Urethral hemangiomas are benign vascular tumors that are found in perimontanal prostatic localization and less frequently in the urethra. Although different urethral procedures have been postulated for its treatment, the best results are achieved using lasers. A patient who underwent endoscopic holmium laser treatment for such hemangiomas is presented. Total disappearance of the lesions without any complications was achieved.

OBJECTIVE To evaluate the results of our experience with endoscopic management of vesico‐ureteric reflux (VUR) in adults, and to describe factors and complications that might contribute to the failure of the technique. PATIENTS AND METHODS Between 1992 and 2006, 21 patients (17 women and four men; mean age 32.1 years, sd 15.6) had endoscopic treatment for VUR (14 unilateral and seven bilateral ureteric units, UU). Patients previously operated for VUR were excluded. The VUR grades were II, III, IV and V in 10, 12, five and one UUs, respectively. The main indication for treatment was a history of repeated episodes of acute pyelonephritis (61%). Complications after surgery were evaluated. RESULTS The success rate of the first endoscopic treatment was 69%, and was 81% after the second. Two UUs with grade IV VUR were endoscopically managed for a third time with complete resolution. Only one UU with grade V VUR required open surgery. The success rate for VUR grades II, III and IV after the first treatment was five of eight, 12/12 and one of five, respectively. After the second treatment the success rate increased to seven of eight and two of five for grades II and IV, respectively. There were no complications related to the intervention. Factors related to a failure of technique were duplex ureter and dysfunctional voiding in eight UUs (seven patients). CONCLUSIONS The endoscopic management of VUR in previously untreated adult patients is a simple and efficient technique, with low comorbidity.

PALABRAS CLAVE Retrasplante; Factores de riesgo; Supervivencia injertoResumen Objetivo: revisar nuestra experiencia en retrasplantes renales. Material y métodos: se realizó un estudio retrospectivo de 71 pacientes retrasplantados entre 1980 y 2005. Se analizaron: características del receptor e injerto, datos de la intervención, causas de pérdida del injerto, número de rechazos y trasplantectomías y supervivencia del injerto. Resultados: la causa más frecuente de pérdida del injerto fue el rechazo crónico. Las causas de pérdida del primer injerto no se asociaron con una mayor pérdida del segundo (p > 0,05). El porcentaje de anticuerpos anti-HLA incrementó en el segundo trasplante respecto del primero (17,23 ± 27,91% vs 1,21 ± 7,43%) (p = 0,001), pero no se correlacionó con un aumento significativo de pérdida del segundo injerto (p = 0,320). No existieron diferencias significativas entre las complicaciones del primer y segundo trasplante (p > 0,05) y no se asociaron con una pérdida del injerto (p > 0,05). Los pacientes con una trasplantectomía en el primer trasplante presentaban un riesgo 8,5 veces mayor de sufrir una segunda (p = 0,0001; OR: 8,54; IC 95%: 0,941 -77,501). La causa más frecuente de trasplantectomía en el segundo trasplante fue el rechazo agudo. El rechazo agudo como causa de trasplantectomía en el primer trasplante se mostró como factor de riesgo independiente de trasplantectomía del segundo trasplante (p = 0,009). La supervivencia media del segundo injerto fue de 5,08 ± 4,81 años, superior al primer trasplante (p = 0,133). La supervivencia del injerto a 1, 5 y 10 años fue del 83, 75 y 52%, respectivamente. Conclusiones: la supervivencia del segundo trasplante no es inferior al primero y tampoco existe incremento en el número de complicaciones. © 2010 AEU. Publicado por Elsevier España, S.L. Todos los derechos reservados. KEYWORDSRetransplantation; Risk factors; Graft survival Renal retransplantation: risk factors and results AbstractObjective: to review our experience in renal retransplantations. Materials and methods: we carried out a retrospective study on 71 patients with retransplantation performed between 1980 and 2005. We studied: the characteristics of the * Autor para correspondencia.

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