[Voiding syndrome of gynaecological origin: the importance of good physical examination]. / Síndrome miccional de origen ginecológico: La importancia de una Buena exploración física.

OBJECTIVES: Urologists daily evaluate many women with voiding disturbances, but proper physical examination has only rarely been previously performed. CASE DESCRIPTION: Case 1: 16-year-old woman presenting augmented daytime urinary frequency and nocturia without enuresis, with drop-by-drop micturition. Case 2: 80-year-old woman with urgency. She referred normal voiding with insensitive urinary loss the hour after. PHYSICAL EXAMINATION: adhesion of the labia minora. TREATMENT: Surgical section of the adhered area in the midline was performed with satisfactory aesthetic and clinical results. CONCLUSIONS: The adhesion of the labia minora is an acquired disease, more frequent in girls under 2 years. Several predisposing factors have been proposed: oestrogen deprivation, inadequate personal care, local irritants, infections or previous trauma. Differential diagnosis is required among three congenital pathologies: vaginal agenesis, imperforated hymen and ambiguous genitalia. Cases in postpubertal or postmenopausal women, or refractory to medical treatment are considered for surgery.

Síndrome miccional de origen ginecológico: la importancia de una buena exploración física / Voiding syndrome of gynaecological origin: the importance of good physical examination

OBJETIVOS: A diario acuden a la consulta pacientes remitidas por alteraciones miccionales, pero en pocas ocasiones han sido exploradas ni se les ha realizado una anamnesis adecuada previa. Descripción de los casos: Caso nº 1: Mujer de 16 años remitida por polaquiuria diurna y nocturna sin enuresis, con micción a gotas. Caso nº 2: Mujer de 80 años remitida por urgencia miccional. Micciones normales con incontinencia urinaria insensible durante la hora siguiente. No escapes urinarios relacionados con la urgencia. Exploración física: fusión de los labios menores de la vulva. Tratamiento: Sección quirúrgica en la línea media el área fusionada. Resultados clínicos y estéticos satisfactorios. CONCLUSIONES: La fusión de labios de la vulva es una enfermedad adquirida más frecuente en niñas menores de dos años de edad. Se postulan diversos factores favorecedores: deprivación estrogénica, higiene inadecuada, irritantes locales, infección o traumatismo previos. Debemos establecer el diagnóstico diferencial con tres patologías congénitas: agenesia vaginal, himen imperforado, y ambigüedad genital. En casos refractarios al tratamiento médico o en mujeres jóvenes y postmenopáusicas, se recomienda cirugía

OBJECTIVES: Urologists daily evaluate many women with voiding disturbances, but proper physical examination has only rarely been previously performed. Case description: Case 1: 16-year-old woman presenting augmented daytime urinary frequency and nocturia without enuresis, with dropby-drop micturition. Case 2: 80-year-old woman with urgency. She referred normal voiding with insensitive urinary loss the hour after. Physical examination: adhesion of the labia minora. Treatment: Surgical section of the adhered area in the midline was performed with satisfactory aesthetic and clinical results. CONCLUSION: The adhesion of the labia minora is an acquired disease, more frequent in girls under 2 years. Several predisposing factors have been proposed: oestrogen deprivation, inadequate personal care, local irritants, infections or previous trauma. Differential diagnosis is required among three congenital pathologies: vaginal agenesis, imperforated hymen and ambiguous genitalia. Cases in postpubertal or postmenopausal women, or refractory to medical treatment are considered for surgery

[Horseshoe kidney rupture]. / Rotura de riñón en herradura.

BACKGROUND: We report a rare case of horses-hoe kidney trauma. METHODS: 67 years old man with a horseshoe kidney, which presented a fracture of the isthmus after falling. RESULTS: The diagnosis was made by IV contrast CT scan. He underwent exploratory laparotomy due to hemodynamic instability and radiologic findings on the CT scan. CONCLUSIONS: The rupture of a horseshoe kidney is a rare injury. CT scan is the test of choice to classify the degree of injury. Depending on the patient's hemodynamic stability and the findings on the CT scan the options are conservative orimmediate surgical treatment.

Don Luis Cifuentes, maestro y escritor / Dr. Luis Cifuentes, master and writer

En el centenario del Dr. Luis Cifuentes se relatan diversas anécdotas sobre su faceta docente, que ayudan a conocer y a entender su calidad profesional y humana

In the centenary of Dr. Luis Cifuentes Delattewe tell several histories about his teaching, which help to know and understand his professional and humanquality

[Dr. Luis Cifuentes, master and writer]. / Don Luis Cifuentes, maestro y escritor.

In the centenary of Dr. Luis Cifuentes Delatte we tell several histories about his teaching, which help to know and understand his professional and human quality.