[Penile tunica albuginea plication for the treatment of penile curvature secondary Peyronie's disease]. / Plicatura de la albugínea como tratamiento de la incurvación de pene causada por la enfermedad de Peyronie.

OBJECTIVE: To evaluate, in a retrospective analysis, our long-term results of patients undergoing the Essed plication procedure for the correction of penile curvature due to Peyronie's disease. METHODS: Between January 1998 and June 2003, 83 patients with acquired penile deviation were treated with the Essed technique in our hospital. We analyse the following data: age, main complaint, type of deviation, erection before and after the surgery, physical exploration, ecographic data, complications and results. RESULTS: Mean follow-up was 36 months. Main complaint was penile curvature in 96.3% of patients. The most frequent types of deviation were dorsal (55.4%) and left lateral (48.1%). Erection before surgery was sufficient for sexual intercourse in 74.7%. Physical exploration revealed a plaque in 79.5% of the patients. 93% of the cases reported complete penile curvature correction or residual deviation < 10 degrees. 65.1% of the patients were satisfied or very satisfied with the result of the operation and 64% were able to perform sexual intercourse. CONCLUSIONS: The Essed plication is a simple and minimally invasive method for correcting acquired penile deviation. Although functional results seem to be satisfactory, in our experience the degree of satisfaction with the outcome is not as good, among the patients, as it could be expected.

Plicatura de la albugínea como tratamiento de la incurvación de pene causada por la enfermedad de Peyronie / Penile tunica albuginea plication for the treatment of penile curvature secondary Peyronie´s disease

OBJETIVO: Evaluar nuestros resultados enel tratamiento de la incurvación peneana causada porla enfermedad de Peyronie mediante la plicatura albugíneadescrita por Essed.MÉTODOS:Revisión retrospectiva de los 83 pacientestratados quirúrgicamente de incurvación peneanaadquirida en nuestro centro mediante la técnica de plicaturaentre enero de 1998 y junio de 2003, analizandolas siguientes variables: edad, motivo de consulta,antecedentes personales, exploración física,datos ecográficos, tipo de incurvación, erección pre ypostcirugía, complicaciones y resultados de la técnicaquirúrgica.RESULTADOS:El seguimiento medio fue de 36 meses.El motivo de consulta principal fue la desviación peneanaen erección (96,3%). El tipo de incurvación másfrecuente fue dorsal (55,4%) y lateral izquierda(48,1%). La erección previa a la cirugía era suficientepara mantener una relación sexual en el 74,7% de lospacientes. La exploración física reveló la existencia deplaca en el 79,5% de los casos. En cuanto a los resultadosde la cirugía, el 93% refieren una correccióncompleta de la incurvación o una desviación residualmenor de 10º. El 65,1% manifestaron encontrarse satisfechoso muy satisfechos con la operación, mientrasque el 64% eran capaces de llevar a cabo una relaciónsexual.CONCLUSIONES: La plicatura de Essed es un procedimientosencillo y mínimamente invasivo para corregirla desviación adquirida de pene. En nuestra experiencia,aunque los resultados funcionales parecen ser buenos,el grado de satisfacción entre los pacientes tras lacirugía no es tan alto como cabría esperar

OBJETIVE: To evaluate, in a retrospective analysis, our long term results of patients undergoing the Essed plication procedure for the correction of penile curvature due to Peyronie´s disease. METHODS: Between January 1998 and June 2003, 83 patients with acquired penile deviation were treated with the Essed technique in our hospital. We analyse the following data: age, main complaint, type of deviation, erection before and after the surgery, physical exploration, ecographic data, complications and results. RESULTS: Mean follow-up was 36 months. Main complaint was penile curvature in 96.3% of patients. The most frequent types of deviation were dorsal (55.4%) and left lateral (48.1%). Erection before surgery was sufficient for sexual intercourse in 74.7%. Physical exploration revealed a plaque in 79.5% of the patients. 93% of the cases reported complete penile curvature correction or residual deviation < 10º. 65.1% of the patients were satisfied or very satisfied with the result of the operation and 64% were able to perform sexual intercourse. CONCLUSIONS: The Essed plication is a simple and minimally invasive method for correcting acquired penile deviation. Although functional results seem to be satisfactory, in our experience the degree of satisfaction with the outcome is not as good, among the patients, as it could be expected

[Testicular epidermoid cyst: report of a new case and bibliographic review]. / Quiste epidermoide testicular: a propósito de un nuevo caso y revisión de la literatura.

OBJECTIVES: The epidermoid cyst of the testis is a rare benign tumor. It accounts for approximately 1% of all testicular tumors. Generally, the testis has a palpable, painless mass with tumor markers (AFP, BHCG, and LDH) within normal ranges. Pathology reveals a cavity consisting of squamous epithelial cells containing keratin and non-nucleated keratic flakes in the absence of atypia or elements of teratoma. METHODS/RESULTS: We report the case of a young man who was diagnosed of epidermoid cyst after orchiectomy. CONCLUSIONS: Tumor enucleation would be a proper treatment when ultrasound studies suggest this diagnosis. However, we often perform orchiectomy due to a low rate of suspicion, non conclusive ultrasound studies, or due to the high percentage of malignant testicular tumors in this age range.

[Neuroendocrine renal carcinoma. Presentation of a case]. / Carcinoma renal neuroendocrino. Presentación de un caso.

OBJECTIVES: To report a new case of neuroendocrine renal cell carcinoma. METHODS: We report the case of a 76-year-old woman with neuroendocrine renal cell carcinoma who underwent radical nephrectomy without any further adjuvant treatment. We performed a bibliographic review about this rare renal neoplasia of which there are less than 20 published case reports. RESULTS: Patient is asymptomatic four years after surgery, although she has local recurrence. CONCLUSIONS: Small cell renal cell carcinoma is a very rare neoplasia, affecting people over the age of 60 years, large in size, and metastatic at diagnosis. It has bad prognosis, with short survival times. The most adequate treatment has not been determined due to the scarcity of published cases; the combination of surgery and chemotherapy is the most frequently used.

Carcinoma renal neuroendocrino. Presentación de un caso / Neuroendocrine renal cell carcinoma. Report of a case

OBJETIVOS: Aportar un nuevo caso a la literatura científica de carcinoma renal neuroendocrino. MÉTODOS: Presentamos un caso de carcinoma renal neuroendocrino en una mujer de 76 años en la que se realizó nefrectomía radical, sin posterior tratamiento adyuvante. Realizamos una revisión de la literatura publicada acerca de esta infrecuente neoplasia renal de la que existen menos de una veintena de casos en la bibliografía. RESULTADO: Tras cuatro años después de la cirugía la paciente se encuentra asintomática, aunque presenta recidiva local. CONCLUSIONES: el carcinoma renal de células pequeñas se trata de una neoplasia muy infrecuente, que afecta a personas por encima de 60 años, de gran tamaño y con metástasis a diagnóstico. Tiene mal pronóstico con escasa supervivencia y donde el tratamiento más adecuado no se ha podido determinar por la escasez de casos publicados, siendo el más utilizado la combinación de cirugía y quimioterapia (AU)

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[[Primary psoas abscess. Presentation of 3 cases]. / Absceso primario de psoas. Presentación de 3 casos.

OBJECTIVE: To present 3 cases of primary abscess of the psoas muscle. The clinical features, diagnostic tests, treatment and outcome are discussed. METHODS/RESULTS: Three patients that presented with fever and pain referred to the renal and/or iliac fossa are described. Physical examination showed psoas involvement in only one patient. Among the complementary tests performed, ultrasound demonstrated the abscess in one of the cases; the definitive diagnosis was made by contrast-enhanced CT. One of the cases was treated only with antibiotics while the other two cases were treated with CT-guided percutaneous drainage and appropriate antibiotic therapy. CONCLUSIONS: Psoas abscess is an uncommon pathology whose presenting features are usually unspecific. CT with contrast enhancement is considered to be the technique of choice for the diagnosis and to corroborate the resolution of the condition. Recently, the use of CT or US-guided percutaneous drainage has replaced surgery as the initial therapeutic approach for this condition.

Absceso primario de psoas. Presentación de 3 casos / Primary psoas abscess: Report of 3 cases

Objetivo: Presentamos 3 casos de absceso de psoas primario, describiendo su presentación clínica, pruebas diagnósticas empleadas y tratamiento realizado, así como la evolución de los pacientes.Métodos/resultados: Se trata de 3 pacientes que presentaban fiebre acompañada de dolor en fosa renal y/o fosa ilíaca. En la exploración física sólo en uno de ellos se objetivaba maniobra del psoas positiva. Entre las pruebas complementarias que se realizaron, la ecografía demostró el absceso en uno de los casos, realizándose el diagnóstico definitivo mediante tomografía computerizada (TC) con contraste. Uno de los casos se trató únicamente con antibióticos, mientras que el tratamiento empleado en los otros dos, fue el drenaje percutáneo guiado por TC asociado a cobertura antibiótica adecuada.Conclusiones: El absceso de psoas es una patología excepcional, cuya clínica de presentación es inespecífica la mayoría de las veces. La TC con contraste se considera la técnica de elección para el diagnóstico y para comprobar la resolución del proceso. En los últimos años, la introducción del drenaje percutáneo guiado por TC o ecografía ha sustituido a la cirugía como abordaje terapéutico inicial de esta entidad (AU)