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Este proyecto busca promover bases educativas que conduzcan hacia el liderazgo y la proyección del ser, a través de la creatividad y la innovación. Sin embargo, la mayoría de sus estudiantes son de estratos bajos, hijos sobrevivientes de la violencia y el desplazamiento que se vivió en la zona; la mayoría de sus cuidadores se dedican a la agricultura y al trabajo informal.evidencian las diversas fallas que existen dentro de nuestra praxis docente, llevando a repensar las didácticas para que los estudiantes generen competencias comunicativas y obtengan aprendizajes significativos a partir del análisis de su entorno, para que minimicen las dificultades evidenciadas, creando espacios que abran rutas coherentes con la riqueza oral tradicional del territorio local. Para el estudio se empleó la metodología de investigación acción educativa y pedagógica y se desarrollaron estrategias que trascienden la práctica de aula hacia la comunidadSe pudo comprobar que la transformación hacia una práctica pedagógica basada en artes provenientes de la tradición oral popular permite mejorar las habilidades comunicativas y especialmente la comprensión lectora.. Maestría Magíster en Educación

Evaluate the association between health relate quality of life and sexual desire in postmenopausal women and the influence of demographic descriptors on sexual desire.A observational-cross-sectional study was conducted in 521 postmenopausal women in La Zarzuela Hospital between 2018-2020. Cervantes-short form (Cervantes-SF) scale and Brief profile female sexual function (B-PFSF) scale were filled out in the consultation. High score in Cervantes-SF implies worse health-related quality of life (HR-QoL). If score is lower or equal to 20 in B-PFSF implies diagnosis of hypoactive sexual desire disorder.There is a positive relationship between HR-QoL measured by Cervantes-SF and sexual desire measured by B-PFSF (Improvement on HR-QoL is related to improvement on sexual desire. Sexual desire is better in women with non-hormonal treatment than in women with systemic or vaginal hormonal treatment. The vaginal hormonal treatment and being current smoker are independent factors of low and high sexual desire, respectively.

To assess the efficacy of treatment with transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urge urinary incontinence, of neurogenic or nonneurogenic origin, refractory to first-line therapeutic options.We included 65 patients with urge urinary incontinence refractory to medical treatment. A case history review, a urodynamic study and a somatosensory evoked potentials (SEP) study were conducted before the TPTNS, studying the functional urological condition by means of a voiding diary. The treatment consisted of 10 weekly sessions of TPTNS lasting 30minutes.Some 57.7% of the patients showed abnormal tibial SEPs, and 42% showed abnormal pudendal SEPs. A statistically significant symptomatic improvement was observed in all clinical parameters after treatment with TPTNS, and 66% of the patients showed an overall improvement, regardless of sex, the presence of underlying neurological disorders, detrusor hyperactivity in the urodynamic study or SEP disorders. There were no adverse effects during the treatment.TPTNS is an effective and well tolerated treatment in patients with urge incontinence refractory to first-line therapies and should be offered early in the treatment strategy. New studies are needed to identify the optimal parameters of stimulation, the most effective treatment protocols and long-term efficacy, as well as its applicability to patients with a neurogenic substrate.

Background Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation (PE). Its safety was established in a thorough clinical development program. Objective To characterize the safety profile of dapoxetine in PE treatment and to report the incidence, severity, and type of adverse events. Design, setting, and participants We conducted a 12-wk, open-label, observational study with a 4-wk, postobservational contact. A total of 10 028 patients were enrolled, with 6712 patients (67.6%) treated with dapoxetine 30–60mg (group A)and 3316 (32.4%) treated with alternative care/nondapoxetine (group B). Interventions Treatment with dapoxetine or alternative care/nondapoxetine. Outcome measurements and statistical analysis Treatment-emergent adverse events (TEAEs) and concomitant therapy use during the 12-wk observational and the postobservational period were reported. Results and limitations The mean age for all patients was 40.5 yr. In group A, 93.0% of the patients were initially prescribed dapoxetine 30mg. Treatment options for group B patients included clomipramine, paroxetine, fluoxetine, sertraline, topical drugs, condoms, and behavioral counseling. Both treatment regimens were well tolerated. TEAEs were reported by 12.0% and 8.9% of group A and group B, respectively, with the highest incidence observed in patients aged >65 yr for group A (21.4%) and 30–39 yr (9.8%) for group B. The most commonly reported TEAEs were nausea, headache, and vertigo, with a higher incidence in group A (3.1%, 2.6%, and 1.0%, respectively) than in group B (oral drugs: 2.3%, 1.3%, and 0.9%, respectively). There were no cases of syncope in group A and one case in group B. A major limitation is that this was a nonrandomized, open-label, short-term study lacking efficacy data. Conclusions The results of this postmarketing observational study demonstrated that dapoxetine for treatment of PE has a good safety profile and low prevalence of TEAEs. Syncope and major cardiovascular adverse events were not reported. The high level of adherence by healthcare providers to the contraindications, special warnings, and precautions for dapoxetine minimizes the risk for its use in routine clinical practice. The current risk minimization measures for its identified and potential risks are effective.

Strategies, recommendations and techniques proposed by sex therapy for intervention on premature ejaculation, have represented for nearly four decades the most effective model of intervention in this sexual dysfunction, which currently is complemented by the efficacy of dapoxetine drug treatment. Clinical experience and recent studies support that combined intervention offers the best therapeutic results. In addition in sex therapy, etiologic diagnosis is obtained from the analysis of the interrelationship of the couple. Diagnostic and therapeutic intervention has to be always centered in the relationship, so the techniques and resources must be applied with the expectation of being implemented in the sexual interaction. It will therefore be the relationship that receive treatment, even if medication is used for one of the members of the couple. On the other hand, this model of intervention can be implemented by a professional with training, although not necessarily a specialist.

Resumen Presentamos un caso de hernia inguinoescrotal gigante de un varon de 64 anos. Se presenta como una masa inguinoescrotal junto con sintomatologia urinaria baja de disuria y hematuria. Diagnosticado mediante cistografia de relleno y ultrasonido y tratado mediante herniorrafia y posterior litotricia de una litiasis vesical y reseccion transuretral de prostata. Una urografia intravenosa, posterior a la herniorrafia muestra un correcto posicionamiento de la vejiga.

A sexual satisfactory life favourably affects quality of life, there being evidence that shows there are multiple organic processes of which sexual dysfunction is often a precocious sign of underlying organic disease (cardiovascular, endocrinological or neurological). Difficulties exist in recording the sexual anamnesis on the part of the professional, the patient, or by the health system. Nevertheless, given its importance, it is necessary for the doctor to adopt an attitude of active search, especially among the population of risk. To do this, it is necessary that the situation is propitious (sense of the opportunity), preserving the confidentiality of the meeting, and it will be carried out naturally and with empathy, adopting a listening attitude, taking into account the non-verbal language, without issuing valued judgments, and resorting to assertivity to overcome the resistances. This article proposes guidelines to perform an anamnesis adequately.

To review the influence of various intravesical treatments on superficial bladder cancer progression.We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different treatment and follow-up schemes, with BCG in 139 cases and intravesical chemotherapy, mainly Mytomicin C, in 80.Overall, the use or not of bladder instillations did not show statistically significant differences in time to progression. The use of intravesical therapy and maintenance therapy was an independent risk factor for disease-free time to progression when compared with induction.The use of maintenance intravesical therapy with BCG resulted in a delayed progression of superficial bladder cancer, so that it seems the most effective treatment, mainly in moderate-high risk tumors.

Objetivo: Revisar la influencia de distintos tratamientos endovesicales sobre la progresión del cáncer vesical superficial. Métodos: Se revisaron retrospectivamente un total de 473 neoplasias vesicales superficiales. A partir del diagnóstico y la RTU vesical, y en función del resultado anatomopatológico, se plantearon distintos esquemas de seguimiento y tratamiento complementario, se empleó BCG en 139 casos y quimioterapia endovesical en 80 pacientes fundamentalmente Mitomicina C (MMC). Resultado: Globalmente, el empleo o no de instilaciones vesicales no mostró diferencias estadísticamente significativas en cuanto al tiempo de progresión Resultó factor independiente para explicar un menor tiempo libre hasta la progresión el empleo de terapia endovesical con terapia de mantenimiento frente a inducción. Conclusiones: La utilización de terapia endovesical de mantenimiento con BCG implicó una progresión más tardía del cáncer vesical superficial, por lo que parece el tratamiento más eficaz, sobretodo en tumores de moderado y alto riesgo. Objectives: To review the influence of various intravesical treatments on superficial bladder cancer progression. Methods: We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different treatment and follow-up schemes, with BCG in 139 cases and intravesical chemotherapy, mainly Mytomicin C, in 80. Results: Overall, the use or not of bladder instillations did not show statistically significant differences in time to progression. The use of intravesical therapy and maintenance therapy was an independent risk factor for disease-free time to progression when compared with induction. Conclusions: The use of maintenance intravesical therapy with BCG resulted in a delayed progression of superficial bladder cancer, so that it seems the most effective treatment, mainly in moderate-high risk tumors.

Objetivo: Revisar la influencia de distintos tratamientos endovesicales sobre la progresión del cáncer vesical superficial. Métodos: Se revisaron retrospectivamente un total de 473 neoplasias vesicales superficiales. A partir del diagnóstico y la RTU vesical, y en función del resultado anatomopatológico, se plantearon distintos esquemas de seguimiento y tratamiento complementario, se empleó BCG en 139 casos y quimioterapia endovesical en 80 pacientes fundamentalmente Mitomicina C (MMC). Resultado: Globalmente, el empleo o no de instilaciones vesicales no mostró diferencias estadísticamente significativas en cuanto al tiempo de progresión Resultó factor independiente para explicar un menor tiempo libre hasta la progresión el empleo de terapia endovesical con terapia de mantenimiento frente a inducción. Conclusiones: La utilización de terapia endovesical de mantenimiento con BCG implicó una progresión más tardía del cáncer vesical superficial, por lo que parece el tratamiento más eficaz, sobretodo en tumores de moderado y alto riesgo.

To report a rare case of a giant epidermoid cyst in an intertesticular localization, analyzing its histological and pathologic features, and to perform a bibliographic review.We report the case of a 49-year-old male consulting for a slowly growing intra-scrotal mass of five years of evolution causing discomfort because of its size. After excision the pathology report showed the presence of a keratoid epidermoid cyst very big in size.Superficial scrotal epidermoid cysts are frequent in clinical practice; that is not the case of the so-called "intra scrotal inclusion cysts". Epidermoid cysts are firm, mobile, slowly growing, generally asymptomatic intra epidermal neoformations. There are descriptions in multiple sites, even the genitalia, nevertheless their size in this location does not usually pass 5 cm.

Syphilis is a systemic disease the course of which follows successive clinical stages. Central nervous system and spinal cord involvement on late phases may lead to bladder dysfunction. We report one case of neurosyphilis with associated bladder hyperreflexia.51-year-old male with the diagnosis of neurosyphilis consulting for voiding disorders with evidence of detrusor hyperactivity of neurogenic etiology on the urodynamic study.The differential diagnosis of neurogenic bladder in patients with psychiatric or neurological symptoms should include neurosyphilis. Etiologic diagnosis is obtained by cerebrospinal fluid examination, and the diagnosis of bladder dysfunction by urodynamic study.

Objetivo: Añadir a la literatura un caso clínico poco frecuente de quiste epidermoide gigante de localización intertesticular, analizando las características histológicas y patológicas del mismo y realizando una revisión de la literatura al respecto. Métodos/Resultados: Presentamos el caso de un varón de 49 años que consultó por bultoma intraescrotal de 5 años de evolución y lento crecimiento que le ocasionaba molestias por su gran tamaño. Tras exéresis del mismo, el resultado anatomopatológico de la muestra evidenció la presencia de un quiste epidermoide queratinoso de gran tamaño. Conclusiones: Los quistes epidérmicos escrotales superficiales son de frecuente aparición en la práctica clínica, no así los denominados "de inclusión" intraescrotales. Los Quistes Epidermoides son neoformaciones intraepidérmicas, firmes y móviles de crecimiento lento y habitualmente asintomáticos. Están descritos en múltiples localizaciones, incluso en genitales, sin embargo el tamaño de estos a este nivel no suele superar los 5 cm. OBJECTIVE: To report a rare case of a giant epidermoid cyst in an intertesticular localization, analyzing its histological and pathologic features, and to perform a bibliographic review. Methods/Results: We report the case of a 49-year-old male consulting for a slowly growing intra-scrotal mass of five years of evolution causing discomfort because of its size. After excision the pathology report showed the presence of a keratoid epidermoid cyst very big in size. Conclusions: Superficial scrotal epidermoid cysts are frequent in clinical practice; that is not the case of the so-called "intra scrotal inclusion cysts". Epidermoid cysts are firm, mobile, slowly growing, generally asymptomatic intra epidermal neoformations. There are descriptions in multiple sites, even the genitalia, nevertheless their size in this location does not usually pass 5 cm.

Objetivo: La sífilis es una enfermedad sistémica que cursa en estadios clínicos sucesivos. La afectación del sistema nervioso central y de la médula espinal en fases tardías puede provocar disfunción vesical. Presentamos un caso de neurosífilis con hiperreflexia asociada. Método: Varón de 51 años diagnosticado de neurosífilis que consultó por trastornos miccionales objetivando en el estudio urodinámico un detrusor hiperactivo de causa neurogénica. Conclusiones: En el diagnóstico diferencial de vejiga neurógena en pacientes que presentan síntomas psiquiátricos y neurológicos debería ser considerada la neurosífilis. El diagnóstico etiológico es por examen del líquido cefalorraquídeo y el diagnóstico de su disfunción vesical mediante estudio urodinámico. Objectives: Syphilis is a systemic disease the course of which follows successive clinical stages. Central nervous system and spinal cord involvement on late phases may lead to bladder dysfunction. We report one case of neurosyphilis with associated bladder hyperreflexia. Methods/Results: 51-year-old male with the diagnosis of neurosyphilis consulting for voiding disorders with evidence of detrusor hyperactivity of neurogenic etiology on the urodynamic study. Conclusions: The differential diagnosis of neurogenic bladder in patients with psychiatric or neurological symptoms should include neurosyphilis. Etiologic diagnosis is obtained by cerebrospinal fluid examination, and the diagnosis of bladder dysfunction by urodynamic study.

Objetivo: La sífilis es una enfermedad sistémica que cursa en estadios clínicos sucesivos. La afectación del sistema nervioso central y de la médula espinal en fases tardías puede provocar disfunción vesical. Presentamos un caso de neurosífilis con hiperreflexia asociada. Método: Varón de 51 años diagnosticado de neurosífilis que consultó por trastornos miccionales objetivando en el estudio urodinámico un detrusor hiperactivo de causa neurogénica. Conclusiones: En el diagnóstico diferencial de vejiga neurógena en pacientes que presentan síntomas psiquiátricos y neurológicos debería ser considerada la neurosífilis. El diagnóstico etiológico es por examen del líquido cefalorraquídeo y el diagnóstico de su disfunción vesical mediante estudio urodinámico.

Objetivo: Añadir a la literatura un caso clínico poco frecuente de quiste epidermoide gigante de localización intertesticular, analizando las características histológicas y patológicas del mismo y realizando una revisión de la literatura al respecto. Métodos/Resultados: Presentamos el caso de un varón de 49 años que consultó por bultoma intraescrotal de 5 años de evolución y lento crecimiento que le ocasionaba molestias por su gran tamaño. Tras exéresis del mismo, el resultado anatomopatológico de la muestra evidenció la presencia de un quiste epidermoide queratinoso de gran tamaño. Conclusiones: Los quistes epidérmicos escrotales superficiales son de frecuente aparición en la práctica clínica, no así los denominados "de inclusión" intraescrotales. Los Quistes Epidermoides son neoformaciones intraepidérmicas, firmes y móviles de crecimiento lento y habitualmente asintomáticos. Están descritos en múltiples localizaciones, incluso en genitales, sin embargo el tamaño de estos a este nivel no suele superar los 5 cm.

To determine the efficacy of endoscopical injections for the treatment of stress urinary incontinence (SUI), evaluating its low invasiveness and positive impact on quality of life.Belween 1997--2003 30 procedures of periurethral injection of various substances for urinary incontinence were performed at our department in women between 47-80 years. All patients were evaluated before surgery, clinically and urodynamically, in accordance to international standardized parameters (filling pressure/flow studies, maximum urethral closure pressure, LPP-leak point pressure). The kind of material employed for injection, surgical technique and satisfaction degree were also evaluated.The indication for surgery was SUI in 17 cases (56.6%), and mixed urinary incontinence in 73 cases (43.3%). 16 cases (53.3%) had history of previous surgery for SUI. Regarding urodynamic parameters, 19 patients (63.3%) have a maximum urethral closure pressure below 25 H2O cm, and 22 patients (73.3%) had a leak point pressure below 60 H2O cm. Collagen was employed in six cases (20%) and macroplastic in 24 (80%) (14 of them with the MIS system). 22 patients had three injection sites (73.3%). Mean follow-up was 38 months. Continence outcomes were evaluated in relation to complete continence (12 cases, 40%), mild incontinence and patient satisfaction (11 cases, 36.6%), and severe incontinence (7 cases, 23.3%).1-To achieve acceptable results it is mandatory to do the best possible indication (Mc Guire type III SUI). 2.-There is an excellent relationship between minimal invasiveness and good results.

OBJETIVO: Determinar la efectividad de las inyecciones endoscópicas en la corrección de la IUE, valorando su escasa agresividad y su impacto positivo en la calidad de vida. MÉTODOS/RESULTADOS: Entre 1997-2003 se realizaron en nuestro servicio 30 intervenciones por incontinencia urinaria con inyección periuretral de diversas sustancias, en mujeres con edades comprendidas entre 47-80 años. Todas las pacientes fueron valoradas previa intervención clínica y urodinámicamente atendiendo a los parámetros internacionalmente reconocidos (cistomanometría de llenado, presión uretral máxima, LPP (Leak point presure o presión abdominal de escape). También se valoró el tipo de material utilizado para la inyección, técnica quirúrgica y grado de satisfacción. RESULTADOS: En 17 casos (56.6%) la indicación quirúrgica fue por IUE pura mientras que en 13 casos (43.3%) fue mixta. En 16 casos (53.3%) existían antecedentes de intervenciones previas por IUE. En cuanto a parámetros urodinámicos en 19 pacientes( 63.3%) la presión máxima de cierre uretral fue menor de 25 cm de agua y en 22 pacientes ( 73.3%) , el leak point presure fue menor de 60 cm de agua. En 6 pacientes (20%) se utilizó colageno y en 24 pacientes (80%) macroplastique ( 14 de ellos con sistema M.I.S). En 22 casos (73.3%) se realizaron 3 habones. El tiempo medio de seguimiento fue de 38 meses. El resultado en cuanto a continencia se valoró en relación a que la paciente estuviese totalmente seca ( 12 casos 40%), incontinencia leve pero satisfecha (11 casos 36.6%) e incontinencia grave ( 7 casos, 23.3%). CONCLUSIONES: 1.-Resulta imprescindible para obtener resultados aceptables la mejor de las posibles indicaciones ( IUE tipo III de Mc Guire). 2.- Existe una relación excelente entre la mínima agresividad y los buenos resultados. OBJECTIVES: To determine the efficacy of endoscopical injections for the treatment of stress urinary incontinence (SUI), evaluating its low invasiveness and positive impact on quality of life. METHODS/RESULTS: Between 1997-2003 30 procedures of periurethral injection of various substances for urinary incontinence were performed at our department in women between 47-80 years. All patients were evaluated before surgery, clinically and urodynamically, in accordance to international standardized parameters (filling pressure/flow studies, maximum urethral closure pressure, LPP-leak point pressure). The kind of material employed for injection, surgical technique and satisfaction degree were also evaluated. RESULTS: The indication for surgery was SUI in 17 cases (56.6%), and mixed urinary incontinence in 13 cases (43.3%). 16 cases (53.3%) had history of previous surgery for SUI. Regarding urodynamic parameters,19 patients (63.3%) have a maximum urethral closure pressure below 25 H2O cm, and 22 patients (73.3%) had a leak point pressure below 60 H2O cm. Collagen was employed in six cases (20%) and macroplastic in 24 (80%) (14 of them with the MIS system). 22 patients had three injection sites (73.3%). Mean follow-up was 38 months. Continence outcomes were evaluated in relation to complete continence (12 cases, 40%), mild incontinence and patient satisfaction (11 cases, 36.6%), and severe incontinence (7 cases, 23.3%). CONCLUSIONS: 1-To achieve acceptable results it is mandatory to do the best possible indication (Mc Guire type III SUI). 2.-There is an excellent relationship between minimal invasiveness and good results.

OBJETIVO: Determinar la efectividad de las inyecciones endoscópicas en la corrección de la IUE, valorando su escasa agresividad y su impacto positivo en la calidad de vida. MÉTODOS/RESULTADOS: Entre 1997-2003 se realizaron en nuestro servicio 30 intervenciones por incontinencia urinaria con inyección periuretral de diversas sustancias, en mujeres con edades comprendidas entre 47-80 años. Todas las pacientes fueron valoradas previa intervención clínica y urodinámicamente atendiendo a los parámetros internacionalmente reconocidos (cistomanometría de llenado, presión uretral máxima, LPP (Leak point presure o presión abdominal de escape). También se valoró el tipo de material utilizado para la inyección, técnica quirúrgica y grado de satisfacción. RESULTADOS: En 17 casos (56.6%) la indicación quirúrgica fue por IUE pura mientras que en 13 casos (43.3%) fue mixta. En 16 casos (53.3%) existían antecedentes de intervenciones previas por IUE. En cuanto a parámetros urodinámicos en 19 pacientes( 63.3%) la presión máxima de cierre uretral fue menor de 25 cm de agua y en 22 pacientes ( 73.3%) , el leak point presure fue menor de 60 cm de agua. En 6 pacientes (20%) se utilizó colageno y en 24 pacientes (80%) macroplastique ( 14 de ellos con sistema M.I.S). En 22 casos (73.3%) se realizaron 3 habones. El tiempo medio de seguimiento fue de 38 meses. El resultado en cuanto a continencia se valoró en relación a que la paciente estuviese totalmente seca ( 12 casos 40%), incontinencia leve pero satisfecha (11 casos 36.6%) e incontinencia grave ( 7 casos, 23.3%). CONCLUSIONES: 1.-Resulta imprescindible para obtener resultados aceptables la mejor de las posibles indicaciones ( IUE tipo III de Mc Guire). 2.- Existe una relación excelente entre la mínima agresividad y los buenos resultados.

Este trabajo pretende aportar los elementos para la comprensión de las consecuencias sociales del envejecimiento demográfico en la provincia de León. Se centra en la evolución de la estructura por edades, en algunos de sus efectos sobre los niveles de bienestar del colectivo de mayores respecto al conjunto de la población. Trata de resaltar los aspectos no económicos, ya que son los menos estudiados: la movilidad espacial, la auto percepción de su estado de salud, el ocio, los hábitos culturales, la soledad, etc. Se tiene en cuenta elementos tan fundamentales como la posición de la red familiar y social y la frecuencia de los contactos, la oferta de servicios sociales y la valoración que de la misma hacen los mayores de la provincia. Estos datos nos premiten conocer cómo viven y cuáles son las preocupaciones de nuestros mayores

To report one new case of endometriosis in a patient with history of caesarean section.It is the case of a female patient presenting with voiding symptoms and hematuria, with a bladder tumor on ultrasound.After TUR of a retro trigonal tumor pathology report showed bladder endometriosis. Treatment was completed with hormone therapy, being the patient relapse free at one year follow-up.History of caesarean section is one of the possible etiologies of bladder endometriosis.

To study the evolution of 49 patients with squamous cell carcinoma of the penis.49 patients who underwent surgery for squamous cell carcinoma of the penis (30 partial penile amputations, 11 total amputations and 7 circumcisions). 27 inguinal lymphadenectomies, superficial, profound and ilio-obturator (2 cases), were performed due to persistent lymph nodes after penile amputation despite of antibiotic treatment for 4 weeks, or to high grade primary tumour. 13 patients were found to have lymph node metastases after treatment, receiving posterior adjuvant treatment with radiotherapy, chemotherapy or a combination of them. Patients were followed in relation to stage, cell differentiation degree, and presence or absence of positive lymph nodes and distant metastases.There were 5 Ta stage tumours, 26 T1(63.2%), 16 T2 (32.6%), and 2 T3 (4.08%). Regarding cytological degree 81% were GI, 16% G II, and 2% G III. Lymph node metastasis were detected in 13 patients (26.53%) after lymph node dissection. 6 patients died from tumour dissemination, 2 of them were T2G2, one T2G1, and three T1G2; two additional patients died from causes different from the tumour, all of them being N+ at the time of diagnosis.Penile squamous cell carcinoma is an aggressive tumour the evolution of which mainly depends on the local-regional stage at the time of diagnosis and cell differentiation; these factors will condition lymphadenectomy versus observation.

We report on the case of a post-traumatic high-flow priapism in a 14 year-old boy, which was confirmed by cavernous blood gas measurement color flow Doppler sonography, and arteriography. It was successfully treated with superselective embolization of the right internal pudendal artery, resulting a clear disappearance of cavernus rigidity.

To report a case of multiple urethral calculi, an uncommon urological condition in our setting. The clinical, radiological and therapeutic aspects are discussed and the literature is briefly reviewed.A 77-year-old male consulted at the emergency services of our hospital for dysuria, pollakiuria and difficulty in voiding. The patient also referred and indurated area in the penile ventral aspect. Radiological examination disclosed three calculi in the penile urethra with were successfully removed by meatotomty and urethrolithotomy. The patient is currently asymptomatic.Urethral calculus is uncommon in developed countries. "Milking" is not advocated due to the high incidence of urethral injury. Treatment is by simple urethrolithotomy in combination with other techniques (urethroplasty, diverticulectomy, etc.), if required.

To compare the usefulness and accuracy of the BTA test versus urinary cytology.The BTA test was performed in 45 patients distributed into three groups: group I comprised patients with hematuria of unknown origin; group II had a diagnosis of bladder cancer; and group III comprised patients who had undergone TUR for a bladder tumor and were undergoing endoscopic control evaluation. The sensitivity and specificity of each diagnostic method were determined for each group of patients.The BTA test showed a higher sensitivity than urinary cytology in all groups, the difference being significant for groups II and III. Its specificity, however, was lower than that of cytology in groups I and III, and similar in group II.The BTA test is a simple and useful method for the diagnosis and follow-up of bladder cancer. It has a higher sensitivity than urinary cytology, although its specificity is lower due to the higher number of false positives observed in patients with inflammatory bladder conditions. Randomized studies are warranted to determine if the accuracy of urinary cytology can be enhanced with the combined use of the BTA test which has been demonstrated to have a higher specificity.

To describe 3 cases of mucinous adenocarcinoma, an uncommon variant of prostatic adenocarcinoma, and review the literature.3 cases of mucinous adenocarcinoma of the prostate are described. The histological and immunohistochemical features, diagnostic and therapeutic aspects of this variant of prostatic adenocarcinoma are presented and the literature briefly reviewed.This variant of prostatic adenocarcinoma is characterized by the presence of extra and intracellular mucus formation. It is generally seen in the advanced stages and responds poorly to any form of therapy.

To describe a patient with severe hematuria of late onset and pelvic arteriovenous fistula secondary to pelvic trauma.A patient with multiple fracture of the pelvis and sacrum from a road traffic accident presented severe posttraumatic hematuria associated with pelvic arteriovenous fistula. The fistula was resolved by selective embolization and the hematuria immediately ceased.Patients with severe or long-lasting hematuria after pelvic trauma and no injuries to the urinary system, warrant arteriographic evaluation to discard vascular lesions. If present, these lesions are generally easily resolved by selective embolization.

New drugs for the treatment of prostatism have been developed in recent years; only surgery, however, has been demonstrated to achieve cure. Each modality of drug therapy may afford symptomatic relief in those patients in whom surgery is not indicated and a symptom-based stepwise indication could be established.329 patients with prostatism were treated by surgery, administration of finasteride, alphablockers or plant extracts, according to the recommendations of the WHO. Patient evaluation included abdominal US. PSA determination and uroflowmetry. Patients with urodynamic or other derangements were excluded from the study.Patients with a worse quality of life and important obstructive symptoms underwent surgery. Patients with important obstructive symptoms and no complications requiring surgery (infection, urinary retention, etc.) received finasteride, which proved to be effective in these patients, although 16.6% required another type of treatment and two presented impotence. Patients treated with plant extracts had moderate prostatism; 17% of these patients required another type of treatment. Patients treated with alphablockers presented symptoms that were similar to those treated with plant extracts, but they had a more important irritative component; 24% of these patients withdrew from the study due to the side effects or inefficacy of their treatment regimen.Further studies and a longer follow-up are warranted to determine whether these new drugs can replace or effectively delay (avoiding the appearance of complications) surgery. We believe that the indications for each treatment should be established according to the different stages of prostatism. Moreover, further insight into the pathogenesis of BPH, appropriate diagnostic methods and patient selection are essential to the development of new therapeutical modalities and to achieving enhanced results.

Crossed fused renal ectopia (CFRE) is a rare anomaly, the incidence of which is estimated in one case per 700-1,000 births. We present here one case of Disk Kidney, an uncommon variant of CFRE, diagnosed in a female adult patient. Fused renal congenital anomalies are reviewed and the etiologies and presentation forms commented.

The possible solutions to a case of ureteral duplication complicated by obstruction of one of the collecting systems are reviewed.We report an uncommon case of ureteropelvic junction obstruction in the lower system of an incomplete duplication of the collecting systems that was resolved by pyeloureterostomy.Anastomosis of the lower renal pelvis to the upper ureter may provide a simple solution for the functional recovery of an important renal segment.