¿Está la urología española de 2018 lo suficientemente madura para realizar cribado poblacional de cáncer de próstata? / Is Spanish urology in 2018 mature enough to perform population screening for prostate cancer?

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Experiencia de Enfermería Urológica en el paciente TVNMI tratado con quimio-hipertermia / No disponible

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[Cutaneous ciliated cyst of the scrotal skin. A case report with discussion of pathogenesis]. / Quiste cutáneo ciliado en piel escrotal. Descripción de un caso con discusión patogénica de la entidad.

Cutaneous ciliated cyst (CCC) is a rare benign lesion predominantly occurring in the lower limbs of young women and exceedingly rare in males. Here, we report a case involving a previously unreported site (i.e., scrotal skin) in a 15-year-old male. We also describe pathologic and immunonohistochemical findings, review the pertinent literature and discuss their pathogenetic mechanisms. We propose that CCC could represent a morphologic pattern encompassing several pathogenetically different entities. Data we provide support the hypothesis that at least a part of CCC, specially those occurring in males, could have their origin in ciliated metaplasia of apocrine sweat glands.

Quiste cutáneo ciliado en piel escrotal. Descripción de un caso con discusión patogénica de la entidad / Cutaneous ciliated cyst of the scrotal skin. A case report with discussion of pathogenesis

El quiste cutáneo ciliado (QCC) es una lesión benigna muy infrecuente, que aparece predominantemente en extremidades inferiores de mujeres jóvenes. En varones es una lesión aún más rara. En esta nota se presenta un caso de quiste cutáneo ciliado en piel escrotal de un varón de 15 años, se describen características histológicas e inmunohistoquímicas, se revisa la bibliografía al respecto y se realiza una discusión patogénica de la entidad. Se plantea que el QCC puede ser en realidad un patrón morfológico que engloba varias entidades patogénicamente diferentes. Los datos aportados en nuestro caso apoyan la teoría de que al menos un grupo de QCC, y en especial los acaecidos en pacientes de sexo masculino, podrían tener su origen en la metaplasia ciliada de glándulas sudoríparas apocrinas (AU)

Cutaneous ciliated cyst (CCC) is a rare benign lesion predominantly occurring in the lower limbs of young women and exceedingly rare in males. Here, we report a case involving a previously unreported site (i.e., scrotal skin) in a 15-year-old male. We also describe pathologic and immunonohistochemical findings, review the pertinent literature and discuss their pathogenetic mechanisms. We propose that CCC could represent a morphologic pattern encompassing several pathogenetically different entities. Data we provide support the hypothesis that at least a part of CCC, specially those occurring in males, could have their origin in ciliated metaplasia of apocrine sweat glands (AU)

Tumor de células granulares de próstata diagnosticado en biopsia transrectal. ¿Qué actitud tomar? / Granular cell tumour of prostate diagnosed by transrectal biopsy. Which therapeutic attitude?

El tumor de células granulares (TCG) es una neoplasia de derivación neural, relativamente frecuente en localización subcutánea y en cavidad oral. En próstata es excepcional, con un solo caso descrito en la literatura indexada de las últimas tres décadas. Presentamos el caso de un varón de 63 años con clínica de prostatismo, próstata aumentada de tamaño e incremento de cifras de PSA sérico, al que en biopsia transrectal por aguja se le diagnostica TCG. Dada la excepcionalidad de la neoplasia no existe un protocolo de actuación establecido. Planteamos el dilema clínicopatológico que representa el diagnóstico de una neoplasia de estas características y proponemos la actitud más adecuada a seguir

Granular cell tumour (GCT) is not an uncommon tumour of neural origin usually located on subcutaneous tissues and oral cavity. In prostate gland is exceptional, with only one case reported on the indexed literature of the last three decades. We report a case of a 63-year-old man presented with urinary complaints, enlarged prostate and increased PSA levels. The patient subsequently underwent transrectal needle biopsy which revealed GCT. The clinicpathological dilemma originated after this diagnosis is discused and the most suitable follow-up is proposed

Referencia al artículo 'Situación epidemiológica del cáncer de próstata en España' / Referred to the article "Epidemiological situation of prostate cancer in Spain

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[Granular cell tumour of prostate diagnosed by transrectal biopsy. Which therapeutic attitude?]. / Tumor de células granulares de próstata diagnosticado en biopsia transrectal. Qué actitud tomar?

Granular cell tumour (GCT) is not an uncommon tumour of neural origin usually located on subcutaneous tissues and oral cavity. In prostate gland is exceptional, with only one case reported on the indexed literature of the last three decades. We report a case of a 63-year-old man presented with urinary complaints, enlarged prostate and increased PSA levels. The patient subsequently underwent transrectal needle biopsy which revealed GCT. The clinicpathological dilemma originated after this diagnosis is discused and the most suitable follow-up is proposed.

[Pneumoscrotum secondary to a massive subcutaneous emphysema after expontaneous pneumothorax drainage]. / Neumoescroto secundario a enfisema subcutáneo masivo tras drenaje de un neumotórax espontáneo.

We present a case of a pneumoscrotum and pneumopenis which appeared after a trocar drainage placement for treatment of a recidivated expontaneous pneumothorax. In spite of is an entity with easy diagnosis and conservative management, maybe be confused with other more aggressive entities which treatment should be invasive.

Neumoescroto secundario a enfisema subcutáneo masivo tras drenaje de un neumotórax espontáneo / Pneumoscrotum secondary to a masive subcutaneous emphysema after expontaneous neumothorax drainage

Presentamos un caso excepcional de presentación de un neumoescroto y neumopene que apareció tras la colocación de un tubo de tórax para el drenaje de un neumotórax espontáneo recidivado. A pesar de tratarse de una entidad de fácil diagnóstico y tratamiento conservador, puede confundirse con otros cuadros más graves y cuyo tratamiento es mas invasivo

We present a case of a pneumoscrotum and pneumopenis which appeared after a trocar drainage placement for treatment of a recidivated expontaneous pneumothorax. In spite of is an entity with easy diagnosis and conservative management, maybe be confused with other more agresive entities which treatment should be invasive

[Female urinary stress incontinence: transobsturator technique]. / Cabestrillo suburetral transobturatriz en el tratamiento de la incontinencia urinaria de esfuerzo femenina.

The wide use of retropubic TVT has been associated with various complications. To avoid these, alternative procedures have been developed and continence rates obtained with these new routes have been quite similar to those after classic TVT. In the transobsturator technique (TOT) described by Delorme and colleagues in 2001, the tape is inserted through the obturator foramens from outside to inside and is positioned without tension under the urethra. Another surgical technique allows the passage of a tape from inside to outside. The aim of this paper is to describe a new, simple surgical technique for the treatment of female urinary stress incontinence and to evaluate its feasibility.

Tejido prostático ectópico en vejiga urinaria / Ectopic protate tissue in urinary bladder

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[Massive bilateral adrenal hemorrhage after conservative tumor surgery in the isthmus of a horseshoe kidney]. / Hemorragia suprarrenal masiva bilateral tras cirugía tumoral conservadora en el istmo de un riñón en herradura.

OBJECTIVE: To present a fatal case of massive bilateral suprarrenal haemorrhage (MBSH) after partial nephrectomy. CLINICAL CASE: An 82 year old male treated with oral anticoagulants was diagnosed by means of CT scan and arteriography of having an avascular tumor located at the isthmus of a horseshoe kidney. A tumorectomy with safety surgical margins was performed; It was diagnosed of having a renal adenocarcinoma, which was almost completely necrotic. During the postoperative period, the patient presented abdominal pain, nausea, fever, hypotension and severe respiratory distress. Biochemical studies showed mild hyponatremia and azotemia, accompanied by anemia, leucocytosis and thrombocytosis. An abdominal CT scan demonstrated a MBSH, which produced the patients death soon afterwards. DISCUSSION: Tumoral pathology of horseshoe kidneys presents important topographic and anatomopathologic differences with respect to non-fused kidneys. MBSH is a rare complication of many stress processes especially if an anticoagulant treatment coexists. The treatment has to be initiated as soon as we suspect MBSH, which should be confirmed by hormonal determinations and/or the presence of hyperdense suprarenal lesions at the CT scan.

Hemorragia suprarrenal masiva bilateral tras cirugía tumoral conservadora en el istmo de un riñón en herradura / Bilated massive adrenal haemorrhage after tumoral conservative surgery at the isthmus of a horseshoe kidney

OBJETIVOS: Presentación de un caso fatal de hemorragia suprarrenal masiva bilateral (HSMB) tras nefrectomía parcial. CASO CLÍNICO: Varón de 82 años en tratamiento con anticoagulantes orales que es diagnosticado mediante TAC y arteriografía de una tumoración prácticamente avascular situada en el istmo de un riñón en herradura. Se realizó tumorectomía con margen de seguridad diagnosticándose un adenocarcinoma renal necrosado casi completamente. Durante el postoperatorio presentó un cuadro de dolor abdominal, nauseas, fiebre, hipotensión y severo distress respiratorio. Los estudios bioquímicos mostraron una leve hiponatremia y azoemia, acompañadas de anemia, leucocitosis y trombocitosis. El TAC abominopélvico demostró una HSMB que desencadenó la muerte poco después. DISCUSIÓN: La patología tumoral de los riñones en herradura presenta importantes diferencias topográficas y anatomo-patológicas con respecto a los riñones no fusionados. La HSMB es una rara complicación de procesos de stress especialmente si coexiste consumo de anticoagulantes. El tratamiento debe iniciarse precozmente, es decir, tan pronto exista una sospecha diagnóstica que deberá ser confirmada mediante determinación hormonal y/o presencia de lesiones hiperdensas suprarrenales en el TAC (AU)

"Sandwich technique" for suburethral placement of Mersilene mesh sling during pubovaginal suspension surgery: preliminary results.

OBJECTIVES: To evaluate the effectiveness of a new "sandwich technique" for heterologous sling placement during pubovaginal suspension for treatment of recurrent stress urinary incontinence. METHODS: A new sling placement procedure was used in 31 women (mean age 65.4 years) who had undergone multiple operations. With this technique, a heterologous sling was placed without dissection over a de-epithelialized vaginal wall and later covered with a vaginal wall flap. Finally, the sling and the bladder neck were suspended from the pubic bone with metallic anchorages and nonabsorbable sutures. RESULTS: The objective success rates for SUI resolution was 87.1% but, subjectively, 90.3% of patients were satisfied or very satisfied with the procedure. The median follow-up time was 34 months. Morbidity was minimal, and the mean hospitalization time was less than 5 days. CONCLUSIONS: This original, simple, noninvasive treatment is applicable to all type II and type III SUI with or without associated cystoceles, regardless of patient age or sexual activity, and has shown encouraging results. This procedure is highly recommended for the treatment of SUI, especially in patients who have undergone multiple previous operations.

Carcinosarcoma in a bladder diverticulum. A case report and literature review.

Carcinosarcoma of the bladder is a rare neoplasm composed of a mixture of malignant epithelial and mesenchymal components. The presentation and clinical course of an infiltrating carcinosarcoma located in a bladder diverticulum coexisting with prostatic adenocarcinoma in a 69-year-old man are described. We believe this to be the fifth report of true carcinosarcoma appearing in a bladder diverticulum.