[Use of urography by magnetic resonance for the study of the urinary apparatus versus conventional urography]. / Uso de la urografia por resonancia magnética en el estudio del aparato urinario frente a la urografía convencional.

UNLABELLED: Conventional urography (IVU) is an essential examination for the assessment of urinary tract but it is not free of complications, such as adverse reactions to contrast agents used (vasovagal and anaphylactic reactions), neurotoxicity, nephrotoxicity, as well as the damage due to the ionizing irradiation applied to the patient. For this reason, alternative imaging techniques such as magnetic resonance (MR) urography or uro-resonance have been developed. OBJECTIVE: We present a case study assessing the diagnostic accuracy, specificity and sensitivity of uro-resonance and IVU as a morphological and functional examination of the urinary tract: and a quality study of the urographic images obtained with MR versus IVU. MATERIALS AND METHODS: 150 patients have submited to a MR study, 63 of them with an IVU study already performed, acquiring high-intensity signals at T2 corresponding to abdominal and retroperitoneal fluid, initially using furosemide at low doses and, in a final study, administering gadolinium at a rate of 0.1 mg/Kg. The test was indicated in patients with antecedents of adverse reactions to iodine contrast, acute or chronic kidney failure, functional cancellation of the kidneys, pregnant patients and those in paediatric age. The capacity of diagnosis of urinary obstruction and the aetiology of this obstruction of both tests was studied, as well as the quality of the images obtained by the urographic study using MR. RESULTS: High resolution images were obtained of all the upper urinary tracts using MR, especially in the renal pelvis, without artefacts caused by peristalsis or intestinal fluid interposition. In 83.3% of cases, examinations revealed urological pathology. The diagnostic accuracy of the involvement cause of the urinary tract was 83.3%, with a sensitivity of 89.6%, a specificity of 69.2%. a positive predictive value of 86.6% and a negative predictive value of 75%. CONCLUSION: MR urography is a high sensitive technique for the study of urinary tract, used as an alternative to conventional urography particularly in cases of the contraindication of ionizing radiation or allergy to the contrast agent, as well as in patients with renal failure, and offers a wider morphological and functional study, with a high image quality, able to displace conventional examinations in the short or medium term.

Uso de la urografía por resonancia magnética en el estudio del aparato urinario frente a la urografía convencional / Use of urography by magnetic resonance for the study of the urinary apparatus versus conventional urography

La urografía convencional (UIV) es una exploración fundamental en la valoración del aparato urinario no exenta de morbilidad, como reacciones adversas al contraste (vasovagales y anafilácticas), neurotoxicidad, nefrotoxicidad, así como la irradiación ionizante a la que somete al paciente. Por este motivo se desarrollan técnicas de imagen alternativas como la urografía por resonancia magnética (RM) o urorresonancia. Objetivos: Presentamos un estudio que valora la precisión diagnóstica, especificidad y sensibilidad de la urorresonancia y de la UIV como exploración morfológica y funcional del aparato urinario; así como de la calidad de las imágenes urográficas obtenidas con la RM frente a la UIV. Material y métodos: 150 pacientes han sido sometidos a un estudio de RM, en 63 de ellos se realizó también estudio urográfico convencional, con apreciación de señales de alta intensidad en T2 correspondientes al fluido abdominal y retroperitoneal, empleando previamente furosemida a bajas dosis, y en un estudio final, administrando gadolinio a razón de 0,1 mg./Kg. La prueba fue indicada en pacientes con antecedentes de reacciones adversas al contraste yodado, fracaso renal agudo o crónico, anulación funcional renal, pacientes embarazadas y en edad infantil así como cuando la UIV no fue diagnóstica. Se estudió la capacidad de ambas pruebas para el diagnóstico de obstrucción urinaria y de la etiología de esta. También se evalúo la calidad de las imágenes que ofrece el estudio urográfico con RM. Resultados: Se obtuvieron imágenes de alta resolución con la RM de toda la vía urinaria superior, especialmente de pelvis renal, no artefactadas por la peristalsis o la interposición del fluido intestinal. En el 83,3% de los casos la exploración reveló patología urológica. La precisión diagnóstica de la causa de afectación del aparato urinario fue de un 83,3%, con una sensibilidad del 89,6%, una especificidad del 69,2%, valor predictivo positivo del 86,6% y valor predictivo negativo del 75%. Conclusión: La urografía por RM es una técnica con una elevada sensibilidad para el estudio del aparato urinario, que puede ser empleada como alternativa a la urografía convencional especialmente en los casos de contraindicación de la radiación ionizante, alergia al contraste, así como en pacientes con fracaso renal, pero que ofrece un estudio morfológico y funcional más amplio, con elevada calidad de imágenes, pudiendo desplazar a los estudios convencionales en un plazo corto o medio de tiempo

Conventional urography (IVU) is an essential examination for the assessment of urinary tract but it is not free of complications, such as adverse reactions to contrast agents used (vasovagal and anaphylactic reactions), neurotoxicity, nephrotoxicity, as well as the damage due to the ionizing irradiation applied to the patient. For this reason, alternative imaging techniques such as magnetic resonance (MR) urography or uro-resonance have been developed. Objective: We present a case study assessing the diagnostic accuracy, specificity and sensitivity of uro-resonance and IVU as a morphological and functional examination of the urinary tract; and a quality study of the urographic images obtained with MR versus IVU. Materials and methods: 150 patients have submited to a MR study, 63 of them with an IVU study already performed, acquiring high-intensity signals at T2 corresponding to abdominal and retroperitoneal fluid, initially using furosemide at low doses and, in a final study, administering gadolinium at a rate of 0.1 mg/Kg. The test was indicated in patients with antecedents of adverse reactions to iodine contrast, acute or chronic kidney failure, functional cancellation of the kidneys, pregnant patients and those in paediatric age. The capacity of diagnosis of urinary obstruction and the aetiology of this obstruction of both tests was studied, as well as the quality of the images obtained by the urographic study using MR. Results: High resolution images were obtained of all the upper urinary tracts using MR, especially in the renal pelvis, without artefacts caused by peristalsis or intestinal fluid interposition. In 83.3% of cases, examinations revealed urological pathology. The diagnostic accuracy of the involvement cause of the urinary tract was 83.3%, with a sensitivity of 89.6%, a specificity of 69.2%, a positive predictive value of 86.6% and a negative predictive value of 75%. Conclusion: MR urography is a high sensitive technique for the study of urinary tract, used as an alternative to conventional urography particularly in cases of the contraindication of ionizing radiation or allergy to the contrast agent, as well as in patients with renal failure, and offers a wider morphological and functional study, with a high image quality, able to displace conventional examinations in the short or medium term

Complicaciones de la prostatectomía radical: evolución y manejo conservador de la incontinencia urinaria / Radical prostatectomy complications: evolution and conservative management of urinary incontinence

Objetivos: La prostatectomía radical retropúbica continúa siendo el tratamiento de elección para el cáncer de próstata órganoconfinado. Realizamos un estudio retrospectivo en el que valoramos las complicaciones de esta cirugía y su evolución en el tiempo así como la cantidad del tratamiento conservador, especialmente la rehabilitación perineal precoz, en la recuperación de la continencia tras esta intervención. Material y métodos: Durante el período comprendido entre diciembre de 1998 a enero del 2005 hemos intervenido en nuestro servicio a 168 pacientes afectos de adenocarcinoma prostático confinado clínicamente a la glándula mediante prostatectomía radical retropúbica. Retiramos la sonda vesical el decimocuarto día del postoperatorio. A los pacientes que presentarion incontinencia urinaria (IU) de esfuerzo se les instruyó para la realización de ejercicios para fortalicer el suelo pélvico. Realizamos un seguimiento clínico el primer, tercer y sexto mes tras la cirugía, y posteriormente de forma semestral. Resultados: De los 168 pacientes intervenidos, el 15% requirió hemotransfusión en el postoperatorio inmediato. Otras complicaciones precoces, de mucha menos incidencia, fueron la perforación intestinal, la infección de la herida quirurgica y la foramción de hematoma en el lecho quirúrgico. Entre las complicaciones tardías más frecuentes registramos la disfunción eréctil, que se presentó en 164 pacientes (98%), alteraciones miccionales en 32 pacientes (19%) y alteraciones intestinales en aproximadamente el 11%. Entre las alteraciones miccionales encontradas, la más frecuente fue la IU (64%) si bien la mayoría de ellas eran de carácter leve (34%) y todas mejoraron durante los primeros seis meses posteriores a la cirugía. Conclusiones: La IU es el principal condicionante de la calidad de vida de los pacientes que son sometidos a prostatectomía radical. Si bien el porcentaje de pacientes que la presenta es alto, la mayoría son de grado leve o moderado y pueden mejorar ostensiblemente con los ejercicios de fortalecimiento del suelo pélvico, constituyéndose así como un arma fundamental en el menejo de estos pacientes, acompañada o no del uso de absorbentes, de la terapia farmacológica o del empleo de colectores peneanos

Objectives: Radical retropubic prostatectomy is the major procedure for curing early stage prostate cancer. In this retrospective study we valued the complication of this surgery and its evolution in time, as well as the efectiveness of the urinary incontinence preservative treatment in the recovery of urinary incontinence. Materials and methods: During the period between december of 1998 to january of the 2005 we have treated 168 patients suffering prostatic adenocarcinoma clinically confined to the gland by means of retropubic radical prostatectomy. We removed the vesical catheter the fourteenth day of the postoperative and made a clinical monitoring the first, third and sixth month after the surgery, and there after every six monoths. Results. Of the 168 patients who underwent clinical surgery, 15% required postoperative blood transfusion inthe immediate postoperative. Other complications, with a lower incidence, were the intestinal perforation, surgical wound infection and the haematoma. The most frequent delayed complications we registered erectile dysfunction, observed in 164 patients (98%), micturition alterations in 32 patients (19%) and intestinal alterations in approximately 11%. Among the micturitional alterations in 32 patients (19%) and intestinal alterations in approximately 11%. Among the micturitional alterations found, the most frequent (64%) was the Urinary Incontinence (UI). However, most of them were of minor importance (34%) and all improved during the first six months after the surgery. We advised patients with minor and moderate UI to perform pelvic floor muscle training, being very useful since they allowed to anticipate the recovery of continence. Conclusions. Radical prostatectomy continues to the most effective treatment for the non spared prostate cancer, in spite, of the associated morbidity. The IU is the main factor for the high standard of living these patients. Despite the number of patients with UI being so high, most cases are moderate and minor and may improve with pelvic floor muscle training. Hence, this is a significant tool to tackle this illness, whether in connection with the use of absorbent, the pharmacologic therapy or the use of penile collectors

[Urological works and biography of Dr. Felipe Alcalá Santaella Nuñez (1927-1977). Historical documentary analysis]. / Obra urológica y biografía del doctor Felipe Alcala-Santaella Núnez (1927-1977). Análisis documental histórico.

OBJECTIVES: In the middle of the 20th century, Urology in Valencia was fully consolidated as a surgical speciality since Prof. Molla started it about the end of the 19th century; Dr. Felipe Alcala Santaella Nuñez stands out as the chairman of the Department of Urology of the "Hospital Provincial de Valencia", after his father Dr. Rafael Alcalá Santaella. He achieved to form a group of renowned professionals, some of which still are in active practice. METHODS: We reviewed all his scientific work and the journals it was published in, mainly Archivos Espaioles de Urologia, through the Department of Medical History of the University of Valencia. His biography was reconstructed using the "Biographic and Bibliographic History of Spanish Urology" by Drs. E. Maganto Pavón and M. Pérez Albacete, as well as direct interviews with family members. DISCUSSION: We emphasize the magnificent approach to the clinical presentations of tuberculosis he does in his doctoral thesis, analyzing its types by location, main features, and most adequate treatment. He also emphasized the importance of relapse in lithiasic patients and recommendations to be follow, as well as the condition of bladder neoplasias. CONCLUSIONS: We consider Dr. Felipe Alcalá Santaella Nuñez as a wide-experience-professional who mode solid contributions to the regional urology in his times, thanks to his excellent surgical abilities and dedication.

Obra urológica y biografía del doctor Felipe Alcalá-Santaella Núñez (1927-1977). Análisis documental histórico / Urological works and biography of Dr. Felipe Alcalá Santaella Núñez (1927-1977). Historical documentary analysis

OBJETIVO: A mediados del S. XX, con una Urología en Valencia ya plenamente consolidada como especializada desde que el Profesor Mollá iniciara tal menester a finales del S. XIX, encontramos al Dr. Felipe Alcalá-Santaella Núñez, quien destacó como jefe del servicio de Urología del Hospital Provincial de Valencia, sustituyendo a su padre, D. Rafael Alcalá Santaella. En dicho ámbito logró formar un grupo de profesionales de renombre en el ámbito nacional, algunos de los cuales todavía ejercen en la actualidad. MÉTODOS: Revisamos a través del Departamento de Historia de la Medicina de la Universidad de Valencia toda su obra científica y las revistas en la que ha sido publicada, fundamentalmente la revista Archivos Españoles de Urología. Su biografía ha sido reconstruida usando como fuente la obra Historia Biográfica y Bibliográfica de la Urología Española de los Dres. E. Maganto Pavón y M. Pérez Albacete, así como entrevista con familiares directos. RESULTADOS: Destaca el magnífico abordaje que hace en su tesis doctoral de las formas clínicas de la tuberculosis renal, donde analiza sus tipos según localización, principales características y terapéutica mas adecuada. Realza también la importancia de la recidiva en los enfermos litiásicos y las recomendaciones a seguir, así como, en otro trabajo, la misma condición de las neoplasias vesicales. CONCLUSIONES: Consideramos a Felipe Alcalá-Santaella Núñez como un profesional de amplio bagaje y de sólida aportación en la Urología Regional de sus tiempos, dadas, según quienes le conocieron personalmente, sus excelentes capacidades quirúrgicas y dedicación a su profesión

OBJECTIVES: In the middle of the 20th century, Urology in Valencia was fully consolidated as a surgical speciality since Prof. Molla started it about the end of the 19th century; Dr. Felipe Alcala Santaella Nuñez stands out as the chairman of the Department of Urology of the “Hospital Provincial de Valencia”, after his father Dr.Rafael Alcalá Santaella. He achieved to form a group of renowned professionals, some of which still are in active practice. METHODS: We reviewed all his scientific work and the journals it was published in, mainly Archivos Españoles de Urología, through the Department of Medical History of the University of Valencia. His biography was reconstructed using the “Biographic and Bibliographic History of Spanish Urology” by Drs. E. Maganto Pavón and M. Pérez Albacete, as well as direct interviews with family members. DISCUSSION: We emphasize the magnificent approach to the clinical presentations of tuberculosis he does in his doctoral thesis, analyzing its types by location, main features, and most adequate treatment. He also emphasized the importance of relapse in lithiasic patients and recommendations to be follow, as well as the condition of bladder neoplasias. CONCLUSIONS: We consider Dr.Felipe Alcalá Santaella Nuñez as a wide-experience-professional who made solid contributions to the regional urology in his times, thanks to his excellent surgical abilities and dedication

[Radical prostatectomy complications: evolution and conservative management of urinary incontinence]. / Complicaciones de la prostatectomia radical: evolución y manejo conservador de la incontinencia urinaria.

OBJECTIVES: Radical retropubic prostatectomy is the major procedure for curing early stage prostate cancer. In this retrospective study we valued the complications of this surgery and its evolution in time, as well as the efectiveness of the urinary incontinence preservative treatment in the recovery of urinary continence. MATERIALS AND METHODS: During the period between december of 1998 to january of the 2005 we have treated 168 patients suffering prostatic adenocarcinoma clinically confined to the gland by means of retropubic radical prostatectomy. We removed the vesical catheter the fourteenth day of the postoperative and made a clinical monitoring the first, third and sixth month after the surgery, and thereafter every six months. RESULTS: Of the 168 patients who underwent clinical surgery, 15% required postoperative blood transfusion in the immediate postoperative. Other complications, with a lower incidence, were the intestinal perforation, surgical wound infection and the haematoma. The most frequent delayed complications we registered were erectile dysfunction, observed in 164 patients (98%), micturition alterations in 32 patients (19%) and intestinal alterations in approximately 11%. Among the micturitional alterations found, the most frequent (64%) was the Urinary Incontinence (UI). However, most of them were of minor importance (34%) and all improved during the first six months after the surgery. We advised patients with minor and moderate UI to perform pelvic floor muscle training, being very useful since they allowed to anticipate the recovery of continence. CONCLUSIONS: Radical prostatectomy continues to be the most effective treatment for the non spared prostate cancer, in spite of the associated morbidity. The IU is the main factor for the high standard of living these patients. Despite the number of patients with UI being so high, most cases are moderate and minor and may improve with pelvic floor muscle training. Hence, this is a significant tool to tackle this illness, whether in connection with the use of absorbent, the pharmacologic therapy or the use of penile collectors.

[The impact of creating andrology units on the treatment of erectile dysfunction with intracavernosal injections]. / Impacto de la creación de las unidades de andrología en el tratamiento por inyecciones intracavernosas de la disfunción eréctil.

OBJECTIVE: The impact of the creation of the andrology unit on intracavernous injection therapy for erectile dysfunction is analyzed in the present study. METHODS: The records of patients treated by intracavernosal injection of vasoactive drugs for erectile dysfunction from 1990 to 1997 were reviewed. RESULTS/CONCLUSIONS: Demands for solutions to the problem of erectile dysfunction have significantly increased over the last decades. The efficacy of intracavernosal injection of vasoactive drugs in the treatment of erectile dysfunction has been demonstrated. After the creation of the andrology unit within the urology services, patient acceptance of treatment and compliance increased, and complications have diminished.

[Adrenal gland myelolipoma: review of the bibliography regarding a case]. / Mielolipoma suprarrenal: revisión bibliográfica a propósito de un caso.

OBJECTIVE: To describe an additional case of this rare disease entity, with special reference to its diagnosis and treatment, and to briefly review the literature. METHODS: We report on an 82-year-old male with adrenal myelolipoma that had been incidentally discovered during evaluation for another condition. A left adrenalectomy was performed due to the large size of the tumor and in order to determine its benign or malignant nature. RESULTS: The histopathological findings disclosed an andrenal myelolipoma. CONCLUSIONS: Adrenal myelolipoma is an uncommon tumor type. CT is the most effective diagnostic method. Surgery is advocated in symptomatic cases and in asymptomatic cases with a large tumor mass.

[Burned out testicular tumor]. / Tumor testicular fundido "Burned out".

OBJECTIVE: Extragonadal germ cell tumor is a rare condition. The present study reports an additional case of this uncommon disease. METHODS/RESULTS: A 24-year-old male with retroperitoneal disease and a testicular lesion detected by ultrasonography is described. Histopathological analysis of the orchiectomy specimen disclosed a 'burned out' tumor. The anatomopathological features of this tumor type are discussed. CONCLUSION: Extragonadal germ cell tumor is a rare condition. It derives from the germ cells that exist in the gonad and is located in every anatomical region but the gonad itself. Ultrasonography must be performed if an extragonadal germ cell tumor is suspected.

[Urologic impact of Crohn disease]. / Sobre las repercusiones urológicas de la enfermedad de Crohn (EC).

Presentation of two cases of Crohn's disease seen in our Service in which the urological symptoms were of special relevance. One patient presented clinically with a picture of anaemic gross haematuria. The other one, was a patient already diagnosed with Crohn's disease who developed an enterovesical fistula in spite of receiving medical treatment. Both cases were resolved surgically. The clinical aspects, natural history and treatment of this uncommon form of urinary tract involvement are discussed.

[Pheochromocytoma: a review of our own cases]. / Feocromocitoma: revisión de nuestra casuística.

Presentation of 6 cases of pheochromocytoma, diagnosed and treated in our Unit over the last 5 years. Five were adrenal pheochromocytomas and 1 an abdominal paraganglioma in a 42 year-old woman. Distribution by gender was 4 male and 2 female, and mean age at presentation was 45.2 years ranging from 35 to 55 years. Clinically, all patients were hypertensive. Two of the 5 cases with adrenal location presented with catecholaminic crisis with BP > 240/140 mmHg. The paraganglioma was diagnosed while studying a case of sustained HBP in a 42 year-old female referred from another unit. With regard to diagnosis, the sensitivity of urinary tests was 100%, and gammagraphy with meta-iodine-benzyl-guanidine (MIBG) was particularly useful in the extra-adrenal location case. In all our patients, computerized tomography (CT) was the choice procedure to locate the tumour. Treatment was surgical in all cases, access being transperitoneal in 3 cases, thoracoabdominal in 2 and classic lumbotomy in 1. All our patients received prior treatment with alpha-blocking agents, and intraoperative complications were 1 arrythmic crisis, 1 hypotensive picture and 1 hypertensive crisis, all of which resolved successfully. Currently, 5 patients remain disease free. Mild HBP controlled with low dose captopril still persists in one patient.

[A glandular-type inverted papilloma of the bladder: apropos a case with an evident chronic irritative factor]. / Papiloma invertido de vejiga tipo glandular: a propósito de un caso con claro factor irritativo crónico.

OBJECTIVES: Inverted papilloma of the bladder is a rare condition that presents in the middle-aged. Its histological features and prognosis are unique and its diagnosis is always by anatomopathology. To date, its histogenesis has not been elucidated. The present study reports an additional case of this uncommon disease entity, which is even more so due to its glandular anatomopathological morphology. METHODS: A case of inverted papilloma of the bladder in a 52-year-old man with a permanent bladder catheter is described. The tumor was located in the posterosuperior bladder wall and had been successfully resected. RESULTS: The histological diagnosis was that of glandular inverted papilloma of the bladder. The patient is asymptomatic at two years follow up. CONCLUSIONS: In our view, inverted papilloma of the bladder results from a previous metaplasia in which the chronic irritative factor plays an important role.

[Endoscopic electrofulguration of intraurethral condylomata acuminata]. / Electrofulguración endoscópica de los condilomas acuminados intrauretrales.

Cluster condyloma is currently one of the sexually transmitted diseases of higher incidence. The most common sites for condyloma in males are the balanopreputial sulcus, frenulum and the glans' mucosa. Associated to penis condyloma there can be urethral lesions in 5% of patients which in 80% of cases develop less than 3 cm from the meatus. This paper presents a series of 14 cases of cluster intraurethral condyloma managed by transurethral electrofulguration. The technique consists in the introduction of a coagulation probe through the urethrotome and the application of electrofulguration to the condyloma base. Results have been satisfactory although relapse has occurred in 2 cases (14%), and in one of them the procedure had to be repeated up to 3 times. There has been no complications such as stenosis in the loop resections. The authors conclude that due to the difficulties in the medical management of these lesions, the use of invasive techniques, of which transurethral electrofulguration of the condyloma base with endoscopic urethrotome is the choice because of its simplicity and effectiveness, is justified.

[Hematuria due to polypoid cystitis. Its differential diagnosis from bladder carcinoma]. / Hematuria por cistitis polipoide. Diagnóstico diferencial con carcinoma de vejiga.

Polypoid cystitis is not uncommon in patients with a permanent urethral catheter. In some cases difficulties are encountered when making the differential or anatomopathological diagnosis from transitional cell carcinoma of the bladder. We report a case of polypoid cystitis mimicking bladder carcinoma in a patient with a permanent urethral catheter.

[Endoscopic trigono-cervico-prostatotomy: our experience]. / Trigonocervicoprostatotomía endoscópica: nuestra experiencia.

Presentation of our experience in treating the disease of the vesical neck through longitudinal endoscopic transurethral incisions in 24 patients following the Orandi procedure. Of the 24 patients seen in our service, 21 showed a clear clinical and urodynamic improvement. Complications were 2 cases of epididimorchitis and 1 iatrogenic stenosis of the anterior urethra. There were no major haemorrhages, urinary incontinence, or retrograde ejaculation except for an obvious decrease of ejaculate volume in 2 cases.

[Urothelial carcinoma after treatment with cyclophosphamide. Review of the literature and presentation of our caseload]. / Carcinoma de urotelio tras tratamiento con ciclofosfamida. Revisión de la literatura y aportación de nuestra casuística.

Cyclophosphamide has been used since 1958 in the treatment of various malignant tumours and certain systemic diseases, toxicity to the urothelium, frequently causing haemorrhagic cystitis and less often urothelial carcinomas, being one of its most notorious side effects--some 60 urothelial carcinoma cases have been published following therapy with cyclophosphamide since 1971. The present paper is a contribution of two new cases and its raises the need of paying special attention to urinary manifestations as well as narrowing the cooperation between the physicians which prescribe cyclophosphamide and the urologist, in order to make an appropriate follow-up and management of the patient.

[Supernumerary kidney with ectopic ureteral opening to the vagina associated with horseshoe kidney]. / Riñón supernumerario con abocamiento de uréter ectópico a vagina asociado a riñón en herradura.

Contribution of one case of supernumerary kidney with ureter ectopically opened to vagina associated to horseshoe kidney. Supernumerary kidneys are extremely unusual entities, there being only about 70 cases described in the international literature. This is the first case where it is found associated to horseshoe kidney.

[Nephrogenic adenoma of the bladder]. / Adenoma nefrogénico de vejiga.

Presentation of one case of vesical nephrogenic adenoma diagnosed as an accidental histological finding following TUR of vesical tumour. This case if considered of interest due to the rarity of the lesion (some 300 cases reported) and the limited number of quotations in the Spanish literature.

[Primary carcinoma of the male urethra: review of the literature and presentation of a new case]. / Carcinoma primario de la uretra masculina: revisión de la literatura y aportación de un nuevo caso.

A primary carcinoma of the male urethra is described. The etiology, diagnosis, clinical features and treatment of this uncommon tumor are discussed. Because this tumor frequently presents as a benign urethral process, biopsies should be performed in urethral conditions with a torpid clinical course.

[Association of giant condyloma acuminatum of the penis with intraurethral simple condylomata. Apropos of a case]. / Asociación de condiloma acuminado gigante de pene a condilomas simples intrauretrales. A propósito de un caso.

We report on an HIV-positive male patient with a giant condyloma acuminatum at the base of penis coexisting with simple intraurethral condylomas and no crown lesions. The association of both processes indicate the likelihood of a common viral etiology. The presentation of this florid picture in a terminal patient with AIDS indicates that urologists are likely to find an increased incidence of this condition in the forthcoming years.