[Simplified Ramírez urethropexy in the treatment of genuine stress urinary incontinence in women. Multicenter study of clinical and urodynamic results]. / Uretropexia simplificada de Ramírez en el tratamiento de la incontinencia urinaria de esfuerzo genuina en la mujer. Estudio multicéntrico sobre los resultados clínicos y urodinámicos.

OBJECTIVES: To evaluate the clinical and urodynamic data of a multicenter study on female urinary stress incontinence undergoing surgical repair with the Ramírez simplified urethropexy. METHODS: Clinical, urodynamic and videocystographic data were analyzed in a multicenter series of 340 female patients with urinary stress incontinence (mean age 51.7 +/- 9.7 years) before and after the Ramírez urethropexy technique (mean follow-up 21.7 months). RESULTS: Post surgical urinary continence was 78.4%. Cystocele repair was demonstrated in 57.7%. Urge incontinence decreased in 17.1%. Daytime frequency statistically significantly decreased in 19%. Urinary obstructive symptoms increased in 19.3%. Bladder instability significantly decreased posturethropexy. Peak urinary flow rate and mean urinary flow rate diminished in 65% and 59%, respectively. Postvoiding residual urine increased significantly. No statistical correlation between posturethropexy continence and videocystographic bladder neck morphology was observed. CONCLUSIONS: The clinical and urodynamic data obtained in our series indicate that the Ramírez urethropexy technique, a simple and fast procedure, may be considered an alternative treatment in female urinary stress incontinence.

[Single metastasis of renal adenocarcinoma in contralateral adrenal gland]. / Metástasis única de adenocarcinoma renal en suprarrenal contralateral.

Presentation of a 63-year old female patient with single metastasis in right suprarenal gland from a simultaneous contralateral renal adenocarcinoma. The approach used was left nephrectomy and right suprarenalectomy. Two years after surgery, the patient is alive and shows no evidence of relapse. The extreme rarity of this finding is emphasized, and clinical, diagnostic, therapeutic and prognostic aspects are commented after reviewing the relevant literature.

[Retroperitoneal abscess: analysis of 26 cases]. / Absceso retroperitoneal: análisis de 26 casos.

Herein we present the experience of our hospital, which spans a period of 10 years, in the diagnosis and treatment of retroperitoneal abscess. The clinical features, origin and localization of the abscesses are described. We underscore the diagnostic value of ultrasound (US) and computerized tomography (CT) which afford a sensitivity of 86.3% and 100%, respectively. An increased incidence of abscess from gram-positive bacteria was observed in i.v. drug addicts.

[New classification of vesicoureteral reflux]. / Nueva clasificación del reflujo vésicoureteral.

Five illustrative cases of vesicoureteral reflux, of different age and sex, are described. All patients were submitted to urodynamic evaluation. A new classification based on the underlying cause is purported. Ureterovesical reflux may be passive or active. The latter type may be involuntary, voluntary or caused by abdominal pressure. In our view, this new classification could be useful in the management of vesicoureteral reflux.

[Cutaneous and gynecologic metastases disclosing renal-cell carcinoma: the diagnostic and therapeutic implications]. / Metástasis cutáneas y ginecológicas reveladoras del carcinoma de células renales: implicaciones diagnósticas y terapéuticas.

The spread of is uncommon renal cell carcinoma to the female genital system it is even more uncommon to observe metastasis or its symptoms or signs, masking or preceding the clinical manifestations of the primary lesion. In the course of nephrectomy due to renal tumor, the early ligation of the gonadal vein during the control maneuvers of the vascular pedicle can reduce the risk of posterior genital metastasis. Similarly, the skin is an uncommon site of metastasis. The appearance of cutaneous metastasis from renal cell carcinoma may precede the detection of the underlying tumor, although most of the cutaneous metastases are observed after the primary lesion has been detected. In patients with solitary skin metastasis and no evidence of spread to other organ systems, nephrectomy and excision of the metastatic lesion have permitted a survival of 35% at 5 years.

[The clinical and urodynamic aspects of enteroplasty]. / Aspectos clínicos y urodinámicos de las enteroplastias.

A study was conducted in 24 patients to determine the usefulness of the intestinal segments used in bladder replacement surgery. Continence and voiding were analyzed, particularly the more important functional symptoms of the lower urinary tract and the urodynamic behaviour of the intestinal reservoirs/conduits. The Bricker ileal conduits (8 cases) showed poor accommodation during the filling phase, making its use as a reservoir little advisable. In general, bladder augmentation (9 cases) with intestinal segments were shown to be useful reservoirs, but of limited capacity for voiding. The ileal reservoirs (7 cases) used for bladder substitution had, in general, compensated voiding, but with defects in the filling phase.

[Spinal cord compression by epidural metastases of urologic tumors]. / Síndrome de compresión medular por metástasis epidurales de tumores urológicos.

We report our experience of 5 consecutive cases of acute spinal cord compression from epidural metastasis of genitourinary tumors seen over a period of 14 months. Three patients developed paraplegia and the remaining two patients developed paraparesis of the lower extremities. Four patients underwent emergency decompression laminectomy and the remaining patient received spot radiotherapy to the metastatic vertebral lesion. The degree of neurologic deterioration and its rapid progression to the more severe forms have significantly influenced patient quality of life and survival. The literature is reviewed highlighting the epidemiological, physiopathological, clinical, diagnostic and therapeutic aspects of this condition.

[Penile metastases. Report of 3 new cases and review of the national literature]. / Metástasis peneanas. Aportación de tres nuevos casos y revisión de la literatura nacional.

Penile metastasis from primary tumors at other sites are extremely rare. To our knowledge, Alonso Gorrea reported the first case in the Spanish literature in 1980. Since then, 20 cases have been reported. Three additional cases of penile metastasis from tumors at other sites are described herein. The pathogenesis, symptoms, prognosis and treatment of this tumor type are discussed.

[Reliability of flowmetry as isolated urodynamic technique for the diagnosis of obstruction of the lower urinary tract in males]. / Fiabilidad de la flujometría como técnica urodinámica aislada en el diagnóstico de la obstrucción del tracto urinario inferior en el varón.

A retrospective evaluation of flowmetry as single urodynamic technique in the diagnosis of lower urinary tract obstruction was performed in 130 male patients. A statistically significant difference was observed for maximum urinary flow minus mean urinary flow in the presence of obstruction. Analysis of the morphology of the flowmetry curve could orient the diagnosis of the underlying condition. Measurement of post-micturitional residual urine appears to have no statistical value. The detrusor pressure/urinary flow test continues to be the most reliable in the diagnosis of male lower urinary tract obstruction.

[Benign hypertrophy of the prostate: pathogenic aspects]. / Hiperplasia benigna de la próstata (HBP): aspectos patogénicos.

In 106 male human cadavers the incidence of benign prostatic hyperplasia was found to be 63%. The present review confirmed age to be a determinant factor of the first order in the development of adenoma of the prostate. A delay in the presentation of BPH was observed in the cirrhotic alcoholic. Surprisingly, prostatic hyperplasia was not observed in those who had died from genitourinary, gastric or malignant hematologic diseases. No evidence of BPH was observed in 68.4% of patients who had died of cancer.

[Clinical and urodynamic results of the treatment of bladder instability with intravaginal/intrarectal electric stimulation]. / Resultados clínicos y urodinámicos del tratamiento de la inestabilidad vesical con estimulación eléctrica intravaginal/intrarrectal.

Twenty-six male and female patients with urinary incontinence due to vesical instability underwent intravaginal/intra-rectal electrostimulation therapy. Positive clinical results were achieved in 65.3% of the cases. During subsequent urodynamic study, 80% of these cases showed absence of vesical instability. Based on these results, intravaginal/intra-rectal electrostimulation would constitute an option for the treatment of urinary incontinence due to vesical instability.