Search

We report a case of ureteral type III triplication according to Smith's classification, without associated anomalies of the urinary tract. The revision of the bibliography indicates the rarity of this maldformacion and its frequent association with other urinary and extraurinary malformations. The absence of associate malformations in this case increases his exceptionality.

Objectives: To study the characteristics and evolution of the epidermoid penis tumours., Material and Methods: It was carried out a retrospective study on the epidermoid penis tumours treated in our center between 1981 and 2005., Results: 16 tumours penis epidermoides were diagnosed. The average age of the patients was of 71.7 years (interval between 54 and 90 years). In 80% of the cases they are diagnosed in advanced stadiums (T3 and T4). The most habitual presentation forms are the ulcerous lesions (53%) and papilar (33%). The average diameter of the lesion was 2.3 cm, and the most frequent localization the glands (53%) and balano prepucial (33%). They were carried out 7 local scissions, 8 partial penectomies, one total penectomy, and an local scission pluslocal treatment with 5-fluoracile. With a follow-up of 24 months 5 relapses took place, mainly in patients subjected to local excision of the lesion (p = 0.06 log-rank test)., Conclusions: The epidermoid carcinoma of the penis is a tumoral lesion characteristic of advanced ages that is diagnosed later and treated in not very aggressive way. Therefore it is frequent the advanced stadiums and the tumour relapses.

Objectives: To evaluate and quantify the association between clinical, ultrasound and immunoserological data and histologic type and stage of testicular tumors., Methods: We analyze a cohort of 80 patients who underwent orchiectomy for testicular neoplasia. Mean patient age was 30.4 years. Past medical history, first symptoms, time from first symptom to operation, physical examination and ultrasound data, and preoperative serum levels of alpha-fetoprotein and beta HCG were retrospectively collected., Results: Patients with non seminomatous germ cell tumor (NSGCT) had a significantly lower mean age (23.7 yr.) than patients with pure seminoma (41.3 yr.), and these latter a significantly lower age than patients with non germinal tumors (50.7 yr.). Initial presentation with general malaise or lumbar pain increased 2.56 times the relative risk of having a tumor in advanced stage (higher than stage I) . Presence of gynecomastia increased 16.5 times the relative risk of having a non germ cell tumor, due to the inclusion of Leydig's tumors in this group. Detection of heterogeneous nodules by ultrasound increased 4.5 times the risk of having a non seminomatous germ cell tumor. Preoperative elevation of alpha-fetoprotein ruled out the existence of seminoma and non germ cell tumor; whereas preoperative elevation of beta HCG increased 3.21 times the risk of having a non seminomatous germ cell tumor. No significant association was shown between preoperative tumor markers and tumor stage., Conclusions: The existence of gynecomastia, age, detection of heterogeneous nodules on ultrasound, and preoperative alpha-fetoprotein and beta HCG are relevant data in relation to histological type of tumor. Lumbar pain or malaise are clinical data associated with tumor stage.

Objectives: The absence of tumor in up to 10% of cystectomy specimens of patients with invasive bladder cancer justify the search for non aggressive therapies. The present study attempts to establish the safety and curative capacity of TUR alone for patients with superficial muscle-infiltrating bladder cancer., Methods: Over a period of 18 months, 12 patients with superficial muscle-infiltrating bladder cancer (T2) were diagnosed at our department, TUR was repeated in 9 of the 12 patients. The extension study was negative in all 9 patients., Results: The mean follow up was 12.8 months (range 7-70 months). Local recurrence was found in 4 patients (44.4%) who were submitted to another TUR; 3 were superficial and 1 invasive (with the same muscle involvement as at the initial diagnosis). The tumor-free survival rate was 9.3 months. No patient showed tumor progression., Conclusion: The percentage and nature of local recurrence, tumor-free survival and the progression rate (which was not observed during the short follow up period) indicate that TUR is a treatment option that must be taken into account in selected patients with invasive bladder cancer.

We report a case of male subfertility with ejaculate volume less than 1 cc and moderate oligoasthenozoospermia. Partial obstruction of the seminal duct system was suspected and transrectal ultrasonography revealed a müllerian duct cyst. We confirmed the diagnosis with transperineal puncture and contrast filling of the cyst and seminal vesicles. This procedure allowed us to avoid scrotal vasostomy and perform conventional vasography as well as to measure the distance between the ceiling of the cyst and the urethra, which facilitated subsequent transurethral surgery.

Over a period of 5 months, 50 patients were entered into the preoperative autologous blood donation program of our Service. Two patients were excluded; one had previously had an acute myocardial infarction and the other had epilepsy. The remaining 48 patients, which accounted for one third of our elective surgery procedures, all accepted to enter the program. These patients were not more severely anemic than the other patients not in the program and who underwent the same surgical procedures. No patients required homologous blood transfusion and no complications ascribable to the procedure were observed. Although it is not utilized widely to date, predeposited autologous blood transfusion is a safe and efficient method, with no remarkable morbidity, even in patients aged over 65 years, the age group of one half of our patients. Autologous blood transfusion programs are necessary. The indications, the exclusion criteria for patients at high risk and the objective parameters for evaluating its success must be established.

We report two cases of eosinophilic cystitis that had been diagnosed anatomo-pathologically after TUR. These patients had a previous history of low grade and stage superficial bladder tumor that had been treated by intravesical interferon after surgery. The literature is reviewed highlighting the etiopathogenic aspects, the possible relationship with immune allergic factors, clinical aspects, diagnosis and treatment.

We report a case of symptomatic myelolipoma with a good evolution at three and a half years' follow up. The clinical features and the diagnosis of this tumor type are discussed. In this case, as in most cases, CT proved to be the most useful in making the diagnosis. Like most of the cases, the patient was middle aged, obese and hypertensive. The etiology, pathogenesis, clinical features and diagnosis of this disease entity are reviewed. The treatment modalities utilized according to the specific features of each case are discussed.