[Urosepsis due to emphysematous cystitis]. / Sepsis urológica secundaria a cistitis enfisematosa.

Emphysematous cystitis is a rare infectious disease which diagnosis requires a high grade of suspicion in patients with compatible clinical symptoms, risk factors that make them susceptible, and a radiographic examination that confirm the suspicion. Patients usually have a favorable evolution with an early diagnosis and an appropriate management. We present a 75 years old diabetic patient with emphysematous cystitis that develops into an urosepsis treated in a conservative management.

Sepsis urológica secundaria a cistitis enfisematosa / Urosepsis due to emphysematous cystitis

La cistitis enfisematosa es una patología infecciosa rara cuyo diagnóstico requiere un alto grado de sospecha ante una clínica compatible en pacientes con factores de riesgo que le hagan susceptible, y unos datos radiográficos que confirmen dicha sospecha. Habitualmente evolucionan bien con un diagnóstico precoz y un manejo adecuado. Presentamos un caso de cistitis enfisematosa en un paciente de 75 años, diabético, que evoluciona a un estado séptico tratado de forma conservadora (AU)

Emphysematous cystitis is a rare infectious disease which diagnosis requires a high grade of suspicion in patients with compatible clinical symptoms, risk factors that make them susceptible, and a radiographic examination that confirm the suspicion. Patients usually have a favorable evolution with an early diagnosis and an appropriate management. We present a 75 years old diabetic patient with emphysematous cystitis that develops into an urosepsis treated in a conservative management (AU)

[A congenital diverticulum of the bulbar urethra]. / Divertículo de uretra bulbar congénito.

OBJECTIVE: To describe an additional case of congenital bulbous urethra. The incidence, etiopathogenesis, symptoms, diagnosis and treatment of this condition are discussed. METHODS: A 16-year-old male consulted at the emergency services for urinary retention and a perineal lesion. Patient evaluation included ultrasound, retrograde and voiding urethrocystography. Treatment was by open surgery. RESULTS: The patient was evaluated at 3, 6 and 12 months. He remains asymptomatic and control urethrograms are normal. CONCLUSIONS: Open surgery is advocated as the treatment of choice for symptomatic diverticulum of a considerable size.

[Sarcoma of the bladder. Report of 2 cases]. / Sarcomas de vejiga. A propósito de dos observaciones.

Discussion of a retrospective study in our unit of two cases of vesical tumours of mesenchymal origin, in adult patients and with different maturation behaviour. The first patient started with haematuria and after an extensive follow-up period is now free from the disease. The second patient was an accidental finding causing death in the course of the immediate postoperative.

[Renal arteriovenous fistula, up-date and presentation of a new case]. / Fístulas arteriovenosas renales, actualizacíon y presentación de un nuevo caso.

Renal arteriovenous fistulae (AVF) conform a pathology the urologist is not used to see. The basic purpose of this paper is to collect and update the current knowledge of this renal-vascular disorder, quite frequently forgotten when establishing the likely causes of haematuria. The paper describes the etiology of renal AVF and their generation mechanisms, as well as clinical presentations they can have. A most appropriate diagnostic method is still selective renal arteriography, which usually evidences the anomaly through indirect arteriographic signs. However, when the lesion is small it can be difficult to detect it. Finally, a discussion of therapeutical possibilities, both conservative and radical, and a case recently treated in out unit are presented.

[Bladder metastasis of a renal cell carcinoma]. / Metástasis vesical de un carcinoma de células renales.

We report on a patient with renal adenocarcinoma that subsequently metastasized to the bladder. Although involvement of any organ in this area can lead to secondary invasion of the bladder wall, hematuria presenting in a patient previously submitted to nephrectomy due to hypernephroma should prompt us to strongly suspect tumor spread to the bladder. The forms of metastatic spread and treatment are discussed. Good results were achieved in our patient who, with a follow-up of 1.5 years, has had no tumor recurrence.

[Pleomorphic bladder rhabdomyosarcoma in an adult male. Apropos of a case]. / Rabdomiosarcoma pleomórfico vesical en un varón adulto. A propósito de un caso.

We report on a 45-year-old male patient with a mesodermal tumor localized in the striated muscle of the bladder wall. The histopathologic analysis revealed a stage I pleomorphic tumor. The clinical and histologic features of this uncommon tumor type are described. Treatment by partial surgery and adjuvant chemo- and radiotherapy (CMT + XRT) have achieved good results. The patient is asymptomatic 44 months thereafter.

[Hemospermia: clinical study]. / Hemospermias: estudio clínico.

We present a clinical study of 29 patients with macroscopic hemospermia. The associated symptoms prevailed over monosymptomatic presentation. Urethral-prostate-vesicular inflammation was the most common etiology (55%). We single out the presence of a seminal vesicle cyst, two malignant urogenital tumours and one patient with presentation of the post-radiotherapy symptom. In 24% of the cases the cause was unknown. Diagnosis was done preferably by means of case clinic and sexual history, physical exploration, prostate/seminal vesicle echography and bacteriological-cytological study of the urine fraction plus semen. We carried out other diagnostic explorations on a selective basis. We consider hemospermia to be a benign symptom, although its presence requires the carrying out of a methodical series of explorations to rule out other pathologies of very diverse condition worthy to being taken into account.