Remeex System Effectiveness in Male Patients with Stress Urinary Incontinence.

Background: When conservative management fails, patients with stress urinary incontinence (SUI) are considered for surgical treatment. Simpler, more economical and less invasive surgical techniques, such as the Remeex system, have been developed.

Objectives: To analyze the objective effectiveness of the Remeex system in the treatment of male stress urinary incontinence.

Balanitis Xerotica Obliterans Associated With Differentiated Penile Intraepithelial Neoplasia and "Bramble-Bush" Elastic Fibers Accumulation: A Finding Not Specific for Penicillamine Intake.

We describe the association of balanitis xerotica obliterans and differentiated penile intraepithelial neoplasia (PeIN) with dermal elastosis and "bramble-bush" elastic fibers in a diabetic patient with no history of penicillamine intake. An 84-year-old man presented with urethral obstruction syndrome that required postectomy, meatotomy, and foreskin excision. Histopathological examination revealed changes of lichen sclerosus and differentiated PeIN.

Use of a barbed suture for the urethro-vesical anastomosis during the learning curve of the endoscopic extraperitoneal radical prostatectomy.

Objectives: The performance of the urethrovesical anastomosis is one of the most difficult steps in urologic laparoscopy. Many different techniques have been developed to improve this step and, recently, new sutures such as the V-loc (R) barbed system have been created. In the present study we analyze the usefulness of this suture for diminishing the time employed for the anastomosis suture during the learning curve of laparoscopic radical prostatectomy.

Morphological keys in the differential diagnosis of bladder inverted papilloma. Study of two types, trabecular and glandular.

Objective: Inverted papilloma of the urinary bladder is an uncommon urothelial neoplasm that may be specially difficult to distinguish from urothelial carcinoma.

Methods: Two patients with obstructive symptoms and hematuria have been studied. In the transurethral resection, accidentally, one showed a papillary lesion in the context of nodular hyperplasia of the prostate, where as the other showed a polypoid tumor of the urinary bladder

Results: Histologically, in both cases, a bladder inverted papilloma was demonstrated, originating from the surface transitional epithelium.

Our experience in the treatment of male stress urinary incontinence with the male Remeex system.

Objectives: We show our experience in the treatment of post-prostatectomy stress urinary incontinence with the male Remeex system (MRS). We also describe the elements of the system, its therapeutic indications, technical implantation and appropriate adjustment.

Methods: From March 2007 to January 2009 five male patients aged 57 to 71 years (mean age 66 years) with postprostatectomy stress urinary incontinence were operated on to insert a suburethral readjustable sling (Remeex).

[Surgical treatment of renal tumours with venous extension].

Objectives: Renal carcinoma accounts for 3% of malignant urological tumors. The existence of tumor thrombus in the venous system is more infrequent, and, despite it was believed until recently its presence worsened the diagnosis of the disease, currently it is accepted that in the absence of metastatic or lymph node disease, surgery is the treatment of choice and potentially curative for these tumors.

Methods: Between June 2003 and November 2007 eight patients with renal disease and venous thrombus underwent surgery; two of them wereT3c and six T3b; in five of them surgery was carried out in association with the heart surgery team in our centre.

[Penile cellulitis after oral sex].

Objective: Nowadays, there is the high prevalence of sexual intercourse including oral sex, which implies some peculiarities in the infections, balanitis and ceIlulitis they may produce.

Methods: We report two new cases of penile cellulitis treated in the urology department in our hospital.

Discussion: We review the indications of prophylaxis, and the medical and surgical treatment both referred in the literature and carried out in our patients.

[Dorsal meatoplasty for the treatment of meatal stenosis in patients with balanitis xerotica obliterans].

Objectives: To present our experience in the treatment of meatal stenosis secondary to balanitis xerotica obliterans with the dorsal meatoplasty technique.

Methods: We have performed dorsal meatoplasty in 15 patients suffering stenosis of the penile meatus secondary to balanitis xerotica obliterans. All cases were performed under local anesthesia, using an inverted V incision plasty following the original of technique from Malone.

[Greenlight KTP-laser photovaporization. Initial experience in a public hospital].

Objectives: Despite the fact that transurethral resection of the prostate (TURP) continues being the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH), the good results obtained with the use of new energy sources have led to their use in daily practice.

Methods: Between September 2005 and January 2007, we have treated 63 patients with KTP laser photoselective vaporization of the prostate (PVP) in our service. Preoperatively we asked for IPSS, performed physical exam, digital rectal exam, abdominal , renal, bladder and prostatic ultrasound measuring postvoid residual volume, as well as flowmetry and PSA determination.

[Inguinoscrotal bladder hernias].

Objectives: Despite the high incidence of inguinal hernias. In the general population, only a small percentage of them involve the bladder. Bladder wall weakness and bladder outlet obstruction are involved in its pathogenesis.

[The usefulness of virtual endoscopy and CT urography in the diagnosis of upper urinary tract tumors].

Objectives: Upper urinary tract (UUT) tumors are a relatively low incidence pathology which often represents a diagnostic challenge for the urologist, because several imaging tests are usually necessary to achieve the final diagnosis. Over the last years CT scan has suffered a notable development and nowadays, with the arrival of new image processing hardware and software, it is possible to detect small urothelial lesions and to perform 3-D urinary tract reconstruction and virtual endoscopic navigation.

Methods: Between January 2004 and June 2005 we performed a total of 15 examinations in 15 patients for the study of asymptomatic hematuria of probable upper urinary tract origin.

[Primary bladder neck obstruction in males].

Objectives: To report our experience on the diagnosis and treatment of this rare type of infravesical functional obstruction.

Methods: Over the last ten years we diagnosed and treated 32 males with this entity. We evaluate previous treatments and time to diagnosis.

[Urological works and biography of Dr. Felipe Alcalá Santaella Nuñez (1927-1977). Historical documentary analysis].

Objectives: In the middle of the 20th century, Urology in Valencia was fully consolidated as a surgical speciality since Prof. Molla started it about the end of the 19th century; Dr. Felipe Alcala Santaella Nuñez stands out as the chairman of the Department of Urology of the "Hospital Provincial de Valencia", after his father Dr.

[Symptomatic hydronephrosis during pregnancy].

Objectives: Hydronephrosis is common during pregnancy, affecting 90% of pregnant women. It is usually asymptomotic, but a small percentage of patients show clinical symptoms requiring treatment. We want to report our experience in the diagnosis and treatment of symptomatic obstructive uropathy in pregnant women.

[Outpatient surgical treatment of female stress urinary incontinence].

Objectives: To evaluate the results of the outpatient surgical treatment of genuine female stress urinary incontinence (SUI) over a five year period since the integration of the Department of Urology in the Ambulatory Surgery Unit at our hospital "Consorcio Hospital General Universitario de Valencia" (CHGUV).

Methods: Between January 2000 and December 2004 26 patients (ages 49-78; mean age 69.8 yr) with the diagnosis of SUI underwent tension-free suburethral mesh sling (TVT) outpatient operations under local anesthesia-sedation at the ambulatory surgery unit of the CHGUV.

[Orthotopic bladder substitution in the treatment of interstitial cystitis].

Objectives: To point out the efficacy of supra trigonal cystectomy with orthotopic substitution iliocystoplasty in the treatment of advanced interstitial cystitis (IC).

Methods: We study the results obtained in four women suffering IC nonrespondent to conservative treatment who underwent the procedure. All patients comply with classic diagnostic criteria of IC, presenting long-lasting symptoms, between 4 and 8 years (mean 5.

[The treatment of hydrocele as ambulatory surgery].

Objectives: To evaluate the results of this surgical treatment of hydrocele over the first four years of integration of the Urology Department in the Major Ambulatory Surgery Unit in our Hospital.

Methods: From January 2000 to July 2004 we have performed 167 hydrocelectomies as ambulatory surgery in 152 patients (15 cases bilateral) with ages ranging from 16-87 years (mean 52.6).

[Valencia's scientific contribution to the consolidation of Urology as a speciality. Bibliometric classification by subject, author and journal. Historical documentary analysis].

Objectives: Urology, as other medical-surgical specialities, had its consolidation process in the mid 19th century. This phenomenon in the history of medicine occurs around certain authors, which in the case of urology in Valencia was Dr. Raphael Molla Rodrigo, and several key elements such as development of lithotripsy and cystoscopy, as cited by prestigious authors in the second national meeting of history of medicine in Salamanca in 1965.

[Management of male sterility in patients taking anabolic steroids].

Objectives/methods: To review the incidence of male infertility secondary to intake of anabolic products and our experience and outcomes with treatment. There is a variety of such substances (testosterone, nandrolone, stanozolol, etc.) in their intake may be unique or combinations, both orally or parenterally.

[Genitourinary tuberculosis in the urologic works of Professor Rafael Mollá Rodrigo].

Objectives: Professor Rafael Molla Rodrigo is considered by some the author who contributed with his scientific work and solid technique to consolidate Urology as a speciality in Valencia. Such importance is also perceived in a national level, as demonstrated by the fact that he belonged to the first board of the Spanish Association of Urology and contributed to its foundation in the two-year period 1910--1911, from his position of head of the department of Surgical Therapy and Operations at the Central University. Genitourinary tuberculosis is one of the most outstanding chapters of his extensive works.

[Bladder squamous metaplasia: report of one case and bibliographic review].

Objectives: We report a new case of squamous metaplasia because of its interest and subtle differential diagnosis with other bladder pathologies.

Methods: We report the case of a male patient with history of previous neoplasia with an exophytic lesion of the bladder wall discovered on follow-up. Pathological diagnosis after TUR was bladder squamous metaplasia.

[Alfredo Tramoyeres Cases (1910-2002): first chairman of the Department of Urology at the Ciudad Sanitaria La Fe. Documentary-historical analysis of his works].

Objectives: Urology, having been part of general surgery for centuries, was completely consolidated as a medical speciality in the middle of the XX Century as the result of years of evolution and development, and all the studies and works of certain authors that represent today the mainstays of our speciality. Valencia in the middle of the 20th century saw the birth of new hospitals including the "Ciudad Sanitaria La Fe". Alfredo Tramoyeres Cases was the first chairman of the Department of Urology.

[Urologic work and biography of Prof. Rafael Alcalá Santaella (1896-1959). Historical document analysis].

Objectives: We find that Urology at the end of the 20th century was a consolidated speciality as a result of years of evolution and development, and the studies and works of authors whose contributions are considered today the basements of our speciality. So we think that Urology should be understood with its historical references, because, as Aristotle said "..