[High flow arterial priapism secondary to post-traumatic bilateral arterio-cavernous fistula. Highly selective embolization with autologous blood clot]. / Priapismo arterial de alto flujo secundario a fístula arterio-cavernosa bilateral post-traumática. Embolización supraselectiva con coágulo autólogo.

High flow arterial priapism is rare and characterized to a prolonged non-painful partial erection. Arteriocavernous fistula, rarely bilateral, is associated with penile or perineal trauma (genitoperineal area). Review of the literature, in only eleven cases this fistula is bilateral. Different treatments with non common norm has been used. We report a case of a 27 years old male who presented high flow priapism secondary to bilateral postraumatic arterio-cavernous fistula. Autologous blood clot was used for fistulas embolization to minimize the risk of impotence in this young patient. No complications was registered. Eight months later the patient had normal erectile function and no fistula was detected on ultrasonography doppler. We consider arteriography with highly selective embolization using re-absorbable agents obtains the best results, the least risks and complications in this process.

Priapismo arterial de alto flujo secundario a fístula arterio-cavernosa bilateral post-traumática. Embolización supraselectiva con coágulo autólogo / High-flow arterial priapism for postraumatic bilateral arterial-cavernous fistula. Highly selective embolization using autologous blood clot

El priapismo arterial de alto flujo es una patología poco frecuente caracterizada por una erección parcial persistente no dolorosa. Por lo general, se asocia a un traumatismo perineal o peneano (área genitoperineal) que ha ocasionado una fístula arterio-cavernosa, raramente bilateral. Tan sólo se han publicado once casos en los que dicha fístula es bilateral. Los tratamientos empleados han sido diversos, sin una pauta común para su resolución. Presentamos el caso de un varón de 27 años con priapismo de alto flujo arterial secundario a traumatismo perineal con fístula arterio-cavernosa bilateral. Se empleó coágulo autólogo para la embolización de las fístulas con el fin de minimizar el riesgo de lesión de la función eréctil en un paciente joven. No se registraron complicaciones. La función eréctil es normal 8 meses después del tratamiento sin evidencia de fístula en ecografía de control. Consideramos que la arteriografía supraselectiva junto a la embolización con sustancias reabsorbibles proporcionan los mejores resultados, menores riesgos y complicaciones en este tipo de patología (AU)

[Follicular cystitis. Presentation as a bladder pseudotumor]. / Cistitis folicular. Presentación como pseudotumor vesical.

Presentation of a case report of follicular cystitis in a 48-year old male patient who referred gross haematuria and repeat urinary infections. Ultrasonographic and endoscopic examinations show the presence of a vesical pseudoneoplasm. Definite diagnosis was achieved through histologic study after TUR-biopsy.

[Bladder metastases of pulmonary carcinoma. A report of 2 cases]. / Metástasis vesicales de carcinoma pulmonar. Presentación de dos casos.

Metastatic vesical tumours caused by blood- or lymph-borne neoplasias from any part of the body are extremely uncommon (less than 1% of vesical tumours), and even within this group lung tumours are the origin in a very small number of cases. Diagnosis usually happens in advanced stages due to the limited symptomatology exhibited. This paper refers two cases of vesical metastatic neoplasias from lung tumours, one an oat-cell anaplastic carcinoma and one epidermoid. Also, in the first one there was the peculiarity of haematuria being the early manifestation which lead to the diagnosis of lung neoplasia.

[Neural crest derived retroperitoneal tumors. General review]. / Tumores retroperitoneales derivados de la cresta neural. Revisión de conjunto.

Presentation of a series of 14 cases of neural crest derived tumours located in the retroperitoneal space in adult patients (five pheochromocytoma, six paraganglioma, two ganglioneuroma, and one neuroblastoma), and review and update of the diagnostic and therapeutic aspects. All pheochromocytoma cases presented high BP and the classic triad of sudation, tachycardia and headaches, as well as high levels of blood and urine catecholamines and/or their metabolites. CAT, ultrasound scanning and 123MIBG were the main diagnostic techniques used. All four paraganglioma were functioning and generally located surrounding both kidneys (one case was paired). No malignancy was found in any of the 11 tumours while controls remain with normal BP and normal levels of urine catecholamine metabolites. None of the two ganglioneuromas showed specific signs and symptoms but were diagnosed accidentally. The one neuroblastoma was juxtavesical showing a highly unfavourable evolution in spite of radical surgery, radiotherapy and multiple chemotherapy and the patient died within 16 months with local recurrence and haematogenous dissemination to bones and lungs.

[Chronic obstructive renal lithiasis. Extracorporeal lithotripsy or percutaneous renal surgery? Analysis of 2 series]. / Litiasis renal obstructiva crónica. Litotricia extracorpórea o cirugía renal percutánea? Análisis de dos series.

Experience has demonstrated that obstructive renal calculi with inferior infundibulocaliceal dilatation is not an indication for extracorporeal shock wave lithotripsy due to a high incidence of residual fragments in the lower calyx. These fragments are generally not spontaneously passed and become compact and form a new stone. We analyzed two groups of patients: 56 had been submitted to ESWL, and 53 to PCN. The results show that for obstructive renal lithiasis with dilatation of the lower calyx treatment is by percutaneous renal surgery first. This approach permits doing an ESWL procedure if stone fragments are observed in the early post-PCN radiologic work up. Similarly, if ESWL as monotherapy fails, we can resort to PCN.