Synchronous enteroid adenocarcinoma at the ureteral implantation site after ureterosigmoidostomy.

Ureterosigmoidostomy is considered to be the oldest urinary diversion technique performed for the first time in the 19th Century in patients with urinary malformations. However, the high rate of complications as well as the significant risk of developing tumors in the colonic portion of the ureteral anastomosis have given rise to other new intestinal urinary diversion techniques. We present the case of a patient with two synchronous enteroid adenocarcinomas, with a latency period of 66 years, at the site of both ureterocolonic anastomoses after ureterosigmoidostomy performed during childhood owing to bladder exstrophy.

[Giant renal oncocytoma]. / Oncocitoma renal gigante.

Renal oncocytoma is a benign neoplasms arising from cells of the distal renal tubule. They acount for 3-7% of all renal tumors. most are incidental findings. Differential diagnosis with renal cells carcinoma is often difficult. Here we report a case of big renal oncocytoma as an incidental finding while performing an abdominal ultrasound in a patient with low abdominal pain. We also review the diagnostic an therapeutic approach in this kind of malignancies.

[Proceedings in the implantation of a laparoscopic radical prostatectomy program]. / Implantación de un programa de prostatectomia radical laparoscópica.

OBJECTIVE: To describe our proceedings in the implatation of our laparoscopic radical prostatectomy program (LRP). METHODS: Our working agenda and step-oriented implementation of our LRP program are shown. RESULTS: Four main steps were scheduled to acomplish this goal. These were: Preparatory phase, programed open conversion, development and analysis. Overlapping of each of these phase occured although their major content run on a time-basis. After basic skills acquisition and updating of our equipment we moved into the fixed-time open conversion we allowed us to progresively improve our performance without putting our patients into risks. Operative time of this phase exceeds that of our open cases in 63 minutes and no major complications took place. A rapid decrease in the operative time was noted after the first 15 cases (197' vs 264'). CONCLUSION: Implantation of a program of LRP can be done safely with a pre-planned program tailored to the needs and characteristics of each group and institution.

[Soft lithiasis ("mous")]. / Litiasis blanda ("mous").

OBJECTIVES: To describe the most relevant features of matrix lithiasis, an infrequent type of lithiasis seldom reported since the generalization of extracorporeal shock wave lithotripsy. METHODS: We report a clinical case and analyze the most important bibliography found by MEDLINE search (1950-1999). We will focus on the physiopathology and etiology of these stones to understand its development and the clinical presentation showed by these patients. RESULTS: Matrix lithiasis is a very rare entity, described almost one century ago. It is mainly composed of lithiasis matrix, and the percentage of mineral content is really low in comparison with usual stones. Persistent urinary tract infection is another constant in these patients, which to some extent conditions the modification of the usual urinary components, creating a series of the disturbances within the urinary tract that favour the aggregation of the components of the lithiasis matrix up to the formation of a stone, without need of aggregation of mineralized crystals. CONCLUSIONS: A high degree of suspicion is necessary for the diagnosis of matrix lithiasis, because it does not show the usual clinical picture of a renal stone. Exhaustive lavage of caliceal cavities and elimination of bacteriuria are essential elements for treatment, in order to avoid recurrence of the disease.

[Renal injuries: diagnosis and current management]. / Traumatismos renales: diagnóstico y manejo actual.

Abdominal trauma is relatively frequent and around 5% of the cases correspond to renal trauma. At present, a large percentage of cases can be managed conservatively. Generalised use of CT and cumulative experience have defined the cases that can be treated with good prospects. The currently accepted indications for imaging techniques and the most frequent ratings used are described. Similarly, the indications for surgical renal examination are listed and the principles for renal reconstruction described in the most recent publications of the most experienced medical centres.

[Leydig cell tumor: report of 8 cases and review of the literature]. / Tumor de células de leydig: presentación de ocho casos y revisión de la literatura.

Leydig cell tumor is the most frequent non-germ cell tumors of testis, included in the group of specialized gonadal stromal neoplasms. It has a low incidence, accounting for 1-3% of testicular neoplasms. This tumor is characterized by its endocrine manifestations, due to the tumor's capacity to secrete hormones. We report eight cases, including the description of their clinical, diagnosis and therapeutic features, as well as their follow-up. We also make a review of the literature about this rare testicular tumor.

[Mesoblastic nephroma in the adult: report of a new case]. / Nefroma mesoblástico del adulto: aportación de un nuevo caso.

OBJECTIVE: A case of adult mesoblastic nephroma is presented. The clinical features, treatment, histological diagnosis and outcome are discussed. METHODS/RESULTS: A 68-year-old patient in whom a renal mass had been detected by ultrasound is described. The patient underwent radical nephrectomy. The anatomopathological analysis demonstrated a mesoblastic nephroma. No signs of recurrence have been observed at 3 years' follow-up. CONCLUSIONS: Mesoblastic nephroma of adulthood has a benign behavior and recurrence is rare after surgery.

[Surgical management of the penile fractures. Our experience]. / Tratamiento quirúrgico de la fractura de pene. Nuestra experiencia.

UNLABELLED: The fracture of the penis is an uncommon injury that is defined as a rupture of the tunica albuginea of the corpus cavernosum. We present our experience in 9 cases admitted to our department between 1989 and 1998. Most of the cases were caused by traumatism during sexual intercourse. Clinical presentation and physical examination were enough to make the diagnosis. The treatment was surgery in all cases, with evacuation of the hematoma and reconstruction of the rupture with absorbable suture. The result about penile function and curvature was excellent in all cases. There was no cases of penile incurvation nor erectil disfunction. CONCLUSIONS: In our experience, surgical management of the penile fracture has good results, with no erectil disfunction, nor penile incurvation.