[Urinary lithiasis secondary to indinavir in an HIV-positive patient]. / Litiasis urinaria secundaria a Indinavir en enfermo HIV positivo.

OBJECTIVE: Indinavir is a protease inhibitor used in the treatment of HIV with a lithogenic capacity as a urological side effect. The pathogenesis, diagnosis and treatment of indinavir urolithiasis are briefly reviewed. METHODS: A 37-year-old male, seropositive for HIV on treatment with indinavir, lamiduvine and zidovudine, consulted for colicky left lumbar pain, nausea, vomiting and dark urine for the past three days. RESULTS: Patient evaluation showed a nonfunctioning left kidney and ureterohydronephrosis of unknown origin. URS showed a yellowish, friable material with a mucinous appearance that occupied the entire lumen of the ureter. Fragmentation was achieved with the lithotriptor probe. Six months later the patient had fully recovered and was asymptomatic. CONCLUSIONS: The incidence of protease inhibitor-induced urolithiasis is increasing. This condition should be distinguished from uric acid calculi whose treatment will aggravate the indinavir urolithiasis.

[Tumor excision in renal oncocytoma: report of a new case]. / Tumorectomía por oncocitoma renal: aportación de un nuevo caso.

OBJECTIVE: To describe a case of renal oncocytoma that was treated by conservative surgery. METHODS: Herein we describe a 55-year-old patient with a preoperative suspicion of left renal oncytoma based on the findings of punction-aspiration biopsy and CT. The patient underwent tumor resection. RESULTS/CONCLUSIONS: Oncocytomas can present typical radiological features. Conservative surgery is a treatment option in carefully selected patients that usually achieves good results.

[The webbed penis. A report of a new case]. / Pene membranoso. Aportación de un nuevo caso.

OBJECTIVE: To report an additional case of webbed penis or penis palmatus, an uncommon malformation caused by alterations that occur during the embryonic development of the external genitalia. METHODS: A 15-year-old by consulted for penile curvature. He was diagnosed as having webbed penis and phimosis, and was submitted to surgery. RESULTS/CONCLUSIONS: Z-plasty and circumcision achieved excellent results. He had no erectile anomalies following surgery.

[An adrenal pseudocyst. A report of a new case]. / Pseudoquiste adrenal. Presentación de un nuevo caso.

We report the case of a female young woman with an incidental cystic lesion in the left adrenal gland while during a routine study by her gynecologist. The change of the aspect in the content of the lesion, its limit size and a not definitive study of punction went to the surgical act. This was made with preservation of both, adrenal and renal units. The pathological report was adrenal pseudocyst.

[Breast metastasis of bladder carcinoma: report of a case]. / Metástasis mamaria de carcinoma vesical: a propósito de un caso.

OBJECTIVE: To report a case of carcinoma of the bladder metastatic to the mammary gland. METHODS: A 72-year-old male with mammary gland metastasis secondary to a bladder carcinoma is described. The more common routes of tumor spread and the approach to these lesions are discussed. CONCLUSIONS: The prognosis for this type of lesion is poor except in a rare few.

[Management of female stress urinary incontinence in a specialized unit]. / Manejo de la incontinencia urinaria femenina de esfuerzo en una unidad especializada.

Urinary exertional incontinence is a very common condition which requires a broad range of therapeutic options being available. Besides, the creation of specialised units in urology is now evident, one of the areas involved being Urogynaecology. To focus the issue of female urinary incontinence, the following should be considered: to begin with, treatment is not imperative, patients must be evaluated on a case-by-case basis, the least invasive principle must prevail, diagnosis must be early, and it should be taken into account that primary and secondary prevention is both possible and necessary. A working pattern was designed accordingly, to sustain therapeutic decisions, which consisted in a detailed anamnesis, complete examination and application of an established diagnostic-therapeutic algorithm. Even so, a therapeutic, medical or surgical decision will be chosen and patients will be monitored at one, four and sixteen months after completion of treatment. To achieve good results in the management of female urinary exertional incontinence it is essential to include a large number of patients. In fact, the key is to establish a close collaboration with the gynaecologists.

[Gonadoblastoma in Swyer syndrome]. / Gonadoblastoma en un síndrome de Swyer.

Swyer's syndrome is a pure gonadal dysgenesis with female external genitalia. A likely complication is the appearance of tumour's dysgenetic gonads. This paper studies a case report of gonadoblastoma in a female patient with this syndrome.

[Complications of immunotherapy with BCG. Report of a case with retractile bladder]. / Complicaciones de la immunoterapia con BCG. A propósito de un caso de vejiga retráctil.

OBJECTIVES: We report a case of contracted bladder following BCG immunotherapy to prevent recurrence of a superficial bladder carcinoma. Other possible complications and their prevention are also discussed. METHODS: The patient had extreme contracted bladder and marked bilateral ureterohydronephrosis that required cystectomy and bladder substitution. The histopathological examination revealed detrusor muscle fibrosis without inflammation. RESULTS: Surgery achieved good results and the patient is disease-free 5 months postoperatively. CONCLUSIONS: The major complication that must be avoided is absorption following traumatic catheterization. Recognizing the early symptoms, particularly cystitis, together with adequate and early treatment of the localized effects can significantly reduce the incidence of severe toxicity.

[Oncocytic cell tumor. Problems, diagnosis, therapy]. / Tumor de células oncocíticas. Problemática, diagnóstico-terapéutica.

Renal oncocytoma is an uncommon tumor. At least 203 such cases have been reported. This urologic condition represents a diagnostic difficulty and because its natural history has not been elucidated, its treatment remains a controversy. Two recent cases of renal oncocytoma seen at our Urology Service prompted us to review the literature and analyze the diagnostic methods, therapeutic approach and its prognosis.

[Immediate surgical complications after 270 renal transplants. Experience and results]. / Complicaciones quirúrgicas inmediatas tras 270 trasplantes renales. Experiencia y resultados.

The present study reports on the early surgical complications observed in 270 renal transplants performed from 1978-1987. A total of 34 (12.5%) surgical complications were observed in the early postoperative period (1 to 6 weeks posttransplant). Among the most prevalent were postoperative hemorrhage, most of which were ascribable to blood coagulation disorders from heparin administration necessary to perform hemodialysis in these patients, and thrombus formation during the initial stages of our experience. Ten patients had urinary fistulas that were resolved in different ways. We advocate performing pyelo-pyelic anastomosis to the excretory tract whenever possible because of the good results achieved with this procedure.