Abstract BACKGROUND: Testicular cancer accounts for 5% of the tumors in reproductive-age men and there has recently been an increase in its incidence. Diagnosis is made through clinical evaluation, tumor markers, and testicular ultrasound. Histologic strain determines treatment response and outcome. OBJECTIVE: To report the epidemiologic, histopathologic, and etiologic characteristics of testicular cancer at a tertiary care hospital within the time frame of 2012-2017. MATERIALS AND METHODS: A retrospective, observational, and descriptive study was conducted on patients with the diagnosis of testicular cancer of any histologic strain seen at the urology service of the Hospital General de México within the time frame of 2012 to 2017. The qualitative variables were expressed as simple, relative frequencies in percentages. Frequency variability was obtained through the 95% CI. Age was expressed in median and maximum and minimum values. The chi-square test and the Kruskal-Wallis test were employed to contrast the differences between tumor types, according to the variables analyzed. RESULTS: A total of 142 patients were studied, 44.4% of whom presented with mixed germ cell tumors and 43.7% with classic seminomas. Fifty percent of the patients presented with the disease at 20 to 30 years of age (mean 35.5). With respect to laterality, 56.3% of the tumors were on the left side and 43.7% on the right. In relation to lymph node dissemination (N) of the seminomatous tumors, 80.6% of the cases (n = 50) were stage N0 and 95.2% (n = 59) did not present with pulmonary metastasis, or any other, at the time of diagnosis. Of the nonseminomatous tumors (mixed germ cell tumors), 57.2% (n = 36) were stage N0 and 87.3% (n = 55) were M0. There was a slight increase in testicular cancer in the last two years. CONCLUSIONS: Despite our results, we believe a different study methodology is required to determine the cause of testicular cancer in our population.

Resumen ANTECEDENTES: El cáncer testicular representa 5% de los tumores que aparecen durante la edad reproductiva del varón, aunque a últimas fechas se está registrando un incremento en su incidencia. El diagnóstico se establece por clínica, marcadores tumorales y ultrasonido testicular. La estirpe histológica es la base para establecer el tratamiento y estimar el pronóstico. OBJETIVO: Reportar las características epidemiológicas, histopatológicas y etiológicas del cáncer testicular en un hospital de tercer nivel. MATERIAL Y MÉTODOS: Estudio observacional, descriptivo y retrospectivo efectuado en pacientes con diagnóstico de cáncer testicular de cualquier estirpe histológica atendidos entre 2012 y 2017 en el servicio de Urología del Hospital General de México. La información de las variables cualitativas se resumió como frecuencias simples y relativas en porcentaje. La variabilidad de las frecuencias se obtuvo mediante IC95%. La edad se resumió en mediana y valores máximos y mínimos. Se utilizó ꭓ2 para contrastar las diferencias entre los tipos de tumores según las variables analizadas y prueba de Kruskal-Wallis. RESULTADOS: Se estudiaron 142 pacientes y en 44.4% se encontraron tumores de células germinales mixtas y en 43.7% seminomas clásicos. En 50% de los casos los tumores aparecieron entre los 20 y 30 años (media 35.5), con una lateralidad: 56.3% izquierdo y 43.7% derecho. En cuanto a la diseminación linfática (N) los tumores seminomatosos tuvieron estadificación N0 en 80.6% de los casos (n = 50) y 95.2% (n = 59) no tuvieron mestástasis pulmonares u otras al momento del diagnóstico. La estirpe no seminomatosa (tumores germinales de células mixtas) fue estadio N0, M0 en 57.2% (n = 36) y 87.3% (n = 55) de los casos, respectivamente. Existe un discreto aumento en la incidencia de esta patología en los últimos dos años. CONCLUSIONES: Pese a los resultados obtenidos, consideramos que se requiere otra metodología de investigación para determinar la causalidad de la presentación del cáncer testicular en nuestra población.

Abstract OBJECTIVE: To report our experience in the management of ureterovesical stricture in transplanted patients. MATERIALS AND METHODS: An ambispective and descriptive study was conducted on patients with ureterovesical junction stricture that were kidney transplantation recipients, seen at the Urology and Transplantation Services of the Hospital General de México Dr. Eduardo Liceaga within the time frame of 2013 to 2018. The variables analyzed were: age, time since transplantation, time with nephrostomy, time from stricture to correction, preoperative and postoperative creatinine levels, length of time with double-J catheter, follow-up, and type of treatment established. Descriptive statistics (mean, median, standard deviation, and range) were used for the data analysis, employing the SPSS 17 program. RESULTS: Four cases of ureterovesical junction stricture were registered: 2 were treated with endoscopic balloon dilation and 2 through cold knife and laser ureterotomy. At present, after 36 months of follow-up, none of the patients have presented with signs of re-stricture. CONCLUSIONS: The different endoscopic treatment modalities are safe and effective in patients with stricture of the ureterovesical anastomosis in the short term and the medium term. However, each case must be individualized, given that at present there is no consensus on the best technique for that type of complication.

Resumen OBJETIVO: Reportar la experiencia en el tratamiento de la estenosis de la unión ureterovesical en pacientes con trasplante renal. MATERIALES Y MÉTODOS: Estudio ambispectivo y descriptivo, efectuado en pacientes con estenosis de la unión ureterovesical que recibieron trasplante renal, atendidos en los servicios de Urología y de Trasplantes del Hospital General de México Dr. Eduardo Liceaga, entre los años 2013 a 2018. Se analizaron variables como: edad, tiempo transcurrido a partir del trasplante, permanencia de la nefrostomía, tiempo de permanencia de la estenosis hasta la curación; determinación de creatinina pre y posquirúrgica, permanencia del cateter doble J, seguimiento y tipo de tratamiento establecido. Para el análisis de los datos se utilizó estadística descriptiva (media, mediana, desviación estándar y rangos) con el programa SPSS 17. RESULTADOS: Se registraron 4 casos con estenosis de la unión ureterovesical: 2 se trataron con dilatación endoscópica con balón y 2 mediante ureterotomía con corte frio y láser. A tres pacientes se les practicó nefrostomía con la finalidad de preservar la función renal y el catéter se retiró, en promedio, 3 meses después de su colocación. Hasta el momento todos los pacientes se encuentran sin evidencia de reestenosis, a 36 meses de seguimiento. CONCLUSIONES: Las distintas modalidades de tratamiento endoscópico son efectivas y seguras en pacientes con estenosis de la anastomosis ureterovesical a corto y mediano plazos; no obstante, debe individualizarse cada caso, porque hasta el momento no existe un consenso que establezca cuál es la mejor técnica en este tipo de complicación.

ABSTRACT Introduction and objective Indwelling double J ureteral stents are used routinely in the resolution of ureteral obstruction caused by different etiologies. Evaluation of urinary symptoms related to double-J stent, indicate that these affect 73-90% of patients. We conducted a prospective, randomized study, to evaluate the efficacy of tamsulosin, oxybutinin and combination therapy in improving the urinary symptoms. Methods Patients who underwent ureteral stent placement after ureterolithotripsy (total 51), were randomized into three groups: Group I: Tamsulosin 0.4 mg. once per day(17 patients), Group II: Oxybutinin 5 mg. once per day (17 patients), Group III: Tamsulosin+ oxybutynin once per day (17 patients). All the groups received the drugs for three weeks and completed a Spanish validated Ureteral Stent Symptom Questionnaire (USSQ) at day 7 and 21. Results Repeated measures ANOVA showed mean urinary symptom index score was 22.3 vs. 15.5 in group three (p<0.001) at day 7 and 21 respectively. The mean work performance index was 6.6 vs 8.1 (p=0.049) favoring tamsulosin group, the mean sexual score was 0.5 vs 1.5 (p=0.03). Among additional problems the mean was 7.2 vs 6.2 (p=0.03). No significant difference was noted among pain and general health index. No side effects were reported. Conclusions Combination therapy with tamsulosin and oxybutynin improved irritative symptoms and work performance as well as sexual matters. Combination therapy should be considered for patients who complained of stent related symptoms.