Antonio Fernández Sánchez

Riñón ectópico intratorácico en un adulto. Aportación de un caso y revisión de la literatura.

OBJECTIVE: We report the case of a 61-year-old male with the incidental diagnosis of intrathoracic renal ectopia during the workup study for a possible lung mass. METHODS: We performed a bibliographic review on the incidence, origin, clinical presentation and diagnosis of this type of renal ectopia. RESULTS: Chest x-ray showed a left posterior mediastinum mass. Bronchoscopy was performed showing signs of extrinsic compression with absence of neoplastic cells. CT scan revealed a left intrathoracic ectopic kidney with diaphragmatic hernia. CONCLUSIONS: Intrathoracic renal ectopia is a very unfrequent finding, often asymptomatic, frequently an incidental diagnosis that does not require treatment.OBJECTIVE We report the case of a 61-year-old male with the incidental diagnosis of intrathoracic renal ectopia during the workup study for a possible lung mass. METHODS We performed a bibliographic review on the incidence, origin, clinical presentation and diagnosis of this type of renal ectopia. RESULTS Chest x-ray showed a left posterior mediastinum mass. Bronchoscopy was performed showing signs of extrinsic compression with absence of neoplastic cells. CT scan revealed a left intrathoracic ectopic kidney with diaphragmatic hernia. CONCLUSIONS Intrathoracic renal ectopia is a very unfrequent finding, often asymptomatic, frequently an incidental diagnosis that does not require treatment.Se presenta el caso clinico de un varon de 61 anos diagnosticado de manera incidental de ectopia renal intratoracica durante el estudio de posible masa pulmonar. METODOS Se realiza una revision bibliografica de la incidencia, origen, clinica y diagnostico de este tipo de ectopia renal. RESULTADOS En la radiografia de torax se aprecia una masa en mediastino posterior izquierdo. Es practicada una fibrobroncoscopia apreciando signos de compresion extrinseca con ausencia de celulas neoplasicas. El TAC revela un rinon ectopico intratoracico con hernia diafragmatica izquierda. CONCLUSIONES La ectopia renal intratoracica es un hallazgo muy infrecuente, habitualmente asintomatico, diagnosticado con frecuencia de manera incidental y que no suele requerir tratamiento.

Priapismo de bajo flujo: Tratamiento mediante shunt safeno-cavernoso

Resumen es: Objetivo: Se presenta el caso clinico de un varon de 21 anos con priapismo de bajo flujo de 36 horas de evolucion, su diagnostico y su posterior tratamie...OBJECTIVE: We report the clinical case of a 21-year-old male presenting with a 36 hour history of low flow priapism, its diagnosis and treatment. METHODS: We performed a bibliography review on the etiology, physiopathology, diagnosis and treatment options. RESULTS: The patient underwent unsuccessful punction-aspiration of intracavernous blood with phenylephrine injection and cavernous irrigation with saline solution. A covernous-spongiosum shunt was performed subsequently, firstly using the Winter technique and followed by the AlGorab technique with a final positive response. CONCLUSIONS: The performance of a sapheno-cavernous shunt is an effective treatment for the low flow priapism resistant to usual medical-surgical treatment.

Uretroplastia dorsal con injerto libre de mucosa prepucial (técnica de Barbagli): resultados preliminares de nuestra serie

OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbaglis technique. METHODS: We retrospectively review 8 patients undergoing dorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results. RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to end anastomosis) with good outcome. CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results.Resumen es: Objetivo: Valoramos la indicacion y nuestros resultados en el tratamiento de la estenosis de uretra compleja mediante la Tecnica de Barbagli. Metodos: Re...

TOA ADJUSTABLE MESH FOR SURGICAL TREATMENT OF FEMALE STRESS URINARY INCONTINENCE

Hypothesis / aims of study There is a delicate balance, after tension-free tape implant, between incontinence, continence and obstruction as it is difficult to calculate the correct degree of tension to be applied during surgery. When the tape is too tight, urinary obstruction is produced. On the other hand, when the tape is too loose incontinence persists. The possibility to readjust postoperatively the tension applied to the tape has shown to be a fact through a transvaginal approach [1]. To test if this is possible with a new adjustable transobturator mesh is our objective.

Tumor testicular metacronico secundario a carcinoma vesical infiltrante

Resumen.- OBJETIVO: Presentar un caso raro de metas-tasis testicular secundaria a carcinoma urotelial infiltrante anos despues de practicada cirugia radical.METODOS: Exposicion del caso clinico: paciente de 71 anos sometido a cistoprostatectomia radical con uretrecto-mia por tumor vesical infiltrante. A los siete anos debuta con dolor y aumento del tamano testicular derecho. Se le practico orquiectomia por via inguinal siendo diagnostica-do de metastasis testicular de carcinoma vesical de alto grado. y revision de la literatura publicada al respecto.Palabras clave: Tumor vesical infiltrante. Metastasis testicular. Tratamiento quirurgico.Summary.- OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cellcarcinoma years after radical surgery.METHODS: Case Report: 71-year-old male patient with history of infiltrative bladder tumor, status post radicalcystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the righttesticle. Inguinal orchyectomy was carried out with thepathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review.RESULTS: The patient is disease-free twelve months after orchyectomy.CONCLUSIONS: Apart from leukemia and lymphoma,testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improveprognosis.

METÁSTASIS SUPRARRENAL METACRÓNICA EN 2 PACIENTES SOMETIDOS A NEFRECTOMÍA RADICAL POR CARCINOMA DE CÉLULAS RENALES PRIMARIO.

Objectives: We report two exceptional cases of metachronous adrenal metastasis of renal cell carcinomas and perform a bibliographic review. After the evaluat...