis fitting this hypothesis and review of the most appropriate etiology, sings and symptoms, diagnosis and therapeutical approach.

[Spontaneous perirenal hematoma secondary to hydronephrosis in pelvic kidney]. / Hematoma perirrenal espontáneo secundario a hidronefrosis en riñón pelvico.

Contribution of one case of Spontaneous Perirenal Haematoma (SPH) secondary to hydronephrosis accompanied by lithiasis in pelvic kidney. SPH can result from multiple causes, the most frequent ones being renal tumours, most particularly angiomyolipoma and hypernephroma. Hydronephrosis is an uncommon cause of SPH, and very few cases are described in the literature. The present paper addresses the diagnostic usefulness of the various radiological tests as well as the therapeutical approach to be followed.

[Tumor of the testicular vitelline sac in children: clinical course and treatment]. / Tumor del saco vitelino testicular en el niño: evolución y tratamiento.

Presentation of a review of 10 paediatric patients with tumour of the testis vitelline sack, to report our experience in the management of this pathology. Mean age was 20 months (14-32), and the interval of the study was from 1970 to 1994. After orchiectomy, 7 children were included in stage I, 1 in stage II, and 2 in stage III. Four underwent Retroperitoneal Lymphadenectomy. All patients in stage I are currently free of disease, with a mean follow-up of 132 months, regardless the type of treatment employed (vigilance in 2 cases, chemotherapy in 2, and chemotherapy plus Retroperitoneal Lymphadenectomy in 3). On the contrary, the 3 children with extratesticular disease died 15, 18 and 15 months after orchiectomy. In conclusion, we believe that patients included in stage I should undergo only a strict vigilance, based on the excellent prognosis of this group and the lack of differences between the survival time obtained with the various therapeutical approaches followed. On the other hand, patients with stage II or stage III disease should receive from the beginning chemotherapy, thus saving the Retroperitoneal Lymphadenectomy for the residual disease.

[Does transurethral resection cause metastatic dissemination of hormone treated prostatic cancer?]. / Produce la RTU diseminación metastásica en el cáncer de próstata tratado hormonalmente?

The evolution of non-metastatic prostate cancer treated with hormonal therapy does not appear to be affected by the performance of a transurethral resection (TUR) as a measure to expedite the common urinary tract. Of 82 patients followed for an interval ranging from 6 months to 15 years, 3 of 45 patients (6.7%) undergoing RUT experienced metastatic dissemination, while the same happened in 2 of 37 (5.4%) patients who did not undergo RUT, p being NS. The group of patients requiring RUT, however, experienced higher local progression rates, 22.2% vs 5.4%, a situation not ascribable to the RUT procedure but to the fact that such surgery was selectively indicated in neoplasias with larger tumoral mass.

[Impact of specific prostatic antigen on the rationalization of the use of bone gammagraphies in the follow-up of hormone-treated non- metastatic prostatic cancer]. / Impacto del antígeno prostático específico en la racionalización del consumo de gammagrafías oseas en el seguimiento del cancer de próstata no metástasico tratado hormonalmente.

Analysis of the evolution of 78 patients with hormonally-treated non-metastatic prostate cancer. During an average follow-up of 62.3 months, local clinical and metastatic progression in 14.1% and 7.7% cases, respectively, was observed. Overall, PSA detected progression of disease in 94.1% cases, with an anticipation which range between 4 and 52 months. Evidence of bone metastatic progression was confirmed in 2.1% of the 286 scintigraphies performed. Following analysis of results, by accepting their indication from a PSA level higher than 100 ng/ml, 97.9% would have been avoided, achieving a 100% sensitivity and 94.1% diagnostic efficacy.

[Urodigestive fistulae: the diagnosis and treatment of 76 cases]. / Fístulas urodigestivas: diagnóstico y tratamiento de 76 casos.

OBJECTIVES: Urodigestive fistulas are secondary complications of inflammatory, traumatic or neoplastic disease and can occasionally be difficult to diagnose, although the typical symptoms of pneumaturia and fecaluria should make the urologist and surgeon suspect the presence of a fistula, determine its etiology and location. The present study reviews our experience in the diagnosis and treatment of this pathology. METHODS: We reviewed the records of 76 patients with urodigestive fistula that had been diagnosed and treated over a period of 23 years. The form of presentation, usefulness of the diagnostic techniques and treatment options were analyzed. RESULTS: The location was vesicointestinal in 52 cases, rectourethral in 19, renointestinal in 4 and urethrointestinal in 1.

Secondary congenital megaprepuce.

We report a case of a 3-month-old boy with a megaprepuce presented since birth. Certain aspects of the aetiology, denomination, diagnosis and treatment are discussed. We compare our case with the three unique cases published in the literature.

[Wunderlich syndrome secondary to the rupture of an aneurysm of the renal artery. Review of the literature]. / Síndrome de Wunderlich secundario a rotura de aneurisma de la arteria renal. Revisión de la literatura.

We report a case of Wunderlich's syndrome secondary to spontaneous rupture of a renal artery aneurysm. Wunderlich's syndrome, also called spontaneous perirenal hematoma, may arise from several causes, the most common being renal tumors, particularly angiomyolipoma and hypernephroma. Spontaneous perirenal hematoma secondary to a ruptured renal artery aneurysm is rare and very few cases have been reported in the literature. We discuss the usefulness of the different noninvasive imaging techniques (US, CT and arteriography), our therapeutic approach and those advocated by others.

[Trigonocervicoprostatotomy]. / Trigonocervicoprostatotomía.

Endoscopic trigonocervicoprostatotomy incision has become a minimally aggressive alternative to surgical treatment of early benign prostatic hypertrophy (BPH). The present article analyzes its indications, advantages and disadvantages. We describe the technique utilized and report on the results achieved in 146 patients (mean age 62.7 years, mean follow-up 15.7 months). Clinically, the results were completely satisfactory in 78.1% of the cases, symptomatology improved in 15.7%, and 4.8% warranted a second procedure. The incidence of retrograde ejaculation was observed to be only 20.5%. With regard to the urodynamics, the preoperative mean maximum flow rate of 9 ml/sec. increased to almost 20 ml/sec. postoperatively. The results of urethral evaluation support the hypothesis of Turner-Warwick which ascribes the obstructive symptomatology in these patients to cervical dysfunction.

[Modification of the simplified Cobb-Radge and Raz techniques in the treatment of stress urinary incontinence. Description and results]. / Modificación de las técnicas simplificadas de Cobb-Radge y Raz en el tratamiento de la incontinencia urinaria de esfuerzo. Descripción y resultados.

Various surgical procedures have been described for correction of stress urinary incontinence (SUI) which have afforded different results. Modifications to these procedures have been made in an attempt to reduce morbidity and the operating time without detriment to the efficacy of the procedures. Herein we describe two procedures, the modified Cobb-Radge and Raz techniques, and report on the results achieved. In patients with no cystocele that had been submitted to the modified Cobb-Radge technique, we achieved 80.4% good results. In patients with significant cystocele, our modified Cobb-Radge technique and anterior colporrhaphy achieved a success rate of 80%, and we achieved good results in 88.3% of these cases with our modified Raz procedure.

[Appendico-vesical fistula secondary to acute appendicitis. Review of the literature]. / Fístula apendicovesical secundaria a apendicitis aguda. Revisión de la literatura.

Acute appendicitis, particularly pelvic, may cause a suppurative process that spontaneously drains to the bladder and an appendicovesical fistula may result. The pelvic appendix and the bladder may occasionally become fused in an inflammatory and necrotic focus, directly creating a fistula. A case of vesicointestinal fistula secondary to appendiceal pelvic peritonitis is described and the cases reported in the literature are reviewed.

[Urethral hemangioma. Description of a case and review of the literature]. / Hemangioma uretral. Descripción de un caso y revisión de la literatura.

OBJECTIVES: This study briefly reviews the histological types, clinical features, diagnostic and therapeutic aspects of urethral hemangioma, an uncommon benign vascular tumor. METHODS/RESULTS: A case of urethral hemangioma in a male patient with a long history of hematuria is described. CONCLUSIONS: Urethroscystoscopy is the most useful diagnostic technique in urethral hemangioma. Treatment is by transurethral resection, radical surgery, radiotherapy or selective arterial embolization depending on tumor location, number, size and patient condition. This tumor type frequently recurs.