Vía intrasinusal de abordaje al hilio renal, un momento EUREKA de la investigación anatómica quirúrgica urológica española / Intrasinus journey to kidney disease, a EUREKA moment of Spanish urological surgical anatomical research

La investigación histórica nos ha permitidorevisar y mostrar documentalmente por la bibliografíael autor de la primera descripción de la via intrasinusalpara el acceso al hilio renal como estrategia de accesoa la litiasis renal. Esta nueva via descrita y publicadapor M. Serés supuso un cambio de paradigma en lacirugía abierta de la litiasis renal. Queremos resaltarque la investigación anatomo-quirúrgica urológica es-pañola con las investigaciones de Manuel Serés, signi-ficó una aportación singular y de enorme trascendenciapara la Historia de la Urología Internacional, cuyo valordebemos reivindicar con sus referencias indiscutibles yfehacientes.(AU)

Historical research has allowed us to re-view and document the author of the first description ofthe intrasinusal route for access to the renal hilum as astrategy for accessing kidney stones through the bibli-ography. This new route described and published byM. Serés represented a paradigm shift in open surgeryfor kidney stones. We want to highlight that the Span-ish urological anatomical-surgical investigation with theinvestigations of Manuel Serés, meant a singular con-tribution and of enormous importance for the History ofInternational Urology, whose value we must claim withits indisputable and reliable references.(AU)

[The diagnosis of prostate cancer dissemination]. / Métodos diagnósticos de la diseminación prostática.

Prostate cancer preferentially metastasizes to regional lymph nodes and bone. The incidence of dissemination has been reduced over the last years mainly due to the compost use of PSA. For this reason, the indication of complementary diagnostic tests has evolved with the aim of improving the diagnostic yield. Some of these techniques are currently under evaluation and may contribute in the close future to change the study of dissemination in the clinical practice. CT scan or MRI are the standard imaging studies for lymph node dissemination, whereas bone scan continues to be the routine test for bone dissemination.

Hemiscrotectomy with contralateral testicular transposition for scrotal cancer.

PURPOSE: Wide excision of scrotal tumors results in serious defects to such an extent that in some cases the contents of the scrotum cannot be preserved. We describe a hemiscrotectomy technique with transposition of the testis to the contralateral hemiscrotum that facilitates closure of the surgical wound and allows preservation of the testis. MATERIALS AND METHODS: Our procedure was used in 3 patients with scrotal neoplasia, including 2 with squamous cell carcinoma and 1 with extramammary Paget's disease. After excision of the hemiscrotum affected by the tumor, which includes all layers of the scrotal wall, the testis is transposed into the contralateral hemiscrotum through a slit made in the medial scrotal septum. The defect is easily closed by apposing the surgical wound edges. RESULTS: The 3 men were disease-free 8, 7 and 4 years after surgery, respectively. After intervention they remained pain-free. None had hydrocele or epididymitis secondary to placement of the 2 testes in the same hemiscrotum. CONCLUSIONS: In appropriate candidates this technique allows the scrotal defect to be easily reconstructed after tumor excision without any need for skin flaps or free skin grafts. The procedure makes it possible to preserve the scrotal content and perform more radical treatment since the scrotal wall is completely excised.