[Epidermoid carcinoma of the penis]. / Carcinoma epidermoide de pene.

OBJECTIVE: To analyze our series and review the prognostic factors in the treatment of epidermoid carcinoma of the penis. METHODS: Age, time to consultation, circumcision, form of presentation, local treatment, tumor stage and grade, lymph node involvement and outcome were analyzed in 27 cases of carcinoma of the penis diagnosed at our hospital from 1981 to 1999. RESULTS: The incidence rate was 1.8 cases/100,000 men/year. No patient had been circumcised, except one who was circumcised in the adult age. The median time to consultation was 24 months (interquartile range: 60-7.75). The median follow-up was 37 months (interquartile range: 84-12). All patients with pT1GI-II and pT2G-II primary tumor (n = 21; 78% of the series) and with no lymphadenopathy were disease-free at 6 months' minimum follow-up [17 of the 21 patients (81%) had more than 32 months' follow-up]. Only one patient with pT1-GII tumor, but with a vertical growth pattern, had positive inguinal lymph nodes (pN2). The remaining patients with lymph node involvement showed infiltration of the erectile tissue and moderately or poorly differentiated tumors. Only two prophylactic lymphadenectomy procedures were performed (pN0). Regardless of treatment, 5 of the 6 patients with lymph node involvement died within one year after diagnosis. CONCLUSIONS: Given the demonstrated relationship between carcinoma of the penis and hygiene, and phimosis which makes hygiene difficult, circumcision should be performed in childhood. Furthermore, circumcision at this age has been demonstrated to have a prophylactic value that disappears in the adult age.

[Suprarenal cysts]. / La suprarrenal quística.

OBJECTIVE: To emphasize that adrenal cysts are an uncommon finding and in most cases incidentally discovered during evaluation for nonspecific abdominal pain or even at outopsy. METHODS: We report a case of a non-hypers-creting right adrenal cyst in a middle-aged woman. RESULTS: A complete hormone, radiological and sometimes isotopic evaluation are required to make an accurate diagnosis and to determine the adequate treatment. CONCLUSION: Surgical resection is usually prompted by an inaccurate diagnosis and failed conservative treatments.

[Transitional cell bladder carcinoma in patients younger than 40 years of age]. / Carcinoma vesical de células transicionales en pacientes menores de 40 años.

OBJECTIVE: The clinical and pathological characteristics of bladder cancer in young patients were analyzed to determine if patients with bladder cancer under the age of 30 have a better prognosis than older adults and if transitional cell carcinoma of the bladder in patients aged 30 to 40 years has a similar behaviour to that observed in the higher risk population. METHODS: A retrospective review of transitional cell carcinoma of the bladder in patients less than 40 years old that had been treated between January, 1993 to August, 1997 was undertaken. RESULTS: We found 8 patients (5 men and 3 women) with urothelial tumor, accounting for an incidence of 4%. Four cases were diagnosed and staged TaG1, 2 T1G1 and 2 T1G2. Recurrence was observed in one case (12.5%) and progression in none. CONCLUSIONS: Transitional cell carcinoma of the bladder in patients under the age of 40 is usually associated with low grade and low stage tumors. The foregoing finding is certainly observed in those aged less than 30 years old. Bladder cancer is relatively rare in this age group, although we have found a higher incidence than that reported elsewhere. Treatment and follow-up depend on tumor grade and stage, regardless of age.

[Kidney trauma with congenital hydronephrosis. Report of a case]. / Traumatismo sobre riñón con hidronefrosis congénita. A propósito de un caso.

We report on a 16-year-old patient with stricture of the pyeloureteric junction (PUJ) that had been incidentally discovered following trauma to the lumbar region. The literature is briefly reviewed.

[Infected urachal cyst in adults]. / Quiste uracal infectado en adultos.

A case of infected urachal cyst in a 42 years old women is described. Cystography shows the spontaneous drainage to the bladder through the vesical extremity of the urachus. Review of the Literature is included.

[Transitional carcinoma of the prostate. Report of a case treated with chemotherapy]. / Carcinoma transicional de próstata. A propósito de un caso tratado con quimioterapia.

A case of transitional cell carcinoma of the prostate is described which had been diagnosed following TUR of the prostate due to cervico-prostatic obstruction. Subsequent cystoscopic and cytological controls, as well as multiple bladder biopsies have discarded a concomitant urothelial tumor. We underscore the rarity of transitional cell tumor of the prostate, its response to chemotherapy and the possibility of suspecting this tumor type when there is massive invasion of the prostate following TUR.

[Eosinophilic cystitis]. / Cistitis eosinofílica.

Six cases of eosinophilic cystitis are described, one of which had no previous surgery or manipulation of the bladder. The literature is reviewed and the clinical and anatomopathological features are described. We discuss the diagnostic criteria, treatment, prognosis and the hypothesis of an immediate-type of anaphylactic reaction as a pathogenic mechanism.

[Spontaneous extravasation of urine at the pyelo-caliceal level. Spontaneous urinomas]. / Extravasación espontánea de orina a nivel pielo-calicial. Urinomas espontáneos.

We present two cases of spontaneous rupture of the excretory tract within the context of reno-ureteral colic due to lithiasis. We comment on the etiopathogenic aspects and underscore the need for emergency evaluation in patients with very severe nephric colic and/or symptoms of peritoneal irritation (ileus, abdominal guarding), and temporary urinary diversion must be performed via nephrostomy as a palliative procedure for the symptoms and to avoid complications.

[Retroperitoneal abscess. Report of 2 cases]. / Abscesos retroperitoneales. A propósito de dos casos.

Two cases of retroperitoneal abscess that had recently been treated in our service are described. The primary infection was localized to the psoas muscle in one patient with a previous injury to the right lumbar region. The other case was secondary to an ascending urinary infection. Staph aureus were isolated in the first case and E. Coli in the second. The different clinical course and treatment of each case are described.

[Nonpenetrating trauma of the penis. Rupture of corpus cavernosum albuginea]. / Traumatismos no penetrantes de pene. Ruptura albugínea de cuerpos cavernosos.

We report a case of penile trauma that had been treated early by surgery. The value of ultrasound in diagnosing rupture of the corpus cavernosum albuginea is highlighted. The good functional and cosmetic results afforded by early surgical treatment is underscored.

[Rhabdomyosarcoma of the epididymis]. / Rabdomiosarcoma de epidídimo.

A 5-year-old boy with intrascrotal rhabdomyosarcoma arising from the epididymis is described. The patient was submitted to radical orchidectomy via the inguinal approach and high ligation of the spermatic cord. The anatomopathological examination revealed germ cell rhabdomyosarcoma of the epididymis with no testicular or spermatic cord involvement, which corresponded to stage I of the IRS classification (Intergroup Rhabdomyosarcoma Study). Its clinical and histological features and treatment are discussed.

[Vesico-uterine fistula]. / Fístula vésico-uterina.

We report a case of uterovesical fistula that had been diagnosed by cystoscopy, vaginoscopy and ultrasonography. Fistulorrhaphy via the transperitoneal transvesical approach resolved the passage of urine to the vagina. The decision to perform a conservative or more aggressive approach is determined by the site of the fistula.

[Colloid carcinoma of the prostate]. / Carcinoma coloide de próstata.

We report a case of colloid carcinoma of the prostate, a rare tumor type whose diagnosis is exclusively based on the anatomopathological findings. The case described herein is a primary prostatic tumor. Patient work up revealed no tumor localized to other organs. The total acid phosphatase and prostate acid phosphatase levels were elevated. Subsequent analyses revealed metastases.

[Review of 36 trigono-cervico-prostatectomies, carried out for prostatic pathology]. / Revisión de 36 trigono-cérvico-prostatotomías, practicadas por patología prostática.

Review of 36 trigone-cervix-prostatectomies, performed in our services. Studies made before and after the procedure. Indications for trigone-cervix-prostatectomies. Complications and results obtained. Trigone-cervix-prostatectomies as an alternative to prostate transurethral resection, in a highly selected group of patients, because of its simplicity and better results.

[Prostatic abscess--new diagnostic and therapeutic guidelines]. / Abscesos prostáticos--nuevas pautas diagnósticas y terapéuticas.

Five prostatic abscesses treated in our Unit over the last three years (1988, 89, 90) are presented. Both the mode of presentation and symptoms as well as the course of treatment followed (three percutaneous drainage through the perineum, lead by ultrasound scanning, one endoscopic abscess incision with Collins' knife and one resolved with antibiotics subsequently needing TUR of the prostatic adenoma) are reviewed. The change of attitude in the treatment of prostatic abscesses (Ultrasound-lead percutaneous drainage) and the major usefulness of ultrasound scanning for diagnosis, treatment and subsequent follow-up are emphasized.