Actas Urol Esp

[Urologic complications of pancreas-kidney simultaneous transplantation]

Year 1998
Regueiro Lopez JC. Padillo Ruiz FJ. Requena Tapia MJ. Alvarez Kindelan J. Carmona Campos E. Anglada Curado J.
Departamento de Cirugia, Hospital Regional Universitario Reina Sofia, Cordoba.
Pancreas Transplantation (PT) is the only available therapy today for diabetes that allows an insulin-independent euglycemic state with complete normalization of glycosilated haemoglobin levels. Survival of patient, pancreatic graft and renal graft is 93%, 86% and 90% respectively at one year and 90%, 84% and 85% at three years. The most accepted method for exocrine drainage in most centres where simultaneous pancreas-kidney transplantation is being performed is vesical drainage. In spite of the improvements achieved in graft and patient survival, it is evident that a most frequent use of this type of technique involves a greater number of urological complications (repeat infections, haematuria, fistulae or leakage, reflux pancreatitis, urethral stenosis and disruption, dehydration and acidosis, previous diabetic bladder) and the familiarization of the urologist with this type of disease in immunodepressed patients. This paper reviews the current situation and illustrates the general approach regimes in our Pancreas-Kidney Transplantation Unit with regard to each complication.

[Urethral diverticulum complicated with giant lithiasis]

Year 1998
Gonzalvo Perez V. Botella Almodovar R. Canto Faubel E. Gasso Matoses M. Llopis Guixot B. Polo Peris A.
Servicio de Urologia, Hospital Lluis Alcanyis, Xativa (Valencia).
Presentation of one case report of acquired urethral diverticulum in a male with giant urethral lithiasis. Urethral diverticulum are rare entities in males, the condition being more frequent in females. In general, they are acquired in up to 90% cases, the remaining 10% being hereditary Giant urethral lithiasis is also uncommon in our milieu, incidence being higher in Eastern Countries; 4-10% of urethral diverticulum are occupied by lithiasis. Diagnosis is mainly through clinical symptomatology involving the development of a perineal mass or phlegmon; however definite diagnosis is made through CUMS. Management of giant diverticulum in males is by open surgery, preferably a one-step diverticulectomy procedure; in cases such as the reported here, where urethral stenosis or a significant inflammatory involvement of the periurethral tissues is present, a two-step urethroplasty should be preferred.

[Diverticulum of the female urethra: presentation of 3 cases]

Year 1998
Ponce Campuzano A. Colom Feixas S. Matias Garcia JJ. Franco Miranda E. Orejas Lopez V. Serrallach Mila N.
Servicio de Urologia, Hospital de Bellvitge Principes de Espana, Barcelona.
Contribution of three cases of female urethral diverticulum diagnosed and treated in our Service. Presence in women presenting to the practice with chronic signs and symptoms of the lower urinary tract unresponsive to conventional medical management should be ruled out. A review is made of the most significant aspects in terms of clinical presentation, diagnosis and therapeutic options.

[Massive inguinal vesical hernia. Report of 3 cases]

Year 1998
Gonzalvo Perez V. Botella Almodovar R. Canto Faubel E. Gasso Matoses M. Llopis Guixot B. Polo Peris A.
Servicio de Urologia, Hospital Lluis Alcanyis, Xativa, Valencia.
Vesical hernia is defines as a vesical shift associated to a direct or indirect inguinal hernia. It accounts for 0.4-3% of all inguinal hernias, but the existence of a massive vesical hernia formation at the inguinoscrotal level is uncommon; a total of 114 cases have been found in the literature. Clinically it should be suspected every time an inguinoscrotal hernia is found in patients over 50 years old with urinary flow obstruction. Diagnosis is usually reached through serial voiding cystouretrography (SVCU). The preferred treatment should be extraperitoneal inguinal herniorrhaphy associated to correction of the obstructive process.

[Ureterohydronephrosis secondary to a cyst of retroperitoneal mesentery]

Year 1998
Vicente Prados FJ. Martinez Morcillo A. Tallada Bunuel M. Cozar Olmo JM. Espejo Maldonado E. Pedrajas de Torres G.
Servicio de Urologia, Hospital Universitario Virgen de las Nieves, Granada.
Retroperitoneal primary cysts are rare clinical entities. A contribution is made of one case presenting this condition with repercussion on the excretory route. Ultrasound and computerized axial tomography studies suggest the diagnosis but this is confirmed through laparotomy. Choice treatment is enucleation, typically easy because of the minimal adherence to surrounding structures. Recurrence is rare and malignancy practically non-existent.