[Treatment of stenosis in uretero-intestinal anastomosis]. / Tratamiento de las estenosis en las anastomosis uretero-intestinales.

UNLABELLED: We report our experience in the treatment of uretero-enteric anastomotic strictures. Our incidence in this complication is 3.8% in orthotopic bladder substitution and 8.3% in ileal conduict. MATERIAL AND METHODS: We have treated this complication in 6 patients with orthotopic bladder substitution and 4 with ileal conduict. We tried to perform a dilatation with a high pressure balloon and to place a Double-J catheter. RESULTS: In 4 cases we could not introduce the guidewire through the stricture because there was a total stop. In the others 6 cases, one is doing well without Double-J, another one did not tolerate the catheter and we performed an open surgical reanastomosis, 2 kept the catheters until their death due to metastases and the other two continue alive with their catheter periodically replaced. CONCLUSIONS: The direct uretero-enteric anastomoses present less stenoses risk. Endourological techniques should be the first option in treatment of these patients.

Tratamiento de las estenosis en las anastomosis uretero-intestinales / Treatment of uretero-enteric anastomotic strictures

Presentamos nuestra experiencia en el tratamiento de las estenosis en las anastomosis uretero-intestinales. Nuestra incidencia en esta complicación en las sustituciones vesicales ortotópicas es del 3,8 por ciento, y en las ileostomías cutáneas del 8,3 por ciento. MATERIAL Y MÉTODOS: Hemos tratado esta complicación a 6 pacientes con plastia de sustitución vesical ortotópica y 4 con ileostomía cutánea. Intentamos realizar una dilatación de la estenosis con balón de alta presión y dejar una sonda doble J. RESULTADOS: En 4 casos no logramos cateterizar la estenosis por existir un stop completo. De los otros 6 pacientes uno está bien sin doble J, otro no toleró la sonda y tuvimos que realizar una reanastomosis abierta, 2 mantuvieron la sonda hasta su fallecimiento por metástasis y otros 2 viven actualmente con sonda y cambios periódicos. CONCLUSIONES: Las anastomosis directas del uréter en el intestino tienen menos riesgo de estenosis. Las técnicas endourológicas deben ser la primera opción en el tratamiento de estos pacientes (AU)

[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.

[Polypoid cystitis in pregnant diabetic]. / Cistitis polipoidea en diabética embarazada.

Presentation of one case of a diabetic patient, who after 8 weeks pregnancy presented polypoid cystitis, with no prior background of vesical catheterism. The rarity of the case, as well as the clinical and pathoanatomical characteristic are commented.

[Treatment of urogenital tuberculosis with ofloxacin. Preliminary study]. / Tratamiento de la tuberculosis génito-urinaria con ofloxacina. Estudio preliminar.

Ofloxacin is a new fluoride quinolone which has been shown to be active both in vitro and in vivo against Mycobacterium tuberculosis. This prospective study presents the results obtained with a new protocol for the treatment of genito-urinary tuberculosis. The comparison drugs were Ofloxacin 200 mg every 12 hours for 6 months, Rifampicin 600 mg every 24 for 3 months and Isoniazid 300 mg every 24 hours for 3 months. The results, were clinically and microbiologically good. It is concluded that this new drug should be a valid alternative to the traditional therapy.

[Retroperitoneal liposarcoma]. / Liposarcoma retroperitoneal.

The paper presents a case of giant retroperitoneal liposarcoma treated in our unit. New diagnostic and therapeutic perspectives for such uncommon tumours are commented upon.

[Primary abscess of the psoas]. / Abscesos primarios de psoas.

We present in this paper a series of cases from our Service of primary abscesses in psoas. We consider the appearance of immunosuppressed patients as a relevant factor of its etiopathogenicity. We believe that a C.A.T. is the best diagnostic method. All three patients that underwent open surgery have had complications. The patients treated with percutaneous puncture has shown a favourable evolution.

[Renal adenocarcinoma thrombosis in vena cava]. / Trombosis de adenocarcinoma renal en vena cava.

We present two cases of renal tumour thrombosis in the vena cava, treated surgically in our Service. We comment on the clinical picture, the diagnosis, treatment and prognosis of this pathology. We emphasize the importance of C.A.T. in the diagnosis and stage evaluation, as well as the need to prevent pulmonary embolism by means of the placement of Adams clip type filters in the cava.

[Adenomatoid tumor of the albuginea testis]. / Tumor adenomatoide de albugínea testicular.

We present a rare case of adenomatoid tumour situated in the testicular albuginea. We comment on its treatment, which we are of the opinion should be conservative.

[Isolated angiomyolipoma of the kidney]. / Angiomiolipoma renal aislado.

We report on four cases of renal angiomyolipoma. Treatment was by conservative surgery in two cases, and regular control for the remaining two cases. The different diagnostic methods and therapeutic modalities are discussed.