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OBJECTIVE: To analyze the management of prenatal urinoma and ureteropelvic junction obstruction (UPJO) postnatally by a case report and literature review. METHODS: We report a case of an UPJO and urinoma in a newborn. After birth, renal function was absent, and nephrectomy was performed. The literature from 1985 to date has been reviewed. DISCUSSION: By the analysis of the literature, we can observe mainly, that prenatally diagnosed urinoma and UPJO are managed conservatively. After birth, different attitudes have been carried out, independently of residual renal function, such as radical or reconstructive surgery, or conservative treatment. CONCLUSION: Intrauterine management is not indicated. Urinary diversion is indicated in symptomatic cases secondary to renal trauma or endoscopic procedure. In non-functional kidney, nephrectomy is indicated.

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OBJETIVO: Analizar el manejo del urinoma prenatal y de la estenosis de la unión pieloureteral postnatalmente mediante el estudio de un caso y revisión bibliográfica. MÉTODOS: Se presenta el caso de neonato con EUPU y urinoma. Se comprueba función renal anulada, realizándose nefrectomía. Se ha revisado la literatura desde 1985 hasta la actualidad. DISCUSIÓN: Analizando la literatura, se observa mayoritariamente que el tratamiento de la EUPU y urinoma prenatales es conservador. Tras el nacimiento existen diversas actitudes, independientemente de la función renal remanente, como son la cirugía radical, la reconstructiva o el tratamiento conservador. CONCLUSIONES: La manipulación intraútero no está indicada sistemáticamente. La derivación urinaria sólo en casos sintomáticos y los secundarios a traumatismo o manipulación endoscópica. En riñones anulados estaría indicada la nefrectomía (AU)

OBJECTIVE: To analyze the management of prenatal urinoma and Ureteropelvic Junction Obstruction (UPJO) postnatally by a case report and literature review. METHODS: We report a case of an UPJO and urinoma in a newborn. After birth, renal function was absent, and nephrectomy was performed. The literature from 1985 to date has been reviewed. DISCUSSION: By the analysis of the literature, we can observe mainly, that prenatally diagnosed urinoma and UPJO are managed conservatively. After birth, different attitudes have been carried out, independently of residual renal function, such as radical or reconstructive surgery, or conservative treatment. CONCLUSION: Intrauterine management is not indicated. Urinary diversion is indicated in symptomatic cases secondary to renal trauma or endoscopic procedure. In non-functional kidney, nephrectomy is indicated (AU)

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Urethral polyps are a rare pathology that is usually diagnosed in childhood hematuria and obstructive urinary symptoms are the most common findings and transurethral resection is the best choice of the treatment. We report three cases, a 6-years-old boy and 9-years-old boy diagnosed and treated of posterior urethral polyp after showing hematuria and obstructive urinary symptoms, and a 2-years-old girl that showed to prolapse of urethral polyp.

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Los pólipos fibroepiteliales de uretra comprenden una patología infrecuente, suelen ser diagnosticados en edad pediátrica por hematuria o síndrome obstructivo bajo y requieren tratamiento quirúrgico para su resolución. Presentamos tres casos clínicos, dos varones de seis y nueve años que fueron diagnosticados y tratados de esta patología tras presentar un cuadro de hematuria franca y dificultad miccional, y una niña de dos años que debutó con clínica de prolapso de masa polipoide por uretra (AU)

Urethral polyps are a rare pathology that is usually diagnosed in childhood hematuria and obstructive urinary symptoms are the most common findings and transurethral resection is the best choice of the treatment .We report three cases, a 6-years-old boy and 9-years-old boy diagnosed and treated of posterior urethral polyp after showing hematuria and obstructive urinary symptoms, and a 2-years-old girl that showed to prolapse of urethral polyp (AU)

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Retrospective study of 124 patients (average age: 3.8 years) with midpenile hypospadias: 48.3% (60 children), distal penile: 45.9% (57) and coronal 5.6% (7), of which the 25.8% (16) presented ventral curvature and the 4.8% (6) resulting from the complication of another previous technique. All of them were operated according to Snodgrass' technique, removing the catheter between the 6th and 7th day in most of them. The global rate of complications was of 12%: 9 fistulae (7.2%) and 6 meatal stenosis (4.8%). Aesthetic result was satisfactory in all cases, getting glans covered by foreskin in 57.3%.

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Estudio retrospectivo de 124 pacientes (edad media: 3,8 años) con hipospadias peneano medio: 48,3% (60 niños), peneano distal: 45,9% (57) y coronal 5,6% (7), de los cuales el 25,8% (16) presentaban incurvación ventral y el 4,8% (6) procedían del fracaso de otra técnica. Todos ellos intervenidos según técnica de Snodgrass, retirando la sonda entre el 6 y 7º día en la mayoría. La tasa global de complicaciones fue del 12%: 9 fístulas (7,2%) y 6 estenosis de meato (4,8%). El resultado estético fue satisfactorio en todos los casos, quedando incluso el glande cubierto por prepucio el 57,3%

Retrospective study of 124 patients (average age: 3.8 years) with midpenile hypospadias: 48,3% (60 children), distal penile: 45,9% (57) and coronal 5,6% (7), of which the 25.8% (16) presented ventral curvature and the 4,8% (6) resulting from the complication of another previous technique. All of them were operated according to Snodgrass´ technique, removing the catheter between the 6th and 7th day in most of them. The global rate of complications was of 12%: 9 fistulae (7,2%) and 6 meatal stenosis (4,8%). Aesthetic result was satisfactory in all cases, getting glans covered by foreskin in 57,3%

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Los quistes de uraco son anomalías congénitas detectadas con mayor frecuencia en la infancia. Suelen manifestarse cuando se infectan, simulando diversas patologías agudas intraabdominales o pélvicas. Presentamos un caso en una niña de 7 años diagnosticada de quiste de uraco infectado. Analizamos el origen embriológico de esta patología, sus formas de presentación clínica y sus aspectos diagnóstico-terapéuticos

Urachal cysts are congenital anomalies detected predominantly during the childhood. They are often diagnosed when an infection occur mimicking a variety of acute intra-abdominal or pelvic processes. We present a case in a 7-year-old female infant, diagnosed of infected urachal cyst. The embryologic origin of this anomaly, clinical features, diagnosis and treatment are discussed

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Objetivo: Analizar la presentación clínica, diagnóstico y manejo terapéutico del megaprepucio congénito (MC). Material y métodos: Estudio retrospectivo de los 4 casos de MC diagnosticados y tratados en nuestro Servicio desde octubre 1997 hasta abril de 2005, describiendo el diagnóstico y la técnica quirúrgica empleada en todos ellos. Conclusiones: El MC es una condición infrecuente, que puede confundirse con otras patologías, que es necesario reconocer y tratar correctamente por parte del Urólogo

Objetive: To analize the clinical presentation, diagnosis and surgical management of congenital megaprepuce (CM). Material and methods: We have made a retrospective study of four cases of CM diagnosed and treated in our centre between october 1997 and april 2005. We studied the diagnosis and surgical treatment. Conclusions: CM is an infrecuent condition that can be confused with others pathologies. It´s necessary to diagnose and treat it correctly

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OBJECTIVE: To value the efficacy in endoscopic treatment of the vesicoureteral reflux (VUR). MATERIAL AND METHOD: We have realized a prospective study in patients with RVU treated with endoscopic polydimethylsiloxane, from January 1999 until December 2001, analyzing the results after an average pursuit of 30 months. We included 144 patients, 92 girls and 52 children, with 213 VUR (124 primary ones and 89 of secondary etiology). The initial efficacy of the treatment was defined as the finished absence of RVU in the isotopic cystography, realized three months after the puncture. RESULTS: The global efficacy of the endoscopic treatment in secondary etiology reflux was lower than the reached one in the treatment of the primary RVU (77.7% against 86.2%) but the differences did not reach statistical significance (p=0,226). We do not also find significant differences on having compared the injected volume and the valuation of resolution of the ebb between the different causes of secondary RVU (p=0.361). We found recurrence in patients with RVU due to lower urinary tract dysfunction (4.34%). CONCLUSIONS: Endoscopic treatment of the secondary VUR is a minimally invasive skill, presents scarce morbidity and it is effective in chosen patients. The risk of a long term recurrence is grater in VUR secondary to functional alterations (neurogenic bladder and functional instability), for what, pursuit has to be established according to the base pathology.

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Objetivo: Valorar la eficacia del tratamiento endoscópico del reflujo vesicoureteral (RVU) de etiología secundaria con polidimetilsiloxano. Material y método: Hemos realizado un estudio prospectivo de los pacientes diagnosticados de RVU y tratados en nuestro servicio por vía endoscópica con polidimetilsiloxano, desde enero de 1999 a diciembre de 2001, analizando los resultados tras un seguimiento medio de 30 meses. Tratamos 144 pacientes, 92 niñas y 52 niños, con 213 reflujos ureterales (124 primarios y 89 de etiología secundaria). La eficacia inicial del tratamiento fue definida como la ausencia completa de RVU en la cistografía isotópica realizada un los tres meses tras la punción. Resultados: La eficacia del global tratamiento endoscópico en reflujos de etiología secundaria fue inferior al alcanzado en el tratamiento del RVU primario (el 77,7 % vs. 86,2 %) sin alcanzar estas diferencias la significación estadística (p=0,226). Tampoco encontramos diferencias significativas al comparar el volumen inyectado y la tasa de resolución del reflujo entre las diferentes etiologías de RVU (p=0,361). Únicamente se objetivó recurrencia del RVU en pacientes con reflujo secundario a disfunción neurogénica o por disfunción de vaciado (4,34 %). Conclusiones: El tratamiento endoscópico del RVU de etiología secundaria es un procedimiento mínimamente invasivo, presenta escasa morbilidad y es eficaz en el RVU de etiología secundaria en pacientes seleccionados. El riesgo de recurrencia a largo plazo es mayor en el reflujo secundario a alteraciones funcionales (vejiga neurógena e inestabilidad funcional), por lo que el seguimiento debería establecerse según la patología de base

Objective: To value the efficacy in endoscopic treatment of the vesicoureteral reflux (VUR). Material and method: We have realized a prospective study in patients with RVU treated with endoscopic polydimethylsiloxane, from January 1999 until December 2001, analyzing the results after an average pursuit of 30 months. We included 144 patients, 92 girls and 52 children, with 213 VUR (124 primary ones and 89 of secondary etiology). The initial efficacy of the treatment was defined as the finished absence of RVU in the isotopic cystography, realized three months after the puncture. Results: The global efficacy of the endoscopic treatment in secondary etiology reflux was lower than the reached one in the treatment of the primary RVU (77.7 % against 86.2 %) but the differences did not reach statistical significance (p=0,226). We do not also find significant differences on having compared the injected volume and the valuation of resolution of the ebb between the different causes of secondary RVU (p=0.361). We found recurrence in patients with RVU due to lower urinary tract dysfunction (4.34 %). Conclusions: Endoscopic treatment of the secondary VUR is a minimally invasive skill, presents scarce morbidity and it is effective in chosen patients. The risk of a long term recurrence is grater in VUR secondary to functional alterations (neurogenic bladder and functional instability), for what, pursuit has to be established according to the base pathology

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INTRODUCTION: Nowadays, around 1% of children suffer from vesicoureteral reflux (VUR), which represents a risk factor for long-term kidney damage. In the last decade, development in this field has shown that subureteric endoscopic injection of bulking agents for childhood VUR is an acceptable alternative unlike long-term antibiotic prophylaxis and open surgery. OBJECTIVE: To establish the complications of childhood VUR endoscopic treatment. MATERIAL AND METHODS: A retrospective analysis was carried out for every patient treated endoscopically in our department from January 1999 to September 2003, with a total amount of 516 implants of submucous bulking agents. All patients were assessed with an ultrasound as a first diagnostic technique so as to establish the complications associated with it, especially ureteral obstruction and injected agent migration. RESULTS: Out of 516 cases, Macroplastique was used in 455, Deflux in 44 and Polytef in 17. 10 patients (1.9%) (5 girls/ 5 boys), with ages ranging from 15 months to 11,4 years, presented some kind of complications (Macroplastique was used in 8cases and Deflux in 2). Among them, 5 were remarkable due to an ureterohydronefrosis, 2 of which needed a nephrostomy. 3 patients presented an implant migration, 1 epididymitis and 1 bladder edema. CONCLUSIONS: Endoscopic bulking agent injection has become a safe alternative to open surgery in childhood VUR management.

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Introducción: El reflujo vesicoureteral (RVU) afecta aproximadamente al 1% de los niños y constituye un factor de riesgo de lesión renal a largo plazo. En la última década los avances en este campo han demostrado que la inyección endoscópica subureteral de agentes inertes para corregir el RVU infantil, es una alternativa aceptada frente a la profilaxis antibiótica a largo plazo y a la cirugía abierta. Objetivo: Determinar las complicaciones del tratamiento endoscópico del RVU en niños. Material y Métodos: Realizamos un estudio retrospectivo de todos los pacientes con RVU sometidos a un tratamiento endoscópico en nuestro centro desde Enero de 1999 a Septiembre de 2003, con un total de 516 implantes submucosos de agentes inertes. Todos los pacientes fueron evaluados mediante ecografía como primera técnica de imagen diagnóstica, con la intención de determinar las complicaciones asociadas, fundamentalmente obstrucción ureteral y migración del material inyectado. Resultados: De las 516 intervenciones, en 455 se utilizaron partículas de polidimetilsiloxano (Macroplastique®), en 44 microesferas de dextrano (Deflux®) y en 17 pasta de politetrafluoroetilo (Polytef®). Se detectaron complicaciones en 10 pacientes (1,9%) (5 niños y niñas), con un rango de edad entre 15 meses y 11,4 años, correspondientes a 8 implantes con Macroplastique® y a 2 con Deflux®. Entre las complicaciones destacan 5 ureterohidronefrosis, de las que 2 precisaron derivación urinaria mediante nefrostomía, 3 migraciones del material implantado, 1 epididimitis y 1 edema vesical. Conclusiones: La inyección endoscópica de agentes inertes se ha convertido en una alternativa segura a la cirugía abierta en el manejo del RVU infantil

Introduction: Nowadays, around 1% of children suffer from vesicoureteral reflux (VUR), which represents a risk factor for long-term kidney damage. In the last decade, development in this field has shown that subureteric endoscopic injection of bulking agents for childhood VUR is an acceptable alternative unlike long-term antibiotic prophylaxis and open surgery. Objective: To establish the complications of childhood VUR endoscopic treatment. Material and Methods: A retrospective analysis was carried out for every patient treated endoscopically in our department from January 1999 to September 2003, with a total amount of 516 implants of submucous bulking agents. All patients were assessed with an ultrasound as a first diagnostic technique so as to establish the complications associated with it, especially ureteral obstruction and injected agent migration. Results: Out of 516 cases, Macroplastique® was used in 455, Deflux® in 44 and Polytef® in 17. 10 patients (1.9%) (5 girls/ 5 boys), with ages ranging from 15 months to 11,4 years, presented some kind of complications (Macroplastique® was used in 8cases and Deflux® in 2). Among them, 5 were remarkable due to an ureterohydronefrosis, 2 of which needed a nephrostomy. 3 patients presented an implant migration, 1 epididymitis and 1 bladder edema. Conclusions: Endoscopic bulking agent injection has become a safe alternative to open surgery in childhood VUR management

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Urachal cysts are congenital anomalies detected predominantly during the childhood. They are often diagnosed when an infection occur mimicking a variety of acute intra-abdominal or pelvic processes. We present a case in a 7-year-old female infant, diagnosed of infected urachal cyst. The embryologic origin of this anomaly, clinical features, diagnosis and treatment are discussed.

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OBJECTIVE: [corrected] To analize the clinical presentation, diagnosis and surgical management of congenital megaprepuce (CM). MATERIAL AND METHODS: We have made a retrospective study of four cases of CM diagnosed and treated in our centre between october 1997 and april 2005. We studied the diagnosis and surgical treatment. CONCLUSIONS: CM is an infrecuent condition that can be confused with others pathologies. It's necessary to diagnose and treat it correctly.

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Hemorrhagic infarction of the testicle is an unusual occurrence in the newborn infant. It usually develops as a consequence of torsion of the spermatic cord. We report a case of global testicular infarction in a newborn associated with a tense hydrocele.

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El infarto testicular hemorrágico es una entidad poco usual en el neonato, desarrollándose generalmente como consecuencia de la torsión del cordón espermático. Presentamos un caso de infarto testicular en neonato asociado a hidrocele a tensión (AU)

Hemorrhagic infarction of the testicle is an unusual occurrence in the newborn infant. It usually develops as a consequence of torsion of the spermatic cord. We report a case of global testicular infarction in a newborn associated with a tense hydrocele (AU)

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Epidermoid cysts of the testis are rare in children (3% of all the testicular tumors). Bilateral appearance has only been described in the pediatric age in 2 cases and none associated to Klinefelter's syndrome. We present, for our knowledge, the first case of bilateral epidermoid testicular cyst associated to klinefelter's syndrome in a boy, highlighting its management and therapeutic approach. We analyze the different kinds of treatment.

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Los quistes epidérmicos testiculares son lesiones muy infrecuentes en la edad infantil (3 por ciento de todas las tumoraciones testiculares). Sólo se ha descrito su aparición bilateral en la edad pediátrica en 2 observaciones y ninguna de ellas asociada a síndrome de Klinefelter. Presentamos, en este sentido, el primer caso en nuestro conocimiento de quiste epidérmico bilateral testicular asociado a síndrome de Klinefelter en un niño, destacando el manejo y la conducta terapéutica realizada analizando asimismo las distintas pautas de tratamiento propuestas (AU)

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