[XXV Anniversary of the Endoscopy-Lithiasis-Laparoscopy (LEL) Working Group]

INTRODUCTION

The purpose of this article is to describe the structural vicissitudes and content changes experienced by our Work Group, LEL over the last twenty-five years.

MATERIALS AND METHODS

The compiled material comes from three sources: the author's experiences; the iconography provided by the co-ordinators; and the data obtained from programmes, letters, etc. This material has been analyzed and organized into six stages and the following has been highlighted in each of these: specific data from each day; key structural data; and the most relevant facts during the period.

RESULTS

Various proposals have been made as a result of the Group's activity: to formally record the endoscopy techniques for the lower urinary tract and extend them to the upper urinary tract: URS and percutaneous surgery, the comprehensive treatment of lithiasis, the defence of our own techniques (such as UTR versus alternatives), as well as to provide an expert opinion on new technologies (laser in urology), and to replace open surgery techniques with others belonging to the Group: PNL and laparoscopy.

CONCLUSIONS

For 25 years, the LEL Work Group has stayed active and closely united. It has participated in both internal and external structural changes prompted by the appearance of spectacular new developments that have emerged over this period of time: endoscopic access to the upper urinary tract; comprehensive treatment of lithiasis; and alternatives to traditional surgeries (percutaneous surgery, laparoscopic surgery).

Polytetrafluoroethylene and autologous fat endoscopic injection for a prostato-perineal fistula

PURPOSE

Prostato-perineal fistula is a rare abnormality. We present a simple endoscopic technique to manage this complicated problem.

MATERIALS AND METHODS

We report on a 34-year-old man with a prostato-perineal fistula after multiple surgeries for imperforate anus. The patient underwent an endoscopic injection of polytetrafluoroethylene and autologous fat in the fistulous tract.

RESULTS

Two endoscopic procedures with the injection of polytetrafluoroethylene and autologous fatty tissue around the prostatic urethral orifice were necessary to occlude the fistula.

CONCLUSIONS

The endoscopic injection of polytetrafluoroethylene and autologous fat was an easy, well tolerated and long lasting solution in this patient.

Value of random endoscopic biopsy in the diagnosis of bladder carcinoma in situ

The data obtained from 2,272 random biopsies performed on cystocopically normal mucosa in 457 cases of primary bladder tumors, that did not undergo any previous treatment, are present. Dysplasia was found in 119 cases (26.04%) and carcinoma in situ in 100 cases (21.88%). The relationship between cancer in situ and tumoral grade was: G1, 4 of 76 (5.26%); G2, 33 of 225 (14.66%), and G3, 58 of 152 (38.16%). The relationship between cancer in situ and tumoral stage for superficial tumors (pTa-pT1) was 52 of 314 (16.56%), and for deep tumors (pT2, pT3, pT4), 42 of 109 (38.53%). In this least group of 109 cases, 53 cystectomies were performed and the diagnosis obtained by random biopsy and mapping of the surgical sample were correlated. A coincidence in both techniques was found in 77.36% of the cases.