Priapism of the clitoris.

Priapism of the clitoris is a rare entity. A case of painful priapism is reported in a patient who had previously suffered a radical cystectomy for bladder carcinoma pT3-GIII, followed by local recurrence in the pelvis. From a symptomatic point of view she showed a good response to conservative treatment (analgesics and anxiolytics), as she refused surgical treatment. She survived 6 months from the recurrence, and died with lung metastases. The priapism did not recur. The physiopathological mechanisms involved in the process are discussed and the literature reviewed.

[Blind bifid ureter associated with duplicity and contralateral vesicoureteral reflux]. / Uréter bífido ciego asociado a duplicidad y reflujo vesicoureteral contralateral.

We report on a pediatric patient who was evaluated for recurrent episodes of urinary tract infection. Evaluation by IVP, cystography and retrograde ureteropyelography revealed a complete ureteral duplicity, grade II vesicoureteral reflux in the lower half of the left kidney and a blind bifid ureter arising at the distal third of the right ureter. This is an uncommon condition (about 150 cases have been reported) difficult to diagnose if undetected by conventional radiological evaluation and retrograde ureteropyelography may be required. It may be associated with urological or other types of malformations. It is generally asymptomatic and with scant consequences, thus treatment is initially conservative. Surgical excision of the blind bifid ureter is warranted only when complications present. In the present case, prophylactic antibiotic therapy was instituted. At one year follow up, the patient is asymptomatic and urine cultures are negative.

[Male XX-syndrome]. / Männliches XX-Syndrom.

Described in this paper is a patient, aged eleven years and eight months, with micropenis, dorsal prepuce, and rugous, partially bifid scrotum. FSH and LH values below normal were obtained from hormonal investigation. LH-RH stimulation was followed by retarded FSH response of moderate intensity, while the LH profile was moderately strong. Cytogenetic tests revealed the presence of 25 per cent of female sex chromatin. The karyotype was 46 XX. The patient did not have internal female genital organs, and his gonads were of testicular appearance. Histologically, both testicles exhibited tubules with primitive germinal cells and Sertoli cells. An inconspicuous number of Leydig cells was recorded from the interstitium.