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Objective: To report a clinical case of testicular rupture and review of the literature published., Method: A 15 years old male with a testicular rupture after a sports injury was diagnosed by Doppler ultrasound., Results: Surgical exploration was performed and the tear was repaired. He had a benign postoperative course. The patient presents a normal size testicle after a year of follow-up., Conclusions: Testicular rupture is an uncommon but important entity that may occur. It is essential early diagnosis and e management to avoid orchiectomy.

Objective: To present the association between Seminoma and Kartagener's Syndrome (KS), and its relation with infertility., Methods: We report one case of Seminoma in a patient with Kartagener's Syndrome, focussing on the possible relation between both pathologies and fertility. Bibliographic references are discussed., Results: Orchyectomy was performed on a patient with Kartagener's Syndrome and testicular tumour. The pathology result was Seminoma. Azoospermia was obtained twice in the post operative espermiogram, not being easy to establish the implication of each pathology (KS or Seminoma) in infertility., Conclusions: A patient with KS and Seminoma plus azoospermia is reported, with a great outcome from the oncological point of view. Bibliographic references are described. The association between KS and Seminoma is exceptional in the literature.

The authors report the case of a 75-year-old man presenting with prostatic syndrome. Ultrasound assessment revealed multiple bilateral solid renal lesions that were confirmed by computed tomography. It was decided to perform bilateral percutaneous biopsy of the masses. The histological diagnosis was that of oxyphilic adenoma with an oncocytic appearance compatible with oncocytoma. In view of the histology and the multiple lesions, none of which was larger than 5 cm, it was decided to perform watchful waiting which did not reveal any change in size with a follow-up of 4 years. Although renal oncocytoma is relatively frequent, only 19 cases of bilateral multiple renal oncocytomas have been published in the world literature. The authors present a new case and review the current state of this entity.

Prostate carcinoma is one of the most frecuent cancers in men. Significant numbers of patients have regional lymph node and bone metastases during the course of the disease. Mediastinal lymphadenopathy and cutaneous metastases are uncommon and signify well-advanced disease. We report the case of a patient with prostate cancer who develops mediastinal lymphadenopathy, pulmonary nodules and cutaneous metastases 8 years after the diagnosis.

Objective: The purpose of this study is to apply the in vitro keratinocyte culture techniques and the tissue engineering principles to human urothelium, to reconstruct an in vitro three-dimensional human bladder mucosa, suitable for grafting., Material and Methods: Biopsy specimens of human bladder mucosa were obtained from patients undergoing suprapubic prostatectomy, in vitro cultured and finally, an immunohistochemical study was made., Results: A three-dimensional in vitro tissue was obtained, composed of a bio-artificial submucosa (fibrin gel and fibroblast) where the uroepithelial cells were seeding. We used a biodegradable polyglycolic acid mesh to facilitate the tissue manipulation and implantation. An immature epithelium was obtained with a weak immunostaining to cytokeratins. The immunohistochemical study could not demonstrate the development of basement membrane., Conclusions: In vitro keratinocyte culture techniques could be applied to other epithelial tissues like the urothelium. We obtained a three-dimensional in vitro tissue suitable for grafting in a relatively short time, which needs the matrix interactions in order to mature.

Objectives: From August 1997 to December 2004 we performed 47 vasovasostomies for vasectomy reversal in the same number of patients. Only 42 patients are available for follow-up, with a mean follow-up of at least six months. Mean age is 40.7 years for the patients and 30.8 for the couples., Methods: The two-layer technique was applied under microscope magnification in the first 22 patients; single layer technique was performed in the others., Results: Overall spermatozoid potency rate was 71.42%, and pregnancy rate was 32.45%. Surgical technique did not have influence on results., Conclusions: Better prognosis is expected in young men; the longer the interval between vasectomy and reversal, the lower the potency rate. Regarding pregnancy rate, it is not influenced by delay of reversal.

Intratesticular epidermoid cysts are rare tumours that constitute one percent of all testicular masses. They are bening lesions that make differential diagnosis from malignant testicular tumours difficult. The absence of serum markers elevation and ultrasound imaging could support these lesions being bening epidermoid cysts, and in that case, conservative surgery is adequate. We present the case of a 22 years old patient who complains of a left testicular mass. In this case ultrasound diagnosis was non-specific and a left radical inguinal orchiectomy was performed.

Objectives: To analyze the surgical aspects and complications from retransplantation into the iliac fossa for third and fourth kidney transplants., Methods: Retrospective study of the 34 third and 5 fourth transplants performed in our department. We analyze patient's characteristics, surgical aspects and complications, and graft outcomes., Results: Mean patient age was 41.6 years. 67% of the first and second transplants had been lost to vascular problems (19%) or chronic rejection (48%). Average time from last transplant in the retransplanted iliac fossa was 9 years (3 days-17 years). There were not significant differences between the groups of first and second transplant and third and fourth in cold ischemia time, number of mismatches, and number of days on hemodialysis after transplantation; there were significant differences in receptor age, number of transfusions, maximum and current antibodies and donor age, all of which were higher in third and fourth transplants. The graft was basically implanted in the right iliac fossa (71%) through a lumbar-iliac iterative incision; vascular anastomosis were equally made to the common and external iliac vessels; ureteral reimplant was performed following an extravesical technique; simultaneous transplant nephrectomy of the previous graft was performed in 33% of the cases. 59% of the cases had immediate diuresis and 49% did not require dialysis within the first 7 postransplant days. Surgical complications were mainly vascular: 4 cases of hemorrhage, 3 venous thrombosis and 2 arterial thrombosis. There were also 4 cases of lymphocele, 1 perirenal hematoma, and 1 enterocutaneous fistula with an abscess of the surgical bed. There were no urologic complications in the series. Globally, there was 1 death (2.5%) secondary to hemorrhage and another 6 grafts (15%) were lost to complications, 5 vascular thrombosis and 1 after surgical bed abscess. 1, 3, 5, and ten-year actuarial graft survival were 65%, 52%, 40% and 28% respectively., Conclusions: Retransplantation into the iliac fossa for third and fourth transplants is associated with a small increase in the number of surgical complications, mainly vascular complications.

Introduction and Objectives: A quarter of patients waiting for kidney transplantation are patients with previous graft failure. Outcome of first and second renal transplant make these the gold standard for end renal stage disease, but this is not so clear in the case of third and further renal transplant, especially at the time of organ shortage. We revise our experience in patients with three or more kidney transplants focusing on surgical aspects and graft outcome., Material and Method: 1364 renal transplants have been carried out in our centre since 1975 until December 2003. We have retrospectively revised the 34 patients with three renal transplants and the 5 with four. We analyse the surgical technique, surgical complications and graft outcome., Results: Mean age was 42 years (21-65). Average mismatches between donor and recipient was 3.2. All kidneys, but one case of living donor, were harvested from cadaver donors, mostly in multiple organ-procurement. Average time from the last renal transplant was 5 years (3 days-17 years) and from the last transplant carried out in the iliac fossa reused until the new transplant was 9 years (3 days- 17.5 years). All implants were performed through an iterative lumboliliac incision (25 on the right side, 11 on the left one and in 3 cases where side was not registered). Mean average duration of the procedure was 166 minutes (100-300). Nephrectomy of previous graft at the moment of the implant was carried out in 13 patients (33%). Vascular anastomosis was made on the common iliac vessels (50%) or on the external ones (50%) in end to side way, Ureteroneocystostomy was performed in an extravesical way except in 1 patient with cutaneous diversion. Vascular complications were 4 haemorrages (1 patient died), 3 venous and 2 arterial thrombosis. We had an abscess secondary to intestinal fistulae. Other surgical complications were 4 lymphoceles, three of them needed surgical treatment, and one perirenal haematoma treated in a conservative way. No urological complications were seen. In total 6 grafts (15%) were lost due to surgical complications. Graft actuarial survival rate at 1 year was 65%, 40% at 5 and 28% at 10 years., Conclusions: Three and four renal transplant survival rates are shorter than first and second ones. Iterative access through lumboiliac incision is associated with a higher vascular complication rate, probably in these patients a transperitoneal access would be better. Multicentric studies with higher numbers of patients are needed to define more clearly which patients would benefit from multiple kidney retransplants.

In the eighties a new field of the medicine appears wich applies the principles of cellular cultivation to synthetic biodegradable polymers scaffolds with the purpose of creating autologous biological substitutes that could improve, maintain or restore the function of organs or damaged tissues. The Tissue Engineering constitutes a new discipline in full phase of development especially in USA, with multiple potential applications in several medical specialities. Our speciality can't remain indifferent to interest and encouraging future originated by this new science. In this work we have made a wide bibliographical revision in the Medline to know the antecedents, current state and the possible future applications of Tissue Engineering in Urology.

Objectives: To analyze our results in terms of continence and complications of treatment of urinary incontinence with TVT during the 4 first years., Methods: 72 patients underwent surgery for urinary incontinence between 1999 and 2002. Chart review was performed for medical history, physical examination, urodynamic tests, surgical procedure, intraoperative and postoperative complications, objective and subjective results., Results: 62 patients were diagnosed of genuine stress urinary incontinence and 10 patients of mixed urinary incontinence. 14 patients had grade 3 cystocele, 12 of them underwent associated colporrhaphy. Operations were performed under local anaesthesia in 1 patient, spinal anaesthesia in 41 and general anaesthesia in 30. Mean operation time was 32 minutes, 66 minutes when colporrhaphy was associated, and previous surgery did not increase the surgical difficulty. 6 patients (8.3%) suffered bladder perforation which was identified during cystoscopy, but only required reposition of the tape without affecting patients' outcomes; 1 patient had a pelvic hematoma that evolved without sequel; 16 patients (22.22%) had urinary retention which spontaneously resolved between 2 and 60 days, except one case that required section of the mesh. 8 patients (11.11%) developed de novo bladder instability; there were 2 cases of late mesh perforation into urethra or bladder, which were solved by endoscopic mesh section; 3 patients had voiding discomfort and 1 chronic perineum pain. 70 patients (97.3%) achieved continence under stress; nevertheless only 57 patients (79.17%) were satisfied with their outcomes. Main causes for dissatisfaction were failure, de novo instability, persistence of urgency in cases of mixed incontinence, and voiding discomfort. Previous surgery and performance of associated procedures did not influence outcomes, although they were associated with longer operation times and higher incidence of urinary retention. Patients with Valsalva's leak point pressure < 60 H2O cm had slightly worse outcomes (63.5% satisfaction)., Conclusions: TVT is an easy to learn and easy to perform technique, with few complications and good results.

Objective: To report a rare case of coexisting renal oncocytoma and pheochromocytoma. To our knowledge, only one such case has been reported in the literature., Methods: The findings of the imaging studies of this rare case and the unsuspected anatomopathological findings are presented., Results/conclusions: Despite its very low frequency, coexisting renal ocnocytoma and pheochromocytoma should be taken into account in patients with synchronous renal and adrenal masses. Unfortunately, there are no radiological patterns that allow us to suspect this rare condition.

Objective: To analyze the role of transrectal ultrasound in the diagnosis of diverticula of the female urethra., Methods/results: Transrectal ultrasound assessment was performed with a biplanar 5 MHz probe and translabial ultrasound was performed with a 7 MHz linear or 3.5 MHz sectorial transducer in 9 women suspected to have urethral diverticula. Cystourethrography was also performed in three patients. Eleven diverticula were found in these 9 patients., Conclusions: The incidence of diverticula of the female urethra has been reported to range from 0.5-6%. Diagnosis is confirmed by urethroscopy or imaging methods. Transrectal ultrasound is the method of choice in the assessment of urethral diverticulum.

Objective: Our experience in the management of priapism, its etiology, blood gas changes, treatment and outcome are presented., Methods: The records of patients that had been treated at the Urology services of our hospital over the last 8 years were reviewed. During this period, patients with erectile dysfunction were treated according to a protocol., Results: There were 9 episodes of priapism in 8 patients; all cases were low flow and the patients were aged 37-71 years. The duration of the prolonged erection ranged from 4 to 72 hours. Of these 9 cases, the etiology was intracavernosal PGE in 7, after trazodone administration in one case, and unknown in one case. Intracavernosal metoxamine was administered in all cases with excellent results, except one case that required a saphenous-cavernosal shunt and another case that was initially treated with adrenalin also with good results., Conclusions: Since intracavernosal agents have been utilized in the treatment of erectile dysfunction, priapism has become a more frequent urological emergency. Although a lower incidence has been reported for PGE, the dose should be well adjusted to avoid a higher incidence.

Objective: To describe a case of mucinous adenocarcinoma of the prostate, an uncommon variant of prostatic carcinoma of which few cases have been reported in the literature. This tumor type is briefly reviewed with special reference to the controversial issues that remain unresolved due to the small number of cases., Methods/results: A case of mucinous adenocarcinoma of the prostate is presented. An extraprostatic origin had been discarded. The diagnosis was made by DRE, transrectal US and histological confirmation by transrectal biopsy. PSA values were normal. Studies to determine the extent of the lesion showed advanced locoregional dissemination. Surgery was therefore not indicated and hormonal therapy was administered. Patient outcome was poor with no apparent clinical response to hormone blockade. Radiotherapy was attempted. The patient rapidly became worse and died., Conclusions: Mucinous adenocarcinoma of the prostate is characterized by the presence of significant amounts of extra and intracellular mucin. Its clinical features are not unlike those of classical adenocarcinoma and in general terms, it is considered to carry a worse prognosis and refractory to hormone therapy.

Objective: To analyze the diagnostic methods utilized in prostate cancer and the preoperative information on the extent of the tumor, and compare these results with those obtained from anatomopathological analyses of the radical prostatectomy specimen., Methods: Data on the radical prostatectomies performed during the study period were obtained from the Admissions and Clinical Records services and were analyzed using the SPSS statistical analysis software for Windows., Results: From 1991 to 1998, 109 radical prostatectomies were performed. Evaluation by transrectal US was carried out in 89 patients (81.6%) and detected a tumor (unilateral or bilateral) in 77, for a sensitivity of 86% (CI 78.8-93.2). A CT study was performed in 94 patients and was positive in 25, for a sensitivity of 26.5% (CI 17.6-35.4). The sensitivity for transrectal US and CT were 4.17% and 3.33% for capsular involvement, 5.88% and 5.26% for seminal vesicle involvement, and 0% and 0% for node involvement, respectively., Conclusions: Transrectal ultrasound is a reliable diagnostic imaging method, although it has a low sensitivity when used to determine the extent of the tumor. In our series, the radiological methods showed a low sensitivity when they were utilized to determine the extent of the prostate cancer. Routine preoperative assessment by CT can be obviated in prostate cancer.

Objective: To report a case of genital gunshot injuries and review the literature., Methods: A case of low velocity multiple gunshot penile injuries is described. Surgical exploration was performed, gunshot removed and the albuginea repaired. A broad spectrum antibiotic was administered prophylactically for infection., Results: Good cosmetic and functional results, including sexual potency and voiding, were achieved., Conclusions: Surgical exploration is mandatory in genital gunshot injuries. The best approach to the albuginea is by a crown incision and denudation of the penile skin, which permits surgical repair with excellent cosmetic results.

The schwannoma is a tumor resulting from the Schwann cells of neural shwath, being its retroperitoneal localization quite unusual. This tumor is clinically unspecified and in most of the cases it originates symptoms coming from the compression of the close structures when its localization is retroperitoneal. Its diagnosis is quite often fortuitous being confirmed by anatomopathological study afterwards. The treatment is surgical radical exeresis with subsequent followup. We report a new case of this uncommon retroperitoneal pathology in a female patient showing a nonspecific clinic. Two years after the surgery she remains asymptomatic without any radiological evidence of recidive.

Objective: To present our experience with Bellini duct carcinoma, a rare form of renal adenocarcinoma with well-defined histological, cytogenetic and immunohistochemical characteristics. The literature is reviewed., Methods/results: We reviewed the records of 430 patients with renal tumor that had been treated over a 10-year period. Only 6 cases with Bellini duct carcinoma were found. The mean age was 60 years, all patients were male and hematuria and lumbar pain were the most common clinical manifestations. Diagnosis was made by imaging techniques (US, urography, CT). The definitive diagnosis was based on the histological and immunohistochemical findings following nephrectomy. The one-year and three-year survival rates were 50% and 0%, respectively, indicating the aggressive nature of this variant of renal adenocarcinoma., Conclusions: Bellini duct carcinoma is an uncommon variant of renal carcinoma with nonspecific clinical features. It is a very aggressive tumor type whose treatment is only by nephrectomy and the outcome is poor.

Objective: An uncommon case of Fournier's gangrene following vasectomy is described., Methods/results: A 35-year-old male with no remarkable previous history, who underwent vasectomy in another hospital, developed a clinical picture compatible with Fournier's gangrene 7-8 days later. The patient required wide, aggressive surgical debridement on several occasions with broad spectrum antibiotic coverage. After a long stay at the hospital, the patient was finally discharged and referred to another hospital for plastic surgery., Conclusions: Fournier's gangrene is a polymicrobial infection of the perineoscrotal region that manifests as a rapidly progressive necrotizing fasciitis. Most of the cases have a predisposing and/or triggering factor. Fournier's gangrene following vasectomy is uncommon. The morbidity and mortality in this severe complication depend on early diagnosis and aggressive surgical management.

Objective: To compare the sensitivity and specificity of the BTA stat test, NMP-22 and voided urine cytology in the diagnosis of bladder cancer., Methods: The study comprised 100 patients or follow-up or with a suspicion of bladder cancer. A voided urine sample was obtained and alliquoted in three samples for the BTA stat test, NMP-22 and cytology. The patients were subsequently evaluated by cystoscopy and TUR was performed when cancer was suspected. The bladder cancer was classified according to TNM stage and WHO grade. The McNemar test was utilized to compare the results. The cut-off level used for NMP-22 was 10 U/ml. ROC curves were plotted to determine the NMP-22 values for optimal sensitivity and specificity in our seires., Results: Two patients were excluded from the study. The overall sensitivity was 76.47% for cytology, 78.43% for the BTA stat test and 84.31% for NMP-22 (p = n.s.). The specificity was 91.49%, 87.23% and 87.23% respectively (p = n.s.). By grade and stage, NMP-22 showed the best results followed by the BTA stat test and lastly cytology, although the differences were not significant. The ideal cut-off for NMP-22 in our series was 6 U/ml and not the generally recognized 10 U/ml., Conclusions: NMP-22 is superior to the BTA stat test and cytology in the diagnosis of bladder cancer, although the differences were not significant. The ideal cut-off in our series was 6 U/ml. The BTA stat test has the advantage of being easy to perform and provides the results in 5 minutes. In our view, NMP-22 and BTA stat test can replace cytology in the diagnosis of bladder cancer.

Objective: To evaluate the utility of the BTA stat test in the follow-up of asymptomatic patients with superficial carcinoma of the bladder., Methods: In 122 asymptomatic patients on follow-up for superficial bladder carcinoma, a sample of recently voided urine was obtained prior to cystoscopy and BTA stat test and cytology were performed. Thereafter we performed cystoscopy and TUR in those patients suspected of having recurrent bladder carcinoma., Results: 51 patients had bladder cancer and 71 were tumor free. The sensitivity was 60.78% for the BTA stat test, 45% for cytology and 98% for cystoscopy. The specificity was 87.32%, 94.36% and 90.14%, respectively. The positive predictive value and negative predictive value were 77.5 and 75.6, 85.16 and 70.5, and 87.7 and 98.46, respectively for each test. The sensitivity by grade was 23% for G1, 71.4% for G2 and 92.8% for G3 for the BTA test versus 15.3%, 37.5% and 85.7% for cytology. The sensitivity by stage was 46.6% for Ta, 52% T1 and 100% for T2-4 and Tis for the BTA test versus 26.6%, 40% and 80% for cytology., Conclusions: The BTA stat test is superior to cytology in the follow-up of patients with bladder cancer. However, it has a low sensitivity in G1 and Ta and T1 tumors, therefore cystoscopy cannot be avoided.

Objective: To evaluate the efficacy of the Anderson-Hynes pyeloplasty in 47 patients with pelviureteric junction syndrome and to compare our results with the reported results for open surgery and other techniques., Methods: The records of 47 patients (21 males, 26 females) with pelviureteric junction syndrome treated at the Marqués de Valdecilla University Hospital from 1979-1997 were reviewed. Twenty-eight patients had right-sided involvement and two were bilateral. Mean age at the time of surgery was 35 years. Pain was the most common presenting feature (nephric colic, 28 pts; chronic lumbar pain, 11 pts)., Results: The Anderson-Hynes technique was performed in 43 of the 47 patients. IVP showed good results in 74.5%., Conclusion: In our experience the success rate achieved with the Anderson-Hynes technique is comparable to those reported elsewhere, which ranges from 65%-100%. Although currently there is considerably less experience with endoscopic and laparoscopic techniques, the results achieved to data appear to be similar to those of open surgery.

Objectives: To analyze our results in the surgery of the stress urinary incontinence in women with the Raz's techniques, to assess the association among continence and factors like surgical technique, grade of incontinence and urethral pressure profile., Material and Methods: We do a retrospective study of 88 operations in 81 patients between the first of January 1990 and the thirty-one of December 1998. We describe the patients, previous treatments, grade of incontinence ans urodynamics data. We analyze the pre and post-operative complications. The outcome is evaluated by the Kaplan-Meier method, and the results are compared by the log rank test., Results: 11 patients had a previous surgery and 7 had done physiotherapy; the grade of incontinence was 1 in 7 patients, 2 in 56 and 3 in 18. There were neither significative difference between UPP and abdominal leak point pressure and grade of incontinence nor between those parameters and continence. We did the Raz 1 technique in 67 patients, Raz 2 in 3, Raz 3 in 18. There were no significant difference among them. There are a progressive loose in the continence rate along the two first years; after that the continence rates are stabilized about 75%. The complications rate was scarce, except for the postoperative urinary retention, that reached the 20.45%., Conclusions: Our results are similar to those cited in the bibliography, mainly in the Spanish one. The highest rate of failure is in the two first years.

Objective: To carry out a revision of iatrogenic ureteral damage during open surgery occurred in our hospital over a 10-year period, to review the literature and to contrast the results., Material and Method: Between January 1987 and December 1996, 19 cases of iatrogenic ureteral damage were reported in 18 patients. Ureteral damage was the result of gynaecological surgery in 8 cases (42%), general surgery in 5 cases (26.5%), vascular surgery in 4 cases (21.1%) and urological surgery in 2 cases (10.5%). Four patients had been given radiotherapy. In 15 of the ureteral units involved, reconstructive open surgery was performed while the remaining 4 units received conservative therapy., Results: In 11 cases of open surgery the results were good, 2 cases are nephrostomy carriers and 2 underwent nephrectomy. Conservative treatment was resolutive in all instances., Conclusions: Gynaecological and general surgery are the major causes of ureteral iatrogeny in our media. In more than half the cases, diagnosis is late. Radiotherapy was associated to late diagnosis in all cases. When diagnosed early, both surgical and conservative therapy achieve good results.

Objective: To review our series of urethral diverticulum in the male, an uncommon condition whose etiology continues to be a subject of discussion. The clinical features, diagnostic methods and treatment are analyzed., Methods: A 10-year retrospective study was conducted at our hospital. The etiopathogenic factors, risk factors, presenting features, methods of diagnosis, treatment, postoperative and non-surgical complications (lithiasis, intradiverticular tumors...) were analyzed., Results: Only six cases of diverticulum of the male urethra were found and were mainly of acquired origin. Recurrent infection was the most common clinical presentation. Patients were evaluated by voiding and retrograde cystourethrography. All patients underwent surgery. Postoperative control evaluation was performed by cystourethrography. The surgical complication rate was low., Conclusions: Diverticulum of the male urethra is an uncommon urological disease whose etiopathogenesis has as yet to be established, although it is accepted to be predominantly of acquired origin. Its clinical features are unspecific, for which reason it should be considered when making a diagnosis. Although transrectal ultrasound appears to be useful, diverticulum of the male urethra is usually diagnosed by conventional cystourethrography. Treatment is by endoscopic or open surgery, which achieves good results.

Objective: To review our series of urethral diverticulum in the female, an uncommon condition whose etiology continues to be a subject of discussion. The etiopathogenic hypotheses are briefly reviewed. The clinical features, current diagnostic methods and treatment are analyzed., Methods: A 10-year retrospective study was conducted at our hospital. The risk factors, presenting features and postoperative complications were analyzed., Results: Only six cases of diverticulum of the female urethra were found. Recurrent infection and the presence of a palpable mass were the most common clinical features. Diagnosis was made by voiding and retrograde cystourethrography and urethroscopy. All patients underwent surgery. Postoperative control evaluation was performed by cystourethrography., Conclusions: Diverticulum of the female urethra is an uncommon urological disease which should be taken into account when making a diagnosis. Its etiopathogenesis has as yet to be established, although it is accepted to be predominantly of acquired origin and related with paraurethral gland pathology. Its clinical features are unspecific or it may cause florid urinary symptoms. Our patients were diagnosed by cystourethrography, although other diagnostic imaging techniques are currently available. Treatment is by surgery, which achieves good results and the complication rate is low.