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Near 70% of patients diagnosed with testicular seminoma make their presentation without metastasis. Although spread at the time of diagnosis is the rule, 25% of non-seminomatous germ-cell tumours are found confined to the testicle at presentation. Standardization of diagnostic and follow-up methods -within reach of most urology services- should allow a closer relationship between urologists and testicular tumours. Observation of "aggressive" surveillance schedules for stage I non-seminomatosous tumours confined with no risk factors, and use of radiotherapy to treat low degree (I,IIa and IIb) seminomas should allow urologists an initial control of up to 50% of patients. Occurrence of relapse or presentation in advanced stages force the use of chemotherapy. The present paper outlines the most basic aspects of non-surgical treatment of patients with testicular tumours.

Ureteral triplicity is a rare abnormality of which there are less than a hundred cases reported up to date. The possible absence of clinical signs can explain why this malformation passes unnoticed specially when there are blind branches and dysplastic renal segments. The paper presents the case of a 43 year-old male, attending the clinic on a testicle tumour consultation, in which in spite of the previously mentioned circumstances a preoperative diagnosis of trifid ureter with ipsilateral ureterocele and renal dysplasia was reached owing to the use of C.A.T.

Between 1974 and 1988, 35 testicle germinal tumours, 16 seminomas and 19 non seminomas, were studied. Mean age in seminoma cases was 34 years and 26 in non seminoma cases; the former were mainly presented as located stages at the time of diagnosis (75%) while the latter were, on the contrary, mostly stages II and III. Following orchiectomy, all histologically pure seminomas received radiotherapy with the exception of two cases. All of them are presently free from the disease with an average follow-up of 2.8 years (range 0.5-5 Yr.) Radiotherapy continues to be proposed as first choice therapeutic action for siminomas in located stages, although we do not disagree with other more conservative possibilities. In the non seminoma group, all three patients diagnosed in stage I were clinically controlled without supplementary therapy, two of them having a recurrence during the first year of follow-up, but currently free of the disease after chemotherapy and surgery of residual masses. Of the three non seminoma patients in stage II, with negative post-orchiectomy markers, two underwent lymphadenectomy and the other one only chemotherapy. In the remaining group of non seminoma patients, and always after an orchiectomy, chemotherapy was performed as first choice therapy, although rescue lymphadenectomy was required in eight cases. Chemotherapy schemes with cisplatin have relegated to a second level any other therapy for the non seminoma patients. The excellent response and reduction of side effects allow the adoption of more conservative attitudes. This paper explains our retrospective study and, following a wide review of exiting literature, discussed any conflictive prognostic and therapeutic items.