Conservative management of high-grade renal trauma.

INTRODUCTION: Renal trauma is the most common of urological trauma and accounts for up to 5% of all. The AAST scale is the most widely used to assess renal trauma. This study focuses on high-grade trauma, whose treatment has evolved towards a conservative approach, with techniques such as angioembolization. The aim is to describe the evolution in the management of high-grade renal trauma in all patients treated at La Paz University Hospital from 2001 to 2022. METHODS: A descriptive retrospective study was conducted on patients treated at the hospital. The study was divided into two periods (2001-2010 and 2011-2022). A total of 285 patients with renal trauma were collected, of which 54 were high grade. The main variable is the type of management, conservative (embolization) or interventional through nephrectomy. RESULTS: In the completed series, there was a decrease in radical nephrectomy in high-grade renal trauma from 50% to 13.8% over time, with an increase in embolization from 23,1% to 44,8%. In patients with isolated renal trauma, those treated with embolization increased from 28.6% to 69.2%, while those undergoing radical/partial nephrectomy decreased from 42.8% to 7.69%. CONCLUSION: The management of renal trauma has evolved over the years in our center. The number of patients treated by embolization has increased, while the number of complications and nephrectomies has decreased.

Randomized clinical trial on the use of IMAGE1 S LIGHT (SPIES) vs. white light in the prevention of recurrence during transurethral resection of bladder tumors: Analysis after 12-month follow-up.

INTRODUCTION: The improved image resolution of IMAGE1 S technology will increase tumor detection, achieve a greater number of complete resections, and would probably have an impact on the reduction of recurrences. AIM: The primary objective was to compare the recurrence rates of IMAGE1 S vs. white light during transurethral resection of the bladder (TUR); the secondary objective was to compare the complication rates according to Clavien-Dindo (CD) at 12 months of follow-up. METHODS: Prospective, randomized 1:1, blinded clinical trial. Recurrence and complication rates according to CD were analyzed using chi-square/U Mann-Whitney tests and recurrence-free survival (RFS) using Kaplan-Meier curves. The European Association of Urology (EAU) 2021 scoring model was used. RESULTS: The analysis included 103 participants; 49 were assigned to the IMAGE1 S group and 54 to the white light group. Recurrence rates were 12.2% and 25.9%, respectively (P = .080). The low and intermediate risk group had a lower recurrence rate with IMAGE1 S (7.7% vs. 30.8%, P = .003) and a higher RFS with IMAGE1 S (85.2% vs. 62.8% Log Rank: 0.021), with a Hazard Ratio of 0.215 (95% CI: 0.046-0.925). No differences were observed in the high and very high-risk groups. Complications were mostly grade I and rates were similar between both groups (IMAGE1 S 20.4% vs. white light 7.4% P = .083). CONCLUSIONS: There were no differences in the recurrence rates between groups. However, the low and intermediate risk group had a lower recurrence rate with IMAGE1 S. In addition, perioperative complication rates were not higher.

Valor pronóstico de la citología urinaria en la recidiva del carcinoma urotelial vesical tras la cistectomía radical / Prognostic value of urinary cytology for detecting urothelial carcinoma recurrence after radical cystectomy

Introducción: Las recidivas del carcinoma urotelial (CaU) en uretra o en el tracto urinario superior (TUS), tras una cistectomía radical (CR) son infrecuentes (4-6%), y su diagnóstico suele ocurrir en los 2 primeros años. Actualmente, no existen claras recomendaciones para la detección de recidivas en el urotelio remanente (UR), aunque se sabe que su detección precoz ofrece beneficios en la supervivencia. Nuestro objetivo es determinar el valor diagnóstico de la citología urinaria (CU) para la detección de recidivas en el UR y calcular su impacto como método de diagnóstico precoz en la supervivencia.Material y métodosRevisión retrospectiva de pacientes intervenidos de CR por CaU entre 2008-2016, con un seguimiento mayor de 24 meses.ResultadosSe incluyeron 142 pacientes. En una mediana de seguimiento de 68,5 meses, 9 pacientes (6,3%) presentaron recidivas en el UR (uretra: 4, TUS: 4, sincrónica: uno). La sensibilidad de la CU para el diagnóstico de recidivas en el TUS fue del 20% y la especificidad del 96%. No se encontraron diferencias significativas entre la supervivencia global y la supervivencia cáncer específica entre pacientes según el resultado de la CU.ConclusiónLas recidivas en el UR tras una CR son infrecuentes, y en nuestro estudio, hemos encontrado una baja sensibilidad para el diagnóstico de estas con CU. Por estas razones, no consideramos que la CU aporta información útil para el seguimiento de estos pacientes. (AU)

Introduction: Urethral or upper urinary tract (UUT) recurrence of urothelial carcinoma (UC) after radical cystectomy (RC) are rare (4-6%), and their diagnosis usually occurs within the first two years. Although it is known that its early detection offers benefit in terms of survival, currently there are no clear recommendations for the detection of recurrence in the remnant urothelium (RU). Our aim is to determine the diagnostic value of urinary cytology for the detection of recurrences in the RU and to estimate its impact as an early diagnostic method on survival.Material and methodsRetrospective review of patients who underwent RC for urothelial carcinoma between 2008-2016, with a follow-up of at least 24 months.ResultsThe study included 142 patients. In a median follow-up of 68.5 months, nine patients (6.3%) presented recurrences in the RU (urethra: four, UUT: four, synchronous: one). The sensitivity and specificity of urinary cytology for the diagnosis of UUT recurrences were 20% and 96%, respectively. No significant differences were found between overall survival and cancer-specific survival among patients according to the urinary cytology results.ConclusionRecurrences in the RU after RC are infrequent; our study has shown that urinary cytology offers a low sensitivity for their diagnoses. For these reasons, we do not consider that urinary cytology provides useful information for surveillance of these patients. (AU)

Prognostic value of urinary cytology for detecting urothelial carcinoma recurrence after radical cystectomy.

INTRODUCTION: Urethral or upper urinary tract (UUT) recurrence of urothelial carcinoma (UC) after radical cystectomy (RC) are rare (4-6%), and their diagnosis usually occurs within the first two years. Although it is known that its early detection offers benefit in terms of survival, currently there are no clear recommendations for the detection of recurrence in the remnant urothelium (RU). Our aim is to determine the diagnostic value of urinary cytology for the detection of recurrences in the RU and to estimate its impact as an early diagnostic method on survival. MATERIAL AND METHODS: Retrospective review of patients who underwent RC for urothelial carcinoma between 2008-2016, with a follow-up of at least 24 months. RESULTS: The study included 142 patients. In a median follow-up of 68.5 months, nine patients (6.3%) presented recurrences in the RU (urethra: four, UUT: four, synchronous: one). The sensitivity and specificity of urinary cytology for the diagnosis of UUT recurrences were 20% and 96%, respectively. No significant differences were found between overall survival and cancer-specific survival among patients according to the urinary cytology results. CONCLUSION: Recurrences in the RU after RC are infrequent; our study has shown that urinary cytology offers a low sensitivity for their diagnoses. For these reasons, we do not consider that urinary cytology provides useful information for surveillance of these patients.

Zinner Syndrome with Ectopic Ureter Emptying into Seminal Vesicle.

A 66-year-old male patient in follow-up in the urology department for a non-muscle-invasive bladder cancer was detected by ultrasound to have absence of the left kidney and a cystic, multilobed image at the location of the seminal vesicle. Magnetic resonance imaging reveals left renal agenesis and the existence of multiple cysts in the ipsilateral seminal vesicle that reaches a size of 6.9 × 3.7 cm, as well as a ureteral remnant that opens into the seminal vesicle. The patient does not present urinary symptoms, neither pain with ejaculation nor hematuria. A triad of seminal vesicle cyst, ipsilateral renal agenesis, and ipsilateral ejaculatory duct obstruction is known as Zinner syndrome. Congenital anomalies of the seminal vesicles are rare; some of them are associated with malformations of the upper urinary system. Seminal vesicle cysts are associated with ipsilateral renal agenesis and ectopic or dysplastic ureter. Patients may remain asymptomatic and be diagnosed incidentally or may present with symptoms such as increased urinary frequency, dysuria, recurrent infections, pain with ejaculation, and perineal discomfort.

La resonancia magnética como herramienta para el diagnóstico del cáncer de próstata: nuevas evidencias y posicionamiento de la ESUT (EAU Section of Uro-Technology) / Magnetic resonance as imaging diagnostic tool in prostate cancer: New evidences-The EAU Section of Uro-Technology position

El cáncer de próstata (CP) es la segunda causa principal de mortalidad por cáncer y la enfermedad diagnosticada con mayor frecuencia en la población masculina. El CP se manifiesta de diversas maneras: desde enfermedad indolente a altamente agresiva. A esto se debe la complejidad de su diagnóstico y de la elección del tratamiento adecuado. El enfoque utilizado actualmente, con pruebas de PSA y examen rectal digital seguido de biopsia transrectal ecodirigida, carece de sensibilidad y especificidad en la detección de CP y ofrece información limitada sobre la agresividad y el estadio del cáncer. La evidencia científica respalda el creciente uso de la resonancia magnética multiparamétrica como la herramienta de imagen más sensible y específica para la detección, la caracterización de lesiones y la estadificación del CP. El presente estudio hace una revisión actualizada del rol de la resonancia magnética en el diagnóstico de CP, revisando los últimos artículos publicados en PubMed

Prostate cancer (PCa) is the second leading cause of cancer-related mortality and the most frequently diagnosed male malignant disease among men. The manifestation of PCa ranges from indolent to highly aggressive disease and due to this high variation in PCa progression, the diagnosis and subsequent treatment planning can be challenging. The current diagnostic approach with PSA testing and digital rectal examination followed by transrectal ultrasound biopsies lack in both sensitivity and specificity in PCa detection and offers limited information about the aggressiveness and stage of the cancer. Scientific work supports the rapidly growing use of multiparametric magnetic resonance imaging as the most sensitive and specific imaging tool for detection, lesion characterization and staging of PCa. Therefore, we carried out an updated review of magnetic resonance imaging in the diagnostic PCa reviewing the latest papers published in PubMed

Magnetic resonance as imaging diagnostic tool in prostate cancer: New evidences-The EAU Section of Uro-Technology position. / La resonancia magnética como herramienta para el diagnóstico del cáncer de próstata: nuevas evidencias y posicionamiento de la ESUT (EAU Section of Uro-Technology).

Prostate cancer (PCa) is the second leading cause of cancer-related mortality and the most frequently diagnosed male malignant disease among men. The manifestation of PCa ranges from indolent to highly aggressive disease and due to this high variation in PCa progression, the diagnosis and subsequent treatment planning can be challenging. The current diagnostic approach with PSA testing and digital rectal examination followed by transrectal ultrasound biopsies lack in both sensitivity and specificity in PCa detection and offers limited information about the aggressiveness and stage of the cancer. Scientific work supports the rapidly growing use of multiparametric magnetic resonance imaging as the most sensitive and specific imaging tool for detection, lesion characterization and staging of PCa. Therefore, we carried out an updated review of magnetic resonance imaging in the diagnostic PCa reviewing the latest papers published in PubMed.

Resultados oncológicos de la cirugía conservadora de parénquima renal. Análisis de 17 años / Oncological outcomes of nephron sparing nephrectomy. 17-year analysis

OBJETIVO: La cirugía renal conservadora de parénquima se considera la técnica de elección en tumores renales menores de 4 cm. Presentamos nuestros resultados oncológicos de un periodo de 17 años. MÉTODOS: Entre enero de 1995 y diciembre de 2012 se han realizado 130 cirugías renales por tumor (58 abiertas, 72 laparoscópicas). Analizamos los resultados anatomopatológicos, la presencia de márgenes positivos, recidiva local, metástasis a distancia y exitus. RESULTADOS: El tumor más frecuente es el de células claras (73%) en un estadio pT1 (87%). El tamaño medio tumoral es de 3,4 cm. La tasa de márgenes positivos es de 7%, sin recidiva tumoral en estos casos en la actualidad (seguimiento de 37 meses). La mortalidad cáncer específica es del 0% y la tasa de recidiva local es del 3%. El seguimiento medio es de 71 meses. CONCLUSIONES: La cirugía conservadora de parénquima tiene resultados superponibles a la nefrectomía radical en tumores por debajo de 4 cm. Los márgenes positivos no parecen tener una repercusión importante en la supervivencia cáncer específica

OBJECTIVES: Nephron sparing renal surgery is considered the technique of choice for renal tumors smaller than 4 cm. We present our oncological results in a 17-year period. METHODS: Between January 1995 and December 2012, 130 renal tumor surgeries (58 open, 72 laparoscopic) were performed. We analize the pathological results, presence of positive surgical margins, local relapse, distant metastases and death. RESULTS: The most frequent tumor was clear cell carcinoma (73%) in a pT1 stage (87%). Mean tumor size was 3 cm. Positive surgical margin rate was 7%, currently without any tumor recurrence among these cases (follow up 37 months). Cancer specific mortality is 0% and local recurrence rate 3%. Mean follow up is 71 months. CONCLUSIONS: Nephron sparing surgery results are similar to radical nephrectomy in tumors smaller than 4 cm. Positive surgical margins do not seem to have an important repercussion in cancer specific survival

[Laparoscopic nephron-sparing surgery. 5 years' experience]. / Cirugía conservadora de parénquima renal laparoscópica. Cinco años de experiencia.

INTRODUCTION: Laparoscopic nephron-sparing surgery is among the most complex urological procedures currently performed. Open surgery continues to be the gold standard of care, but the laparoscopic approach is gaining ground slowly but surely. Our 5 years' experience is reported. MATERIALS AND METHODS: From September 2004 to March 2009, 38 laparoscopic nephron-sparing procedures were performed at our hospital. A transperitoneal laparoscopic approach was used in all cases, with en bloc clamping of renal hilum in most patients. RESULTS: Mean operating time was 141 min, mean intraoperative bleeding 130 mL, mean warm ischemia time 24 min, and mean hospital stay 3.3 days. Bleeding was the most common complication (requiring transfusion in 13.5% of patients). Positive surgical margins were found in 5.4% of patients. CONCLUSIONS: Adequate selection of the patient (tumor size, location) and the procedure to be used, surgeon experience, and surgical skills are essential for achieving good oncological results and for minimizing the complications of this demanding procedure.

[Laparoscopic adrenalectomy. Five-year experience]. / Suprarrenalectomía laparoscópica. Experiencia de 5 años.

OBJECTIVE: Adrenal conditions requiring surgery are uncommon and are usually seen in several surgical departments. Our experience in laparoscopic management of adrenal pathology after almost five years of use of laparoscopy for retroperitoneal conditions at our center is reported. MATERIALS AND METHODS: A total of 37 laparoscopic adrenalectomies were performed over 53 months for benign and malignant conditions. The transperitoneal approach was used in most cases (97%) because of the greater surgeon experience with this route. Pregnancy and suspected periadrenal infiltration were considered as absolute contraindications. RESULTS: Mean operating time was 90 minutes, mean intraoperative bleeding 80 ml, and mean hospital stay was 2 days. The main complication was one death. A malignancy was found in 4 patients (10%), while all other patients (90%) had a benign condition, including 8 pheochromocytomas. CONCLUSIONS: Laparoscopy is considered to be the gold standard for benign adrenal conditions. When the malignant mass is a single metastasis from a primary tumor, the laparoscopic approach appears to be reliable. When the malignant lesion is a primary adrenal tumor, laparoscopic management is more controversial, although the results reported by experienced surgeons in their series appear to be adequate.

Cirugía conservadora de parénquima renal laparoscópica. Cinco años de experiencia / Laparoscopic nephron-sparing surgery. 5 years’ experience

Objetivo: La cirugía renal conservadora de parénquima laparoscópica es una de las técnicas más complejas que se pueden realizar en Urología en el momento actual. En la actualidad, la técnica abierta continúa siendo el gold standard, aunque lentamente la laparoscopia se va implantando. Presentamos nuestra serie de casi 5 años. Material y métodos: Desde septiembre de 2004 hasta marzo de 2009 se han realizado 38 cirugías conservadoras de parénquima renal por vía laparoscópica. Todas ellas se han realizado con el abordaje transperitoneal, con un clampaje en bloque del hilio renal en la mayoría de los casos. Resultados: El tiempo quirúrgico medio es de 141min, sangrado intraoperatorio medio de 130cm3, con un tiempo medio de clampaje de 24min y una estancia media postoperatoria de 3,3 días. La complicación más frecuente es el sangrado (transfusión, el 13,5%). El porcentaje de márgenes positivos es del 5,4%. Conclusiones: Con el fin de obtener unos buenos resultados oncológicos y reducir al mínimo las complicaciones, es fundamental la buena selección del caso (tamaño y localización del tumor) así como de la técnica que se va a emplear. La experiencia del cirujano y sus recursos laparoscópicos son de vital importancia (AU)

Introduction: Laparoscopic nephron-sparing surgery is among the most complex urological procedures currently performed. Open surgery continues to be the gold standard of care, but the laparoscopic approach is gaining ground slowly but surely. Our 5 years’ experience is reported. Materials and Methods: From September 2004 to March 2009, 38 laparoscopic nephron-sparing procedures were performed at our hospital. A transperitoneal laparoscopic approach was used in all cases, with en bloc clamping of renal hilum in most patients. Results: Mean operating time was 141min, mean intraoperative bleeding 130mL, mean warm ischemia time 24min, and mean hospital stay 3.3 days. Bleeding was the most common complication (requiring transfusion in 13.5% of patients). Positive surgical margins were found in 5.4% of patients. Conclusions: Adequate selection of the patient (tumor size, location) and the procedure to be used, surgeon experience, and surgical skills are essential for achieving good oncological results and for minimizing the complications of this demanding procedure (AU)

Suprarrenalectomía laparoscópica. Experiencia de 5 años / Laparoscopic adrenalectomy. Five-year experience

Objetivo: la patología adrenal susceptible de indicación quirúrgica es poco frecuente y normalmente se encuentra dividida entre varios servicios quirúrgicos. Presentamos nuestra experiencia en el manejo laparoscópico tras casi 5 años de implantación de la laparoscopia en la patología retroperitoneal en nuestro centro. Material y métodos: en 53 meses se han realizado un total de 37 suprarrenalectomías por patología benigna y maligna. El abordaje más frecuentemente empleado es el transperitoneal (97%) debido a la mayor experiencia del cirujano con esta vía. La paciente embarazada y la sospecha de infiltración periadrenal se han tomado como contraindicaciones absolutas. Resultados: el tiempo quirúrgico medio es de 90 minutos, sangrado intraoperatorio de 80 cc, estancia media postoperatoria de dos días y la principal complicación ha sido un exitus. En4 ocasiones la patología es maligna (10%), el resto (90%) benigna, con 8 feocromocitomas. Conclusiones: la laparoscopia se considera el patrón oro para la patología benigna adrenal. Cuando la lesión es de naturaleza maligna, en caso de ser una metástasis única procedente de otro tumor primario, parece que el abordaje laparoscópico es fiable. Cuando la lesión maligna es primaria adrenal existe más controversia en este tipo de abordaje, si bien es cierto que en series de cirujanos experimentados los resultados parecen adecuados (AU)

Objective: Adrenal conditions requiring surgery are uncommon and are usually seen in several surgical departments. Our experience in laparoscopic management of adrenal pathology after almost five years of use of laparoscopy for retroperitoneal conditions a tour center is reported. Materials and methods: A total of 37 laparoscopic adrenalectomies were performed over 53months for benign and malignant conditions. The transperitoneal approach was used in most cases (97%) because of the greater surgeon experience with this route. Pregnancy and suspected periadrenal infiltration were considered as absolute contraindications. Results: Mean operating time was 90 minutes, mean intraoperative bleeding 80 ml, and mean hospital stay was 2 days. The main complication was one death. A malignancy was found in 4 patients (10%), while all other patients (90%) had a benign condition, including8 pheochromocytomas. Conclusions: Laparoscopy is considered to be the gold standard for benign adrenal conditions. When the malignant mass is a single metastasis from a primary tumor, the laparoscopic approach appears to be reliable. When the malignant lesion is a primary adrenal tumor, laparoscopic management is more controversial, although the results reported by experienced surgeons in their series appear to be adequate (AU)

A review of penile cancer.

UNLABELLED: Cancer of the penis is a rare tumour in Europe and mainly affects the elderly patient population. The aim of this paper was to analyse and study the characteristics of this tumour, in our patient population. MATERIALS AND METHODS: A retrospective study was conducted on penile tumours diagnosed and treated in the Urology Department of the Hospital Universitario La Paz, Madrid, in the last ten years. RESULTS: A total of 34 patients were diagnosed and treated. The mean age at presentation was 71.27 years. The mean time between symptoms and the first consultation was 12.54 months with a median of 6 months. The most common form of presentation was balanoposthitis (32%) and the most common site in our series was the glans. Partial penectomy was performed in 22 cases, total amputation in 8, and local excision in 3. DISCUSSION: Carcinoma of the penis is a pathology which mostly affects elderly patients; in our series, the highest incidence was observed in patients in the group aged 75-84 years. The most common histological type was epidermoid carcinoma in its various forms of presentation. We recorded a mortality of 23%. CONCLUSION: Penile carcinoma is a rare pathology which affects elderly persons and is diagnosed late.

Tratamiento de la litiasis con láser en condiciones especiales / Treatment of urinary stones with laser in special conditions

Durante la última década, se ha producido un rápido desarrollo en la nefroscopia y la ureterorrenoscopia flexible, litotricia láser y diferentes instrumentos para manejar las litiasis. Realizaremos una revisión del empleo del láser en distintas situaciones. Se deben hacer esfuerzos para minimizar el daño renal y el láser juega un papel importante en el tratamiento de pacientes con urolitiasis y riñones en herradura, insuficiencia renal crónica, pacientes neurológicos (AU)

During the last decade there has been a rapid development in flexible nephroscopy, flexible ureterorenoscopy, laser lithotripsy and instruments for stone manipulation. We are going to review the use of Laser in the management of lithiasis in different situations. Efforts should be made to minimize renal injury and lasers play a significant role in patients with urolithiasis and horseshoe kidneys, chronic renal failure, neurological patients (AU)

Cirugía retroperitoneal laparoscópica. Experiencia del Hospital Universitario La Paz / Retroperitoneal laparoscopic surgery. Experience at the Hospital Universitario La Paz

Objetivo: Con la popularización de la prostatectomía radical laparoscópica, dicha técnica vuelve a tomar un papel importante en el funcionamiento de los servicios de urología. Nuestra mayor experiencia en laparoscopia hace que cada vez realicemos más intervenciones mediante este abordaje. En este sentido, la cirugía retroperitoneal probablemente se beneficie más claramente que la prostática de la cirugía mínimamente invasiva. En este artículo describimos nuestra serie de casi 4 años. Métodos: El periodo analizado abarca desde Junio 2004 hasta Marzo 2008, durante el cual se han llevado a cabo 288 cirugías retroperitoneales (179 nefrectomías, 109 procedimientos varios). La vía de abordaje ha sido tranperitoneal en la gran mayoría de los casos. Resultados: La estancia hospitalaria media fue de 3,6 días para las nefrectomías y 3 días para los otros procedimientos. La tasa de transfusión de las nefrectomías es del 5% y un 2% de reconversión. En las cirugías variadas el porcentaje de transfusión fue del 6% y no existió ninguna reconversión. Conclusiones: La expansión de la laparoscopia en Urología debe venir acompañada de una buena selección de pacientes y una progresiva adquisición de experiencia por parte del cirujano. Determinadas intervenciones deberán ser abordadas únicamente en caso de gran experiencia (AU)

Objectives: With the popularisation of laparoscopic radical prostatectomy, the above technique has once again taken on an important role in the work of urology departments. Our extensive experience in laparoscopy means that we are performing increasingly more interventions using this approach. In the context of minimally invasive surgical procedures, this is probably bringing clearer benefits to retroperitoneal surgery than to prostatic surgery. In this article, we describe our series over nearly 4 years. Methods: The period analysed covers June 2004 to March 2008, during which time 288 retroperitoneal operations were performed (184 nephrectomies, 113 other procedures). In the majority of cases, the route of approach was transperitoneal. Results: The mean hospital stay was 3.6 days for the nephrectomies and 3 days for the other procedures. The transfusion rate for the nephrectomies was 5% and there was a conversion rate of in 2%. In the other types of surgery, the transfusion rate was 6% and there were no conversions. Conclusions: The expansion of laparoscopy in Urology has to be accompanied good patient selection and the progressive acquiring of experience on the part of the surgeon. Certain interventions should only be tackled in cases where there is extensive experience (AU)

[Leukemic infiltration of the urinary bladder. A new case and literature review]. / Infiltración vesical por leucemia linfoblástica aguda. A propósito de un caso y revisión de la literatura.

We expose you one case of leukemic infiltration of the urinary bladder. This kind of infiltration is rare so we reviewed the literature finding 14 cases since 1932. Although this hematological infiltration is very unusual, it should be considered in patients with leukemia and hematuria.

Infiltración vesical por leucemia linfoblástica aguda. A propósito de un caso y revisión de la literatura / Leukemic infiltration of the urinary bladder. A new case and literature review

Exponemos el caso de un paciente con infiltración vesical por Leucemia Aguda Linfoblástica. Debido a lo infrecuente de su presentación, revisamos la literatura publicada hasta el momento encontrando14 casos desde 1932. Aunque excepcional, en un paciente que presenta hematuria de novo o repetida y ha tenido como antecedentes alguna enfermedad hematológica, debemos pensar en la infiltración vesical por la leucemia como posible diagnóstico diferencial (AU)

We expose you one case of leukemic infiltration of the urinary bladder. This kind of infiltration is rare so we reviewed the literature finding 14 cases since 1932. Although this hematological infiltration is very unusual, it should be considered in patients with leukemia and hematuria (AU)

[Experimental laparoscopic renal autograft as learning laparoscopic model]. / Autotrasplante renal laparoscópico experimental como modelo de aprendizaje de técnica laparoscópica.

INTRODUCTION: Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased. GOALS: The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vacular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed. MATERIAL AND METHODS: Laparoscopic renal autotransplant was perfomed in female lab pigs weighing 15-20 kg. International Experimental Animal Care rules were accomplished. RESULTS: After sacrifizing the animals, only one case of vascular thrombosis was observed. The other cases showed normal arterial and venous flow. CONCLUSIONS: Experimental Renal Laparoscopic autotransplant constitutes a good surgical model. We are trying to implement the technique in the clinics in the next future.