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Introducción: La semblanza y hechos del licenciado Martín de Castellanos de Maudes (¿1545-1614), cirujano romancista especializado en el tratamiento de afecciones urológicas, y que por sus méritos y prestigio llegó a ser nombrado por Felipe III catedrático de "Urología", quedaron casi definitivamente perfilados en 1994 a raíz de la publicación de su biografía en una exhaustiva obra. Material y método: Revisión exhaustiva de nuevos hallazgos documentales en la Iglesia de Santa Cruz de Madrid y en el Archivo General de Simancas, a propósito de nuevos datos biográficos de Martín de Castellanos. Resultados: Se demuestra la existencia de otros hijos en su matrimonio y que su primogénito, colegial en la Universidad de Salamanca, murió como consecuencia de las heridas sufridas tras una reyerta a espada entre estudiantes el 13 de noviembre de 1595. En el trabajo se da amplia noticia del proceso que tuvo lugar en la Universidad de Salamanca a raíz de la muerte del hijo de Castellanos, de la querella interpuesta por éste contra los culpables y de la intervención del propio rey Felipe II a petición del cirujano mediante un mandamiento por escrito al corregidor de la ciudad. Conclusión: Si bien la trascripción de dichos documentos no modifica los hechos fundamentales de su vida, sí permite dar a conocer este suceso que actualiza su biografía y relaciona de forma directa al urólogo con el monarca. Introduction: The semblance and facts of licentiate Martín de Castellanos from Maudes (1545-1614?), a novelist surgeon specialized in treating urological diseases and who due to his merits and prestige was appointed professor of "Urology" by Philip II, were almost definitively profiled in 1994 through the publication of his biography in a exhaustive piece of work. Materials and methods: Thorough review of new documentary findings at the Santa Cruz Church in Madrid and at the Simancas General Archive regarding new biographical information on Martín de Castellanos. Results: It demonstrates the existence of other children from his marriage and that his eldest son, a collegiate at the University of Salamanca died as a result of the injuries he sustained following a sword fight among students on 13 November 1595. The work provides abundant information on the process that occurred at the University of Salamanca as a result of the death of Castellanos' son, of the lawsuit he filed against the culprits, and of the intervention of Philip II himself at the request of the surgeon, by means of a written order to the city magistrate. Conclusion: Although the transcription of the documents does not modify the fundamental facts of his life, they do give information on this occurrence, which updates his biography and directly associates the urologist with the king.

Resumen Introduccion la semblanza y hechos del licenciado Martin de Castellanos de Maudes (?1545-1614), cirujano romancista especializado en el tratamiento de afecciones urologicas, y que por sus meritos y prestigio llego a ser nombrado por Felipe III catedratico de “Urologia”, quedaron casi definitivamente perfilados en 1994 a raiz de la publicacion de su biografia en una exhaustiva obra. Material y metodo revision exhaustiva de nuevos hallazgos documentales en la Iglesia de Santa Cruz de Madrid y en el Archivo General de Simancas, a proposito de nuevos datos biograficos de Martin de Castellanos. Resultados se demuestra la existencia de otros hijos en su matrimonio y que su primogenito, colegial en la Universidad de Salamanca, murio como consecuencia de las heridas sufridas tras una reyerta a espada entre estudiantes el 13 de noviembre de 1595. En el trabajo se da amplia noticia del proceso que tuvo lugar en la Universidad de Salamanca a raiz de la muerte del hijo de Castellanos, de la querella interpuesta por este contra los culpables y de la intervencion del propio rey Felipe II a peticion del cirujano mediante un mandamiento por escrito al corregidor de la ciudad. Conclusion si bien la trascripcion de dichos documentos no modifica los hechos fundamentales de su vida, si permite dar a conocer este suceso que actualiza su biografia y relaciona de forma directa al urologo con el monarca.

The Virus of the Human Papiloma (HPV), classically he/she has been related with infections of sexual transmission and processes wicked oncologists of the feminine genital apparatus and with less frequency of the masculine one. The new technical diagnostics, based on molecular biology (by means of polymerase chain reaction), they help to a better epidemic approach, an improvement in the I diagnose viral, and a correct therapeutic focus. The object of this work is to revise the current state of the HPV from the points of view etiopathogenics, epidemic, clinical, diagnosis, therapeutic and preservative.

Resumen El Virus del Papiloma Humano (VPH), clasicamente se ha relacionado con infecciones de transmision sexual y procesos oncologicos malignos del aparato genital femenino y con menos frecuencia del masculino. Las nuevas tecnicas diagnosticas, basadas en biologia molecular (mediante reaccion en cadena de la polimerasa), ayudan a una mejor aproximacion epidemiologica, una mejora en el diagnostico viral, y un correcto enfoque terapeutico. El objeto de este trabajo es revisar el estado actual del VPH desde los puntos de vista etiopatogenico, epidemiologico, clinico, diagnostico, terapeutico y profilactico.

To report a case of solitary metachronous contralateral metastasis of a renal carcinoma that had been previously resected.A 63-year-old male that had previously undergone a right radical nephrectomy due to renal carcinoma is presented. The patient's left breast was found to be slightly larger at the control evaluation 24-months postoperatively. Analytical and hormonal studies showed no significant findings except for a serum creatinine value of 1.75 mg/dl. However, a CT scan showed a left adrenal nodule of 3 cm. After 6 months of watchful waiting, the nodule had increased to 4.3 cm. A CT-guided fine needle punction aspiration biopsy demonstrated a malignant lesion and a left adrenalectomy was performed.Histopathological analysis of the surgical specimen showed adrenal metastasis of clear cell renal carcinoma. At 21 months' follow-up after adrenalectomy, there is no evidence of recurrence of the metastasis.This type of lesion is uncommon. We emphasize the importance of the analytical and hormonal studies, as well as CT and FNPA, in the diagnosis of this adrenal pathology. Like other authors, we advocate performing adrenalectomy in these cases.

To review the history of the development of the double-J ureteral catheter, a device that is necessary in current urological practice.A review of the literature shows that although there are references on the use of the ureteral catheter before 1967, the history of its development began in that year, when Zimskind and co-workers designed and used the first self-retaining catheter that was inserted cystoscopically. However, it was not until 1978 when the double-J shape was adopted following the design of Finney.A review of the history of bioimplants development in the field of Urology shows that catheter design and its biomaterials have developed in parallel, in an attempt to create a device that functions well and one that is also well-tolerated by the body in order to reduce the catheter-related complications.

Few cases of verrucous carcinoma of the penis with foci of invasive squamous cell carcinoma have been reported and denominated "hybrid tumors". The accuracy of this term is discussed in this paper.A huge penile mass in a patient that had undergone three previous operations for lesions diagnosed as verrucous carcinoma is reported. Partial penectomy was performed. Histological examination showed a very well-differentiated squamous cell carcinoma. PCR (polymerase chain reaction) did not detect any type of human papillomavirus (HPV) in the tumor.Verrucous carcinoma is a strictly-defined lesion with a different biological behaviour from that of squamous carcinoma. Preoperative deep biopsy may miss the squamous cell carcinoma. Definitive diagnosis can only be achieved by histological examination of the surgical specimen. In future, DNA studies could possibly support preoperative diagnosis of this lesion.

To analyze the clinical indications of double-J ureteral catheters.The most relevant studies published in the literature since the self-retained indwelling catheter was first described in 1967 are reviewed.The experience and results reported in the most relevant studies are presented.The double J ureteral catheter is essential in urological practice. Although its clinical indications are well-established, its use depends on the urologist's experience in most of the cases.

The most widespread opinion, and until recently the only option, is that every vesical transitional cancer invading the muscle is, regardless its extent, candidate for radical cystectomy and that in spite of nobody questioning the advantages of partial cystectomy.45 patients with vesical infiltrant cancer T2 or higher, followed between 9 and 258 months and managed with partial cystectomy, were analyzed. Only patients with no radiotherapy were included and only in one patient pre-operative chemotherapy was used.In 8 patients no tumour was found in the specimen (pTO). Tumour grade was pTa in 2; pT1 in 11; pT2 in 5; pT3a in 4; pT3b in 11; and pX in 4 patients. Eight (8) patients had nodal involvement. Twenty-one (21) cases showed bladder relapse. In six (6), vesical infiltrant relapse was associated to metastasis. One case showed vesical relapse, pelvic mass and metastasis, and 4 only metastasis. Extravesical disease-free time and survival are better than in the group treated with radical cystectomy. But this is a highly selected group.With the same prospects of extravesical disease-free time and survival we offer: shorter, less risky surgery with low post-surgical morbidity and mortality and less hospitalization and proportion of late sequela. Better quality of life, with no skin stoma, incontinence or impotence Although the risk of vesical relapse persists, the procedures required to resolve vesical shunt or replacement complications are more aggressive than TUR sufficient to treat most relapses, and when recurrence is infiltrant radical cystectomy may be used as a rescue measure. This is so even now with the profusion of the so-called "mini-invasive" procedures. We believe that neither radio- and/or chemotherapy combinations contribute nothing to partial cystectomy alone. They may even be harmful and have significant side-effects. It is plain that POs are the result of total removal by TUR. Due to the little reliability when defining T, it is very hard to evaluate the contribution of adjuvant measures. Patients with no vesical tumour (pTOs) or pT1-pT2 tumours, and even up to pT3a, should not be included in protocols to evaluate the efficacy of combined cytostatic agents since their use is superfluous. Radiotherapy makes no contribution to this type of tumour in terms of local relapse and apparently has no effect on the metastasis.

Verrucous carcinoma of the penis accounts for 5-17.8% of total carcinomas in the referred location that are diagnosed in our environment. Six cases of this rare neoplasia have been treated in our service and revised retrospectively. The epidemiological, clinical, diagnostic and therapeutic aspects of our series are analyzed and the issues around them discussed. Eventually, the benign biological behaviour of this tumour warranting conservative surgical treatment is ratified. In selected cases where the therapeutic modalities used do not yield material for histopathological analysis (laser, cryotherapy, etc.) prior obtention of a deep biopsy of the lesion to identify the likely presence of a well differentiated epidermoid carcinoma is imperative. Also, every effort should be made to monitor the cases of associated premalignant conditions.

Although the background and major details concerning the events that in 1911 culminated with the creation of the Spanish Association of Urology are well known as they have been published earlier in several papers, until now and as far as we know, no paper had presented the dates and particulars of the preparatory and constituent meetings of the Society, the first Regulations, and the semblance and biographies of the project's main inspirators and initiators. This article, prepared with abundant material from newspapers and literature of the period, extricated from the resources of the National Library and the archives of the Royal Academy of Medicine in Madrid, uncovers some unpublished data on the foundation and its advocates, and rediscovers other that although published in journals at the beginning of the century, remained forgotten or were unknown for most urologists. In this way, we complete the history of a part of our past, perhaps the most interesting one, and that of its main players.

The history of Spanish medical publications runs parallel with the history of Spanish Medicine. The 18th century witnessed the development of the scientific press in Europe. During this period, leading Spanish physicians established 11 periodicals, some of which continue to be published and are ranked among the oldest in the continent. However, the social, political and military turmoil in Spain during the period spanning 1800-1834, led to the decline of Spanish Medicine and consequently, of Spanish medical literature. With the liberal changes of the mid-19th century, and as a consequence of doctors' returning from exile, the Spanish scientific press resumed its activity with renewed vigour and more than 700 new journals were established up to 1905. During this period of unequalled expansion, which reached its apex in the 20th century, the specialized medical journals that developed in the late 19th century had a notable influence that grew as the medical and surgical specialties became more defined. Those dedicated to the diseases of the genitourinary system appeared during this period. There were 6 journals by 1903 and 7 more were established until the Spanish Civil War broke out in 1936. The specific contribution of the Spanish urologists in the past and present centuries to the promotion and permanence of the medical publications in general and the urological in particular has yet to be elucidated.

The history of Spanish urological periodicals, like that of the surgical specialties, encompasses several periods as the specialties emerge, are then defined and finally established. It is difficult to determine precisely when the urological specialty began in Spain, since there were surgeons with some dedication to Urology early in the 19th century. Perhaps it began in 1884, when the first service dedicated to the diseases of the urinary tract was created at the Instituto de Terapéutica Operatoria (Institute of Surgical Therapeutics) of the Hospital de la Princesa in Madrid. Although some periodicals with urological descriptions that date back to an earlier period (1800-1850) can be found, it is widely recognized that regular publication of literature and periodicals on the urinary tract started in the mid-19th century, when 'El Especialista' (The Specialist) first appeared in Madrid in 1859. This was the first non monographic specialized periodical where the section 'Genitourinary Disorders' appeared for the first time together with three other specialties. During this second period, journal names were nonspecific or too comprehensive to the point that other medical fields became indiscernible, but they became more explicit as the specialties became more defined. In 1887, the first issue of 'Gaceta de Enfermedades de los Organos Génito-Urinarios' (Gazette of Diseases of the Genitourinary Organs) was published in Madrid. It was the first Spanish journal dedicated exclusively to urological topics. It ushered in a third period, which can be defined as the period of specialized monographic publications, that concluded in 1911 with the founding of the Asociación Española de Urología (Spanish Urological Society). The present article reviews the historical and bibliographical data concerning the six periodicals that were established during these two latter periods.

This report documents the usefulness of the argon laser in the treatment of urethral hemangioma.We report a case of urethral hemangioma in a 45-year-old patient who referred a 10-year history of urethrorrhagia following normal erection. The hemangioma was treated successfully by argon laser in a single outpatient session with no postoperative complications.To our knowledge, this is the first reported case of hemangioma of the urethra treated with the argon laser, an effective therapeutic option which causes little trauma to the urethra and provides comfort to our patients.

Herein we describe an additional case of bilateral multiple renal cell carcinoma, a rare condition outside the context of phacomatosis.A 57-year-old man presented with asymptomatic hematuria. He had no other remarkable medical or urological history. Radiological evaluation disclosed multiple tumors in both kidneys that required bilateral nephrectomy.Multiple syncronous renal cell carcinoma has been described in Von Hippel Lindau disease or the polycystic conditions of chronic renal failure. A few cases have been reported in patients who did not have the foregoing conditions or were asymptomatic as the case described herein, who required bilateral nephrectomy.

The widely accepted and, until recently, the only alternative in muscle-infiltrating transitional cell carcinoma of the bladder, whatever the extent of muscle infiltration, has been radical cystectomy, although the advantages of partial cystectomy has not been questioned.We reviewed the records of 34 patients with infiltrating carcinoma of the bladder stage T2 or higher and a follow-up ranging from 3 to 194 months, who underwent partial cystectomy. The patient received no radiotherapy and only one patient was treated with preoperative chemotherapy.The surgical specimen was tumor free (pTO) in 7 patients, pT1 in 7 pts, pT2 in 4 pts, pT3 in 4, pT3b in 8 and Px in 4. Six patients showed lymph node involvement. Eleven patients had bladder recurrence; 3 had bladder recurrence and metastasis; 1 had bladder recurrence, a pelvic mass and metastasis and 2 had metastasis alone. We performed radical cystectomy in 2 cases; one for a prostatic cancer and the other for an upper urothelial tumor in a solitary kidney. Both bladders were tumor free. The extravesical disease free interval and survival were better that those of patients submitted to radical cystectomy, although this was a highly selected group.With the same possibilities relative to the extravesical disease free interval and survival, this approach requires a shorter operating time, carries less risk, low postoperative morbidity and mortality, requires less hospitalizations, and has less late sequelae. It affords a better quality of life, with no cutaneous stoma, incontinence or impotence. The risk of bladder recurrence persists, although the procedures required to resolve the complications of bladder diversion or substitution are more aggressive than TUR, which is sufficient for most of the recurrences, and if the recurrence is an infiltrating tumor, one can always recur to radical cystectomy. This is the current situation, even in the era of the so-called "minimally invasive techniques". We believe that in this group of patients combination preoperative radio- and chemotherapy would have contributed little to the partial cystectomy. In our series, it is evident that the pT0 is the result of complete resection by TUR. The differences in tumor definition make it very difficult to evaluate the benefits of the neoadjuvant measures. Patients with no bladder tumor (pT0) or pT1-pT2, and even pT3a tumors, should not be included in protocols for evaluating the efficacy of combination cystostatic therapy; many of them can be overtreated. Preoperative radiotherapy adds nothing with respect to local recurrence of this tumor type and it evidently has no effect on metastasis. We should not forget that the cytostatic agents currently utilized in combination therapy have severe side effects and are therefore only indicated in patients at higher risk of distant dissemination at diagnosis. Some studies, however, have indicated that the cytostatics may have some negative tumoral effect.

Management of surface vesical tumours using laser photocoagulation has proven to be a safe and effective method. The technique can be performed under anaesthetic sedation and in the outpatient clinic environment thus allowing a considerable cost saving and the reduction of hospital's waiting lists. Throughout 1990, 47 patients with relapsing vesical tumours were treated in 55 sessions. Most cases were performed on ambulatory patients with a low complications rate and an estimated saving of 18,326,400 pesetas as compared to transurethral resection.

Prostate lesions whose morphological features raise doubt to the pathologist may be classed generically as being atypical hyperplasia or pseudoneoplastic lesions and are referred to in the literature using different terms. However, these have histopathological features such as dysplasia that appear to be frequently associated with small, low stage prostatic adenocarcinoma. Small atypical lesions found in the biopsy specimens of patients with stage A1 adenocarcinoma warrant a more radical therapeutic approach particularly in the younger patients.

Primary signet ring cell adenocarcinoma of the bladder is a very uncommon tumor type. Only 20 cases have been reported to date. Two additional cases are described. One patient was diagnosed as having plastic linitis of the bladder. The interval between the onset of symptoms and diagnosis ranged from 2-8 months. Tumor stage was P4 N4 MO and P4 N4 M1 at the time of diagnosis and survival was 3 and 1 month, respectively. This is a tumor with a remarkable intramural proliferation, in the advanced stages at the time of diagnosis, and a poor prognosis. To date, no widely-accepted therapeutic approach has been established.

Primary vesical adenocarcinoma is an extremely uncommon tumour, representing 0.5 to 2% of all the urothelial vesical neoplasias. Its behaviour is aggressive and its prognosis poor, especially in the seal ring cell variety. We present our experience in seven cases of vesical adenocarcinoma: one of urachal origin, two of the seal ring cell type, and four of the urothelial type with no other specificity. All were advanced stage tumours at diagnosis. There is no unified therapeutic strategy, and poor results were obtained with the various treatments used. Survival eight months after diagnosis was 42.8%. Longest survival is 15 months, corresponding to the adenocarcinoma of urachal origin.

A rare case is presented in which a Carcinoma of the prostate gland simulated an Adenoma. We feel that in similar cases, in particular with a "soft" rectal probe but with no infectious clinical picture, the possibility of a Carcinoma of the prostate gland should be considered. Prior to any handling of the "adenoma", a complete analytical, gammagraphic study, etc. should be carried out in order to rule our the existence of a carcinoma. Finally, in a similar case, anatomopathological study of the hematic material should also be carried out.

We present a case of leiomyoma of the vesical trigone in women, which was studied with intravenous urography, serial micturition cystourethrography, computerized axial tomography, abdominal echography and transvaginal echography. Comparing the data obtained by each of these morphological study techniques with those found in surgery, we were able to appreciate the high precision of those obtained by transvaginal echography. We think that this technique should be taken into account in the study of masses located on the bladder surface in women.