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Objective: Cross-sectional descriptive observational study of incidence and association, to determine whether the higher incidence of prostate cancer in Castilla y León (with respect to the national rate) could be due to modifiable factors., Location: University Hospital Río Hortega., Participants: New prostate cancer diagnoses., Main Measurements: Incidence rate (IR). Age, family history, symptoms, comorbidity, rectal examination, ultrasound volume (cc), PSA (ng/mL), cylinders, volume cylinder ratio, Gleason, TNM and D'Amico groups., Results: Castilla y León showed the highest prostate cancer IR in Spain (141.1 per 100,000 inhabitants per year), with a peak of early incidence (65-74 years) and significant differences in < 64 and 65-74 years. Age at diagnosis was the lowest (Castilla y León, 66.9 ±7.1 vs. Spain, 69.1 ± 8.2 years; P < .001). No differences: family history, symptoms, comorbidity and PSA. The number of cylinders was 10.7 ± 1.8. In multivariate analysis (AUC = 0.801; P < .001), they were more frequent in Castilla y León: grade i rectal examination, non-palpable rectal examination, Gleason < 6, stage T2c and the volume cylinder ratio < 6 (only in < 64 years: OR 5.2; 95% CI 1.2-22-22.3; P = .027). In Spanish regions, volume cylinder ratio showed inverse correlation with IR in < 74 years, while age showed positive correlation in all age groups., Conclusions: The higher prostate cancer IR in Castilla y León in 2010 was not associated to an older population. However, the biopsy technique influenced IR, as more cylinders were obtained in younger subjects, without conditioning overdiagnosis., (Copyright © 2021 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To determine the actual incidence of prostate cancer (PC) in the healthcare areas of Castilla-Leon in 2014., Material and Methods: A multicentre study was conducted with the participation of 7 of the 9 healthcare areas of Castilla-Leon. We collected retrospective data that included 87.8% of the target population (men diagnosed with PC with histopathological confirmation in 2014). We calculated the raw and age-adjusted incidence rates based on the direct method and consulted the community and national epidemiological data in the Spanish National Institute of Statistics., Results: A total of 1198 new cases of PC were diagnosed, with a raw incidence rate in the community of 109.54 cases per 100,000 men. The adjusted rates for the Spanish and European populations were 115.41 and 110.07, respectively. The age group with the highest diagnostic concentration was the 60-70-year group, with 41.97% of the diagnoses. The group with the highest incidence was the 70-80-year group, with 438.87 cases per 100,000 inhabitants. There were differences in the raw and age-adjusted incidence rates and in the age at diagnosis among the various included healthcare areas., Conclusions: The community raw incidence rate was higher than most existing data. We observed significant differences among the various geographical areas, which could be explained mainly by the age distribution and the opportunistic screening policies for each area., (Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The progressive reduction in the calibre of the tract in percutaneous kidney surgery to the point of miniaturisation has expanded its use to smaller stones that until now have been treated with extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS)., Objective: To provide an update on the various techniques of small-calibre nephrolithotomy (SC-PCNL) analyse their efficacy, safety and indications and determine their degree of implantation at this time., Material and Methods: We performed a review in PubMed of Spanish and English medical literature on the various techniques of SC-PCNL., Results: The use of SC-PCNL has reduced the morbidity associated with standard PCNL, particularly bleeding, and has enabled tubeless nephrolithotomy with greater safety. There are various techniques with blurred terminology (Miniperc, Microperc, Mini-microperc, Ultraminiperc), which differ in terms of gauge employed and in certain technical aspects that require their indications be specified. Currently, SC-PCNL competes with techniques that are less invasive than standard PCNL such as ESWL and the RIRS in treating small stones, but the role of SC-PCNL is still not sufficiently understood and continues to be the subject of debate., Conclusions: The indications for PCNL are expanding to small stone sizes due to the miniaturisation of the technique. PCNL competes in this field with ESWL and RIRS. Larder studies are needed to establish the specific indications for PCNL in treating nephrolithiasis., (Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Our objective was to elaborate a predictive model of bladder cancer, in an unselected clinical population submitted to cystoscopy., Materials and Methods: We recruited consecutive patients that underwent cystoscopy due to suspicion of bladder cancer or surveillance of a previously diagnosed bladder cancer. Urine cytology and a BTA-stat® (BTA) test were carried out for all patients. To avoid an assessment bias, the BTA-tests, cytologies and cystoscopies were conducted in a blinded fashion. We used logistic regression to predict cystoscopy results from cytology, BTA-test and clinical variables., Results: From August 2011 to July 2012, we recruited 244 patients and 237 were valid for analysis. Newly diagnosed and surveillance cases were 13% and 87% respectively. Cytology and BTA-test sensitivities were 57.9% (CI 95: 42.2-72.1) and 63.2% (CI 95: 47.3-76.6) with specificities of 84.4% (CI 95: 78.7-88.8) and 82.9% (CI 95: 77.1-87.5). The predictive model included the BTA-test, cytology, time since previous tumour, and treatment with mitomicin or BGC during the last three months. The model predictive accuracy (AUC) was .85 (.78-.92), and dropped to 0.79 when excluding the BTA-test (P=.026). For the surveillance of bladder cancer, a 10% threshold on the model predicted probabilities resulted in an overall negative predictive value of 95.7%, and 95.0% in low grade tumours., Conclusion: In a cost containment environment, our prediction model could be used to space out cystoscopies in patients with previous, low grade tumours, resulting in a more efficient use of resources in the healthcare system., (Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)

Objective: Percutaneous nephrolithotomy (PCNL) is the minimally invasive procedure of choice for removing renal stones larger than 2 cm. This study has aimed to identify the different variables that might influence decrease of hemoglobin during the surgery performed in supine position., Material and Methods: A prospective, multicenter, observational study of supine PCNL, based on the Spanish Association of Urology database, was analyzed. The different preoperative and postoperative factors that might affect the decrease of hemoglobin were assessed: demographics and anthropometric data, comorbidities, size and location of the stones, anatomical variants and technical aspects of the procedure., Results: From September 2008 to December 2012, 397 supine PCNL procedures performed in 15 Spanish centers were registered. Mean hemoglobin decrease was 2.3±1.5 g/dl and overall blood transfusion rate was 5.5%. No statistically significant differences were found between genders, body mass index (BMI) and age in terms of blood loss. There were also no differences between patients with cardiovascular, hypertensive, diabetic and anticoagulant treatment background. Blood loss was not significantly influenced by stone size and location. Technical aspects of the procedure as operative time (> 120 min ≤), access to the pelvi-caliceal system (ultrasound, fluoroscopy), percutaneous tract dilation technique (Alken, balloon or Amplatz) or placement of nephrostomy (tube versus tubeless) were not associated with differences in pre-op/post-op hemoglobin. Only multiple percutaneous tracts (≥2) and middle calix access were statistically significantly (P=.03 and P=.01) related with less blood loss., Conclusions: PCNL in supine position is a minimally invasive procedure for removal of large (≥2 cm) and multiple renal stones, with a low incidence of blood loss and minimal transfusion rate. Multiple percutaneous tracts and middle calix puncture were the only statistically significant variables associated with decrease in hemoglobin levels., (Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)

Objectives: To study the technical opinion of an expert panel and reach a consensus of professional criterion in relation to the most recent scientific evidence in Benign Prostatic Hyperplasia (BPH) in the scopes of diagnosis, progression criteria, medical treatment and surgical treatment., Material and Methods: Systematized review of the literature of the last 10 years in BPH by means of a scientific committee and elaboration of a 64-question questionnaire divided into three strategic areas: 1.- Diagnosis and stratification of the patients with BPH considering the progression risk factors. 2.-Novelties in the medical treatment and 3.- New contributions in the surgical and minimally invasive treatment in BPH. A panel of 50 urologists standing out for their knowledge in BPH distributed throughout the national geographic area was chosen, establishing the Delphi methodology for the study through the application of two successive online surveys., Results: The 50 experts consulted completed the two groups of the questionnaire. In the first, a consensus of criterion was observed in 50 out of the 64 questions analyzed, achieving a consensus in 59/65 (92.5%) in the second round, which included aspects of morbidity of the lower urinary tract symptoms (LUTS), diagnostic tests necessary in the initial evaluation of the specialist, stratification of the patients in relation to the risk of progression, strategies of step-by-step medical therapy and combination in patients with risk of Acute Urinary Retention (AUR) or surgery and of the indications of surgical therapy and the role of new less invasive treatments., Conclusions: In a condition of the high prevalence of BPH, in which we have seen important changes in its entire spectrum in recent years, the obtaining of an elevated consensus to which a large number of reference specialists in this condition have contributed will be of great importance for the usual clinical management of this disease., (Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.)

Introduction: Although the supine position created by Dr. Valdivia two decades ago to perform the procedure known as percutaneous nephrolitectomy (PNL) presents advantages against the prone position in some aspects concerning anesthesia and surgical ergonomy, its use has failed to spread widely among the urology community due to certain technical difficulties, a lower rate of calculi clearing and a higher rate of complications, in spite of the fact that the scarce comparative studies do not show enough data to support this opinion. The present study compares both positions considering the technical difficulties encountered, their effectiveness and their results and complications., Material and Methods: A series of 50 patients that underwent PCNL by prone position is compared retrospectively with another series of 54 patients that underwent consecutively PCNL by prone position. All procedures were performed under general anesthesia, the inferior calyx approach was the one used the most over the supracostal approach, and the sole tract over the multi-tract approach was predominant. Dilatation of the nephrostomy tract was done, in most of the cases, with a high-pressure balloon catheter. The stone surface treated was 399.93+/-58.2 mm2 for the supine group, and 416.36+/-46.54 mm2 for the prone one (p=0.456). The management of the stones was carried out by ultrasonic or ballistic fragmentation, and a small group of patients underwent direct stone removal., Results: As far as demographic parameters and operative variables such as number of tracts performed, calyx election, type of tract dilatation and kind of energy used for fragmentation, both groups were homogeneous. In 3 cases of each group there was a failure to access the kidney. The rate of failure was 6%, and 5.56%, for the supine and prone groups, respectively (p=0.716). Average operating time was 74.55+/-25.54 and 91.82+/-24.82 minutes, respectively, p=0.123. A postoperative x-ray showed a stone-free rate of 76% for the supine group and 74% for the prone group, p=0.308. ESWL was the supplementary treatment for 12% of the patients in the supine group, and for 12.96% of the patients in the prone group p= 0.478, and a second procedure was performed on 4 (8%) patients in the supine group and on 3 (5.56%) in the prone one, p=0.697. Hospital stay was the same for both groups (5.89+/-4.7 for the supine group, and 5.5+/-4.09 for the prone one, p=0.694). As far as analgesia required, 6.89+/-4.87 was administered for the supine against 6.18+/-4.09 for the prone, p=0.580. The complications rate was very low for both groups and also very similar; one of the patients in the supine group suffered a lesion to the colon., Conclusion: Valdivia position is as feasible as the prone position for PCNL. Success rates, as far as stone clearing, and complications are similar for both positions.

Objective: Laparoscopic technique has been developed with the aim to decrease the morbidity of the open radical prostatectomy., Material and Methods: From january 2002 to may 2002, 8 patients were treated for prostate cancer with laparoscopic radical prostatectomy. Unilateral linfadenectomy has been carried out in only one patient. We usually employ the transperitoneal technique published by the Montsouris Institute, with some modifications., Results: The main surgical time was 356 minutes (540-240). Transfusion wasn't needed in any case. Intraoperative complications were: 2 bladder injuries, 1 bleeding of the epigastric artery. Postoperative complications were: 1 ileus, 2 compressive neurapraxia, 4 anastomotic fistutas. All complications were treated conservatively. No patient were converted to open surgery. Surgical limits were negatifs in all cases, and the PSA rate was less than 0.1 ng/ml in the first month follow up., Conclusion: Laparoscopic radical prostatectomy is a difficult technique, but we think that, the learning curve is getting lower and lower than in the first series. Oncologic results with this technique is similar to the open one. However, laparoscopic approach shows us some benefits such as less bleeding, less time catheterisation, less hospital stay, better continence, better sexual function, better stetic result, less postoperative pain, and finally an earlier back to work.

Objective: To emphasise a case of splenic hematoma secondary to ESWL., Methods: We report the case of a 69 year old patient with the diagnosis of left kidney stone who underwent ESWL. The treatment was performed with an electric lithotripter after pre-treatment antibiotic prophylaxis; 2000 shock waves of 18 Kv were given to the patient., Results: Patient presented abdominal pain and hematocrit descent after lithotripsy. The diagnosis of splenic hematoma was established after abdominal ultrasound and CT-scan and the patient was treated conservatively. He required a posterior emergency splenectomy secondary to infection of the hematoma, with the result of death secondary to septic shock., Conclusion: Splenic lesion is an exceptional complication after ESWL. There are no studies about the effect of shock waves on the spleen, having been reported only four cases. It is believed that extreme care should be taken in cases with splenic pathology: leukaemia, lymphoma, etc.

Purpose: Nowadays, psychcological and social aspects of treatment of urinary diversion after cystectomy, have become of utmost importance. Body image, potency, continence, emotional distress and dissatisfaction, functional and social activities are majors factors to improve quality of life after surgery. The aim of this study is to compare health-related quality of life after bladder substitution with ileal conduit diversion., Materials and Methods: We developed a questionnaire based upon a literature review, to compare health related quality of life between bladder substitution and ileal conduit (45 multiple choice mailed questionnaire). We examined functional and social activities, sexual dysfunction, urinary problems, and body image dissatisfaction., Results: 78 male patients with bladder cancer, were interviewed. 91% of the questionnaires were answered, 48.7% by patients' family and 42.3% by the patients themselves. 6 patients underwent ileal conduit and 27 underwent bladder substitution. Patients with ileal consuit presented higher body image dissatisfaction than those who underwent bladder substitution. When urine leakage occurred it caused more distress to the conduit patients, indicating urinary leakage as their main problem. Bladder substitution patients did not consider continence problems as very important, they had not interrupted social activities such as travelling or seeing friends. 100% of bladder substitution patients would not mind to undergo this operation again, while only 66% of ileal conduit patients would., Conclusion: Health-related quality of life is higher after bladder substitution. In our opinion we should use bladder substitution as the standard method of diversion after radical cystectomy for bladder cancer.

Unlabelled: We report our experience in the treatment of uretero-enteric anastomotic strictures. Our incidence in this complication is 3.8% in orthotopic bladder substitution and 8.3% in ileal conduict., Material and Methods: We have treated this complication in 6 patients with orthotopic bladder substitution and 4 with ileal conduict. We tried to perform a dilatation with a high pressure balloon and to place a Double-J catheter., Results: In 4 cases we could not introduce the guidewire through the stricture because there was a total stop. In the others 6 cases, one is doing well without Double-J, another one did not tolerate the catheter and we performed an open surgical reanastomosis, 2 kept the catheters until their death due to metastases and the other two continue alive with their catheter periodically replaced., Conclusions: The direct uretero-enteric anastomoses present less stenoses risk. Endourological techniques should be the first option in treatment of these patients.

Objective: We have studies both the morphologic and morphometric modifications that the alcohol induces in subjected rats to chronic intake of alcohol and to evaluate the reversibility of this alterations after suppressing the ingesta of alcohol., Material and Methods: The animals underwent diverse outlines of chronic intake of alcohol and diverse morphometric parameters of the prostate were valued at the level of optic microscopy., Results: Two morphologic prostatic patterns was observed according to the studied group of animals (experimental or control). It seems to be that the dose of alcohol was the factor that more it influenced in the morphometric variations of the cells.

Replacement plasty allows to perform oncology surgery while maintaining body image and preserving renal function. Entero-ureteral anastomosis is a significant element in this procedure where the main responsible for the loss of renal function are stenosis, infection and reflux. Our group has performed 206 orthotopical vesical replacements (November 1981-November 1998), using a direct Wallace-type uretero-ileal anastomosis. An intussusception valve system was used as antireflux mechanism. The number of obstructions, rate of stenosis at the uretero-ileal junction and incidence of valve stenosis were all analyzed as part of the complications occurred over a follow-up period of 54 months (6-183). Findings included 6 stenosis at the uretero-intestinal junction and 2 at the intussusception valve. Two (3.8%) of the uretero-ileal stenosis were earlier and associated to fistula; one was treated with open surgery and one had a double J placed through antegrade percutaneous access. Of the remaining late four, only one was treated with a double J catheter while the other three had to be re-operated. Stenoses of the valvular system (1.2%) were solved with open surgery. From our experience, we believe that direct uretero-ileal implantation with scraping of the ureter is a safe technique with little risk for stenosis at the uretero-ileal junction. Intussusception was used a antireflux system in all cases.

Objective: The results obtained in 9 female patients who underwent bladder substitution after a modified anterior pelvic exenteration are presented., Methods: From 1994 to 1999, 9 women underwent bladder substitution after a modified anterior pelvic exenteration that preserved the two distal thirds of the urethra, the pubourethral ligaments and endo-pelvic fascia and limited laterovaginal dissection to preserve the innervation of the striated sphincter for continence., Results: The bladder capacity was 332.9 +/- 35.6 ml and urinary flow was 17.7 +/- 2.9 ml/sec. Seven patients are completely continent and two patients have stress incontinence grade II. None of the patients had difficulty with bladder emptying. Fistula (one case) and diarrhea (one case) were the most important complications., Conclusions: Our approach is based on a better understanding of the anatomical mechanisms of female continence and the viability of the remaining urethra from the oncologic perspective. This technique achieves a high level of patient satisfaction and quality of life.

Dielt's syndrome is generally known as nephritic colic due to the dilation of the urinary tract that results from a renal ptosis. In spite of renal ptosis being a commonly seen occurrence, sometimes it can be the cause of a serious painful clinical manifestation. This paper presents one case successfully treated through laparoscopic nephropexy. It also includes a discussion on the various diagnostic and therapeutical techniques.

Presentation of the results obtained using the intraprostatic prosthesis UroLume in 78 patients wit BPH obstruction, 69 of which presented high surgical risk (ASA IV). Mean age was 79.8 years (r: 62-93). All patients carried urethral catheters, except 4 (5.1%) who had a provisional metal coil that required replacement. Prosthesis were implanted successfully in 72 cases (93.3%). The most significant exclusion criterion was an excessive length of prostate urethra. Mean follow-up was 15.3 months (r: 3-38). Mean maximum flow at 1 year after implant was 12.7 mL/sec; mean symptoms score (I-PSS score) was 6.2 points and in most prosthesis, epithelization had taken place. Three patients required implant of another prosthesis, either during the same surgical procedure (1 case) or later due to retention or dysuria (2 cases). Due to acute urine retention (AUR) during the immediate postoperative, resection of the middle lobe was performed in one case while a second case required late resection of intraluminal hyperplastic tissue. Three patients (4.1%) had haematuria that forced hospital admission some months after the implant, and three cases (4.1%) required removal of the prosthesis; at patient's request (1 case), due to calcification (1 case) and for stress incontinence (1 case). After a follow-up of over three years, it can be concluded that the UroLume prosthesis is an effective alternative to TUR in patients at high surgical risk.

Rationale: Analysis of complications resulting from the renal percutaneous approach., Methods: Between 1990 and 1996, 175 percutaneous surgical procedures were performed by our group. In 69.2% cases, the reason was a lithiasic condition. We also carried out: 35 endopyelotomies, 12 renal cyst resections, 4 stenosis of uretero-ileal anastomosis, 2 diagnostic nephroscopies and 1 pyelic tumour resection., Results: Total rate of complications was 22.2%. Mortality was 0.5% (one case). Surgery had to be terminated in 13 cases for different reasons. Blood transfusions were required in 9 cases. 3 cases of route perforation required extended maintenance of nephrostomy. Infectious problems developed in 9 cases. There were also 2 renocutaneous fistula, one renocolic fistula and one pneumothorax. No significant differences were found between the total number of complications and the type of treatment carried out. There is however a relationship between the lithiasic condition and the haemorrhagic complications and also with the failure of the approach. There are no significant differences between the number of complications and other variables such as age, sex, side, calix approached or duration of surgery., Conclusions: The percutaneous approach to the kidney can be considered as a technique with a low morbidity-mortality ratio.

Congenital bilateral absence of vasa deferens appears in 6% of obstructive azoospermia, and 60-70% of these patients also have cystic fibrosis mutations. Unilateral aplasia or agenesia of vasa deferens occurs in less than 1% male individuals and some studies have found that up to 43% cases show mutations in the cystic fibrosis gen. We contribute four case reports of bilateral agenesia who were seen for infertility, all of which showed presence of mutation. In none of the two cases of unilateral agenesia, who consulted for vasectomy, a mutation in the cystic fibrosis gen was found. Patients with bilateral agenesia and their partners should be screened for cystic fibrosis, prior to spermatic microaspiration and assisted fecundation.

Presentation of one case of a diabetic patient, who after 8 weeks pregnancy presented polypoid cystitis, with no prior background of vesical catheterism. The rarity of the case, as well as the clinical and pathoanatomical characteristic are commented.

Endopyelotomy is a minimally invasive surgical alternative to the classic open surgery in the treatment of stenosis of the pyelo-ureteral attachment with similar success rates. This paper presents the results from 38 endopyelotomies performed between February 1989 and December 1993 in equal number of patients, 36 of them using percutaneous approach, 29 through the medium calix and 7 through the lower calix. Acucise's catheter was used in both cases. With the total of 38 endopyelotomies performed the complications and results obtained are presented as well as the results assessed by clinical, radiological and renographic criteria. The overall rate of success for endopyelotomy was 77.8%. When only improvement of urographic signs was evaluated, the success rate was lower (66.7%). In 4 clinically asymptomatic patients who showed no radiological improvement, a good response to diuretic therapy was seen in the renogram which was shown to be a basic test in the diagnosis, evaluation of results and follow-up of these patients. It is concluded that currently, endopyelotomy represents a choice technique in the treatment of stenosis of the pyelo-ureteral attachment with a low rate of intraoperative complications (3.4%). Also, it must be established that failure of this minimally invasive technique does not condition any added surgical difficulties to perform pyeloplasty.

One of the aims of bladder substitution or augmentation using the intestine is to preserve renal function. If reflux impairs renal function, an antireflux mechanism should be attempted. Direct ureteroileal reimplantation with spatulation of the ureter is safer and carries a lower risk of stenosis. The antireflux mechanism is created by ileoileal or ileocecal intussusception without involvement of the ureter. Thus we can diminish the risk of stenosis and reflux at the same time.

When the ureter is extensively compromised, preservation of the kidney without recurring to external diversion may be attempted by a psoas bladder procedure, transureteroureterostomy, renal autotransplantation or ureteral substitution using the intestine. The first two are not always possible and transplantation is perhaps extremely disproportionate. We therefore recur to ureteral substitution using the intestine. Ureteral substitution may be partial or total, although it is recommended to preserve the upper segment of the lumbar ureter whenever possible. The procedure can be performed using the entire ileal segment with or without modelling to the appropriate thickness. Reducing the diameter of the ileal graft will enhance urine propulsion, reduce mucus secretion and improve antireflux dynamics. Nine cases of ureteral substitution are described herein. Treatment depended on the underlying pathology, extent of ureteral compromise and location. The techniques employed were ureteral substitution with or without modelling and ureteral substitution combined with a bladder repair procedure.

Ofloxacin is a new fluoride quinolone which has been shown to be active both in vitro and in vivo against Mycobacterium tuberculosis. This prospective study presents the results obtained with a new protocol for the treatment of genito-urinary tuberculosis. The comparison drugs were Ofloxacin 200 mg every 12 hours for 6 months, Rifampicin 600 mg every 24 for 3 months and Isoniazid 300 mg every 24 hours for 3 months. The results, were clinically and microbiologically good. It is concluded that this new drug should be a valid alternative to the traditional therapy.

Twelve patients with giant renal serous cyst located superiorly, inferiorly or in the central zone underwent percutaneous resection. The symptoms that had prompted the operative procedure disappeared immediately post-operatively in all patients. To evaluate the efficacy of resection, a CT scan was obtained pre-operatively and at 3 months post-operatively. All 9 patients in whom complete removal of the cyst wall had been achieved revealed a completely normal renal morphology on the post-operative scan with no evidence of cyst. In the remaining 3 patients in whom the cyst could only be partially resected, the postoperative scan revealed residual cystic cavity, although its size had markedly diminished. The technique utilized and the maneuvers that permit removal of the cyst wall without risk are described. The indications and the therapeutic alternatives are discussed.

The paper presents a case of giant retroperitoneal liposarcoma treated in our unit. New diagnostic and therapeutic perspectives for such uncommon tumours are commented upon.

We present in this paper a series of cases from our Service of primary abscesses in psoas. We consider the appearance of immunosuppressed patients as a relevant factor of its etiopathogenicity. We believe that a C.A.T. is the best diagnostic method. All three patients that underwent open surgery have had complications. The patients treated with percutaneous puncture has shown a favourable evolution.

We present two cases of renal tumour thrombosis in the vena cava, treated surgically in our Service. We comment on the clinical picture, the diagnosis, treatment and prognosis of this pathology. We emphasize the importance of C.A.T. in the diagnosis and stage evaluation, as well as the need to prevent pulmonary embolism by means of the placement of Adams clip type filters in the cava.