[Spontaneous extraperitoneal bladder perforation in an elderly patient with genitalia prolapse]. / Rotura vesical espontánea en paciente senil con prolapso genital.

There are many etiologic reasons which explain the bladder perforation. Bladder injuries happen most commonly in poli-traumatisms (traffic accident), blunt trauma, penetrating injury and iatrogenic injury (surgery, laparoscopic...). However, there is not always a vigorous, direct, extern and blunt agent causing the rupture. In the case reported the extraperitoneal bladder rupture started after a smooth perineal injury caused when the patient seated down. The patient already suffered from a cystocele III/IV plus uterine prolapse for a long time ago.

Rotura vesical espontánea en paciente senil con prolapso genital / Spontaneous extraperitoneal bladder perforation in an elderly patient with genitalia prolapse

Son múltiples y diversas las causas etiológicas de la rotura vesical. Los politraumatismos (accidentes de tráfico), el traumatismo directo abdominal, cerrado o abierto, y las lesiones y atrogénicas (cirugía abierta, endocirugía, cateterismo uretral) figuran entre las más frecuentes; sin embargo, la rotura vesical no siempre exige para su producción un enérgico, violento, directo y evidente agente externo que la provoque. En el caso que a continuación se comunica, la rotura vesical extraperitoneal tuvo su origen en un leve traumatismo perineal ocasionado al sentarse la paciente , la cual presentaba y padecía desde mucho tiempo atrás un cistocele grado III/IV acompañado de prolapso uterino (AU)

There are many etiologic reasons which explain the bladder perforation. Bladder injuries happen most commonly in poli-traumatisms (traffic accident), blunt trauma, penetrating injury and iatrogenic injury (surgery, laparoscopic…). However, there is not always a vigorous, direct, extern and blunt agent causing the rupture. In the case reported the extraperitoneal bladder rupture started after a smooth perineal injury caused when the patient seated down. The patient already suffered from a cystocele III/IV plus uterine prolapsed for a long time ago (AU)

[Flowmetry analysis in patients undergoing transurethral resection of the prostate for BPH]. / Análisis flujométrico en pacientes sometidos a RTU de próstata por HBP.

Transurethral resection (TUR) is the most frequent surgical treatment for symptomatic benign prostate hyperplasia (BPH). Prostate size is a significant factor for choosing TUR versus prostate adenomectomy. Analysis of flowmetry results obtained with TUR in 203 patients, based on weight of resected prostate tissue. Flowmetry was performed prior to TUR and prostate size was estimated with transabdominal ultrasound. Prostate tissue was weighed after TUR and a new flowmetry was performed 6 months after treatment. Mean weight of resected tissue was 31.34 g. When all flowmetry parameters analyzed pre-and post TURs were compare, there were significant differences (p < 0.001). Increased maximum flow (Qmax) and increased mean flow (Qmed) occurred in 91.7% and 96.31% patients, respectively. Mean increase of post-surgical Qmax was significantly higher (p > 0.01) in patients with Qmax prior to surgery lower than 8 ml/s. No significant correlation was demonstrated between prostate volume measured by ultrasound or resected prostate tissue and increased post-surgical Qmax. TUR improves flowmetry parameters, mainly in patients with pre-surgical Qmax lower than 8 mL/s. Extensive prostate resection does not appear to improve the flowmetry results obtained with a sufficient functional TUR.

[Primary mucinous adenocarcinoma of the prostate]. / Adenocarcinoma mucinoso prostático primario.

Contribution of a new case of prostatic mucinous adenocarcinoma of primary origin. Diagnosis was established by histochemical techniques alcian blue, PAS and alcian-PAS) processing the fragments from the prostate transurethral resection (PTUR). Neither the existence of extraprostatic tumoration, local infiltration, or metastasis was recognized. No correlation between preoperative prostatic acid phosphatase (PAP) (50) and prostatic specific antigen (PSA) values (3ng/m) was evidenced. After radical prostatectomy both markers remain undetected one year after surgery.