[Bladder leiomyomas.] / Leiomiomas vesicales.

Bladder leiomyomas are rare benign tumors; their common presentation are irritative and obstructive urinary symptoms. The treatment is complete surgical resection. OBJECTIVE: To present our experience in the diagnosis and the treatment of bladder leiomyoma. METHODS: A series of three clinical cases. RESULTS: In our series, two patients were women and one was man. The mean age was 33 years. Two women presented with irritative urinary symptoms and palpation of a pelvic mass, and the man was asymptomatic. Ultrasound showed the presence of an adnexal mass with left hydronephrosis in a female patient, bladder tumor in another female patient and pelvic mass of unknown etiology in the male patient. CT scan and MRI demonstrated the bladder origin of the lesion. A biopsy confirmed a bladder leiomyoma. Surgical treatment was partial cystectomy in all patients, and in one of them, nephrectomy was performed. During follow-up, all patients were asymptomatic and without recurrence. CONCLUSIONS: Imaging studies guide to diagnosis. Transurethral resection is recommended in lesions smaller than 3 cm. and enucleation or partial cystectomy in larger lesions. Prognosis is good.

Los leiomiomas vesicales son tumores benignos infrecuentes, causan sintomatología miccional y su tratamiento es quirúrgico. OBJETIVO: Presentar nuestra experiencia en el diagnóstico y tratamiento del leiomioma vesical. MATERIAL Y METODO: Serie de 3 casos clínicos. RESULTADOS: De los 3 casos, 2 fueron mujeres y 1 fue hombre. La edad media fue 33 años. Las dos mujeres presentaron síntomas miccionales irritativos y palpación de una masa pélvica, y el hombre cursó asintomático. La ecografía halló una masa anexial e hidronefrosis izquierdas en una paciente, tumoración vesical en otra paciente y masa pélvica de etiología no definida en el paciente varón. La tomografía y la resonancia magnética demostraron el origen vesical de la lesión. La biopsia confirmó el diagnóstico de leiomioma. Se realizó cistectomía parcial en todos los casos, con nefrectomía en uno de ellos. Durante el seguimiento no ocurrió recidiva tumoral. CONCLUSIONES: Los estudios de imagen nos orientan al diagnóstico. La resección transuretral está indicada en lesiones menores de 3 cm. y la enucleación o cistectomía parcial en lesiones de mayor tamaño. Su pronóstico es bueno.

Testicular adrenal rest tumors.

We report a case of congenital adrenal hyperplasia in a 29 year old patient, who presented with testicular pain, bilateral testicular masses, and oligospermia. Ultrasonography confirmed, in both testis, the presence of heterogeneous and hypoechoic lesions with irregular borders and internal and peripheral vascularization. Seric tumor markers were negative. The patient was scheduled for perioperative testicular biopsy and bilateral orchiectomy. Perioperative biopsy was suggestive of testicular adrenal rest tumor and not additional procedure was performed. Treatment was initiated with high doses of glucocorticoids, decreasing the size of testicular masses and testicular pain was alleviated.

Testicular adrenal rest tumors / Tumores testiculares de restos adrenales

We report a case of congenital adrenal hyperplasia in a 29 year old patient, who presented with testicular pain, bilateral testicular masses, and oligospermia. Ultrasonography confirmed, in both testis, the presence of heterogeneous and hypoechoic lesions with irregular borders and internal and peripheral vascularization. Seric tumor markers were negative. The patient was scheduled for perioperative testicular biopsy and bilateral orchiectomy. Perioperative biopsy was suggestive of testicular adrenal rest tumor and not additional procedure was performed. Treatment was initiated with high doses of glucocorticoids, decreasing the size of testicular masses and testicular pain was alleviated

Presentamos el caso de un varón de 29 años diagnosticado de hiperplasia suprarrenal congénita, que fue derivado a nuestra consulta por dolor testicular, masas testiculares bilaterales y oligospermia. La ecografía confirmó la existencia de lesiones heterogéneas e hipoecoicas con bordes irregulares y vascularización interna y periférica en ambos testículos. Los marcadores tumorales séricos fueron negativos. El paciente fue programado para biopsia testicular perioperatoria y orquiectomía bilateral. La biopsia perioperatoria fue sugestiva de tumor testicular de restos suprarrenales y no se realizó ningún procedimiento adicional. Se inició tratamiento con altas dosis de glucocorticoides, disminuyó el tamaño de las masas testiculares y se alivió el dolor testicular

Tumores escrotales / Scrotal tumors

OBJETIVO: El carcinoma basocelular y el leiomioma escrotal son de presentación excepcional. Nuestro objetivo es describir tres casos de tumores escrotales y aportar información respecto a esta patología. MÉTODO: Entre 2000 y 2014, 3 pacientes fueron diagnosticados y tratados de tumor escrotal en nuestro servicio. Se revisaron las historias clínicas de dichos pacientes. RESULTADOS: Presentamos dos casos de carcinoma basocelular en varones de 72 y 71 años de edad respectivamente, que se presentaron con una lesión escrotal izquierda cuyo diagnóstico anatomopatológico tras su exerésis fue carcinoma basocelular. En un paciente, estaba afectado el borde quirúrgico y cursó con un carcinoma basocelular recurrente que fue extirpado con ampliación de bordes quirúrgicos. Describimos también un caso de leiomioma escrotal en un varón de 48 años con una lesión escrotal derecha excrecente, indolora y de bordes lisos. En el seguimiento, los pacientes continuaban clínicamente asintomáticos. CONCLUSIONES: Las lesiones escrotales en un adulto mayor deben ser extirpadas y enviadas para estudio histológico. El carcinoma basocelular de escroto se presenta como una placa, nódulo o úlcera. Precisa seguimiento y su pronóstico es bueno. El leiomioma se presenta como un nódulo no ulcerativo y su tratamiento es la extirpación completa de la lesión

OBJECTIVE: Basal cell carcinoma and leiomyoma of the scrotum are rare. We describe three cases of scrotal tumors and provide information regarding this disease. Methos: Between 2000 and 2014, 3 patients with scrotal tumors were diagnosed and treated at our institution. A review was performed using the clinical records of these patients. RESULTS: We describe two cases of basal cell carcinoma of the scrotum in men 72 and 71 year old, who presented with a left scrotal lesion that was excised and the pathological diagnosis was basal cell carcinoma. In one patient, surgical margin was affected and a recurrent basal cell carcinoma appeared. It was excised with enlargement of surgical margin. We also describe a case of scrotal leiomyoma in a 48 year old man with an elastic, firm and nontender lesion in the right scrotum. During follow-up the patients remain clinically asymptomatic. CONCLUSIONS: Scrotal lesions in the elderly should be excised and submitted for pathological examination. The basal cell carcinoma of the scrotum appears as a plaque, nodule or ulcer. Long-term surveillance is recommended for these patients. Leiomyoma of the scrotum is presented as a non-ulcerative nodule and his treatment is complete surgical excision

[The second kidney transplantation in Spain]. / El segundo trasplante renal en España.

The first two living donor kidney transplants in our country (isotransplant and homotransplant respectively) were reported in 1961. We reviewed the clinical history of the renal homotransplant performed between father and son, more than half a century ago, by Carlos Younger de la Peña and Ramiro Rivera at "La Paloma' Clinic in Madrid. We comment on the organizational, legal, immunobiological and technical difficulties in those times when the successful future of transplantation was barely in sight. From the XXI Century we can see the long path of renal transplantation during the XX century. Despite all the initial troubles and failures our present must recognize, and so does it, the work and dedication of the pioneers.

El segundo trasplante renal en España / The second kidney transplantation in Spain

En 1961 se comunicaron en nuestro país los dos primeros trasplantes renales de donante vivo (isotrasplante y homotrasplante respectivamente). La historia clínica recogida se refiere al homotrasplante renal efectuado entre padre e hijo, hace más de medio siglo, por Carlos Younger de la Peña y Ramiro Rivera en la Clínica madrileña de "La Paloma". Se comentan las dificultades organizativas, jurídicas, inmunobiológica y técnicas de aquellos momentos en los que apenas se vislumbraba el exitoso futuro de los trasplantes de órganos. Desde el siglo XXI podemos contemplar el largo camino del trasplante renal durante todo el siglo XX. A pesar de todos los inconvenientes y fracasos iniciales nuestro presente debe y cumple con el reconocimiento al trabajo y dedicación de los pioneros

The first two living donor kidney transplants in our country (isotransplant and homotransplant respectively) were reported in 1961. We reviewed the clinical history of the renal homotransplant performed between father and son, more than half a century ago, by Carlos Younger de la Peña and Ramiro Rivera at "La Paloma" Clinic in Madrid. We comment on the organizational, legal, immunobiological and technical difficulties in those times when the successful future of transplantation was barely in sight. From the XXI Century we can see the long path of renal transplantation during the XX century. Despite all the initial troubles and failures our present must recognize, and so does it, the work and dedication of the pioneers

Multilocular cystic nephroma: A clinical case.

OBJECTIVE: To describe the clinical presentation, preoperative diagnostic possibilities, and treatment of cystic nephroma. METHODS: We describe a case of cystic nephroma in an adult male and show that, both in our patient and in the literature, a definitive diagnosis can only be obtained postoperatively, even when there is a reasonable clinical suspicion. CONCLUSIONS: Cystic nephroma is rare, and some authors consider it a questionable entity. However, it should be distinguished from renal cystic neoplasms, which can resemble the condition.

Nefroma quístico multilocular: a propósito de un caso / Multilocular cystic nephroma: A clinical case

OBJETIVO: Mostrar la presentación clínica, las posibilidades diagnosticas preoperatorias y el tratamiento del nefroma quístico. MÉTODOS: Se presenta un caso de nefroma quístico en un varón adulto, comprobando en nuestro caso y en la revisión de la literatura que aunque exista una razonable sospecha clínica, el diagnóstico cierto solo es posible postcirugía. CONCLUSIONES: El nefroma quístico es de frecuencia escasa y por algunos autores es considerada una entidad dudosa, pero hay que tratar de distinguirla de neoplasias quísticas renales, que pueden simular este proceso

OBJECTIVE: To describe the clinical presentation, preoperative diagnostic possibilities, and treatment of cystic nephroma.METHODS: We describe a case of cystic nephroma in an adult male and show that, both in our patient and in the literature, a definitive diagnosis can only be obtained postoperatively, even when there is a reasonable clinical suspicion.CONCLUSIONS: Cystic nephroma is rare, and some authors consider it a questionable entity. However, it should be distinguished from renal cystic neoplasms, which can resemble the condition

Adrenal ganglioneuroma.

OBJECTIVE: To present one case of adrenal ganglioneuroma incidentally diagnosed in an adult. METHODS/RESULTS: 44-year-old woman with a 2.3 cm incidentaloma in the left adrenal gland diagnosed by CT scan. At 6 months, MRI was performed and a left adrenal nodule 3.7 cm was shown. Due to the progressive growth of the mass, surgery was indicated and left laparoscopic adrenalectomy was carried out. The final pathologic diagnosis was adrenal ganglioneuroma. CONCLUSIONS: The ganglioneuroma is a tumor composed of Schwann cells and ganglion cells. Its location in the adrenal gland is unusual, most frequently affecting other regions. Being asymptomatic lesions, they are often detected incidentally when performing imaging tests. There are radiological features that differentiate them from other adrenal masses. The treatment of choice is surgery, with adrenalectomy.

Ganglioneuroma de glándula suprarrenal / Adrenal ganglioneuroma

OBJETIVO: Presentar el caso clínico de un ganglioneuroma de suprarrenal diagnosticado, en un adulto, de manera incidental. MÉTODOS/RESULTADOS: Mujer de 44 años diagnosticada de incidentaloma de 2,3 cm en la glándula suprarrenal izquierda en un TAC realizado por estudio de hemoptisis. Con estudio analítico completo de masa suprarrenal no funcionante, se realizó a los 6 meses una RMN en la que se objetiva un nódulo suprarrenal izquierdo de 3,7 cm. Ante el crecimiento progresivo de la masa se decide tratamiento quirúrgico mediante suprarrenalectomía laparoscópica izquierda, estableciendo el diagnóstico anatomopatológico definitivo de ganglioneuroma de glándula suprarrenal. CONCLUSIÓN: El Ganglioneuroma es un tumor caracterizado por una mezcla de células de Schwann y células ganglionares maduras. Su localización en la glándula suprarrenal es inusual, presentando predisposición por otras regiones. Al tratarse de lesiones asintomáticas suelen ser detectadas de manera incidental al realizar una prueba de imagen. Presenta unas características radiológicas que lo diferencian del resto de masas suprarrenales. El tratamiento es quirúrgico, mediante suprarrenalectomía (AU)

OBJECTIVE: To present one case of adrenal ganglioneuroma incidentally diagnosed in an adult. METHODS/RESULTS: 44-year-old woman with a 2.3 cm incidentaloma in the left adrenal gland diagnosed by CT scan. At 6 months, MRI was performed and a left adrenal nodule 3.7 cm was shown. Due to the progressive growth of the mass, surgery was indicated and left laparoscopic adrenalectomy was carried out. The final pathologic diagnosis was adrenal ganglioneuroma. CONCLUSIONS: The ganglioneuroma is a tumor composed of Schwann cells and ganglion cells. Its location in the adrenal gland is unusual, most frequently affecting other regions. Being asymptomatic lesions, they are often detected incidentally when performing imaging tests. There are radiological features that differentiate them from other adrenal masses. The treatment of choice is surgery, with adrenalectomy (AU)

46,XX T testicular disorder of sex development. Case report.

OBJECTIVE: We present a case of X-Y translocation with male phenotype (46,XX testicular disorder of sex development) and review the literature. METHODS: Disorders of sex development with mismatch of genetic, gonadal and phenotypic sex are quite rare, and some are due to genetic or chromosomal abnormalities. The karyotype was investigated by a cytogenetic study of peripheral blood (phytohemagglutinin-timulated lymphocyte culture over 72 hours). G-banding analysis of 25 metaphases showed a 46,XX chromosome constitution (46 chromosomes with XX sexual composition). Fluorescence in situ hybridization (FISH) analysis with probes for X centromeres and the sex-determining region of the Y chromosome (SRY) (testis-determining factor gene) showed two X chromosomes. The analysis also showed the SRY signal in the telomeric region of the short arm of one of the chromosomes. RESULTS: In recent years, a number of other genes involved in disorders of sex development in animals and humans have also been identified. Genetic defects in the peptide hormone receptors, members of the steroid receptor superfamily, and other transcription factors, as well as any of a series of enzymes and cofactors involved in steroid biosynthesis can cause abnormal determination and differentiation. CONCLUSIONS: Although chromosomal abnormalities are rarely present in patients with apparently normal external genitalia, they should be considered in urology consultations by adolescents and adults, particularly in the investigation of gynecomastia or infertility.

46, XX testicular DSD. Aportación de un caso / 46, XX testicular disorder of sex development. Case report

OBJETIVO: Presentamos un caso de translocación entre cromosomas X e Y, con fenotipo masculino (46,XX testicular DSD) y revisamos la literatura.MÉTODOS: Los trastornos de la diferenciación sexual en los que no hay correspondencia entre los sexos genético, gonadal y fenotípico son relativamente infrecuentes, algunos son debidos a alteraciones genéticas o cromosómicas.Se efectuó estudio citogenético, realizando cariotipo en sangre periférica (cultivo de linfocitos de 72 horas de duración estimulados por fitohemaglutinina). Las 25 metafases analizadas con bandas G muestran una formula cromosómica de 46,XX (46 cromosomas con formula sexual XX). Tras realizar FISH (hibridación “in situ” fluorescente) con sondas para centrómero de X y región SRY(gen determinante de testículos) de Y, se observan dos cromosomas X, y en la región telomérica del brazo corto de uno de ellos la señal para SRY.RESULTADOS: En los últimos años se han identificado varios genes a parte del SRY, en animales y en humanos que intervienen en los trastornos de la diferenciación sexual. Los defectos genéticos en los receptores de las hormonas péptidicas, los miembros de la superfamilia de los receptores esteroideos y otros factores de transcripción, así como cualquiera de una serie de enzimas y cofactores que intervienen en la biosíntesis de los esteroides pueden inducir una determinación y una diferenciación anómala.CONCLUSIONES: Aunque son poco frecuentes las alteraciones cromosómicas con genitales externos aparentemente normales, hay que tenerlas en cuenta sobre todo en la consulta de urología de adolescentes y adultos, fundamentalmente en el estudio de ginecomastia o de infertilidad(AU)

OBJECTIVE: We present a case of X-Y translocation with male phenotype (46,XX testicular disorder of sex development) and review the literature.METHODS: Disorders of sex development with mismatch of genetic, gonadal and phenotypic sex are quite rare, and some are due to genetic or chromosomal abnormalities. The karyotype was investigated by a cytogenetic study of peripheral blood (phytohemagglutinin-stimulated lymphocyte culture over 72 hours). G-banding analysis of 25 metaphases showed a 46,XX chromosome constitution (46 chromosomes with XX sexual composition). Fluorescence in situ hybridization (FISH) analysis with probes for X centromeres and the sex-determining region of the Y chromosome (SRY) (testis-determining factor gene) showed two X chromosomes. The analysis also showed the SRY signal in the telomeric region of the short arm of one of the chromosomes.RESULTS: In recent years, a number of other genes involved in disorders of sex development in animals and humans have also been identified.Genetic defects in the peptide hormone receptors, members of the steroid receptor superfamily, and other transcription factors, as well as any of a series of enzymes and cofactors involved in steroid biosynthesis can cause abnormal determination and differentiation.CONCLUSIONS: Although chromosomal abnormalities are rarely present in patients with apparently normal external genitalia, they should be considered in urology consultations by adolescents and adults, particularly in the investigation of gynecomastia or infertility(AU)

Tumor inside an inguinoscrotal bladder hernia.

OBJECTIVE: To describe two cases of urothelial tumors in inguinoscrotal bladder hernias and comment on the low incidence of this condition. METHODS: Two patients were diagnosed and treated by partial cystectomy and hernia repair. RESULTS: The clinical outcome of both patients was good at two and three years, respectively, and neither patient experienced hernia or tumor recurrence. CONCLUSIONS: Inguinal bladder hernias are relatively common. However, few reports of tumor in the herniated bladder have been published. Treatment consists of tumor removal, hernia repair and treatment of any associated urethroprostatic condition.

Tumor en hernia vesical inguinoescrotal / Tumor inside an inguinoscrotal bladder hernia

OBJETIVO: Mostramos dos casos de neoplasia urotelial en hernias vesicales inguinoescrotales y referimos su escasa incidencia.METODOS: Se describe el diagnóstico y tratamiento efectuado con cistectomía parcial y herniorrafia.RESULTADOS: Ambos pacientes al cabo de dos y tres años respectivamente han tenido buena evolución clínica, sin recidiva herniaria ni del tumor.CONCLUSIONES: Las hernias vesicales inguinales son relativamente frecuentes, pero los casos de tumor en la vejiga herniada son escasos en la literatura. El tratamiento persigue eliminar el tumor, reparar la hernia y tratar si existe la patología uretroprostática (AU)

OBJECTIVE: To describe two cases of urothelial tumors in inguinoscrotal bladder hernias and comment on the low incidence of this condition.METHODS: Two patients were diagnosed and treated by partial cystectomy and hernia repair.RESULTS: The clinical outcome of both patients was good at two and three years, respectively, and neither patient experienced hernia or tumor recurrence.CONCLUSIONS: Inguinal bladder hernias are relatively common. However, few reports of tumor in the herniated bladder have been published. Treatment consists of tumor removal, hernia repair and treatment of any associated urethroprostatic condition (AU)

[Spermatic cord sarcomas: current status and report of four cases]. / Sarcomas de cordón espermático: estado actual y presentación de cuatro casos clínicos.

OBJECTIVE: To study and review spermatic cord sarcomas, including symptoms, diagnosis, and treatment. METHODS/RESULTS: We review the Spanish and international literature and report 4 new cases: 2 patients with well-differentiated spermatic cord liposarcomas (1 treated by simple tumorectomy), 1 patient with liposarcomatous degeneration of a previously excised atypical lipoma, and 1 patient operated for a malignant retroperitoneal fibrous histiocytoma with subsequent local recurrence in the paratesticular region. CONCLUSIONS: Spermatic cord sarcomas are rare entities that usually appear as painless paratesticular mass. They are diagnosed by imaging studies (ultrasound, computed tomography, magnetic resonance) and confirmed by histological examination. Spermatic cord sarcomas are treated surgically; the efficacy of adjuvant treatments such as chemotherapy or radiation therapy is still under debate.

[Impact of surgical treatment of female stress urinary incontinence on the quality of life of patients]. / Impacto de la cirugía de la incontinencia urinaria de esfuerzo en la calidad de vida de las pacientes.

OBJECTIVES: To evaluate the quality of life of patients with stress urinary incontinence (SUI) operated in the Department of Urology at the Complejo Hospitalario Universitario in Albacete (CHUA). METHODS: Between November 2001 and December 2005, 126 patients with SUI have completed a questionnaire in our centre, before and after undergoing surgery with sling techniques. The questionnaire was the King's Health Questionnaire (KHQ), which is a specific instrument for the measurement of quality of life in patients with urinary incontinence. RESULTS: Mean patient's age was 57.09 years (DE: 9.57). Twelve women (9.5%) had history of previous urinary incontinence surgery. Mean urinary incontinence evolution time was 114.48 months, with a median of 96 months. 38 patients (30.2%) did not present cystocele, 61 (48.4%) presented grade III cystocele, 25 (19.8%) grade II, and 2 (1.6%) grade I. Before surgery, the scale with best score was Personal relationships, with a mean score of 26.8, whereas the scale with worst scores was Impact of urinary incontinence, with a mean score of 82.96. All operations performed consisted in various techniques of transvaginal slings, except one case (0.8%) in which the Kelly technique was performed. Impact of urinary incontinence was the scale with a greater number of patients improving after surgery; 82.9% of the patients (101 cases) gave a better score. The scales showing greater differences of the mean value comparing before/after surgery were impact of urinary incontinence, limitation on the daily life activity, and limitation on social activity. Personal relationships and General health were the two with the smallest improvements. CONCLUSIONS: Surgery demonstrated to improve the symptoms secondary to this disease, therefore, it results in an improvement of the quality of life that is evident in all scales of the questionnaire, mainly in the impact of urinary incontinence, limitations on physical activity, limitations on daily life, and limitation on social activity scales.

Sarcomas de cordón espermático estado actual y presentación de cuatro casos clínicos / Spermatic cord sarcomas: current status and report of four cases

OBJETIVO: Estudio y revisión de los sarcomas de cordón espermático, de la clínica, diagnóstico y tratamiento de dicha patología.MÉTODOS/ RESULTADOS: Se revisa la literatura nacional e internacional, aportando cuatro nuevos casos: dos liposarcomas de cordón espermático bien diferenciados, uno de ellos tratado mediante tumorectomía simple; un paciente con degeneración liposarcomatoide de un lipoma atípico previo resecado; y otro paciente intervenido de un fibrohistiocitoma maligno retroperitoneal con posterior recidiva local a nivel de la región paratesticular.CONCLUSIONES: Los sarcomas de cordón espermático son una entidad poco frecuente que habitualmente se manifiestan como una masa paratesticular indolente. Su diagnóstico se efectúa mediante métodos de imagen (ecografía, TAC, RNM) y se confirma mediante el estudio histológico. El tratamiento es quirúrgico, existiendo cierta controversia acerca de la eficacia de tratamientos adyuvantes como la quimioterapia o la radioterapia(AU)

OBJECTIVE: To study and review spermatic cord sarcomas, including symptoms, diagnosis, and treat-ment.METHODS/RESULTS: We review the Spanish and international literature and report 4 new cases: 2 patients with well-differentiated spermatic cord liposarcomas (1 treated by simple tumorectomy), 1 patient with liposarcomatous dege-neration of a previously excised atypical lipoma, and 1 pa-tient operated for a malignant retroperitoneal fibrous histio-cytoma with subsequent local recurrence in the paratesticular region.CONCLUSIONS: Spermatic cord sarcomas are rare entities that usually appear as painless paratesticular mass. They are diagnosed by imaging studies (ultrasound, computed tomography, magnetic resonance) and confirmed by histological examination. Spermatic cord sarcomas are treated surgically; the efficacy of adjuvant treatments such as chemotherapy or radiation therapy is still under debate(AU)

Impacto de la cirugía de la incontinencia urinaria de esfuerzos en la calidad de vida de las pacientes / Impact of stress urinary incontinence surgery on quality of life

OBJETIVO: Valorar la calidad de vida de las pacientes con incontinencia urinaria de esfuerzo (IUE), intervenidas en el Servicio de Urología del Complejo Hospitalario Universitario de Albacete (CHUA).MÉTODO: Entre noviembre de 2001 y diciembre de 2005, se han encuestado en nuestro centro a 126 pacientes afectas de IUE, antes y después de ser intervenidas con técnicas de cabestrillo, mediante el King’s Health Questionnaire (KHQ), el cual es un instrumento específico para la medida de la calidad de vida en pacientes con incontinencia urinaria.RESULTADOS: La edad media de las pacientes fue de 57,09 años (DE: 9,57). Tuvieron antecedentes de cirugía por incontinencia urinaria 12 mujeres (9,5%). La media de evolución de la incontinencia urinaria fue 114,48 meses, con una mediana de 96 meses. No presentaban ningún grado de cistocele 38 pacientes (30,2%) y del resto de mujeres con cistocele, en 61 casos éste fue de grado III (48,4%); en 25 de grado II (19,8%) y en 2 de grado I (1,6%). Antes de la cirugía la escala mejor puntuada fue la de Relaciones personales con una puntuación media de 26,8, mientras que la escala peor puntuada fue la del Impacto de la incontinencia urinaria, con una puntuación media de 82,96. Todas las cirugías realizadas consistieron en diversas técnicas de cabestrillo por vía transvaginal, salvo un caso (0,8%) en el que se realizó según técnica de Kelly. La escala que mayor número de pacientes mejoraron tras la cirugía, fue la del Impacto de la Incontinencia Urinaria, la cual puntuaron mejor un 82,9% (101 casos) de las enfermas. Las escalas que presentaron mayor diferencia de medias entre las puntuaciones de antes y después de la cirugía fueron la del Impacto de la I.U., la de limitaciones de la actividad física, limitación de la actividad de la vida diaria y limitación de actividad social. Las que mejoraron en menor medida fueron las de relaciones personales y salud general(AU)

CONCLUSIONES: La cirugía demostró una mejoría en los síntomas que produce dicha patología repercutiendo, por tanto, en una mejoría de su calidad de vida, como es patente en todas las escalas del cuestionario y sobre todo en las escalas del Impacto de la I.U., limitación de la actividad física, limitación de la actividad de la vida diaria y limitación de la actividad social(AU)

OBJECTIVES: To evaluate the quality of life of patients with stress urinary incontinence (SUI) operated in the Department of Urology at the Complejo Hospitalario Universitario in Albacete (CHUA).METHODS: Between November 2001 and December 2005, 126 patients with SUI have completed a questionnaire in our centre, before and after undergoing surgery with sling techniques. The questionnaire was the King’s Health Questionnaire (KHQ), which is a specific instrument for the measurement of quality of life in patients with urinary incontinence.RESULTS: Mean patient`s age was 57.09 years (DE: 9.57). Twelve women (9.5%) had history of previous urinary incontinence surgery. Mean urinary incontinence evolution time was 114.48 months, with a median of 96 months. 38 patients (30.2%) did not present cystocele, 61 (48.4%) presented grade III cystocele, 25 (19.8%) grade II, and 2 (1.6%) grade I. Before surgery, the scale with best score was Personal relationships, with a mean score of 26.8, whereas the scale with worst scores was Impact of urinary incontinence, with a mean score of 82.96.All operations performed consisted in various techniques of transvaginal slings, except one case (0.8%) in which the Kelly technique was performed.Impact of urinary incontinence was the scale with a greater number of patients improving after surgery; 82.9% of the patients (101 cases) gave a better score. The scales showing greater differences of the mean value comparing before/after surgery were impact of urinary incontinence, limitation on the daily life activity, and limitation on social activity. Personal relationships and General health were the two with the smallest improvements(AU)

CONCLUSIONS: Surgery demonstrated to improve the symptoms secondary to this disease, therefore, it results in an improvement of the quality of life that is evident in all scales of the questionnaire, mainly in the impact of urinary incontinence, limitations on physical activity, limitations on daily life, and limitation on social activity scales(AU)

Tumor testicular bilateral sincrónico de distancia histología / Bilateral synchronic testicular tumor of different histology

Objetivo: Presentar el caso de un tumor testicular germinal bilateral sincrónico de distinta histología. Método/ Resultado: Se trata de un paciente de 37 años que durante un estudio ecográfico, por sospecha de tumor testicular izquierdo, se apreció una tumoración testicular contralateral sincrónica. Se practicó orquiectomía inguinal bilateral y en el posterior estudio anatomopatológico se confirmó la presencia de la tumoración testicular bilateral de distinto componente histológico. Conclusión: Alrededor del 75% de los casos de tumoración testicular bilateral son metacrónicos, presentándose únicamente el 10% con diferente histología. El tipo histológico suele correlacionarse con el aspecto ecográfico, y el tratamiento de elección de un paciente con patología oncológica de este tipo es la orquiectomía inguinal bilateral (AU)

Objective: To report one case of bilateral synchronic germ cell testicular tumour of different histology. Methods/Results: 37-year-old patient with left testicular tumor under study was found to have a contralateral synchronic testicular tumor on ultrasound. Bilateral inguinal orchiectomy was performed and pathology reported the presence of bilateral testicular tumours of different histological type. Conclusions: Around 75% of the cases of bilateral testicular tumours are metachronic, with only 10% presenting different histology. Histological type often correlates with the ultrasound findings, and the treatment of choice in patients with this type of oncological pathology is bilateral inguinal orchiectomy (AU)