[Extrinsic ureteral obstruction secondary to appendiceal mucocele]. / Obstrucción ureteral extrínseca secundaria a mucocele apendicular.

OBJECTIVE: To report a case of extrinsic ureteral obstruction arising from mucocele of the appendix and review the clinical, diagnostic and therapeutic aspects of this appendiceal pathology of interest in urology. METHODS: A 71-year-old female patient that had previously undergone radical gynecological surgery and postoperative radiotherapy presented with right lumbar pain. Patient evaluation by ultrasound, IVP and CT showed a pelvic mass causing right extrinsic ureteral obstruction. Release and reinsertion of the right ureter and appendectomy were performed. RESULTS: The anatomopathological study showed an appendiceal mucinous cystadenoma. The patient is asymptomatic after surgery. CONCLUSIONS: Appendiceal mucocele is a dilatation of the vermiform appendix due to collection of mucoid material that is frequently produced by a cystadenoma. The presenting feature is usually that of acute appendicitis. The definitive diagnosis is based on the anatomopathological findings. Treatment is by appendectomy for the benign tumors and by right hemicolectomy in a second stage procedure for malignant tumors. This appendiceal pathology should be taken into account in the differential diagnosis of right extrinsic ureteral obstruction.

[Nephrogenic adenoma: study of 9 cases, including one of the urethra in a 14-year-old male]. / Adenoma nefrogénico: estudio de nueve casos, incluyendo uno de uretra en un varón de 14 años.

OBJECTIVES: To review our series of nephrogenic adenoma and compare our results with those reported in the literature. METHOD: The records of our Department of Pathology were reviewed to determine the cases of nephrogenic adenoma diagnosed at our center. The clinical features, diagnostic aspects, pathological findings, treatment and outcome are presented. RESULTS/CONCLUSIONS: Nephrogenic adenoma is a rare lesion, probably arising from nephrogenic metaplasia caused by injury to the urothelial mucosa. The site of presentation is frequently the bladder, followed by the urethra. The diagnosis is based on the histopathological findings, which can be occasionally equivocal. The cases described in the present series were benign. To date there is no established therapeutic approach. We performed TUR in two patients, antibiotic therapy was administered in one patient and 4 patients were managed conservatively. Two of our patients had no control evaluation following biopsy of the lesion. In 2 of the 4 patients that were managed conservatively, the lesion remitted spontaneously.

[Bilateral renal angiomyolipoma associated with tuberous sclerosis: conservative surgical treatment]. / Angiomiolipomas renales bilaterales asociados a la esclerosis tuberosa: tratamiento quirúrgico conservador.

OBJECTIVES: To evaluate the efficacy of surgical treatment of angiomyolipoma. METHODS: We present a case of multiple, bilateral renal angiomyolipoma in a patient with tuberous sclerosis, who was treated by conservative surgery. RESULTS: The patient is clinically asymptomatic one year after surgery and both kidneys are functioning correctly as shown by pyelography. CONCLUSIONS: We recommend conservative surgical treatment of symptomatic or developing angiomyolipomas.

[Ambulatory treatment of urinary lithiasis with extracorporeal lithotripsy (Dornier MFL-5000): comparative study of its use with low and high kilovoltages]. / Tratamiento ambulatorio de la litiasis urinaria mediante litotricia extracorpórea (Dornier MFL-5000): estudio comparativo de su utilización a bajos y altos kilovoltajes.

The present study compared the results achieved with ESWL using the Dornier MFL 5000 lithotriptor in 133 patients who received analgesics alone during treatment versus 141 patients who received analgesics plus sedation with midazolam. Both patient groups received the maximum tolerated energy and shock waves necessary to fragment the calculi. The patients who received analgesics plus midazolam tolerated the maximum energy of the lithotriptor (30 Kv), which permitted reducing the total number of shock waves required for fragmentation by 49%. Furthermore, the number of retreatments dropped by 38% (1.15 versus 1.53 sessions per renal unit) and the time required for treatment was reduced by 40% (p < 0.01).

[Injection of autologous fatty tissue in the bladder submucosa: experimental study in swine]. / Inyección en la submucosa vesical de tejido graso autólogo: estudio experimental en suidos.

The results achieved by the use of inert materials via endoscopic injection for the treatment of urological pathologies have been disappointing. Furthermore, these materials are costly, carry the risk of migration and may not be tolerated locally. Autologous fatty tissue, however, is not costly and is tolerated better. The authors have conducted an experiment in the pig to evaluate the degree of resorption and persistence of autologous fat injected into the bladder submucosa. The results show that submucosal injection of autologous fat acts like an autograft and persists as mature fatty tissue. The degree of resorption and/or steatonecrosis is directly related to the amount injected; the smaller the amount used the better the results.

[Cutaneous metastasis of epithelioid sarcoma of the penis: report of a case]. / Metástasis cutánea de un sarcoma epitelioide de pene: a propósito de un caso.

Exposition of one case of skin metastasis in a 35 year-old patient, diagnosed 10 years previously with epithelioid sarcoma of the penis, which was treated with total penectomy. The singularity of this case lies in the rarity of a pineal site for this tumour, as well as the infrequency of the skin metastasis. It should be noted the significance of long-term follow-up in this patients, since quite frequently they develop metastasis following a long asymptomatic period.

[Bilateral adrenal masses during clinical staging of renal carcinoma]. / Masas adrenales bilaterales durante el estadiaje clínico del carcinoma renal.

We report a case of renal adenocarcinoma with bilateral adrenal masses at the time of diagnosis. Owing to the methods currently used for clinical staging, this association is no longer infrequently observed. Experience has demonstrated the value of the diagnostic techniques in this condition. The use of some of these techniques will depend on the findings during clinical staging of the tumor. Well-selected cases with metastasis to the adrenal gland can benefit from surgery.

[Giant hydronephrosis: conservative treatment by endopyelotomy]. / Hidronefrosis gigante: tratamiento conservador mediante endopielotomía.

A case of giant hydronephrosis in the right kidney and inferior pelvis of the left kidney in a 60-years-old female patient with nonspecific abdominal symptoms and signs is reported. Because involvement was bilateral and the patient insisted on conservative treatment, we performed a bilateral percutaneous endopyelotomy. The excellent results achieved were demonstrated by ultrasound. This however was not true for the functional results due to the irreversible renal lesion.

[Endoureteropyelotomy in impassable stenosis of the pyeloureteral junction: instrumental conversion of the stenosis into an intrapelvic ureterocele]. / Endoureteropielotomia en estenosis de la unión pieloureteral infranqueable: conversión instrumental de la estenosis en uretrocele intrapiélico.

The authors describe a new endourological procedure for resolving cases of stenosis of the impassable ureteropyelic union. The procedure consists in raising the pyeloureteral union by means of a Chevassu's catheter equipped with its wire guide, introduced backwards into the ureter and which, when pushed externally, situates the ureteropyelic union by way of intrapyelic ureterocele. We then proceed to the lengthwise cutting of this ureterocele under nephroscopic view until the ureteral catheter is exposed. With this procedure a successful solution is provided for those cases that were debarred from endourological surgery because the tutor catheter was unable to pass.

[Endoscopic injection of autologous adipose tissue in the treatment of female incontinence]. / Inyección endoscópica de tejido graso autólogo en el tratamiento de la incontinencia femenina.

We describe a new procedure utilizing autologous fat instead of teflon injection in the treatment of female urinary incontinence that is equally useful in correcting postadenomectomy incontinence in the male and vesicoureteral reflux. We have used this new procedure over the past 4 months in 10 patients with urinary stress incontinence and no concomitant cystocele. The procedure is performed under spinal anesthesia. Small cylinders of subcutaneous abdominal fatty tissue are obtained by microliposuction. The fat graft in the form of four 10 ml. wheals is then injected in the vesical neck. We emphasize that this technique is simple and there are no complications. The low cost of this technique requiring a 24 h stay at the hospital affords additional advantages. Likewise, the procedure can be repeated or subsequent surgical procedures can be performed without difficulty in the event correction is unachieved.