Torsión testicular: ¿qué sutura utilizar? / Testicular torsion: wich type of suture must be used?

Presentamos un caso de torsión testicular izquierda ocurrida cuatro meses después de un cuadro similar homolateral en el que se realizó detorsión y fijación bilateral de ambos testículos. La orquidopexia previa se realizó con seda 3-0 y fijación transeptal del testículo contralateral. El antecedente de orquidopexia bilateral no debe influir en el diagnóstico diferencial en el escroto agudo. La fijación creemos que debe realizarse con sutura irreabsorbible en tres localizaciones entre el testículo y el músculo dartos, y se debe realizar exploración del hemiescroto contralateral (AU)

[Testicular torsion: which suture should be used?]. / Torsión testicular: qué sutura utilizar?

We report a case of left testicular torsion four months after a similar homolateral case in which we did detorsion and bilateral fixation of both testicles. The antecedent orchiopexy was accomplished using 3-0 silk and transseptal fixation of the contralateral testicle. A history of bilateral orchiopexy should nor interfere with diagnosing torsion in the acute scrotum. We recommend the use of nonabsorbable suture material joining the testis to the dartos muscle in 3 locations and the contralateral hemiscrotum must be explored.

[Penile fracture involving cavernous bodies and urethra]. / Fractura de pene con afectación de cuerpos cavernosos y uretra.

Reports on fracture of the penis are scarce in the spanish urological literature and in most cases injury appear limited to the corpora cavernosa. In this report a case of rupture of both corpora cavernosa and the urethra during sexual intercourse is presented. Early surgical treatment rendered good results. A literature review on currently recommended diagnostic and treatment practices is presented.

[Current overview of the treatment of postmyelomeningocele neurogenic bladder]. / Panorama actual del tratamiento de la vejiga neurogénica postmielomeningocele.

OBJECTIVE: The present article reviews the current therapeutic modalities for neurogenic bladder secondary to myelomeningocele. METHODS: The procedures utilized in the treatment of neurogenic bladder are described. The results achieved by the artificial urinary sphincter in 43 patients are presented. RESULTS: Most of the patients were 8 to 20 years of age at the time the artificial urinary sphincter was implanted. A complementary surgical procedure was required in 11 patients and 10 have been included in the program of intermittent catheterization. Few complications have been observed. CONCLUSION: The implantation of an artificial sphincter can enhance the quality of life of incontinent patients that meet the appropriate clinical and urodynamic criteria.

[New report of epididymal adenomatoid tumor. Infrequent pathology]. / Nueva aportación de un tumor adenomatoide de epididimo. Una patología poco frecuente.

Case report of a 42-year old patient with an epididymal adenomatoid tumour found after a three-month history of increased left hemiscrotum and scrotal discomfort. Definite diagnosis was arrived at following surgical exeresis and pathoanatomical study. The etiopatogenesis, clinical presentation and management are all analyzed. Since urological incidence is very low within intrascrotal processes, we believe it is important to understand the condition so that a differential diagnosis from other inflammatory processes can be established; also the convenience of a much more aggressive attitude in scrotal diseases is restated due to the low morbidity of this type of surgery.

[A fibroepithelial polyp of the ureter. A report of 2 new cases]. / Pólipo fibroepitelial del ureter. Aportación de dos nuevos casos.

Primal neoplasias of the ureter are very rare and account for less than 1% of all genitourinary tumours. Only 20% of them are benign, and the fibroepithelial lineage is the more frequent. We contribute two cases of fibroepithelial polyps of the ureter; a brief comment on the etiology of these lesions, the routine diagnosis procedures and current therapeutical options is presented. Due to breakthroughs in radiologic and endoscopic techniques for the upper urinary tract, a more precise pre-operative diagnosis of these lesions has been achieved as well as a more conservative therapy which avoids incorrect and unnecessary nephroureterectomies, so frequent in past times, considering the benign nature of this unusual pathology.

[Asymptomatic bladder paraganglioma. Report of a case]. / Paraganglioma vesical asintomático. Aportación de un caso.

Paragangliomas are tumors which arise from collections of neuroepithelial cells (paraganglion system) scattered throughout the body and rarely in the urinary bladder. In this work, we described a case of bladder paraganglioma, not suspected in a 64-year-old male who showed occasional total hematuria as only symptom. Cystoscopically, it was diagnosed as a rounded, not papillary tumor, one centimeter in diameter on account of which it was subjected to TUR. Confirmed the diagnosis, a partial cystectomy and a limited regional lymphadenectomy were subsequently practised. Posterior evolution, after a year, was completely favourable. The main clinicopathologic characteristics of this entity are revised.