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Purpose: We tested the hypothesis that the urethral pressure profile, in combination with electromyography of the urethral sphincter, may be useful as a predictor of urinary incontinence after radical prostatectomy (RP). The aim of this study was to assess whether the combination of these tests resulted in an improved tool for the prediction of post-RP urinary incontinence.Methods: Patients with indications for RP were included. The urethral pressure profile, including prostatic and sphincter components for maximum urethral closure pressure (MUCP) and functional urethral length, was recorded in combination with needle electromyography of the urethral sphincter. The mean and maximum amplitude of waves were measured twice: 1 month before RP and 6 months after the procedure. The 1-hour pad test was conducted in parallel with other tests. Patients completed the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The relationship of the results of the tests with post-RP urinary incontinence was studied. Age, urodynamic parameters, pathologic stage, and surgical technique were recorded for analysis as potential confounding factors.Results: Nineteen patients were included within the 1-year study period. Their mean age was 63 years. According to the 1-hour pad test and ICIQ-SF, 42.1% of the sample had urinary incontinence after RP. Prostate MUCP with the mean and during-stress amplitude of waves predicted post-RP urinary incontinence with a sensitivity of 87.5% (P=0.002) in our model. Age, urodynamic parameters, pathological stage, and surgical technique were not related to incontinence after surgery.Conclusions: The combination of the urethral pressure profile (prostatic MUCP) and electromyography of the urethral sphincter might be a useful prognostic predictor of post-RP urinary incontinence.

Introduction: The urachus is an embryologic remnant which is formed from the obliteration of the allantois. Urachal abnormalities are caused when defective obliteration of the urachus happens. They are an infrequent condition. Incidence is estimated to be between 5,000 and 8,000 live births. Its diagnosis and management remain a challenge due to the lack of an specific clinical picture and the controversy about the management. Objective: The objective of this study is to assess the clinical presentation, diagnosis, therapeutic management, and outcomes of urachal anomalies in our health area. Materials and Methods: We performed a retrospective review of all cases of urachal anomalies recorded Tenerife (southern health area), La Gomera, and El Hierro Islands during a 5 year period. Results: Twenty-three cases of urachal pathology were included. The mean age of presentation was 32 years old. 73.9% were male. 65% were diagnosed in adults. In 30.3% of the cases, it was a casual finding. Symptoms included fever, umbilical exudate, hematuria, abdominal pain, and umbilical granuloma. The main diagnostic tests were ultrasound and computed tomography scan. Treatments were selected conservative management (43.5%), selective resection, partial cystectomy, and radical cystectomy. All patients had a good evolution. However, 2 cases where benign tumors were suspected, clinically, had a final histology of cancer in the specimen. Conclusions: Due to the lack of a specific clinical picture and undefined findings in image tools, diagnosis is difficult and it may be inaccurate. Despite more data are needed, our results suggest that the systematic excision of urachal lesions could result in safer outcomes since cases where a benign lesion is clinically suspected might result in malignant tumors.

Introduction: Thrombosis is defined as the formation of a clot in a blood vessel that obstructs the flow of blood to the peripheral tissues. The incidence of thromboembolic disease ranges from 0.7 to 1.2% within urology. Case Report: A 40-year-old warehouse worker male presented to the emergency department with worsening of a month’s lasting scrotal pain. Physical examination showed the presence of an enlarged and painful left testicle with no other findings. Right testicle, penis and abdominal examination showed no abnormalities whatsoever. Bilateral varicocele with a partial thrombosis of the left one associated with left inguinal hernia was diagnosed by performing an urgent testicular ultrasound test. Conservative treatment was first given. However, since pain was not relieved, surgery was indicated with left varicocelectomy and a left inguinal hernia repair procedure leading to complete symptoms control and normal testicular flow in the control Doppler ultrasound study 2 months after the surgery. Conclusion: Spontaneous thrombosis of the pampiniform plexus is a rare entity where the management remains controversial. The clinical case we report here shows that surgery may be considered an effective option.

Most cases of urogenital parasitosis are registered in Africa. However, migration movements and travellers moving from developed to developing countries are responsible for leading to an increased incidence of genitourinary infections caused by parasites in the western world including Spain having serious economic and health implications. The importance of its early detection and treatment also results from its potential risk for infertility, susceptibility for HIV infection and the development of bladder cancer. The most common presentation symptom is terminal haematuria, and when diagnosed, praziquantel is the treatment of choice. We report a series of 6 cases of urinary schistosomiasis that happened in a single centre in Spain and reminds the importance of having the infection in mind in certain cases of haematuria study.

Lymphomas of the urinary bladder are rare and can be primary or secondary. The latter group includes Richter's Syndrome-which is a transformation of a chronic low-grade lymphoproliferative syndrome into a common type of non-Hodgkin lymphoma, most commonly localized in the lymph nodes. We report a case of an 84-year-old male, former-smoker with a history of low-grade chronic lymphocytic leukemia, treated with chemotherapy, with a recurrence of the disease to retroperitoneal and iliac lymph nodes, splenomegaly, and thickening of the bladder wall. The hematologist consulted us because of hematuria with coexistent bilateral obstructive uropathy. We performed transurethral resection of the bladder which revealed secondary lymphoma in the bladder, probably the result of a high-grade transformation from chronic leukemia, a very rare location of this transformation.

Urethral leiomyoma is an infrequent benign tumor. Much more infrequent is recurrence. It has been described in exceptional cases. We report a rare case of a 46 year old woman who had a surgery for a urethral leiomyoma eight years ago. Now, she presents with nodulation in her vagina with no other symptoms. The patient underwent surgical excision of the tumor, and pathological examination revealed an recurrence of urethral leiomyoma.

Resumen Introduccion Los leiomiomas son neoplasias benignas de musculo liso. En la piel existe este tipo de tejido en los musculos pieloerectores, paredes de los vasos y como musculo especializado de la region genital, que incluye vulva, escroto y musculo liso del pezon. De estos tejidos se derivan leiomiomas pilares, vasculares y leiomiomas de la piel genital, respectivamente. El leiomioma de piel genital es frecuentemente una lesion solitaria, bien circunscrita, situada profundamente, ocasionalmente pediculada y raramente dolorosa, microscopicamente formada por fasciculos entrecruzados de musculo liso, sin componente vascular prominente. Solamente se han descrito ocho casos de leiomioma de pene en la bibliografia revisada. Caso clinico Presentamos el caso de un varon de 38 anos, con lesion indolora de 4 cm de diametro a nivel del surco balano-prepucial, de un ano de evolucion y asociada a incurvacion del glande. Se realizo exeresis de la lesion subcutanea, situada adyacente al cuerpo cavernoso derecho, con buenos planos de separacion. El estudio histopatologico fue informado como leiomioma de pene, presentando alta celularidad, bajo indice mitotico y calcificaciones frecuentes. La inmunohistoquimica expresa positividad para actina y desmina, y un indice proliferativo de un 5–10% con Ki-67. Discusion Se han descrito ocho casos de leiomioma de pene en la bibliografia, los cuales presentan diferentes localizaciones, con un tamano que oscila entre 0,8 y 4 cm. El glande es la localizacion mas frecuente y aparece tanto en pacientes pediatricos como en adultos y ancianos. En ningun caso se presento recurrencia. Conclusiones Dado el crecimiento progresivo de los leiomiomas, esta indicada su exeresis para establecer su diagnostico diferencial con otro tipo de neoplasias y para evitar las deformaciones esteticas y funcionales que conlleva, especialmente en el area genital.