The following Conclusions were drawn from the results obtained and from the analysis of the texts. Both medical and surgical treatment present similar effectiveness concerning resolution of grades I, II and III VUR, and the former one is the recommended initial treatment following diagnosis. Endoscopic treatment is exactly as effective as open surgery for grades I, II and III with fewer undesirable secondary effects. There are no differences concerning the efficacy of the different injected substances. Not enough evidences exist for degrees IV and V that may recommend or advise against any of the treatments. In any degree of VUR, open surgical treatment is superior as far as medical treatment is concerned only regarding the number of acute pyelonephritis episodes during follow-up. This conclusion cannot be applied on endoscopic treatment.
IMÁGENES EN UROLOGÍA M ujer de 56 años, fumadora, que acude a urgencias por presentar hematuria de dos meses de evolución. Al tacto vaginal se observa útero en anteversoflexión y masa de consistencia dura y dolorosa a la palpación.Se realiza ecografía donde se aprecia una masa heterogénea ecogénica sugestiva de neoformación vesical, que mide 91,7 x 83,3 mm (Fig. 1).Se completa el estudio con TAC donde se observa una ocupación prácticamente total de la vejiga por una masa heterogénea de 9 cm, con probable base de implantación en la pared posterolateral derecha (Fig. 2).Tras la RTU vesical, los hallazgos anatomopatológicos fueron carcinosarcoma. Se realizó exanteración pélvica anterior (Figs. 3 y 4) con linfadenectomía y derivación urinaria tipo Bricker.La anatomía patológica definitiva fue de carcinoma vesical pT2bN0.
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