[Xanthogranulomatous pyelonephritis in renal allograft. Report of a case and review of the literature]. / Pielonefritis xantogranulomatosa en un aloinjerto renal. Presentación de un caso y revisión de la literatura.

Clinic report case of a kidney-transplanted female who, after one year of normal functioning, developed xantogranulomatous pyelonephritis in the renal allograft. Clinical presentation was mesorenal tumoration causing pyelocaliecstasis, which coincided with a progressive decline of renal function due to interstitial rejection. Diagnosis by eco-doppler imaging, CAT, arteriography, renogram and descending pyelography were non-specific in relation to the process benignant or malignant nature. Surgical examination with obtention of biopsy was not conclusive with regard to diagnosis and so, during a second surgery, transplanctectomy was chosen. The histological examination showed that the expansive process of the allograft corresponded to a case of xantogranulomatous pyelonephritis. After reviewing the existing literature, only 4 cases were found reporting this rare condition in a renal allograft.

[Ureteral obstruction caused by periureteral venous dilatation secondary to infrarenal caval obstruction]. / Obstrucción ureteral por dilatación venosa periureteral secundaria a obstrucción de la cava infrarrenal.

Presentation of a case report of a female patient with single right kidney and background of left nephrectomy 21 years earlier due to hypertension who presented to the clinic after an episode of oliguria with lower limbs oedema and renal failure. Renal ultrasound evidenced moderate hydronephrosis, and backward pyelography showed medialization and lumbar ureter compression. CAT examination confirmed the ureteropyelocalycectasis as well as the reduction of the infrarenal lower cava vein to a fibrous cord with internal calcification. Axillary cavography and venography through both femorals demonstrated absence of the infrarenal cava vein segment and existence of a large replacement venous network. During surgery it became evident that the latter was displacing a retrovenous right lumbar ureter medially. Ureterolysis and ureter section with transposition, and termino-terminal anastomosis were performed. The morphological and functional results were excellent with recovery of the renal function (normal serum creatinine) which is still maintained after 7 years follow-up. As a consequence of this case, a review was made of different cava vein anomalies with repercussion in the urine excretory tract.

[Clinical impact of idiopathic bladder instability]. / Repercusiones clínicas de la inestabilidad vesical idiopática (I.V.I.).

Idiopathic vesical instability (I.V.I.), defined as the detrusor's spontaneous contraction during vesical filling or at its end, with a pressure higher than 15 cm H2O, is a urodynamic concept of unknown origin related to clinical disorders such as urinary incontinence, urgency-frequency syndrome, vesicoureteral reflux, repeat urinary infections, upper urological diseases due to pseudo-obstruction and morphological changes in vesicourethral X-rays. From January 1988 to January 1994, 2500 patients have been urodynamically examined. In 24% cases the diagnosis arrived at was vesical instability, 72% of them being I.V.I. I.V.I. was present as single diagnosis in 53% of prostate post-surgical incontinence, 71% of enuresis, 11% of clinically labelled stress incontinence, 46% of non-subsidiary incontinence, 16% of patients examined for prostatism, 55% of vesicoureteral reflux and 59% of repeat urinary infections.