[Treatment of the dysfunction of the pelvic floor]. / Tratamiento de la disfunción del suelo pélvico.

The perineum is formed by muscle-aponeurotic elements that are integrated under the control of the nervous system. Their alterations are responsible for urogynecological, coloproctologic and sexual pathologies. In order to obtain a successful treatment, it is obliged not to forget the role that plays the perineum in those pathologies. The treatment of the dysfunction of the pelvic floor groups conservative techniques and procedures like changes in life habits, behavioural therapy, biofeedback, electroestimulation (neuromodulation and peripheral electrical stimulation) and training with muscular exercises of the pelvic floor (perineal rehabilitation). The objective of all of them is to improve or to obtain the urinary continence, the strengthening of its musculature to be able to balance pelvic static, to improve the local vascularization and the anorrectal function besides securing a satisfactory sexuality.

Tratamiento de la disfunción del suelo pélvico / Treatment of the dysfunction of the pelvic floor

El periné está formado por elementos músculos-aponeuróticos que se integran bajo el control del sistema nervioso. Su alteración es responsable de patologías uroginecológicas, coloproctológicas y sexuales. Para conseguir su tratamiento exitoso es obligado no olvidar el papel que juega el periné en las mismas. El tratamiento de la disfunción del suelo pélvico agrupa una serie de técnicas y procedimientos conservadores como cambios en hábitos de vida, terapia conductual, biofeedback, electroestimulación (neuromodulación y estimulación eléctrica periférica) y entrenamiento con ejercicios musculares del suelo pélvico (rehabilitación perineal). El objetivo de todas ellas es mejorar o conseguir la continencia urinaria, el fortalecimiento de su musculatura para conseguir equilibrar la estática pélvica, mejorar la vascularización local y la función ano-rectal además de conseguir una sexualidad satisfactoria

The perineum is formed by muscle-aponeurotic elements that are integrated under the control of the nervous system. Their alterations are responsible for urogynecological, coloproctologic and sexual pathologies. In order to obtain a successful treatment, it is obliged not to forget the role that plays the perineum in those pathologies. The treatment of the dysfunction of the pelvic floor groups conservative techniques and procedures like changes in life habits, behavioural therapy, biofeedback, electroestimulation (neuromodulation and peripheral electrical stimulation) and training with muscular exercises of the pelvic floor (perineal rehabilitation). The objective of all of them is to improve or to obtain the urinary continence, the strengthening of its musculature to be able to balance pelvic static, to improve the local vascularization and the anorrectal function besides securing a satisfactory sexuality

[Testicular epidermoid cyst]. / Quiste epidermoide testicular.

OBJECTIVE: Benign tumors account for less than 1% of testicular tumors and the incidence is even lower in children. A rare case of epidermoid cyst of the testis in a child is described. The differential diagnosis and treatment options are discussed. METHODS/RESULTS: A case of unilateral epidermoid cyst of the testis in an 11-year-old boy is presented. The clinical and diagnostic aspects are discussed. Definitive diagnosis could be made only after surgical excision. CONCLUSIONS: Pathological analysis of the entire testis is warranted to make the definitive diagnosis of epidermoid cyst. However, preservation of the testis can be considered, particularly in those cases with bilateral involvement, if supported by solid, consistent diagnostic evidence, including intraoperative biopsy.

[A giant adrenal mass: the anatomicopathological surprise finding]. / Masa suprarrenal gigante: sorpresa anatomopatológica.

OBJECTIVE: The present study reviews the differential diagnosis of adrenal masses, including the uncommon forms, as the one described herein. METHOD/RESULTS: A patient with a giant adrenal mass that required differential diagnosis from other types of adrenal masses is presented. The diagnosis could only be made following anatomopathological analyses. CONCLUSIONS: The present case demonstrates that the uncommon forms of adrenal masses must be taken into account in the differential diagnosis, which, however, can only be confirmed by the pathological analysis since the findings on diagnostic imaging mimic other forms.

[Partial nephrectomy for pyelo-renal duplication with pseudocoraliform lithiasis in non-functioning upper pyelon]. / Nefrectomía parcial por duplicidad pielorenal con litiasis pseudocoraliforme en pielon superior afuncionante.

We performed a right heminephrectomy in a patient with pyelorenal duplicity, pseudostaghorn stone in nonfunctioning superior pyelon and a history of right perirenal abscess. The history, indications, variations and complications of this surgical procedure are briefly described. The importance of performing a complete evaluation prior to surgery is emphasized.

[Complex renal lithiasis: conservative surgery]. / Litiasis renal compleja: cirugía conservadora.

We report a case of complicated renal lithiasis which had been successfully treated by conservative surgery. The present case shows that this surgical procedure continues to be a valid therapeutic option for this pathology, although occasionally the new, less invasive treatment modalities that continue to develop are utilized in the treatment of renal lithiasis far beyond the indications.

[A new cases of transitional cell papilloma of the bladder, inverted type]. / Un nuevo caso de papiloma de células transicionales de vejiga, tipo invertido.

We report on a 75-year-old male patient with inverted transitional cell papilloma located on the right side of the bladder, behind the prostate lobe. It was a large (4 x 4 x 0.9 cm) exophytic, papillary tumor with a wide base and all the gross features of a typical transitional cell tumor of the bladder. The presenting symptom was gross hematuria and treatment was by transurethral resection. The literature is briefly reviewed.

[Calcification+ of both ends of "double-J catheter", with long staying, without impact on renal unit]. / Calcificación de ambos extremos de "cateter doble J", con larga permanencia de éste, sin repercusión sobre la unidad renal.

We report on a patient who had previously undergone ESWL and had a double-J catheter indwelling for 32 months. Both ends of the catheter were found to be completely calcified. Renal function and morphology were completely recovered following removal of the catheter. Like other authors, we believe that urinary drainage around the double-J catheter will suffice in some cases.

[Pyo-urachal cyst]. / Quiste piouracal.

A case of infected and suppurating pyourachal cyst is described. The rarity of urachal pathology in the adult prompted us to report the present case. The clinical features, diagnosis and treatment of this urachal complication are discussed.

[Calcification of seminal vesicles and deferent duct]. / Calcifición de vesículas seminales y ampolla deferencial.

Herein we describe a chronic diabetic with calcification of both seminal vesicles and the deferent duct which had been disclosed by a plain film of the urinary tract and an IVP. Currently the foregoing condition can be considered to be pathognomonic of diabetes mellitus, although these patients generally do not present urological symptoms or signs.

[Late surgical complications in kidney transplantation. Experience and results]. / Complicaciones quirúrgicas tardías en el trasplante renal. Experiencia y resultados.

The present study reports the late surgical complications observed following 270 renal transplant procedures performed at our department. Their etiologic, clinical, and therapeutic aspects are discussed. With respect to arterial stenosis, we consider percutaneous transluminal angioplasty the procedure of choice when drug therapy fails to control hypertension. Surgery should be reserved for those cases where this procedure fails. We advocate treatment of lymphoceles whose size cause displacement or compression of the excretory tract using drainage and instillation of povidone iodide as advocated by González Martín. Stenosis of the excretory tract is the most common complication in our series. Treatment was by corrective surgery. In our view, the etiologic and ultrastructural features of this complication make it unamenable to endourologic correction.