[Infection for papillomavirus in the man. Current state]. / Infección por papillomavirus en el hombre. Estado actual.

The Virus of the Human Papiloma (HPV), classically he/she has been related with infections of sexual transmission and processes wicked oncologists of the feminine genital apparatus and with less frequency of the masculine one. The new technical diagnostics, based on molecular biology (by means of polymerase chain reaction), they help to a better epidemic approach, an improvement in the I diagnose viral, and a correct therapeutic focus. The object of this work is to revise the current state of the HPV from the points of view etiopathogenics, epidemic, clinical, diagnosis, therapeutic and preservative.

Infección por Papillomavirus en el hombre. Estado actual / Infection for papillomavirus in the man. Current state

El Virus del Papiloma Humano (VPH), clásicamente se ha relacionado con infecciones de transmisión sexual y procesos oncológicos malignos del aparato genital femenino y con menos frecuencia del masculino. Las nuevas técnicas diagnósticas, basadas en biología molecular (mediante reacción en cadena de la polimerasa), ayudan a una mejor aproximación epidemiológica, una mejora en el diagnostico viral, y un correcto enfoque terapéutico. El objeto de este trabajo es revisar el estado actual del VPH desde los puntos de vista etiopatogénico, epidemiológico, clínico, diagnóstico, terapéutico y profiláctico (AU)

The Virus of the Human Papiloma (HPV), classically he/she has been related with infections of sexual transmission and processes wicked oncologists of the feminine genital apparatus and with less frequency of the masculine one. The new technical diagnostics, based on molecular biology (by means of polymerase chain reaction), they help to a better epidemic approach, an improvement in the diagnose viral, and a correct therapeutic focus. The object of this work is to revise the current state of the VPH from the points of view etiopatogenics, epidemic, clinical, diagnosis, therapeutic and preservative (AU)

Fístulas urinarias: puesta al día / Urinary fistulas: an update

Las fístulas urinarias constituyen una patología poco frecuente en nuestra práctica diaria, si excluimos las vésico-vaginales. Se necesita, sin embargo, conocerlas para diagnosticarlas y tratarlas adecuadamente. De una forma bastante resumida ponemos al día el manejo de las fístulas uro-vasculares, urocutáneas, urodigestivas y uro-ginecológicas, repasando igualmente su etiología (AU)

[Urinary fistula: update]. / Fístulas urinarias: puesta al día.

The urinary fistulas are not a frequent problem in our urological rutinary work, being the vesicovaginal ones the most common. However, it will be necessary to know them to be able to diagnose and treat them in the best way. In this article we classificate the different urinary fistulas (uro-gynecologicals, uro-vasculars, uro-cutaneous and entero-urinarys), explaining the possible etiologies and the correct management.

Sustitución de prótesis de pene: 1990-1999 / Replacement of penile prosthesis: 1990-1999

OBJETIVO: Analizar la serie de pacientes sometidos entre los años 1990 y 1999 a sustitución de su prótesis de pene debido a la aparición de algún tipo de complicación. MATERIAL Y MÉTODOS: 85 pacientes fueron sometidos a implante, siendo utilizados 13 modelos diferentes de prótesis. En 15 de estos pacientes (17,64 por ciento) ésta tuvo que ser sustituida una vez o más. La edad media en el momento de la sustitución fue de 51,5 años. El acceso quirúrgico más frecuente fue el infrapúbico. RESULTADOS: Se realizaron en total 32 intervenciones de sustitución protésica. Las causas principales fueron: fallo mecánico (13 casos, 40,62 por ciento); infección (10 casos, 31,25 por ciento); y perforación de cuerpos cavernosos (cinco casos, 15,62 por ciento). No se observó incremento progresivo en la incidencia de complicaciones en relación con el número ordinal de la prótesis implantada. Mejores resultados globales: Mentor Mark II y AMS 700 Ultrex Plus. Actualmente sólo ocho (53,33 por ciento) de los 15 pacientes reimplantados hacen uso normal de su prótesis. CONCLUSIONES: Los pacientes sometidos a sustitución de su prótesis de pene son fuente potencial de complicaciones posteriores. Su conocimiento y correcto manejo es importante, de cara a una mejora progresiva en los resultados finales, (sobre todo si éstos -como en nuestro caso- no son aptos para el conformismo) (AU)

[Replacement of prosthesis of the penis]. / Sustitución de prótesis de pene: 1990-1999.

OBJECTIVE: To analyze the series of patients who underwent replacement of their penile prosthesis between years 1990 to 1999, due to any kind of complication. MATERIAL AND METHODS: 85 patients underwent implantation, 13 different prosthesis models being utilized. It was replaced (once or more) in 15 of these patients (17.64%). The mean age at the moment of the replacement was 51.5 years. The most frequent surgical approach was the infrapubic one. RESULTS: A total of 32 prosthesis-replacement interventions were carried out. The main causes were: mechanical failure (13 cases, 40.62%); infection (10 cases, 31.25%); and corpus cavernosum perforation (five cases, 15.62%). Progressive increase of complications incidence with regard to the ordinal number of the implanted prosthesis was not observed. Best overall results: Mentor Mark II and AMS 700 Ultrex Plus. At present day, only eight (53.33%) out of 15 reimplanted patients use their prosthesis with normality. CONCLUSIONS: Those patients who undergo replacement of their penile prosthesis are potential sources for later complications. Their knowledge and proper handling is important in order to a progressive improvement of the final results, (above all if--such as our case--these ones are not suitable for conformity).

[Is there a role for partial cystectomy in the treatment of infiltrating bladder cancer? (2nd part)]. / Tiene cabida la cistectomía parcial en el tratamiento del cáncer infiltrante de vejiga? (2a parte).

Experimental studies and the clinical course have shown that bladder cancer is confined to the bladder wall for some time, during which optimal treatment by complete surgical excision can be achieved. Failures are most often due to the presence of distant metastasis at the time of surgery and most patients invariably die although local and regional control of the tumor have been achieved. It is difficult to evaluate the benefits that neoadjuvant measures (radio and chemotherapy) contribute to surgery, basically due to the difficulty in classifying the tumor with precision. Preoperative chemotherapy in patients with less than a 40% likelihood of metastasis is unreasonable since 60% will not require it and will be unnecessarily exposed to the side effects of the cytostatic agents, which are not negligible. Furthermore, a considerable number of candidates to partial surgery have no metastasis at the time of diagnosis, therefore preoperative chemotherapy is not useful. It would be more reasonable to give chemotherapy postoperatively to those that are more likely to require it. Radiotherapy will not prevent tumor recurrence and is ineffective in carcinoma in situ. Furthermore, surgery is sufficiently aggressive in regard to the tumor and the possible dissemination to the lymphatics to require adjunctive measures with locoregional effects.

[Metastasizing adenocarcinoma of the colon in a patient with ceco-cystoplasty]. / Adenocarcinoma de colon metastásico en paciente portador de cecocistoplastia de ampliación.

Augmentation and substitution erocystoplastias are currently widely accepted techniques for the treatment of several benign and malignant diseases. Appearance of neoplasia on the various gut segments used after a latency period ranging from 5 to 25 years following initial surgery has been described. The paper presents one case of metastatic colon adenocarcinoma initially located in the region of ureteral reimplantation, in a patient with augmentation cecocystoplastia performed as a result of vesical retraction secondary to genitourinary tuberculosis. Appearance of this type of neoplasia in an increasing population, quite often young, compels the urologist to keep a tight watch. Endoscopic monitoring of the new bladder is the most effective diagnostic procedure. A once-a-year endoscopy after an interval as yet not definitely established, but which could be around 10 years after initial enterocystoplastia, seems advisable at least in cases at higher risk.

[Abscess of the seminal vesicle. Clinico-therapeutic review apropos of a case]. / Absceso de vesícula seminal. Revisión clínico-terapéutica a propósito de un caso.

Reporting the case of a patient diagnosed with an abscess of the seminal vesicle, treated successfully through parasacral transgluteal percutaneous aspiration lead by computerized axial tomography (CAT). This represents the first case in the literature of percutaneous access to the seminal vesicles through this route. CAT is an effective diagnostic test which makes non-surgical treatment for this type of abscess simpler. A review is made of the literature with regard to the etiology, diagnosis and therapy of seminal vesicle abscesses.

[Etiologic and diagnostic aspects of Peyronie's disease. Apropos of 42 cases]. / Aspects étiologiques et diagnostiques de la maladie de La Peyronie. A propos de 42 cas.

The authors present the results from a retrospective study conducted on 42 patients with Peyronie's disease. For each case, all possible etiological factors were investigated, such as family history, history of trauma, history of other collagenoses, of diabetes, and so on. These studies yielded results comparable to published data. Calcifications within the plaques were found on simple X-ray films in 10.8% of cases. Out of 20 radiological examinations of the corpora cavernosa that were performed, 80% demonstrated pathological processes. It was possible, in some of the cases, to measure echographically the plaque widths, while autophotography was useful in a small number of cases. We were more particularly concerned with sexual dysfunction, impotence, and premature ejaculation, which could be observed in 14 patients.

Appearance of gas in renal tissue after therapeutic embolization.

We present a case of therapeutic embolization in a patient with adenocarcinoma who demonstrated the presence of gas in the renal infarcted tissue on the second day. The pattern of air distribution was intravascular. There was no sign of abscess clinically or radiographically. To the syndrome of postembolization we add a new sign--the presence of postembolization air.

Prostatitis: are the gram-positive organisms pathogenic?

In 268 patients seen for sterility, sexual impairment or suspected prostatitis symptoms, first and midstream urine fractions, prostatic secretion and post-massage urine cultures as well as semen cultures and exfoliative cytologies of the first urine fraction and prostatic secretion were performed. Gram-positive bacteria were isolated in 160 cases. Of these, 111 (69.3%) had significant cultures (Meares and Stamey criteria). Nevertheless, when we repeated the study without previous therapy, the results could not be confirmed. This shows that Gram-positive bacteria do colonize urethra and/or prostatic ducts, but are not responsible for prostatic infection.