Search

Primary adenocarcinoma of the bladder is a rare tumor type. Histologically it can be mucinous, signet ring cell or clear cell. When diagnosed, it is in the advanced stages and carries a poor prognosis because of its aggressive nature. We report on 9 cases with primary adenocarcinoma of the bladder (2 signet ring cell and 7 mucinous tumors). Those with the advanced stage had a mean survival of 13 months. Of the remaining 4, one survived up to 6 years. This patient had a medium stage tumor and had undergone radical treatment.

The study of impotentia coeundi requires separating the organic from the psychogenic cause. Arteriogenic impotence falls within the first group and has been assessed with the papaverine test, simple Doppler and arteriography. Currently, more sophisticated techniques such as the pulsed Doppler permit noninvasive assessment of the blood supply to the penile arteries. Intracavernous injection of vasoactive substances such as papaverine cause vascular changes. Evaluation of these changes permits making the diagnosis of arterial insufficiency without recurring to more invasive diagnostic techniques such as arteriography. Currently, this invasive technique is only justified in revascularization surgery but not for diagnosis. The availability of color Doppler facilitates arterial evaluation even further.

We report on two cases of renal liposarcoma. The clinical features of this tumor type are described and diagnostic and therapeutic considerations are put forward. The usefulness of CT in the diagnosis of this disease entity is underscored. This permits us to evaluate the response to treatment and furthermore, it permits early detection of recurrence.

Despite the cases reported in the literature, anterior urethral valves continue to be an uncommon condition. The foregoing has to be considered when evaluating children with urinary obstruction or recurrent infections. A case of anterior urethral valves associated with segmental saccular dilatation of the urethra is described and the diagnostic methods are highlighted.

A case of ureteral injury with urinary extravasation following aortofemoral by-pass is presented, the world bibliography of ureteral complications following aortofemoral by-pass reviewed. As possible causes of the ureteral injury of our case, a) decubitus by the dacron prosthesis and b) retroperitoneal fibrosis, are stressed. The etiology and the different methods of treatment are discussed.

The authors present four cases of metastasic penis tumours, two of which followed a prostate carcinoma, one vesical carcinoma and the other a carcinoma of the excretory duct. They make a review of world literature on the subject and study the possible ways of dissemination as well as the clinical picture and differential diagnosis with other pathological processes of the male genital organ and they stress in particular the bad prognosis as the metastases appear at a very advanced stage of the primitive illness.

We present 8 patients treated with Dimethyl-sulphoxide, suffering from inflammatory processes of the lower, urinary tract which include: interstitial cystitis, urethral syndrome, incrustation of the prostatic cell, actinic cystitis and chronic prostatitis. All the patients have shown an improvement in their symptoms which, along with the absence of side effects and its easy administration, means that the said drug constitutes a means of therapy to be taken into account in the treatment of these inflammatory processes, following the consideration of more aggressive therapies.

The authors present 6 cases of torsion of Morgagni's hydatid treated in the Emergency Urology Department over a two-year period. They stress the importance of the clinical diagnosis, as well as the differential diagnosis with other "acute, testicular bag" processes, in particular with funicular torsion. Surgical treatment is the only way of overcoming the pain, confirming the diagnosis and preventing the risk of secondary, testicular atrophy.

Immediately after ureterolysis in the treatment of idiopathic retroperitoneal fibrosis, we covered the ureter with a large epiploon, forming a sheath with omentum covering the entire ureter from the renal pelvis to the juxtavesical area of the same. This technique revitalizes the ischemic ureter resulting from ureterolysis and protects against the reinclusion of the ureter mobilized inside the sclerolipomatous mass.

These operations, in which the risk is essentially ureteral, must be carried out in a urological rather than gynaecological way; the said ureter must be sought after a permanent, ureteral probe has been placed before the operation. We feel that a vaginography is more useful than a retrograde pyelography for diagnosing ureterovaginal fistulae. Another important indication is the need for an intravenous urography to be systematically carried out in the postoperative period of all pelvis operations. Only I.V.U. enables the discovery in time of ureteral lesions which would otherwise remain undiscovered too long. We feel that nephrostomy is an emergency therapy in cases of anuria and septic shock with a urinary focus. It is a safety measure for preventing kidney deterioration in ureter lesions which have remained undiscovered for a long time. In pelvic ureter lesions and providing that there is no vesical retraction, we perform a vesical psoization along with the ureterocystoneostomy (1). When the ureteral lesion is bilateral and the elasticity of the bladder enables us to do so, we perform a ureterocystoneostomy with vesical bipartition and psoization of both vesical wings. In cases of extensive, bilateral ureteral lesions associated with vesical damage such as: vesico-vaginal fistulae and retracted bladder, we perform a ureteroileocystoplasty and vesical stretching.