Tracheal stenosis (TS) is a fibrosis originated by prolonged inflammation and increased transforming growth factor beta 1 (TGF-β1) expression and collagen deposition (CD) in the tracheal wound. Several wound-healing modulators (WHMs) have been used to modulate the tracheal healing process and prevent TS, but they have failed, justifying the need to evaluate alternative WHM. The pirfenidone (PFD) and collagen-polyvinylpyrrolidone (Collagen-PVP) decrease inflammation and fibrosis. This study assessed the effect of PFD administration and Collagen-PVP topical application on macroscopic and microscopic changes, TGF-β1 expression, and CD in an experimental model of tracheal wound healing. Forty Wistar rats underwent cervical tracheoplasty, were divided into 4 groups (n = 10), and were treated with different WHM: group I, saline solution (SS); group II, Collagen-PVP; group III, mitomycin C (MMC); and group IV, 40 mg/kg PFD. Four weeks after surgery, the macroscopic and microscopic changes, in situ TGF-β1 expression, and CD in posttracheoplasty scars were evaluated. The animals treated with Collagen-PVP and PFD developed less inflammation and fibrosis than animals in the other study groups (p < 0.05, Kruskal-Wallis) and, moreover, showed lower TGF-β1 expression and CD than animals in group I (p < 0.05, ANOVA and Tukey's test). In conclusion, PFD and Collagen-PVP decrease inflammation, fibrosis, TGFβ-1 expression, and CD in the posttracheoplasty rats' scar.

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Introduction: The COVID-19 pandemic has delayed screening, diagnostic workup, and treatment in prostate cancer (PCa) patients. Our purpose was to review PCa screening, diagnostic workup, active surveillance (AS), radical prostatectomy (RP), radiotherapy (RT), androgen deprivation therapy (ADT) and systemic therapy during the COVID-19 pandemic. Materials and Methods: We performed a systematic literature search of MEDLINE, EMBASE, Scopus, LILACS, and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) statement for relevant material published from December 2019 to February 2021. Results: Prostate biopsy can be delayed, except when high-risk PCa is suspected or the patient is symptomatic. Active surveillance is appropriate for patients with very low risk, low risk (LR) and favorable intermediate risk (FIR). RP and RT for high risk and very high risk can be safely postponed up to 3 months. Hypofractionated external beam RT (EBRT) is recommended when RT is employed. ADT should be used according to standard PCa-based indications. Chemotherapy should be postponed until the pandemic is contained. Conclusions: The international urological community was not prepared for such an acute and severe pandemic. PCa patients can be adequately managed according to risk stratification. During the COVID-19 pandemic, LR and FIR patients can be followed with active surveillance. Delaying RP and RT in high risk and locally advanced disease is justified.

Invasive bladder Aspergillosis has only been reported in six publications so far. A 74-year-old male, presented to the emergency department with fever, abdominal pain, and right testicular enlargement. Abdominal computed tomography concluded a bladder tumor and testicular ultrasound reported right epididymitis. Cystoscopy showed a bladder fungal mass, which was extracted with cystotomy. Pathological findings reported Aspergillus species. The patient was successfully treated with 4-week oral Isovuconazole. The first bladder Aspergillosis was published in 1978. The most recent case was published in 2020. Aspergillosis infection is extremely rare disease, treatment with Isavuconazole is efficient.

Introducción: El cáncer de vejiga se clasifica en general como urotelial y no urotelial. El no urotelial representa menos del 5% de todos los tumores vesicales y de estos el 90% son de origen epitelial, incluyendo: carcinoma de células escamosas, de células pequeñas y adenocarcinoma. El 10% restante es de origen no epitelial (linfoma, paranganglioma, sarcoma, etc.). Objetivo: Presentar la experiencia del cáncer de vejiga no urotelial y describir las características de los pacientes en nuestra institución. Materiales y métodos: Estudio retrospectivo y descriptivo de expedientes de pacientes con cáncer vesical no urotelial, diagnosticados y tratados en nuestro servicio de 2004 al 2016, obteniendo 7 casos. Resultados: 7 pacientes, 5 hombres y 2 mujeres. Edad 53 años (35-76). Síntomas principales hematuria 4, STUI 2 y mucosuria 1 . Histopatología: adenocarcinoma 3, carcinoma epidermoide 2, paraganglioma 1 y linfoma 1. Localización mas frecuente: domo vesical. Tratamiento: Adenocarcinoma (3): Cistectomía parcial 2, solo rtuv 1. Carcinoma epidermoide (2): 1 nefroureterectomía izquierda + cistoprostatectomía radical, 1 cistectomía radical + exenteración pélvica, ambos casos con RT adyuvante; Paraganglioma: 1 Cistectomía parcial laparoscópica asistida por robot, Linfoma: 1 rtuv + Quimioterapia + radioterapia. 2 defunciones por carcinoma epidermoide. Discusión: Dada la poca frecuencia de estos casos es difícil la estandarización entre el tratamiento y la histopatología, pero en general la cirugía es la mejor opción terapéutica para evitar la recurrencia y mejorar supervivencia, en algunos casos se recomiendan terapias conservadoras de órgano con terapias adyuvantes personalizadas a la histopatología. Conclusiones: El manejo de los tumores vesicales no uroteliales es complejo y requiere de un equipo multidisciplinario. Los tumores mas agresivos son epidermoides con alta posibilidad de extensión locorregional. La experiencia en México es limitada.