Factores predictivos de recidiva de estenosis uretral tras uretrotomía endoscópica / Predictors of urethral stricture recurrence after endoscopic urethrotomy

Objetivo: El objetivo del trabajo fue analizar las variables clínico-demográficas de la serie y los factores predictores de recidiva de estenosis uretral tras uretrotomía endoscópica. Material y métodos: Se analizó retrospectivamente a 67 pacientes tratados mediante uretrotomía endoscópica tipo Sachse entre junio de 2006 y septiembre de 2014. Se excluyó a los intervenidos previamente de uretrotomía endoscópica o uretroplastia y se incluyó al resto de los pacientes que presentaban estenosis uretral. Se analizó edad, peso, hábito tabáquico, factores de riesgo cardiovascular, número, localización, longitud y etiología de la estenosis, uretrotomía previa, tiempo de sonda vesical y dilataciones posquirúrgicas. Se realizó un análisis univariado y multivariado mediante el test de chi-cuadrado o de Fisher y regresión logística para identificar las variables relacionadas con la recidiva. Resultados: El 37% recidivaron. La mayoría eran > 60 años (56,7%), obesos (74,6%), no fumadores (88%) y sin factores cardiovasculares (56,7%). La mayoría de las estenosis fueron únicas (94%), < 1 cm (82%), de uretra bulbar (64,2%), iatrogénicas (67,2%) y sin uretrotomía previa (89,6%). La mayoría llevaron sonda vesical durante < 15 días (85,1%) y no realizaron dilataciones posquirúrgicas (65,7%). Solamente la longitud de la estenosis resultó factor de riesgo independiente de recidiva (p = 0,025) con un riesgo relativo de 5,7 para un IC 95% (1,21-26,41). Conclusiones: En el tratamiento de la estenosis uretral mediante uretrotomía endoscópica, la longitud de la estenosis > 1 cm es el único factor que predice un incremento del riesgo de recidiva. No se encontró factores clínicos ni demográficos que condicionaran un incremento en la incidencia de recidiva. Del mismo modo, factores técnicos como incrementar el tiempo de sondaje vesical o las dilataciones uretrales no alteran el curso de la enfermedad, por lo que su uso rutinario es innecesario

Objective: The aim of the study was to analyse the clinical-demographic variables of the series and the predictors of urethral stricture recurrence after endoscopic urethrotomy. Material and methods: We retrospectively analysed 67 patients who underwent Sachse endoscopic urethrotomy between June 2006 and September 2014. Those patients who had previously undergone endoscopic urethrotomy or urethroplasty were excluded. The other patients who presented urethral stricture were included. We analysed age, weight, smoking habit, and cardiovascular risk factors, as well as the number, location, length and aetiology of the strictures, previous urethrotomies, vesical catheter duration and postsurgical dilatations. A univariate and multivariate analysis was conducted using the chi-squared test or Fisher's test and logistic regression to identify the variables related to recurrence. Results: Thirty-seven percent of the patients had a relapse. The majority of the patients were older than 60 years (56.7%), obese (74.6%), nonsmokers (88%) and had no cardiovascular factors (56.7%). The majority of the strictures were single (94%), < 1 cm (82%), bulbar urethral (64.2%), iatrogenic (67.2%) and with no prior urethrotomy (89.6%). The majority of the patients carried a vesical catheter for < 15 days (85.1%) and did not undergo postsurgical dilatation (65.7%). Only the length of the stricture was an independent risk factor for recurrence (P = .025; relative risk, 5.7; 95% CI 1.21-26.41). Conclusions: In the treatment of urethral strictures through endoscopic urethrotomy, a stricture length > 1 cm is the only factor that predicts an increase in the risk of recurrence. We found no clinical or demographic factors that caused an increase in the incidence of recurrence. Similarly, technical factors such as increasing the bladder catheterisation time and urethral dilatations did not change the course of the disease. Their routine use is therefore unnecessary

Cavernoplastia con injerto de mucosa oral para el tratamiento quirúrgico de la enfermedad de La Peyronie / Cavernoplasty with oral mucosa graft for the surgical treatment of Peyronie's disease

Introducción: La enfermedad de La Peyronie es un trastorno de la albugínea que condiciona incurvación peneana, y que precisa corrección quirúrgica cuando la deformidad dificulta la penetración. Material y métodos: Análisis retrospectivo de los resultados a corto plazo (longitud del pene, ángulo de incurvación y función eréctil) del tratamiento de la enfermedad de La Peyronie en 10 pacientes mediante cavernoplastia con injerto de mucosa oral. En esencia, el tratamiento incluyó la incisión de la placa fibrótica con bisturí eléctrico y el posterior recubrimiento del defecto cavernoso mediante un parche de mucosa oral. Al sexto mes medimos la longitud e incurvación peneanas, y recogimos la función eréctil mediante el cuestionario IIEF-5. Finalmente, se planteó a los pacientes la pregunta «¿volvería a repetir la misma intervención?». Resultados: La edad media fue de 53,4 años. El seguimiento promedio fue de 22,7 meses y la mediana de 24. La incurvación media preoperatoria fue de 68,5° (50-90°); la longitud media del pene de 11,2 cm (9-15) y el IIEF-5 medio de 16,1 (8-25). La longitud peneana media postoperatoria fue de 10,7 cm y el IIEF-5 medio de 18,9. Las diferencias entre los registros pre- y postoperatorios no alcanzaron significación estadística (p = ns). Un paciente desarrolló disfunción eréctil. En todos los casos la incurvación residual fue < 20°. Nueve pacientes (90%) aseguraron que repetirían la misma intervención. Conclusiones: Los resultados a corto plazo señalan que la cavernoplastia con injerto de mucosa oral puede ser una alternativa a los injertos tradicionales para la corrección quirúrgica de la enfermedad de La Peyronie

Background: Peyronie's disease is a disorder of the tunica albuginea and causes penile curvature, requiring surgical correction when the deformity impedes penetration. Material and methods: Retrospective analysis of the short-term results (penile length, angle of curvature and erectile function) of treating Peyronie's disease in 10 patients through cavernoplasty with oral mucosa graft. Essentially, the treatment included the incision of the fibrotic plaque with electrical scalpel and the subsequent coating of the cavernous defect using a patch of oral mucosa. At month 6, we measured the penile length and curvature and recorded the erectile function using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Finally, the patients were asked 'Would you undergo the same operation again?'. Results: The mean age was 53.4 years. The average and median follow-up was 22.7 months and 24 months, respectively. The mean preoperative curvature was 68.5° (50°-90°), the mean penile length was 11.2 cm (9-15) and the mean IIEF-5 score was 16.1 (8-25). The mean postoperative penile length was 10.7 cm, and the mean IIEF-5 score was 18.9. The differences between the preoperative and postoperative values were not statistically significant (P=ns). One patient developed erectile dysfunction. In all cases, the residual curvature was <20°. Nine patients (90%) stated that they would undergo the same operation. Conclusions: The short-term results suggest that cavernoplasty with oral mucosa graft can be an alternative to traditional grafts for surgically correcting Peyronie's disease

Predictors of urethral stricture recurrence after endoscopic urethrotomy. / Factores predictivos de recidiva de estenosis uretral tras uretrotomía endoscópica.

OBJECTIVE: The aim of the study was to analyse the clinical-demographic variables of the series and the predictors of urethral stricture recurrence after endoscopic urethrotomy. MATERIAL AND METHODS: We retrospectively analysed 67 patients who underwent Sachse endoscopic urethrotomy between June 2006 and September 2014. Those patients who had previously undergone endoscopic urethrotomy or urethroplasty were excluded. The other patients who presented urethral stricture were included. We analysed age, weight, smoking habit, and cardiovascular risk factors, as well as the number, location, length and aetiology of the strictures, previous urethrotomies, vesical catheter duration and postsurgical dilatations. A univariate and multivariate analysis was conducted using the chi-squared test or Fisher's test and logistic regression to identify the variables related to recurrence. RESULTS: Thirty-seven percent of the patients had a relapse. The majority of the patients were older than 60 years (56.7%), obese (74.6%), nonsmokers (88%) and had no cardiovascular factors (56.7%). The majority of the strictures were single (94%), <1cm (82%), bulbar urethral (64.2%), iatrogenic (67.2%) and with no prior urethrotomy (89.6%). The majority of the patients carried a vesical catheter for <15 days (85.1%) and did not undergo postsurgical dilatation (65.7%). Only the length of the stricture was an independent risk factor for recurrence (P=.025; relative risk, 5.7; 95% CI 1.21-26.41). CONCLUSIONS: In the treatment of urethral strictures through endoscopic urethrotomy, a stricture length >1cm is the only factor that predicts an increase in the risk of recurrence. We found no clinical or demographic factors that caused an increase in the incidence of recurrence. Similarly, technical factors such as increasing the bladder catheterisation time and urethral dilatations did not change the course of the disease. Their routine use is therefore unnecessary.

Cavernoplasty with oral mucosa graft for the surgical treatment of Peyronie's disease. / Cavernoplastia con injerto de mucosa oral para el tratamiento quirúrgico de la enfermedad de La Peyronie.

BACKGROUND: Peyronie's disease is a disorder of the tunica albuginea and causes penile curvature, requiring surgical correction when the deformity impedes penetration. MATERIAL AND METHODS: Retrospective analysis of the short-term results (penile length, angle of curvature and erectile function) of treating Peyronie's disease in 10 patients through cavernoplasty with oral mucosa graft. Essentially, the treatment included the incision of the fibrotic plaque with electrical scalpel and the subsequent coating of the cavernous defect using a patch of oral mucosa. At month 6, we measured the penile length and curvature and recorded the erectile function using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Finally, the patients were asked "Would you undergo the same operation again?". RESULTS: The mean age was 53.4 years. The average and median follow-up was 22.7 months and 24 months, respectively. The mean preoperative curvature was 68.5° (50°-90°), the mean penile length was 11.2cm (9-15) and the mean IIEF-5 score was 16.1 (8-25). The mean postoperative penile length was 10.7cm, and the mean IIEF-5 score was 18.9. The differences between the preoperative and postoperative values were not statistically significant (P=ns). One patient developed erectile dysfunction. In all cases, the residual curvature was <20°. Nine patients (90%) stated that they would undergo the same operation. CONCLUSIONS: The short-term results suggest that cavernoplasty with oral mucosa graft can be an alternative to traditional grafts for surgically correcting Peyronie's disease.

Reanastomosis uretro vesical por extraccion accidental de sonda vesical tras prostatectomia radical / Urethrovesical redo anastomosis after accidental removal of the urethral catheter after radical prostatectomy

No disponible

Predicting factors for recurrence in low-grade Ta primary bladder tumours.

OBJECTIVES: Ta bladder tumors constitute 53% of primary bladder neoplasms, 70% of them being low-grade (G1). These tumors present a 15- 38% chance of recurrence during the first year. The aim of this paper is to identify the predicting factors of the first recurrence in a series of TaG1 primary bladder tumors. METHODS: We have retrospectively analyzed patients who were diagnosed with TaG1 primary bladder tumor by transurethral resection between 2004 and 2012. We established their tumor grade and pathological stage according to the WHO's classification guides for 1973 and 2004 as well as 2009's TNM. Those patients who were diagnosed before 2009 did not receive any adjuvant treatment. Those who were diagnosed later on received 40 mg of endovesical Mitomycin C during their immediate post operative period as their only treatment. We define recurrence as the presence of tumor after the first cystoscopy and relapse-free survival (RFS) as the period of time (in months) until the first recurrence appeared. Follow up constitutes the period of time (in months) until the last check-up or first recurrence. We also analyzed different variables: age, gender, smoking habits, muscular representation in the sample, size of the tumor (> or < 1 cm), multiple or single tumors and adjuvant treatment. The survival analysis was performed by the Kaplan-Meier method, using the long-rank test to evaluate the differences between groups. RESULTS: 68 patients were included in the study (73.5% men, 75% smokers). The average age was 61.9 years (the median being 58.5). Average follow up was 33.2 months (median 28.4). 35.3% of patients experienced recurrence. Average RFS was 19.2 ± 12.7 months (median 13.5). The majority of tumors were of a single nature (77.9%), with a size of less than 1 cm (55.9%) and with muscle representation (52.9%). 57.4% of patients did not receive adjuvant treatment. Only the absence of adjuvant treatment was associated with recurrence in uni and multivariate analysis (p<0,001), with a relative risk of 17,5 IC95% (7,6-30,2). CONCLUSION: The absence of adjuvant therapy with Mitomycin C is the only factor that, in a statistically significant way, increases the risk of recurrence, regardless of demographic factors and the characteristics of the tumor.

Factores predictores de recidiva en el tumor vesical primario Ta de bajo grado / Predicting factors for recurrence in low-grade Ta primary bladder tumours

OBJETIVO: Los tumores vesicales Ta constituyen el 53% de las neoplasias primarias de la vejiga, siendo el 70% de bajo grado (G1), presentando una probabilidad de recurrencia al primer año del 15-38%. El objetivo de nuestro trabajo es identificar los factores predictivos de primera recidiva de nuestra serie de tumores vesicales primarios TaG1. MÉTODOS: Analizamos retrospectivamente los pacientes diagnosticados mediante RTU de tumor vesical primario TaG1 entre 2004 y 2012. Los pacientes diagnosticados antes de 2009 no recibieron tratamiento adyuvante. Los diagnosticados posteriormente recibieron 40 mg de Mitomicina C endovesical en el postoperatorio inmediato como único tratamiento. Definimos como recidiva la presencia de tumor después de la primera cistoscopia. Definimos como supervivencia libre de recidiva (SLR) el tiempo en meses hasta la primera recidiva y como tiempo de seguimiento el tiempo en meses hasta la última revisión o primera recidiva. Analizamos las variables: edad, sexo, tabaquismo, representación muscular en la muestra, tamaño tumoral (> o < 1 cm), tumor único o múltiple y tratamiento adyuvante. Realizamos un análisis univariado y multivariado mediante chi-cuadrado y regresión logística para identificar las variables relacionadas con la recidiva. Realizamos un análisis de supervivencia mediante el método de Kaplan-Meier, utilizando el test Log-Rank para evaluar las diferencias entre los grupos. RESULTADOS: Incluimos 68 pacientes (73,5% varones, 75% fumadores). La edad media fue 61,9 años (mediana 58,5). El seguimiento medio fue 33,2 meses (mediana 28,4). El 35,3% de los pacientes recidivaron. La SLR media fue 19,2±12,7 meses (mediana 13,5). La densidad de incidencia de recidiva fue 13,5 recidivas /100 casos/año. Mayoritariamente los tumores fueron únicos (77,9%), <1 cm (55,9%) y con representación muscular (52,9%). El 57,4% de los pacientes no recibieron adyuvancia. Solamente la ausencia de tratamiento adyuvante se asoció con la recidiva en los análisis uni y multivariado (p<0,001), con un riesgo relativo de 17,5 IC95% (7,6-30,2). CONCLUSIONES: La ausencia de adyuvancia con Mitomicina C es el único factor que incrementa de forma estadísticamente significativa el riesgo de recidiva, independientemente de los factores demográficos y características tumorales

OBJECTIVES: Ta bladder tumors constitute 53% of primary bladder neoplasms, 70% of them being low-grade (G1). These tumors present a 15-38% chance of recurrence during the first year. The aim of this paper is to identify the predicting factors of the first recurrence in a series of TaG1 primary bladder tumors. METHODS: We have retrospectively analyzed patients who were diagnosed with TaG1 primary bladder tumor by transurethral resection between 2004 and 2012. We established their tumor grade and pathological stage according to the WHO’s classification guides for 1973 and 2004 as well as 2009’s TNM. Those patients who were diagnosed before 2009 did not receive any adjuvant treatment. Those who were diagnosed later on received 40 mg of endovesical Mitomycin C during their immediate post operative period as their only treatment. We define recurrence as the presence of tumor after the first cystoscopy and relapse-free survival (RFS) as the period of time (in months) until the first recurrence appeared. Follow up constitutes the period of time (in months) until the last check-up or first recurrence. We also analyzed different variables: age, gender, smoking habits, muscular representation in the sample, size of the tumor (> or < 1 cm), multiple or single tumors and adjuvant treatment. The survival analysis was performed by the Kaplan-Meier method, using the long-rank test to evaluate the differences between groups. RESULTS: 68 patients were included in the study (73.5 % men, 75% smokers). The average age was 61.9 years (the median being 58.5). Average follow up was 33.2 months (median 28.4). 35.3% of patients experienced recurrence. Average RFS was 19.2 ± 12.7 months (median 13.5). The majority of tumors were of a single nature (77.9%), with a size of less than 1 cm (55.9%) and with muscle representation (52.9%). 57.4% of patients did not receive adjuvant treatment. Only the absence of adjuvant treatment was associated with recurrence in uni and multivariate analysis (p<0,001), with a relative risk of 17,5 IC95% (7,6-30,2). CONCLUSION: The absence of adjuvant therapy with Mitomycin C is the only factor that, in a statistically significant way, increases the risk of recurrence, regardless of demographic factors and the characteristics of the tumor

Predictors of success and hospitalization in semi-rigid ureteroscopy for lithiasis as an outpatient procedure.

OBJECTIVES: To analyze the outcomes, predictors of success and predictors of need for hospital admission in our series of patients who underwent ureteroscopy (URS) as a major outpatient surgery (MOS) procedure. METHODS: We carried out a retrospective analysis of 402 patients who had undergone semi-rigid URS for ureteral calculi as a MOS procedure in our center between 2004 and 2012. Patients with previous DJ catheter were excluded. We classified the calculi according to their location (lumbar, pelvic, iliac), size (< or> 1cm) and number (single or multiple). Follow-up was done by plain X-ray of the abdomen and ultrasound one month after surgery. The procedure was considered successful when patients were free from the treated calculi or had ureteral fragments < 3 mm one month after surgery. Univariate and multivariate analyses were carried out to identify the factors involved in success and hospitalization not being required. RESULTS: A total of 269 patients were included. The majority of the stones were single (92.2%), <1 cm in size (76.6%), pelvic (62.1%), and left-sided (57.2%). 89.6% of the procedures were performed as MOS and 82.2% were considered to be successful. In the multivariate analysis, left-sided (p<0.001) and pelvic location of the calculi (p=0,01) were found to be independent predictors for the success of the procedure In terms of hospital admission, the only independent predictor was the presence of intraoperative complications ( p=0.006). CONCLUSIONS: Left-sided and pelvic locations were the independent predictors for the success of the URS. A lack of intraoperative complications was the independent predictor for not requiring hospitalisation.

Factores predictores de éxito y necesidad de ingreso en la ureteroscopia semirigida en régimen ambulante / Predictors of success and hospitalization in semi-rigid ureteroscopy for lithiasis as an outpatient procedure

OBJETIVO: La ureteroscopia constituye una opción con elevadas tasas de éxito en el tratamiento de los cálculos ureterales, siendo superiores a la litotricia en la mayoría de los casos. El objetivo de nuestro trabajo es analizar las variables clínicas y demográficas, resultados y complicaciones, de nuestra serie de pacientes sometidos a ureteroscopia en régimen de cirugía mayor ambulatoria (CMA) y analizar los factores predictores de éxito del tratamiento y necesidad de ingreso hospitalario. MÉTODOS: Analizamos de forma retrospectiva 402 pacientes sometidos a ureteroscopia semirrígida (URS) por litiasis ureteral en régimen de CMA en nuestro centro entre 2004 y 2012. Excluimos los pacientes con catéter doble jota (CDJ) previo. Clasificamos las litiasis según su localización (lumbar, iliaca, pélvica) tamaño (< o > 1cm) y número (única o múltiple). El tratamiento se realizó mediante extracción con pinzas, LASER Holmium, o fragmentación mecánica. La revisión se realizó mediante radiografía simple de abdomen y ecografía al mes de la intervención. Consideramos éxito del procedimiento los pacientes libres del cálculo tratado o con restos litiásicos ureterales <3 mm al mes de la intervención. Realizamos un análisis univariante y multivariante mediante chi cuadrado y regresión logística para identificar los factores implicados en el éxito y la no necesidad de hospitalización. RESULTADOS: Incluimos 269 pacientes, 59% varones. La mayoría de la litiasis fueron únicas (92,2%), menores de un centímetro (76,6%), de localización pélvica (62,1%) e izquierdas (57,2%). Realizamos dilatación neumática del orificio ureteral en 67,3% de los casos, tratamos la mayoría de las litiasis con LASER (48%) y dejamos CDJ postoperatorio en el 92,2% de los casos. En el 83,3% de los procedimientos no existieron complicaciones intraoperatorias, realizándose el 89,6% en CMA, considerándolo éxito en el 82,2%. En el análisis multivariante, la lateralidad izquierda (p<0,001) y la localización pélvica de la litiasis (p=0,01) resultaron factores predictivos independientes de éxito del procedimiento. Para la necesidad de ingreso hospitalario solo la ausencia de complicaciones intraoperatorias resulto factor predictivo independiente (p=0,006). CONCLUSIONES: La lateralidad izquierda y la localización pélvica constituyen los factores predictores independientes de éxito de la URS. La ausencia de complicaciones intraoperatorias constituye el factor predictor independiente de no precisar hospitalización (AU)

OBJECTIVES: To analyze the outcomes, predictors of success and predictors of need for hospital admission in our series of patients who underwent ureteroscopy (URS) as a major outpatient surgery (MOS) procedure. METHODS: We carried out a retrospective analysis of 402 patients who had undergone semi-rigid URS for ureteral calculi as a MOS procedure in our center between 2004 and 2012. Patients with previous DJ catheter were excluded. We classified the calculi according to their location (lumbar, pelvic, iliac), size (< or > 1cm) and number (single or multiple). Follow-up was done by plain X-ray of the abdomen and ultrasound one month after surgery. The procedure was considered successful when patients were free from the treated calculi or had ureteral fragments <3 mm one month after surgery. Univariate and multivariate analyses were carried out to identify the factors involved in success and hospitalization not being required. RESULTS: A total of 269 patients were included. The majority of the stones were single (92.2%), <1 cm in size (76.6%), pelvic (62.1%), and left-sided (57.2%). 89.6% of the procedures were performed as MOS and 82.2% were considered to be successful. In the multivariate analysis, left-sided (p<0.001) and pelvic location of the calculi (p=0,01) were found to be independent predictors for the success of the procedure In terms of hospital admission, the only independent predictor was the presence of intraoperative complications (p=0.006). CONCLUSIONS: Left-sided and pelvic locations were the independent predictors for the success of the URS. A lack of intraoperative complications was the independent predictor for not requiring hospitalisation (AU)

Manejo perioperatorio y resultados en pacientes con neovejiga ileal ortotópica / Orthotopic ileal neobladder. Postoperative management and results

La reconstrucción del tracto urinario tras la cistectomía radical ha evolucionado desde la simple derivación urinaria hasta la reconstrucción anatómica y funcional del mismo lo más próxima posible al estado preoperatorio del paciente. En los últimos 20 años, la reconstrucción ortotópica ha pasado de cirugía experimental a ser el método preferido de derivación urinaria en ambos sexos. Los urólogos que realizan este tipo de intervención deben tener experiencia en cirugía pélvica y ser capaces de realizar una cistectomía con preservación nerviosa. Sin embargo, lo más importante en estos enfermos es el manejo postoperatorio, para lo cual se requiere un profundo conocimiento de la fisiología de la neovejiga, sus posibles complicaciones y tratamientos. Revisamos en este artículo los principales aspectos del manejo postoperatorio de los pacientes con neovejiga ileal. También se revisan los resultados de la técnica a largo plazo con respecto a continencia, función sexual, preservación de función renal, control oncológico y calidad de vida de los pacientes (AU)

Urinary diversion after cystectomy have evolved from simple diversion and protection of the upper tracts to functional and anatomic restoration as close as possible to the natural preoperative state. Over the past15 years, orthotopic reconstruction has evolved from “experimental surgery” to the “preferred method of urinary diversion” in both sexes. Urologist that perform this technique should have an appropriate experience with pelvic surgery and be able to perform a nerve sparing radical cystectomy. Nevertheless, the postoperative management of these patients is more important than the surgical construction if good longterm results are to be achieved. For this reason, a great knowledge about the neobladder´s physiology, postoperative complications and their treatment are needed. We review the most important aspects in the postoperative management of patients with ileal neobladder. We also resume the long term outcomes concerning to continence, sexual function, renal impairment, oncologic safety and quality of life (AU)

[Giant renal oncocytoma]. / Oncocitoma renal gigante.

Renal oncocytoma is a benign neoplasms arising from cells of the distal renal tubule. They acount for 3-7% of all renal tumors. most are incidental findings. Differential diagnosis with renal cells carcinoma is often difficult. Here we report a case of big renal oncocytoma as an incidental finding while performing an abdominal ultrasound in a patient with low abdominal pain. We also review the diagnostic an therapeutic approach in this kind of malignancies.

Oncocitoma renal gigante / Giant renal oncocytoma

El oncocitoma renal es un tumor benigno derivado de las células del túbulo renal distal. Aunque no es muy frecuente, representa entre el 3-7 % de las masas renales. La mayoría de las ocasiones se presenta como un hallazgo incidental en pruebas de imagen realizadas por otros motivos. El diagnóstico diferencial preoperatorio con el carcinoma de células renales es complejo y a menudo sólo se puede confirmar después de la cirugía. Presentamos un caso clínico de oncocitoma renal de gran tamaño diagnosticado mediante una ecografía abdominal realizada por molestias en hipogastrio. Revisamos el enfoque diagnóstico y terapéutico de este tipo de tumores (AU)

Renal oncocytoma is a benign neoplasms arising from cells of the distal renal tubule. They acount for 3-7% of all renal tumors. Most are incidental findings. Differential diagnosis with renal cells carcinomais often difficult. Here we report a case of big renal oncocytoma as an incidental finding while performingan abdominal ultrasound in a patient with low abdominal pain. We also review the diagnostican therapeutic approach in this kind of malignancies (AU)