[Vesicourethral dysfunction in the acquired immunodeficiency syndrome (AIDS)]. / Disfunción vesicouretral en el síndrome de inmunodeficiencia adquirida (SIDA).

OBJECTIVES: Ten patients with AIDS and voiding disorders were assessed to determine the most common type of lower urinary tract dysfunction and its possible usefulness in detecting neurological disease. METHODS: A complete urodynamic evaluation was performed. RESULTS: The most common symptom was urge incontinence and the most common urodynamic finding was detrusor-external sphincter dyssynergia. Of the 5 patients found to have a neurological disorder, only 3 had demonstrable functional disorder of the lower urinary tract (2 patients had detrusor hyperreflexia: one of them had a history of encephalopathy from HIV and the other patient had polyneuritis; the third patient had myelitis and a urodynamically diagnosed sympathetic decentration. CONCLUSIONS: Knowing the functional disorders of patients with AIDS can avoid complications and improve patient quality of life. Furthermore, it can be useful in detecting an existing neurological lesion or one that may develop in the future.

[Endoscopic myocapsulotomy. Evaluation of the short-term clinical and urodynamic results]. / Miocapsulotomía endoscopia (MC). Evaluación de los resultados clínicos y urodinámicos a corto plazo.

Clinical and urodynamic evaluation of a series of 35 patients aged between 49 and 85 years. Clinical symptoms presented post-miocapsulotomy reduction both in obstructive and irritative signs and symptoms in 97.2% and 91.6% cases, respectively. Likewise, a decrease in peak flow and peak flow percentile was shown in 80.5% and 80% of cases, respectively. Vesical instability was seen in 90.9% and 55.5% of cases in pre- and post-operative studies respectively. An statistically significant post-operative drop (p < 0.05) in the detrusor's peak pressure during miction, (76.6 vs. 56 cm H2O), was confirmed. From our results it may be concluded that MC is a useful surgical technique in the treatment of prostatic obstruction, with the advantage versus other techniques that very frequently it preserves the proximal urinary continence mechanism and the sexual sphincter.

[Renal carcinoma with tumor embolism of the supradiaphragmatic inferior vena cava: therapeutic alternatives and review of the literature]. / Carcinoma renal con trombo tumoral en vena cava inferior supradiafragmática: opciones terapéuticas y revisión de la literatura.

We report a case of a man with a left renal cancer and vena caval thrombus extending to the right atrium, that was not possible to remove because infiltration of the posterior plane was detected intraoperatively. The patient was rehospitalized for intractable haematuria. He underwent selective embolization of the left renal artery with ethanol and coil. There were no complications and the patient is well seven months after the procedure. We review the literature on the diagnostic and therapeutic options in such cases. We can conclude that it is necessary to know the exact stage of the primary cancer in order to choose the best treatment. MRI or dynamic CT should be utilized to determine the presence of infiltration of adjacent structures or distant metastasis. Radical nephrectomy and the removal of the caval thrombus afford the only possibility of survival in these patients.

[Bladder amyloidosis in a female patient with suspected bladder carcinoma]. / Amiloidosis vesical en una paciente con sospecha de carcinoma vesical.

We report on a patient with a long history of rheumatoid arthritis who consulted for intense hematuria that was initially ascribed to carcinoma of the bladder. Subsequent patient evaluation, however, disclosed amyloidosis of the urinary bladder. The literature on amyloidosis of the urinary tract is reviewed. A detailed analysis of the biopsy specimens taken from a lesion that looks like a bladder carcinoma may disclose other pathologies such as amyloidosis of the urinary bladder.