[Endoscopic cystolithotomy: hypogastric approach]. / Cistolitotomía endoscópica: acceso hipogástrico.

Vesical lithiasis is a relatively frequent problem, the solution of which has changed over the last few years driven by major technological evolution. Traditional open surgery has been outstaged by the new endoscopic techniques and extracorporeal lithotrity. Here, we present our endoscopic resolution protocol through a hypogastric puncture approach, using a conventional nephroscope, with or without the use of ultrasound. This technique has been applied to 39 patients obtaining a 97.4% success rate with minimal morbidity. This procedure is usually performed under local anaesthesia and ambulatory, using an urethrovesical catheter for 1 to 2 days. This approach offers certain advantages over the one through the urethra due to the difficulties of passage through the latter, and the inconvenience of working within a relatively narrow and rigid duct. It is faster and more efficient than extracorporeal lithotrity especially in the presence of very hard or very numerous calculi and, if necessary, can be complemented immediately with a prostate transurethral resection. In summary, this is a simple, efficient and safe technique, and it has become our choice therapy to resolve a vesical lithiatic condition in males.

[Rescue of infected penile prosthesis: initial experience with prosthesis conservation]. / Rescate de prótesis peneana infectada: experiencia inicial con conservación de la prótesis.

Fitting a penial prosthesis has become an effective procedure to treat sexual impotence. However, its main complication, infection, remains a relatively frequent problem which forces the implant removal with the resulting treatment failure. This paper summarizes our early experience in 4 patients with infected penial prosthesis, who were treated by correcting the patient's general status, adequate antibiotic treatment, and deep and regular curing of the infected area. In these 4 patients, we managed to preserve the implant, achieving an adequate functional and cosmetic result. The paper discusses the pathophysiological mechanisms which would explain these improvements and points to the eventual indications and contraindications of the treatment. Finally, a recommendation is made to use this treatment with caution since our experience was still preliminary.

[Treatment of priapism with phenylephrine]. / Tratamiento del priapismo mediante fenilefrina.

Pathological erection may be ascribed to different causes and its treatment represents a challenge to the attending urologist. For the past 3 years we have utilized intracavernous phenylephrine to treat this condition. Our success rate is 93.1%, with detumescence achieved between 30 sec to 15 min. No complications have been observed and the responders have referred no changes in their sexual activity. We therefore advocate its use before recurring to more aggressive maneuvers.