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Emphysematous cystitis is a very uncommon clinical activity as compared to the high incidence of urinary infections in diabetic patients. The paper explains the pathophysiological mechanisms and updates its clinical and therapeutic diagnostic choices regarding one case of favourable evolution following medical treatment.

The dermatomyositis is a connective tissue disease characterized by changes affecting both the skin and the muscle, appearing most frequently around the fifth and sixth decades and which association to a vesical tumour is very rare. This paper contributes one case of paraneoplastic dermatomyositis associated to infiltrant vesical tumour, presenting erythematous damage in face, nape of the neck and upper thorax, as well as periorbital heliotrope erythema and fingernails base and sides telangiectasia, all of which are typical signs of dermatomyositis.

Review of 18 patients with complex urethral stenosis, who underwent a two-stage urethroplasty in our Unit over the last three years. Clinical results have been favourable in all patients and, from the radiological point of view, there has been only one re-stenosis. Complications rate has been low and can be superimposed to that of any urethroplasty procedure. The paper emphasizes the enormous relevance of the care taken between both surgical stages on the procedure's final result.

Presentation and clinical picture outline of a patient who underwent transperitoneal laparoscopy-assisted nephrectomy. The procedure lasted 4 hours and the patient was discharged 72 hours later without incidence or complications. The paper describes the technique (presently unique and for selective indications), as well as the resources that the extensive laparoscopic experience of our group put into practice to perform the first successful laparoscopic nephrectomy in humans in our country.

Presentation of three cases of haemodialysis patients with acquired cystic renal disease (ACRD) who, over the course of their illness, developed clear cells renal carcinoma. The paper emphasizes the common association of these two entities and the need to consider ACRD cases as patients at high risk of developing renal neoplasia.

The determination and quantification of grey levels in the echography scale, designated by some authors Echodensitometry, is viewed as a new method for diagnosis using ultrasound techniques. This paper advances the results from a study conducted with an echographer equipped with an echographic density measuring device. This model analyzes the number of pixels in the image showing the most frequent level of grey. Normal and pathological parenchymatous urological organs (kidney, prostate and testicle) have been examined. Normal organs show a gaussian distribution of grey with a predominant level of typical grey for each of them. When affected by an acute inflammatory process the organs maintain their gaussian distribution but the predominant grey is lower (darker) due to the edema and the hyperaemia. When the inflammatory process becomes chronic, distribution, although somewhat irregular, is still gaussian but with higher predominance of grey (lighter) probably due to the fibrosis. The tumoral cases of our study also showed a gaussian curve even more irregular and with levels of variable grey. When specific areas of the tumour are analyzed the findings are very distinct depending on whether the areas are hypo or hyperechoic. Hyperechoic areas produce highly irregular maps. Research should be directed to provide more complex, although easy to perform systems of analysis which can correlate adequately with the histological study. It would be desirable that the equipment would be standardized to allow analysis of 'in vitro' images. If and when these objectives can be accomplished we would be able to venture into an echography histological diagnosis, something nowadays yet impossible.

Prostate small cell carcinoma (SCC) is a rare and fatal condition over which countless enigmas hover both with regard to its origin and biological behaviour as well as to its management, the topic of this paper. We contribute the case of a 69-year old male diagnosed through transrectal biopsy and presenting lung, nodes and bone metastasis who underwent palliative UTR but died within four days of the intervention as a consequence of the metastatic condition. Microscopic and immunohistochemical findings characteristic of this type of tumour are described, emphasising the relevance of diagnosing this entity based on its poor prognosis and different therapeutic approach from that used for typical prostate adenocarcinoma.

Alkaline encrusted cystitis is an infrequent process, almost forgotten by urologists. It tends to appear complicating an underlying cystopathy. Consists in a vesical inflammatory state, characterized by precipitation and incrustation of calcareous (phosphate, carbonate) and ammonium-magnesium salts on the vesical mucosa, their genesis being conditioned by the existence of pre-existing mucosa damage, urinary infection by urolithic microorganisms and alkaline urine. The present paper discloses an exceptional case of incrusted cystopathy with alkaline urine associated to uroinfection by E. coli (microorganism of uncertain and questionable urolithic activity). Treatment with urinary antiseptics, acetohydroxamic acid associated with curettage and UTR of calcareous plates was resolutive. With regard to the present cases, we review the limited literature available on the coexistence of incrusted cystitis and E. coli uroinfection and discuss the mechanisms through which E. coli could induce formation of lithiasis and incrustations in the urinary tract.

Review of our experience in the diagnosis and treatment of 44 patients with inferior vena cava tumoral thrombosis (IVCTT), associated or not to other neoplastic processes: 34 hypernephroma, 2 cava leiomyosarcoma, 1 paratesticular rhabdomyosarcoma and 1 biphasic synovial sarcoma. Twenty-five patients with hypernephroma and tumor thrombi in the ipsilateral renal vein only were excluded from the analysis since this fact did not change the usual therapeutic approach. In the 19 remaining patients, concomitantly to the primary tumour exeresis a thrombectomy was performed, using cavotomy with proximal and distal clamping in 11 patients and cardiopulmonary by-pass, deep hypothermia and cardiocirculatory arrest in 8 patients. The paper analyzes the radiological investigations performed in order to reach a IVCTT diagnosis, and reviews the related literature.

Renal angiolipomas are the most frequent benign renal tumours. Since ultrasound techniques have been in use to study algetic lumbar syndromes, their symptomatic appearance has decreased. Most authors agree that CAT has a 100% specificity. The paper contributes one case of renal angiomyolipoma isolated in a 39-year old woman, its primary interest being the clinical presentation, within an extensive septic milieu of urinary origin, the intra-operative diagnosis, considering the previous false-negative echography and dubious tomographic diagnoses, and the findings of regional node invasion, all exceptional states in the reviewed literature.

Seven cases of inverted papilloma (IP), two located at the UUT level and five in the bladder, one associated to transitional cells carcinoma. Treatment was conservative for the whole series, and neither co-adjunctive therapy or chemoprophylaxis was applied, except for the last case; after an average follow-up of 19.8 months they all show complete remission. A discussion of urinary tract IP is suggested, studying the epidemiology, histology, pathogeny, clinical characteristics and diagnostic methods, of which endourological investigations are the most effective for a reliable diagnosis, since they allow direct visualization and biopsy sampling. Regarding the therapeutic options, the paper highlights the need for conservative surgery due to its benign biological behaviour. A strict control of the patients is necessary due to likelihood of recurrence and malignant transformation.

This paper examines the behaviour of PSA in 70 patients with metastatic prostate cancer. PSA serum concentration, prior to therapy, was directly related to the tumoral mass and inversely related to the histological degree, which does not constitute a prognostic factor with regard to the disease evolution. Within 3 months of therapy, PSA concentration decreased more noticeably in clinically responding patients, down to less than 10 ng/ml in 93% of them. Also, this level represented a prognostic factor with regard to the free-of-progression interval of the disease.

Nephrocalcinosis and distal tubular acidosis are two infrequent processes caused by several etiologies which can present in association. This paper describes a clinical case of tubular acidosis and explains the differential diagnosis of both entities.

One of the major challenges of using prostate transrectal ultrasound scanning as a procedure to diagnose through images is the theoretical possibility of reaching an early diagnosis of prostate cancer. This paper compiles the author's experience in this field. Based on 142 established diagnosis of prostate cancer since 1984, the conclusion being reached is that prostate cancer has no pathognomonic signs, and therefore it is impossible to make an early diagnosis just by using the images obtained with transrectal ultrasound scanning. This procedure could be used, however, to select patients with scan abnormalities (Alarm signs) who should have a biopsy performed. The support of ultrasound-led transperineal biopsy of the prostate is currently indispensable to achieve an early diagnosis. This paper suggests that a biopsy should be done at the appearance of just one alarm sign, although this may involve a large number of cancer negative biopsies. The almost null incidence of complications from transperineal biopsies enhances this reasoning.

The publication of the Treaty of Urology of Francisco Díaz towards the end of the sixteenth Century, was a milestone in the History of medicine. The originality and precociousness of his doctrine entailed a true revolution in the genesis of medicosurgical literature, considering that the text constitutes an inspired anticipation to the specialization age. Ever since the last century, all historians and annotators of this work have asked themselves whether there was an earlier edition to that of 1588 since the title "Newly printed treaty ..." invites such a inference. So far, every investigation searching for the original or a copy of the first edition have been in vain. This paper, based on documents and old works from the Archive of Protocols in Madrid, Library of the Royal Palace and Library of El Escorial Monastery, reveals certain data until now unpublished on the destiny of most of the copies belonging to the second edition presented and brings into light old references on which account is given that the original "Treaty of Urology" by Francisco Díaz, considered to be a Sixteenth Century Codex was lost in the fire of the El Escorial Monastery in 1671.

Appearance of orbital metastatic (OM) neoplasia is the most frequent cause of eye tumour; however, its incidence related to prostatic carcinoma (PC) is rare, primarily when there is sole infiltration of the periorbital soft tissue (STOM). The paper describes the case of a patient diagnosed with PC presenting proptosis and diplodia as first spread symptoms. The rarity of STOM of the prostatic carcinoma prompted the diagnosis to be seen sceptically until immunohistochemical confirmation was obtained. An analysis is made of various features of interest regarding the grading of OM, clinical incidence and diagnostic methods. The singularity of the present case, affecting only the periocular soft tissues is illustrated. Finally, the situations requiring orbital biopsy in order to avoid a second neoplasia are analyzed.

The present paper is a review of 71 cases of uretero-vaginal fistulae secondary to pelvic surgery which were treated in the Urology Unit of our hospital. Surgical management of these fistula intrinsically depends on their number, location and severity. The results obtained by the different techniques were analyzed, emphasizing their merit when using the Turner-Warwick technique (uretero-cystoneostomy on psoic bladder) and any urodynamic troubles this technique can bring about when used bilaterally in patients from radical gynaecological surgery.

The paper shows the value of echography in tumoral grading based on 87 patients who besides cystoscopy, bimanual touch and histology study by transurethral resection, had an echography performed. Sensitivity achieved for tumour detection through echography was 85% with a positive predictor value of 98.8%. On the 72 patients who were diagnosed a tumour through echography, TUR histology showed an echography under-grading of 2.7% (2 cases) and an over-grading of 9.7% (7 cases) with grading correlation in 86.3% cases.

Our experience in surgical injuries of the ureter, as well as the therapeutic approach followed to repair them as expounded in this paper. Immediate nephrostomy following diagnosis, and restoration deferred a minimum of three weeks have provided good results, as well as it has allowed us to detect and achieve spontaneous restoration in one case. These reasons, together with the absence of technical difficulties during the second intervention, invite us to consider the reevaluation and deferred restoration--if appropriate--of the surgical ureteral injuries as a therapeutic approach from which a number of patients can profit.

Alkaline encrusted cystitis is characterized by the formation of calcareous plaques in the bladder mucosa and submucosa in the presence of several factors: infection by urolithic organisms, earlier pathology of the vesical wall and precipitation of calcium phosphate salts. Treatment includes: urine acidification, correction of the urinary infection and use of acetohydroxamic acid. This paper presents three patients where the response to medical treatment was conditioned by the evolution of the existing vesical impairment. The conclusions state that in the alkaline encrusted cystitis, the concurrent pathology is a major predictor of the disease's future evolution.

Wilms tumour is an infantile neoplasia with low incidence in adults. Worldwide literature describes 260 cases but only 50 meet the diagnostic criteria described by Kilton. This paper presents one case diagnosed in our service and includes a review of the literature.

Attendance generated in an urology outpatients office, reaching up to 6564 visits, was studied for a complete year. Considering only the initial visits handled during that period (1968), we evaluated the following parameters: age, sex, mode of remission, data presented, type of consultation, most common type of urological pathology. No particular period of life has come out as showing greater incidence of urological pathology. Males represented twice as many visits as women. 84.29% patients had been correctly referred to the office. Sixty percent of visits happened without appropriate clinical data to support the case. Emergencies represented 13.31%, but 90% of those actually lacked such condition. Renal-ureteral lithiasis (25.57%) was the most frequently present pathology in our office, followed by benign hypertrophy of the prostate (16.07%). Urinary lower tract infections (15.59%) and inflammatory and/or congenital prepuce pathologies (14.09%) were the second most frequent ones. In this paper, we emphasize the increasing prevalence of male-related sterility visits in the outpatients environment, as well as nephrological.

The evolution of 168 patients, 136 of which underwent bilateral lymphadenectomy is analyzed in this paper. In 126 cases it was possible to obtain all the data in order to define N within the T.N.M. rating. With regard to the remaining patients 10, of which we lack the anatomopathological report, and 32 which did not undergo lymphadenectomy, are included under item Nx. During follow-up, metastasis was diagnosed in 60% node-positive patients. We believe it to have been already present at the time of undergoing surgery. Survival was significantly higher in the group without node dissemination than in both negative-nodes and Nx groups. When assessing the nodular dissemination group, patients treated with 2000 rad prior to cystectomy showed higher survival rates: 36% vs 22% and 11% for groups treated with 4500 rad and no radiotherapy. respectively. Metastatic percentage, however, was lower for the group managed with surgery alone (50%) than those treated with pre-operative radiotherapy (73% and 67% with 2000 and 4500 rad, respectively), on the other side, it would seem a contradiction that a 2000 rad dosage should be more effective than a 4500 rad dosage for this group of patients, since theoretically, the latter is closer to the ideal dosage to eradicate the nodular disease. Since 3 of 5 patients have micrometastasis, which we are yet unprepared to detect, all positive-node patients should receive chemotherapy immediately after recovery from surgery.

Osteoid tissue can eventually be identified outside the bone skeleton adopting the form of metastasis, osteoid metaplasia or primitive osteosarcoma. This latter presentation is most frequently located in soft tissues and exceptionally at the visceral level. The term used for any of these forms is extra-bone osteogenic sarcoma. This paper reports the case of a 62 year-old female patient diagnosed with vesical urothelial carcinosarcoma treated with external radiotherapy. After a disease-free period of 20 years the patient developed osteosarcomatous-differentiated vesical carcinosarcoma. A literature review is made to analyze, from a clinical and histopathological perspective, several items of interest presented by this pathology. The role of sarcomatous radio-induction is also highlighted. Finally, we emphasize the relevance of using radical treatments from the start, so as to restrain the highly malignant potential of this condition.

The paper presents the results obtained with endovesical dimethylsulphoxide in the treatment of interstitial cystitis in 30 women. Up to 80% patients showed clinical improvement with an average of 10 installations. Volume of maximal vesical capacity was increased in 24 patients (80%), the increase being greater than 100 cc in 10 cases. Presently, 24 (80%) patients remain under treatment, 14 with one instillation monthly and 10 once every six months. Six patients are fully asymptomatic without treatment after an average symptoms-free interval of 32 months. Since this is directly related to a decrease both in pain and miction frequency, the increase in vesical capacity appears to be a good improvement index. Dimethylsulphoxide in neither a healing nor a definite therapy but it seems to be effective in the management of this unknown disease.

Report of one paratesticular RMS in a 28 year-old male. The paper includes a review of the various clinical, etiopathogenic and therapeutic features involved. RMS is a neoplasia difficult to diagnose through M.O. and, quite often, it is necessary to use immunohistochemical techniques in order to discover some of the muscular fibre markers, such as Desmin, Myosin and Myoglobin. Several theories have been put forward to explain its origin, and the most widely accepted defends an origin in a poorly differentiated mesenchymal tissue. The advantages of retroperitoneal lymphadenectomy following orchiectomy are discussed as treatment.

The paper presents the experimental work carried out on the influence of various surgical situations on ureteral peristalsis in the rat. It included 43 rats divided in three groups. Group I (n = 10) acted as control group and had only ureterolysis performed. In group II (n = 10), single section and subsequent anastomosis was performed. Group III (n = 23) included section at two levels, ureter extraction from the animal and subsequent autotransplantation of the ureter. The three groups were re-operated two months later to ratify peristalsis of the intervened ureter. Both in the first and second operations peristalsis, as well as the features and appearance of antiperistaltic waves were quantified. After 60 days, no changes were observed in group I, but groups II and III exhibited normal peristalsis to presence of antiperistaltic waves. Both groups had complications like stenosis, fistulas and hydronephrosis, but also normal functioning, histology and peristalsis.

Unilateral essential haematuria is an unusual clinical entity where diagnosis is achieved by exclusion of other urological and nephrological conditions. The paper reports two female patients with unilateral anaemic macroscopic haematuria which were evaluated using flexible ureteropyeloscopy, and one also underwent percutaneous pyeloscopy. In one of the patients a renal papilla haemangioma was found which was fulgurated, while the lesion was not identified in the other patient, although neither of them has shown haematuria recurrence during the follow-up period. The authors believe that uretororrenoscopy and percutaneous nephroscopy should be considered in selected patients with unilateral essential haematuria due to its diagnostic and therapeutic possibilities.

We submit the present paper three cases of prostate abscess. The various aspects related to ethiopathogeny, clinic, and current diagnostic procedures are analyzed emphasixing the use of endocavitary echography, as well as the different therapeutic approaches that can be used, with particular attention to ecomonitored aspirative drainage.

Thirty three cases of surgically corrected vesicovaginal fistulae, from a total of 73 patients with iatrogenic or pathological urinary tract conditions examined and treated in our service, are presented in this paper. Both the etiology and different surgical techniques that can be used are reviewed, contributing the novelty use of freeze dried dura mater as the material to interpose for the correction of the fistulae by means of abdominal surgical techniques. The material was used in 6 patients, with recovery being obtained in all cases and achieving the fistulae closure with a single surgical procedure.

Extra-adrenal pheochromocytoma or paraganglioma are rare, usually benign tumours, which clinical behaviour varies in function of whether they are able to secrete vasopressor hormones. The case of a 66 year-old male with non-functional retroperitoneal paraganglioma (chemodectoma) accidentally found with an echography is presented here. The paper analyzes the most relevant features from a pathological, clinical, evolutive, diagnostic and therapeutic point of view.

We present our experience in the diagnosis-through-image with 25 primitive retroperitoneal tumours over a period of 17 years. The histological type most frequently found was that derived from mesodermal tissue (64%). Abdominal pain and mass were the typical symptoms of the presentation. The paper analyzes the radiological studies used (except NMR) with regard to the diagnostic value they have in this sort of pathology. UIV continues to be the initial examination when a retroperitoneal tumour is suspected, obtaining a diagnostic orientation of 70%. The remaining diagnostic techniques (except arteriography and CAT) should be used as a diagnostic supplement or to assess the disease progression, unless the initial clinical symptoms make their use advisable, since the diagnostic orientation provided is usually below 50%. The use of CAT together with monitored aspiratory puncture provided a diagnostic reliability over 90%, so we conclude this should be the examination technique of choice when retroperitoneal tumour is suspected.

The paper describes an unusual angiographic pattern within the context of stenosis of the pyeloureteral union and giant hydronephrosis of the adult, with a presumed congenital origin. From the embryonic point of view we discuss the remote possibility of this being a real "agenesis" of the renal artery with no agenesis of the kidney, irrigated by multiple segmental arteries following the characteristic metamerism of the mesonephros. On the other hand, it seems more consistent to explain such vascular pattern as an image of severe atrophy, in correlation with the hydronephrosis advanced stage, and not as a primary congenital defect. However, the interaction of both factors (congenital-malformative and acquired-involutive) could be more overlapped than what initially appears to be.

Renal metastasis of localized tumours in the economy are rare. In our series of 162 renal tumours only 3 were metastatic. Even more unusual is that the metastasis should be the presenting form. Such is the case we are reporting: a 59 year-old male complaining from back pain and toxic syndrome. Supplementary examinations were performed sequentially until arriving at an open biopsy which confirmed the oat cell histology. The paper explains the results from the various examinations. The ominous prognosis of this histology is illustrated.

Appearance of residual masses following chemotherapy of retroperitoneal metastasis from testicle's non-seminomatous germinal cell tumour does not always imply we are facing an active tumoral disease. When exeresis of these masses discovers the presence of a mature teratoma during the histological study, what we have is the so called Growing Teratoma Syndrome. Such teratoma is unresponsive to chemotherapy but the patient can be cured by means of a full exeresis of the residual mass, thus the relevance of having into account the likelihood of this pathology. The paper presents the case of a patient with retroperitoneal non-seminomatous testicle tumour and metastasis which, following chemotherapy, presented a residual mass with normal serological markers. After the exeresis it was found out that it was made up by mature teratoma. Four months after rescue surgery, the patient remains asymptomatic, has normal markers and no signs of neoplastic recurrence.

Penis epidermoid carcinoma is responsible for about 1% of deaths by neoplastic diseases in developed countries. During a 5-10 years follow-up review, we found 14 patients, 9 of which started as localized stages in glans and/or prepuce. Lymph node affection was found in 9 cases, either at beginning of diagnosis or during follow-up. Lymphadenectomy, which demonstrated metastatic affection in 4 cases, was considered indicated in 6 patients. Two cases received inguinal chain radiotherapy and the remaining one underwent chemotherapy as first therapy. Percentage of actual survival rate, found after 5 years, among the 14 patients studied was 42.8% (6 cases), still unchanged after a 10-year follow-up. Five patients died due to their basic illness progression and 3 died of other tumour-unrelated processes. The paper analyzes the results obtained based on the literature reviewed, and discusses current therapy approaches for inguinal metastatic conditions.

The paper presents our experience with in situ carcinoma associated to bladder surface tumour. The relationship between in situ carcinoma associated to surface tumour and new occurrences, as well as increase of tumoral stage, versus those tumours not associated to in situ carcinoma is assessed through a comparative study. It is concluded that bladder surface tumours with associated in situ carcinoma begin to recur from the first months at higher rate than other surface tumours. Bladder surface tumours with associated in situ carcinoma, however, do not increase tumoral stage at a different rate than other surface tumours, at least not for a period of 18 months.

Enlargement of Cowper gland ductus (syringocoeles) is an uncommon lesion, normally found in children and young adults. The paper presents a case of one adult syringocoele, treated through transurethral route, and reviews the lesion's etiology, clinic, radiology and therapy.

Endometriosis is defined by the presence of functionally active endometria in ectopic position; so when its clinical behaviour adopts the characteristics of tumoration, endometrioma is accepted as an alternative name. Location of this pathology in the urinary apparatus is uncommon in terms of incidence, since the bladder is a selected site. This condition implies a high morbidity rate because it requires a high level of suspicion in order to be diagnosed. It is acknowledged that no image study (CAT, Echography, MNR, etc.) is pathognomonic for endometriosis and it is necessary to perform endoscopy and biopsy to achieve a correct diagnosis. The paper includes the strategy to follow, both with regard to diagnosis and the current therapeutic approaches.

Renal arteriovenous fistulae (AVF) conform a pathology the urologist is not used to see. The basic purpose of this paper is to collect and update the current knowledge of this renal-vascular disorder, quite frequently forgotten when establishing the likely causes of haematuria. The paper describes the etiology of renal AVF and their generation mechanisms, as well as clinical presentations they can have. A most appropriate diagnostic method is still selective renal arteriography, which usually evidences the anomaly through indirect arteriographic signs. However, when the lesion is small it can be difficult to detect it. Finally, a discussion of therapeutical possibilities, both conservative and radical, and a case recently treated in out unit are presented.

Renal Vein Thrombosis is an uncommon entity associated to various clinical conditions which develop in hypercoagulant states. The paper describes one case of idiopathic thrombosis of the renal vein in an adult patient, also making a review of the literature on this clinical syndrome and its diagnostic and therapeutic aspects.

Presentation of a case of prostatic infiltration by malignant lymphoma, discovered through manifestation of simple urinary symptomatology. The paper describes the diagnostic process followed, and includes reproduction of the most interesting findings. The rarity of this disorder and the good response obtained from the alternative chemotherapeutic therapy is emphasized.

The paper refers to thirteen patients with epithelial tumours of the upper urinary tract, diagnosed and treated at our unit during the last five years and emphasizes the need of early diagnosis, custumorized therapy and close follow-up. Evolution is clearly more favourable in well differentiated and low stage tumours, regardless the type of surgery performed, versus the poor results obtained in infiltrative and undifferentiated cases for which there is no effective treatment available. Results are analyzed based on a brief literature review and considering the short number of cases contributed.

Due to the rarity of the cases presented in this paper, the prolonged time of residence in the urethra and the limited functional repercussion produced by the foreign bodies lodged in the urethra, we consider convenient the exposition of the mentioned cases.

Unlabelled: Peri- and post-operative complications higher than 37c (15%) encountered in 250 urethroscopies performed between May 1985 and January 1989 are presented in this paper. These experiences are compared to those from other 20 series (2,599 urethroscopies) representing 14.5% complications. In order to study their pathogeny, the sample was divided into four groups:, Control Group: 27 patients where normality of urinary tract was demonstrated in 92.6% of all evaluations made at intervals of about 20 months. Technical scope: Two groups chronologically different: 16% complications in urethroscopies performed in 1985 and 7% complications in those performed in 1986. Differences in the techniques applied: classic extraction (14%) vs. urethroscopy (13%) and electrohydraulic lithotrity (42%) vs ultrasonic lithotrity (12%). Finally, a description is made of those cause believed to be responsible for major complications: perforation, avulsion and ureteral stenosis.

This paper outlines the evolution experienced in the treatment of male urethral stenosis over the last 25 years, based on self experience and the review of relevant literature. Criteria justifying such evolution are illustrated including explanations and criticism of techniques from the primitive urethral "dilatation" to endoprothesis. Special emphasis is laid on the importance of pre-operative diagnosis and the need for adequate urethrographic examination which, very often, the urologist himself should perform in order to avoid interpretation mistakes and lamentable surprises during surgery. Finally, in view of all the above, a strategy of practical actuation is outlined.

The paper reports 2 cases of cystic-pyelocalyceal communication one secondary to traumatism and the other one infection-induced, demonstrating the possibilities of using etiological diagnosis in these communications, and the therapy to be followed. Endoscopic manipulation is usually enough to allow correct diagnosis as well as treatment.

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.

The paper presents a case of giant retroperitoneal liposarcoma treated in our unit. New diagnostic and therapeutic perspectives for such uncommon tumours are commented upon.

Necrosing infections of subcutaneous cell tissue are uncommon processes which constitute a diagnostic and therapeutic vital emergency. Generally secondary to anorectal or genitourinary processes, a small percentage of these infections have no apparent cause. This paper presents one case of primary necrosing cellulitis in a diabetic patient. Etiological and diagnostic aspects are discussed, outlining the need of an aggressive surgical attitude as the only valid therapeutic offer.