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VA is currently considered the treatment of choice for patients with low and very low risk prostate cancer. We analyzed the evolution of this treatment strategy in our series and adherence to the protocol.Ambispective study of patients in VA in our center between 2014- 2019. 237 meet inclusion criteria, of which 142 (60%) have a minimum of 12 months of follow- up. Mean age: 68.5 (4678), median PSA 6.37 ng / ml (1-33). 229 (96.6%) are ISUP 1 and 8 (3.4%) ISUP 2. Objectives are proposed to assess our adherence to the protocol. Descriptive statistics are used to communicate the results.According to the classification by risk groups of the NCCN, 145 (61.2%), 49 (20.7%) and 42 (17.7%) were very low risk, low risk and favorable intermediate risk patients, respectively. The median of follow-up is 14 months (0-66). Of the patients with a minimum follow-up of 12 months, 107 (75.4%) were re-biopsied. 80 (33.8%) leave the protocol in these 5 years, 31.3% (25) by their own decision, 55% (44) due to medical criteria, and 11.3% (9) go to WW. After 5 years of follow-up, 99.2% of patients are still alive, 0.8% died of specific non-cancer causes. Of the objectives to assess adherence, 8 are achieved, 1 partially and 1 is not evaluable.VA in our center is already the treatment of choice for very low-risk patients, with a constant increase from year to year. Adherence to the protocol has been favorable during the period of time studied.La VA se ha convertido en uno de los tratamientos de elección del CP localizado de bajo y muy bajo riesgo. Analizamos la evolución de esta estrategia de tratamiento en nuestra serie, así como la adherencia al protocolo.MATERIAL Y MÉTODOS: Estudio ambispectivo de los pacientes incluidos en VA en nuestro centro entre los años 2014-2019. 237 pacientes cumplen los criterios de inclusión en VA, de los cuales 142 (60%) tienen un seguimiento mínimo de 12 meses. Edad media: 68,5(46-78), mediana PSA 6,37 ng/ml (1-33). 229 pacientes (96,6%) son ISUP 1 y 8 (3,4%) ISUP 2. Se proponen unos objetivos para valorar nuestra adherencia al protocolo. Se utiliza estadística descriptiva y contraste de hipótesis para comunicar los resultados.RESULTADOS Y DISCUSIÓN: Atendiendo a la clasificación por grupos de riesgo de la NCCN, 145 (61,2%), 49 (20,7%) y 42 (17,7%) eran pacientes muy bajo riesgo, bajo riesgo y riesgo intermedio favorable respectivamente. El tiempo (mediana) de permanencia en el programa es de 14 meses (0-66). De los pacientes con un seguimiento mínimo de 12 meses, 107 (75,4%) son re – biopsiados. 80 pacientes (33,8%) salen del protocolo en estos 5 años, 31,3% (25) por decisión propia, 55% (44) por criterios médicos, y 11,3% (9) pasan a WW. Tras 5 años de seguimiento, el 99,2% de los pacientes continúan vivos, el 0,8% falleció por causas no cáncer específicas. De los objetivos para evaluar la adherencia, 8 de ellos se alcanzan, 1 parcialmente y 1 no es evaluable.La VA en nuestro centro constituye actualmente el tratamiento de elección para los pacientes con muy bajo riesgo. La adherencia al protocolo ha sido favorable durante el periodo de tiempo estudiado.

e16574 Background: Liquid biopsy has the potential to provide information about cancers without invasive biopsy, using circulating biomarkers. The aim of present study was determinate the presence of androgen receptor splice variant 7 (AR-V7) in plasma using capillary nano-immunoassay in metastasis PCa and correlation with clinical and analytical data. Methods: Whole blood (10 ml) was collected and processed in EDTA tubes. Previously to determinate the presence of ARV-7 in plasma Capillary Electrophoresis Immunoassay or SimpleWestern analyses were performed using the WES™ machine. With this technique, proteins are separated by size, immobilised and probed with specific antibodies. The primary antibody used was Anti-Androgen Receptor antibody. Results: The study included 31 patients with diagnostic of PCa metatasic . Clinical characteristics of the patients were described in the table. AR-V7 signal was detected in 11 cases (36%). Twenty samples (64%) were considered as negative. The most of patients with expression positive for AR-V7, showed a Gleason score ≥ 8 (64% of cases). In AR-V7+, hemoglobine and dehydrogenase lactate levels were statistically significant (p < 0,05) respect to ARV7-. So, in AR-V7+ patients showed increased of FA and Albumin. Conclusions: Assessing the presence of AR-V7 in plasma from PC patients is feasible by a novel capillary nano-immunoassay. AR-V7 was observed in 36% of the PCA metastasic. These findings lay the foundations for liquid biopsy as a means of obtaining biological data in a more convenient way for the patient.[Table: see text]

Urologists daily evaluate many women with voiding disturbances, but proper physical examination has only rarely been previously performed.Case 1: 16-year-old woman presenting augmented daytime urinary frequency and nocturia without enuresis, with drop-by-drop micturition. Case 2: 80-year-old woman with urgency. She referred normal voiding with insensitive urinary loss the hour after.adhesion of the labia minora.Surgical section of the adhered area in the midline was performed with satisfactory aesthetic and clinical results.The adhesion of the labia minora is an acquired disease, more frequent in girls under 2 years. Several predisposing factors have been proposed: oestrogen deprivation, inadequate personal care, local irritants, infections or previous trauma. Differential diagnosis is required among three congenital pathologies: vaginal agenesis, imperforated hymen and ambiguous genitalia. Cases in postpubertal or postmenopausal women, or refractory to medical treatment are considered for surgery.

REFERENCES1. Parente RCM, Freitas V, Moura Neto RS, et al. Metaplasia ossea en-dometrial: quadro clinico e seguimento apos tratamento. Rev Bras GinecolObstet. 2010;32:33–8.2. Shalev J, Meizner I, Bar-Hava I, et al. Predictive value of transvaginalsonography performed before routine diagnostic hysteroscopy for evalua-tion of infertility. Fertil Steril. 2000;73:412–7.3. Shroff CP, Kudterkar NG, Badhwar VR. Endometrial ossification – re-port of three cases with literature review. Indian J Pathol Microbiol. 1985;28:71–4.4. Pinto AP, Guedes GB, Tuon FFB. Metaplasia ossea do endometrio: relatode caso. J Bras Patol Med Lab. 2005;41:287–9.5. Umashankar T, Patted S, Handigund R. Endometrial osseous metapla-sia: clinicopathological study of a case and literature review. J Hum ReprodSci. 2010;3:102–4. http://dx.doi.org/10.1590/0100-3984.2015.00326. Basu M, Mammen C, Owen E. Bony fragments in the uterus: an associa-tion with secondary subfertility. Ultrasound Obstet Gynecol. 2003;22:402–6.7. Onderoglu LS, Yarali H, Gultekin M, et al. Endometrial osseous meta-plasia; an evolving cause of secondary infertility. Fertil Steril. 2008;90:2013.e9–11.8. Cayuela E, Perez-Medina T, Vilanova J, et al. True osseous metaplasia ofthe endometrium: the bone is not from a fetus. Fertil Steril. 2009;91:1293.e1–4.Mesothelioma of the tunica vaginalis in a patient with gianthydroceleMesotelioma da tunica vaginal em um paciente com hidrocele gigante

We present the case of a patient with eosinophilic ureteritis.The patient was admitted with pain on the right renal fossa, and after several imaging tests, a mass was found on the right ureter, compatible with urothelial neoplasia on the right ureter.Right nephroureterectomy was performed and the histopathological diagnosis was eosinophilic ureteritisEosinophilic ureteritis is a rare entity with an unclear etiology,which is not easily distinguished from urothelial tumours. In the differential diagnosis we must take it into account whenever we find a ureteral mass associated to eosinophilia.

Background Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor arising from its smooth muscle cells. Methods and Results We report the case of a 38-year-old woman presenting with back pain and weight loss who was diagnosed with a 22-cm leiomyosarcoma of the right IVC and thrombosis of the left IVC. The patient is alive and free of recurrence a year after radical tumor resection with removal of the affected IVC, reconstruction with polytetrafluoroethylene prosthetic graft, and anastomosis of both right and left IVC. Conclusions Leiomyosarcoma is a rare and aggressive tumor with a deceitful course. Radical surgical en bloc resection is the mainstay of treatment for IVC leiomyosarcomas. For an adequate restoration of venous return, complex vascular repair may be necessary.

We report one case of a spontaneous resolution of a uretero-vaginal fistula, and we review the current diagnostic and therapeutic features of this condition in the literature.We present the case of a 41-year-old woman who, during the late postoperative period of a radical hysterectomy, presented episodes of daily and nocturnal incontinence with episodic flank pain compatible with uretero-vaginal fistula.One month after diagnosis the patient does not report incontinence during day or night, and the lumbar pain has disappeared. An intravenous urography shows that there has been a spontaneous resolution of the uretero-vaginal fistula.Spontaneous resolution of a uretero-vaginal fistula is rare. Most fistulas require endourological or surgical treatment.

We report a rare case of horses-hoe kidney trauma.67 years old man with a horseshoe kidney, which presented a fracture of the isthmus after falling.The diagnosis was made by IV contrast CT scan. He underwent exploratory laparotomy due to hemodynamic instability and radiologic findings on the CT scan.The rupture of a horseshoe kidney is a rare injury. CT scan is the test of choice to classify the degree of injury. Depending on the patient's hemodynamic stability and the findings on the CT scan the options are conservative orimmediate surgical treatment.