[Paratesticular rhabdomyosarcoma]. / Rabdomiosarcoma paratesticular.

Contribution of one case of paratesticular rhabdomyosarcoma in a 10-years old male patient. Following radical orchiectomy it was classified as Group Ia (Intergroup Rhabdomyosarcoma Study). Treatment was completed with 9 polychemotherapy courses of Ifosfamide, Vincristine and Actinomicine D. The patient was disease-free 6 months after the treatment.

Rabdomiosarcoma paratesticular / Paratesticular rhabdomyosarcoma

Presentamos un caso de rabdomiosarcoma paratesticular en un niño de 10 años. Tras practicar orquiectomía inguinal radical fue clasificado como estadio Ia según el IRS (Intergroup Rhabdomyosarcoma Study). El tratamiento se completó con quimioterapia adyuvante (9 ciclos de Ifosfamida, Vincristina y Actinomicina D) y el paciente permanece libre de enfermedad 6 meses después del tratamiento (AU)

Contribution of one case of paratesticular rhabdomyosarcoma in a 10-years old male patient. Following radical orchiectomy it was classified as Group Ia (Intergroup Rhabdomyosarcoma Study). Treatment was completed with 9 polychemotherapy courses of Ifosfamide, Vincristine and Actynomicine D. The patient was disease-free 6 months after the treatment (AU)

Hematuria por fístula arterioureteral. Tratamiento endovascular / Hematuria for arterioureteral fistula. Endovascular treatment

Se presenta el caso clínico de una paciente con hematuria macroscópica anemizante, causada por la presencia de una fístula entre la arteria iliaca externa y el uréter. Tras su diagnóstico, se realizó un tratamiento mediante abordaje endovascular. Las fístulas arterioureterales son una rara entidad, que supone una urgencia vital. Su diagnóstico debe basarse en la sospecha clínica (falta de datos en las exploraciones complementarias). Su tratamiento clásico ha sido la cirugía abierta, pero el abordaje endovascular debe ser valorado dada su menor agresividad (AU)

[Treatment of lithiasis in horseshoe kidney with extracorporeal shock-wave lithotripsy]. / Tratamiento de la litiasis en el riñón en herradura mediante litotricia extracorpórea por ondas de choque.

UNLABELLED: The horseshoe kidney is the most frequent renal anomaly. As a consequence of impaired urinary drainage, urolithiasis is present in 20% of the cases. Indications for extracorporeal shock wave lithotripsy (ESWL) in the treatment of patients with anomalous kidneys is still the subject of controversy. OBJECTIVE: To evaluate ESWL efficacy in the treatment for lithiasis in horseshoe kidney. MATERIAL AND METHODS: Between april 1988 and december 1999 a total of 32 symptomatic lithiasis in 30 patients with horseshoe kidneys were managed by 65 sessions with ESWL. Until march 1999 a Dornier HM-4 electrohydraulic lithotripter was used. Posteriorly, two treatments was performed with an electromagnetic Dornier Lithotripter S. These procedures have been performed without anaesthesia or sedation for the Dornier HM-4 equipment. Analgesia with Meperidine was used for the Dornier Lithotripter S. Diuresis was not forced during or after treatment with diuretics or serotherapy. Treatments was conducted in an outpatient clinic in all cases. RESULTS: Treatment/lithiasis rate was 2.03. Following treatment 16 patients (54%) were stone-free by X-ray, 9 patients (30%) had residual fragments and in 5 patients (16%) no sign of stone disintegration was observed. Open surgery was performed in three of this patients. Better results was achieved in stones located in the renal pelvis and stone size is 10 mm or less. Clinical evolution: free of symptoms in 20 patients; chronic vague flank pain in 5 patients and acute renal colic with or without hematuria in 5 patients. No major complication was observed in our compilation. CONCLUSIONS: These results suggest that ESWL is the method of primary choice in the treatment for small lithiasis (10 mm or less) in horseshoe kidney.

Tratamiento de la litiasis en el riñón en herradura mediante litotricia extracorpórea por ondas de choque / Extracorporeal shock wave lithotripsy in the treatment for lithiasis in horseshoe kidney

El riñón en herradura constituye la anomalía congénita más frecuente del riñón. La dificultad en el drenaje urinario influye en que un 20 por ciento de los mismos desarrollan litiasis renal. El papel de la litotricia extracorpórea por ondas de choque (LEOC) en el tratamiento de la litiasis en pacientes afectos de malformaciones congénitas renales es todavía motivo de controversia. OBJETIVO: Evaluar la eficacia de la LEOC en el tratamiento de la litiasis en el riñón en herradura. MATERIAL Y MÉTODOS: Entre abril de 1988 y diciembre de 1999 hemos tratado a 30 pacientes con riñón en herradura portadores de 32 litiasis sintomáticas que han requerido de 65 sesiones de LEOC para su resolución. Hasta marzo de 1999 hemos utilizado un equipo Litotriptor Dornier HM-4 de energía electrohidráulica. Posteriormente dos tratamientos se han realizado con equipo Dornier Lithotripter S de energía electromagnética. Todos los tratamientos han sido realizados sin anestesia ni sedación con el equipo Dornier HM-4 y utilizamos analgesia con meperidina con el Dornier Lithotripter S. En ningún caso se ha forzado diuresis con diuréticos ni sueroterapia. Todos los tratamientos se han realizado de forma ambulatoria. RESULTADOS: El índice tratamiento/litiasis ha sido de 2.03. El número de pacientes libres de litiasis tras el tratamiento es de 16 lo que supone un 54 por ciento. En 9 pacientes (30 por ciento) se consiguió fragmentación de la litiasis y en 5 pacientes (16 por ciento) no se produjeron cambios tras el tratamiento. En tres de los casos se recurrió a la cirugía convencional para la resolución de su litiasis. Se ha producido recidiva en 2 pacientes lo que supone un 6 por ciento. Obtenemos mejor o total eliminación de la litiasis cuando ésta está alojada a nivel piélico y es de un tamaño igual o inferior a 10 mm. Evolución clínica: asintomáticos 20 pacientes; lumbalgia 5 pacientes; cólico nefrítico con o sin hematuria: 5 pacientes. No hemos asistido a ninguna complicación mayor en esta serie. CONCLUSIONES: Estos resultados sugieren que la LEOC es la primera opción terapéutica a utilizar ante una litiasis renal de pequeño tamaño (=10 mm) alojada en un riñón en herradura (AU)

[Hematuria secondary to arterioureteral fistula. Endovascular treatment]. / Hematuria por fístula arterioureteral. Tratamiento endovascular.

Presentation of case of patient with macroscopic anemic hematuria caused for the presence of a fistula between the external iliac artery and the ureter. After the diagnosis, a treatment with endovascular mangement was made. The arterioureteral fistulae are a very rare entie, which supposes a vital emergency. The diagnosis depend upon the clinical evidences (complementary explorations rarely provide specific findings). Classic treatment is bases on open surgery, while endovascular treatment may be an alternative with less aggressiveness.

[Treatment of urethral stenosis with thermo-expandable prosthesis "Memotherm". Our experience]. / Tratamiento de la estenosis uretral mediante prótesis termoexpandible "Memotherm". Nuestra experiencia.

OBJECTIVE: To report our experience in the treatment of recurrent urethral stricture in the male with the Memotherm heat-expansible stent. METHODS: From December 1995 to March 1999, the Memotherm heat-expansible stent was utilized in 4 patients with urethral stricture that had undergone urethrotomy procedures, periodic urethral dilatation and in those cases with post-traumatic stricture, open surgery for urethroplasty and urethral reattachment. All patients had multiple recurrences of the urethral stricture that was not amenable to the treatments utilized, therefore the intraurethral stent was inserted. RESULTS: All patients had a good postoperative course with unhampered voiding and ample stream. The patients were followed in the outpatient setting by a 6-monthly assessment of micturition and a yearly endoscopic control evaluation to detect hypertrophic growth of the urethral mucosa and/or intraluminal calcification. All the stents were completely enveloped in the urethral wall 12 months after insertion. The only side effects observed was limited postvoid leaking during the first few months following insertion of the prosthesis and one case of transient hemospermia. CONCLUSIONS: The Memotherm intraurethral heat-expansible stent is a valid treatment option for selected cases of recurrent urethral stricture. Although this approach can be utilized before performing urethroplasty, which is often a complicated technique with uncertain results, currently it is a valid treatment option in case of failure.

[Electrovaporization in the treatment of benign prostatic hypertrophy. Our experience]. / Electrovaporización en el tratamiento de la HBP. Nuestra experiencia.

OBJECTIVE: To report our experience in the treatment of BPH with transurethral electrovaporization of the prostate (TUEVP) with the Roller device (Storz). METHODS: 105 patients with clinical BPH of 30 to 60 gm were treated by TUEVP. This technique allowed removal of the bladder catheter 14-16 hours after the procedure, with a mean length of hospital stay ranging from 19-36 hours. The postoperative clinical situation is similar to that of TUR, with a maximum flow of 17-41 ml/sec. CONCLUSION: In our experience, transurethral electrovaporization of the prostate is a simple, efficient, safe and economic technique with a very low morbidity.

[Diverticulum of the female urethra: presentation of 3 cases]. / Divertículo de uretra femenino: presentación de tres casos.

Contribution of three cases of female urethral diverticulum diagnosed and treated in our Service. Presence in women presenting to the practice with chronic signs and symptoms of the lower urinary tract unresponsive to conventional medical management should be ruled out. A review is made of the most significant aspects in terms of clinical presentation, diagnosis and therapeutic options.

[Role of electrohydraulic extracorporeal shockwave lithotripsy (Dornier HM 4) in the treatment of caliceal diverticulum lithiasis]. / Papel de la litotricia extracorpórea por ondas de choque electrohidráulicas (Dornier HM 4) en el tratamiento de las litiasis en divertículos caliciales.

UNLABELLED: Caliceal diverticula may be congenital or acquired malformations of the collecting system, normally asymptomatic and discovered during an IVP. Indications for treatment included chronic vague flank pain, acute renal colic, urinary tract infection and hematuria. We present the results of 29 patients with symptomatic calculi in caliceal diverticula who were managed by ESWL monotherapy. All treatments were performed with electrohydraulic machine (Dornier HM 4) in ambulatory form. RESULTS: The average followup was 42 months. 12 patients (40%) had passed successfully all of the stone fragments, while 2 patients (7%) had passed more than half and 4 (13.5%) had passed less than half of the fragments. 66 per cent of patients had been rendered free of symptoms. The possibility of producing a satisfactory result (66% free of symptoms and 40% stone free by X ray) and the low morbidity of ESWL suggest that this treatment may be appropriate for majority of calculi in calicea diverticula.