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Introduction: The improved image resolution of IMAGE1 S technology will increase tumor detection, achieve a greater number of complete resections, and would probably have an impact on the reduction of recurrences., Aim: The primary objective was to compare the recurrence rates of IMAGE1 S vs. white light during transurethral resection of the bladder (TUR); the secondary objective was to compare the complication rates according to Clavien-Dindo (CD) at 12 months of follow-up., Methods: Prospective, randomized 1:1, blinded clinical trial. Recurrence and complication rates according to CD were analyzed using chi-square/U Mann-Whitney tests and recurrence-free survival (RFS) using Kaplan-Meier curves. The European Association of Urology (EAU) 2021 scoring model was used., Results: The analysis included 103 participants; 49 were assigned to the IMAGE1 S group and 54 to the white light group. Recurrence rates were 12.2% and 25.9%, respectively (P = .080). The low and intermediate risk group had a lower recurrence rate with IMAGE1 S (7.7% vs. 30.8%, P = .003) and a higher RFS with IMAGE1 S (85.2% vs. 62.8% Log Rank: 0.021), with a Hazard Ratio of 0.215 (95% CI: 0.046-0.925). No differences were observed in the high and very high-risk groups. Complications were mostly grade I and rates were similar between both groups (IMAGE1 S 20.4% vs. white light 7.4% P = .083)., Conclusions: There were no differences in the recurrence rates between groups. However, the low and intermediate risk group had a lower recurrence rate with IMAGE1 S. In addition, perioperative complication rates were not higher., (Copyright © 2023 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: Nephron sparing renal surgery is considered the technique of choice for renal tumors smaller than 4 cm. We present our oncological results in a 17-year period., Methods: Between January 1995 and December 2012, 130 renal tumor surgeries (58 open, 72 laparoscopic) were performed. We analize the pathological results, presence of positive surgical margins, local relapse, distant metastases and death., Results: The most frequent tumor was clear cell carcinoma (73%) in a pT1 stage (87%). Mean tumor size was 3 cm. Positive surgical margin rate was 7%, currently without any tumor recurrence among these cases (follow up 37 months). Cancer specific mortality is 0% and local recurrence rate 3%. Mean follow up is 71 months., Conclusions: Nephron sparing surgery results are similar to radical nephrectomy in tumors smaller than 4 cm. Positive surgical margins do not seem to have an important repercussion in cancer specific survival.

Introduction: This study assesses long-term outcome of patients with neuropatic bladders who underwent a bladder augmentation before puberty., Patients and Methods: A total of 21 patients with low compliant neuropathic bladders who did not respond satisfactory to clean intermittent catheterization and/or anticholinergic therapy underwent bladder augmentation (mean age 8.3 yr, range; 2.5-12). Eighteen patients (86%) had VUR and/or ureterohydronephrosis and 17 (81%) had DMSA renal scars. Renal function was normal in all cases except one. All patients were followed at regular intervals with serum electrolyte and creatinine determination, urinary tract imaging, urodynamic evaluation and 24-hour urine collection. In the 18 cases augmented with intestine, urine cytology, cystoscopy and biopsy were also performed., Results: Mean follow-up was 11 yr (8-14.5) and mean age at the end of follow-up was 19 yr (13.3-26.8). Urodynamic studies showed a significant improvement in bladder compliance. Upper urinary tract dilatation disappeared in all patients, VUR in 13/15p (86%) and no new renal scarring occurred. Renal function was normal at the end of follow-up in 20. Only 1 patient had UTI and another had a bladder stone. All patients are dry and 2 of them do not need clean intermittent catheterization. Urine cytology and cystoscopy were normal and no malignat lessions have been found in the biopsy specimens., Conclusions: Bladder augmentation done pre-puberty preserves renal function and resolves VUR and/or hydronephrosis in most cases without reimplanting the ureters. Close lifelong follow-up, including a cystoscopy, improves the results and prevents complications.

Donor graft lithiasis is a unusual complication of renal transplantation, however, it is associated to a high morbidity. This pathology is due to several causes such us: metabolic factors, infectious disease, drugs, foreign bodies or transferred in the donor graft. The objective of the treatment is to remove the lithiasis without damaging the renal unit. We report the successful percutaneous anterograde treatment of an ureteral obstructive hard calculi, in renal allograft.

Objective: Various tumors have been described in the scrotal area arising from skin and the underlying tissues: nevus, dermoid and epidermoid cysts, epidermoid carcinomas, lipomas, leiomyomas, angiokeratomas, lymphangiomas, granular cell tumors, granuloma, malignant tumors of the peripheral nerve tissue, and some 'pseudotumors' such as fibromatosis and nodular calcinosis. We describe for the first time a sweat gland tumor, which is also remarkable for its unusually large size., Methods/results: A 76-year-old patient consulted for a painful left scrotal tumor that he had noted for some time and that had slowly and gradually grown. Ultrasound assessment of the GU system confirmed the presence of a 4.2 cm left, solid paratesticular mass that was removed under local anesthesia., Conclusions: Chondroid syringoma is a tumor arising from the sweat gland that is usually localized to the head and neck. It has an excellent prognosis and recurrence has only been described in patients in whom the tumor had not been completely resected.

Objective: To describe the clinical and histological findings of the unusual involvement of the urinary bladder by multiple inverted papillomas of transitional cells., Methods/results: A 53-year-old male presented with obstructive symptoms and gross hematuria lasting for one year. Ultrasound examination of the urinary bladder demonstrated two polypoid masses. Transurethral resection was performed and histopathological examination of specimens showed a subepithelial, non-atypical cell proliferation arranged in a trabecular pattern. DNA-ploidy showed diploid population and ki-67 determination revealed a low proliferation index., Conclusions: Multiple inverted papillomas of the urinary bladder are very rare. Histological examination is essential for the definitive diagnosis. Determination of DNA-ploidy and proliferative index may be useful for appropriate management of this disease.

Objective: To report a case of locally invasive angiomyofibroblastoma of the scrotum. To our knowledge, this is the first case of invasive scrotal angiomyofibroblastoma reported in the literature., Methods: A case of invasive angiomyofibroblastoma of the scrotum is presented. The literature is reviewed with special reference to the etiopathogenesis, clinical features, diagnosis and treatment of this rare soft tissue tumor., Results/conclusions: The case described herein shows that angiomyofibroblastoma can be invasive.

We report 15 cases of spontaneous retroperitoneal haematoma. The etiology and the diagnostic and therapeutic procedures were evaluated. The haematoma source was the adrenal gland in 4 patients and the causes were pheochromocytoma (1), adenoma (1), myelolipoma (1) and idiopathic (1). In 10 patients the source was the kidney and the causes were angiomyolipoma rupture (6), renal cell carcinoma (3) and ureteral calculi (1). In the remaining case, the haematoma was produced by fibrinolytic and anticoagulant therapy in a patient with acute myocardial infarction. The imaging diagnostic techniques employed were abdominal ultrasonography and CT scan, which allowed the diagnosis of haematoma and showed his size and extension in all the cases. With these two techniques, and with the retrograde pyelography in one patient, we obtained the etiologic diagnosis in 12 of the 15 cases. Surgical treatment was performed in 12 patients (adrenalectomy in 2, simple nephrectomy in 3, radical nephrectomy in 5 and partial nephrectomy in 2).

Objective: To report a case of spontaneous rupture of adrenal pheochromocytoma., Methods/results: A patient previously diagnosed as having arterial hypertension and chronic renal failure secondary to adult polycystic renal disease was admitted to the emergency services with abdominal pain, signs of peripheral vasoconstriction and syncope. A CT scan showed a large perirenal hematoma. The patient underwent an extended left radical nephrectomy and evacuation of the hematoma. The histopathological analysis showed a polycystic kidney and a ruptura adrenal pheochromocytoma. The clinical features, diagnosis and treatment of this condition are discussed.

Fungal urinary infections are becoming increasingly frequent as a result of widespread use of broad spectrum antibiotics, an increased number of immunocompromised patients and the greater longevity of chronic patients. Urinary tract infections by Toruplosis glabrata only come second in frequency after those caused by Candida albicans, accounting for 5 to 25% of all infections caused by fungi. The paper presents one case of pyonephrosis by Toruplosis glabrata in a female patient treated with fluconazole who later underwent nephrectomy. A description is made of the clinical picture, diagnosis and treatment of these infections.

Objectives: The present study discusses both primary and secondary malignant lymphoreticular proliferative tumors of the urinary tract., Methods: Two patients with urinary tract involvement are described: one female and one male with bladder and prostate involvement, respectively., Results: Both cases presented clinical features that were not distinct from those of other tumors of the urinary tract., Conclusions: The anatomopathological study is essential to the differential diagnosis of urinary tract involvement from non-Hodgkin lymphoma and discards other extralymphatic conditions.

Objective: To describe an unusual type of vesical carcinoma (sarcomatoid carcinoma) associated with the spread of inflammation. The article discusses the diagnostic difficulties and prognosis., Method/results: We describe a patient with vesical sarcomatoid carcinoma associated with the spread of inflammation that practically obscured the undifferentiated area, mimicking a lymphoma. This is interpreted as a favourable immunological reaction, despite the highly aggressive behaviour of the sarcomatoid component., Conclusions: Only on rare occasions do vesical carcinomas present such a prominent degree of spindle-shaped cells. This finding could create some diagnostic confusion, hence an immunohistochemical study is essential. The identification of sarcomatoid carcinoma has important implications both for treatment and for prognosis. The literature refers to the marked aggressiveness of this type of tumour. The peculiarity of the case resides in the associated spread of inflammation which improved the prognosis.

Objectives: To report on a case of melanoma, a rare tumor type metastatic to the bladder., Method/results: A case of melanoma metastatic to the bladder was incidentally discovered in a patient with urothelial cancer. The clinical features, diagnostic and therapeutic aspects are described., Conclusions: In a patient with malignant melanoma presenting irritative micturion syndrome and/or hematuria, endoscopic bladder exploration with multiple random biopsy must be performed to rule out melanoma metastatic to the bladder metastasis.

Objective: This article reports our experience with lyophilized human dura in the treatment of complex urethral stenosis., Method: Seven patients with iatrogenic/inflammatory urethral stricture underwent a 13 cms long x 1.5 cms wide medial urethral augmentation., Results: During a mean follow-up of 23 months, good results accounted for 85.7%., Conclusion: Lyophilized dura patches constitute a suitable choice in selected patients who, for local or systemic reasons, are not good candidates for other urethroplasty procedures.

A 10 x 6.5 cm cyst with ciliated cell lining was removed from a 43-year-old woman. The immunohistochemical studies demonstrated that the cyst cells expressed keratins (Lu 5+) and the adrenal cortical cells did not, suggesting that the cyst lining was not derived from adrenal cells. The presence of ciliated cells indicates that the cyst was derived from embryonal vestiges.