ABSTRACT
We report the case of a 73 year old male with a bulky endovesical mass infiltrating near organs at the radiologic studies and urinary obstruction. We specify the diagnostic tests which end in the diagnosis of giant benign prostatic hyperplasia. Regarding the case, we consider the causes of solic pelvic masses and the diagnostic methods available, making a stand on the paramount importance of the hystologic exam.
Subject(s)
Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnosis , Aged , Humans , MaleABSTRACT
Presentamos el caso de un varón de 73 años con una gran masa endovesical infiltrante de estructuras vecinas en los estudios radiológicos y uropatía obstructiva secundaria. Se detalla la batería diagnóstica realizada que concluye con el diagnóstico de H.B.P. masiva. A propósito del caso, comentamos las posibles causas de masas pelvianas sólidas (endo y retrovesicales) y los mecanismos diagnósticos disponibles, haciendo hincapié en la importancia capital de un estudio anatomopatológico (AU)
No disponible
Subject(s)
Aged , Male , Humans , Prostatic HyperplasiaABSTRACT
OBJECTIVE: In this study we have evaluated the urinary and sexual alterations of patients with multiple sclerosis (MS) by means of neurourological and neuroandrological studies. PATIENTS AND METHODS: In 41 patients with MS we took a clinical history and made a neurourological physical examination. We also did a full urodynamic study including measurement of flow and postmictional residue, cystomanometry and test of the detrusor pressure/mictional flow. Selective electromyography of the periurethral sphincter and a cystourethrographic study were also done. In patients complaining of erection dysfunction this was also studied by means of an erection test with intracavernosal vasoactive drugs and special neurophysiological techniques including the obtention of S2-S4 evoked potentials in the bulbo-cavernosal muscle and the somatosensorial potentials of the pudendal nerve. RESULTS: In patients with MS there is a predominance of mixed and irritative urinary symptoms rather than obstructive symptoms. The vesico-urethral dysfunction of upper motor neurone type was the most frequent urodynamic diagnosis. There were no statistically significant differences between the urinary symptoms of the different urodynamic diagnoses. Ninety percent of the patients with erectile dysfunction had associated vesico-urethral dysfunction of upper motor neurone type and 100% of the patient with erectile dysfunction had dysfunction of the sphincter of the urinary bladder. CONCLUSIONS: In patients with MS there is no correlation between the clinical symptoms and urodynamic diagnosis. Therefore urodynamic diagnosis is essential not only for diagnosis but also for development of suitable treatment. The urodynamic diagnosis of dysfunction of the bladder sphincter is a risk factor in patients with MS. In our series 100% of the cases with erectile dysfunction also had dysfunction of the bladder sphincter.
Subject(s)
Erectile Dysfunction/diagnosis , Erectile Dysfunction/etiology , Multiple Sclerosis/complications , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/etiology , Vesico-Ureteral Reflux/etiology , Adult , Evoked Potentials/physiology , Female , Humans , Male , Severity of Illness Index , Urinary Bladder/physiopathology , Urodynamics , Vesico-Ureteral Reflux/diagnosis , Vesico-Ureteral Reflux/physiopathologyABSTRACT
Objetivo. En este trabajo se han evaluado mediante estudios neurourológicos y neuroandrológicos las alteraciones urinarias y sexuales de pacientes con esclerosis múltiple (EM). Pacientes y métodos. A 41 pacientes con EM se les realizó historia clínica y exploración física neurourológica, así como un estudio urodinámico completo que incluía flujometría con medición de residuo postmiccional, cistomanometría y test de presión detrusor/flujo miccional. También se llevó a cabo un estudio electromiográfico selectivo del esfínter periuretral y un estudio cistouretrográfico. A los pacientes que refirieron disfunción eréctil se amplió el estudio mediante la aplicación de un test de erección con fármacos vasoactivos intracavernosos y de técnicas neurofisiológicas especiales que comprenden la obtención de los potenciales evocados S2-S4 del músculo bulbocavernoso y de los potenciales somatosensoriales del nervio pudendo. Resultados. En los pacientes con EM predominan los síntomas urinarios mixtos e irritativos sobre los obstructivos. La disfunción vesicouretral tipo neurona motora superior fue el diagnóstico urodinámico más frecuente. No hay diferencias estadísticamente significativas entre los síntomas urinarios de los diferentes diagnósticos urodinámicos. El 90 por ciento de los pacientes con disfunción eréctil tenían asociada una disfunción vesicouretral tipo neurona motora superior, y el 100 por ciento de los pacientes con disfunción eréctil presentaron disinergia vesicoesfinteriana. Conclusiones. En los pacientes con EM no existe correlación entre los síntomas clínicos y el diagnóstico urodinámico por lo que éste se convierte en imprescindible no sólo para el diagnóstico, sino también para el desarrollo de un tratamiento adecuado. El diagnóstico urodinámico de disinergia vesicoesfinteriana es un factor de riesgo en los pacientes con EM, y, en nuestra serie, el 100 por ciento de los casos con disfunción eréctil presentaron también disinergia vesicoesfinteriana (AU)
Subject(s)
Adult , Male , Female , Humans , Urodynamics , Vesico-Ureteral Reflux , Multiple Sclerosis , Erectile Dysfunction , Evoked Potentials , Severity of Illness Index , Urinary Bladder , Urinary Bladder, NeurogenicABSTRACT
OBJECTIVE: To report an additional case of malignant Leydig cell tumor of the testis. The clinical, hormonal and histological criteria for malignancy are analyzed and the different therapeutic options are discussed. METHODS/RESULTS: A 75-year-old male presented with a painful testicular tumor, dyspnea and generalized syndrome. The chest film showed multiple bilateral metastatic pulmonary lesions. Pathological analysis disclosed malignant Leydig cell tumor. The patient died one month after orchidectomy due to the neoplasm. CONCLUSIONS: Metastatic Leydig cell tumor is uncommon. To date, no available treatment can significantly alter the course of the disease.
Subject(s)
Leydig Cell Tumor , Testicular Neoplasms , Humans , Leydig Cell Tumor/pathology , Leydig Cell Tumor/secondary , Male , Testicular Neoplasms/pathologyABSTRACT
Presentation of an exceptional case of priapism in an 82-year-old male, secondary to primary bilateral abscess corpus cavernosum. Diagnosis was reached through aspiration puncture and pus drainage, which also allowed the resolution of the condition. After a literature review, no similar case was found. This was a painful, long-lasting erection that resulted from corpus cavernosum repletion with purulent material instead of blood.
Subject(s)
Abscess/complications , Bacteroides Infections/complications , Citrobacter freundii , Enterobacteriaceae Infections/complications , Penile Diseases/complications , Priapism/etiology , Abscess/diagnosis , Abscess/therapy , Aged , Bacteroides Infections/diagnosis , Bacteroides Infections/therapy , Combined Modality Therapy , Emergencies , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/therapy , Humans , Male , Penile Diseases/diagnosis , Penile Diseases/therapy , Priapism/diagnosis , Priapism/therapyABSTRACT
Contribution of one case of epidermoid carcinoma of the urethra in a 47-year old male with a several years old urethral stenosis. The significance of urethroscopy and the obtention of biopsies for diagnosis is emphasised. Also a review is made of the existing literature on the different therapeutical alternatives.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Urethral Neoplasms/diagnosis , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To report an additional case of condylomata acuminata in a child, review the literature and discuss the medicolegal implications due to the possibility of sexual abuse. METHODS/RESULTS: The diagnosis, treatment and clinical course of the lesions are discussed. Psychological evaluation of the child discarded infection by sexual transmission. CONCLUSION: Condylomata acuminata in children represent a diagnostic difficulty due to the possibility of infection by sexual transmission, although it should be taken into account that non sexual transmission of this sexually transmissible disease is very frequent in childhood.
Subject(s)
Condylomata Acuminata/etiology , Penile Diseases/etiology , Child, Preschool , Humans , MaleABSTRACT
Vesical carcinosarcoma is a very poor prognosis, infrequent tumour normally presenting with haematuria and for which the only treatment available is radical cystectomy. Here we present a new case of this tumour in a 61 year-old male with a brisk evolution to death.
Subject(s)
Carcinosarcoma , Urinary Bladder Neoplasms , Carcinosarcoma/diagnosis , Humans , Male , Middle Aged , Urinary Bladder Neoplasms/diagnosisABSTRACT
OBJECTIVES: This paper describes our MAS (major ambulatory surgery) unit and its application in urology. METHODS: We reviewed our series of 415 patients seen over a period of 14 months; of these, 71 (17%) did not meet the criteria and the remaining 344 patients (83%), with ages ranging from 6 months to 78 years, were treated in our MAS unit. Surgery was performed for circumcision, cryptorchidism, PVCP and hydrocele. RESULTS: Only 2 (0.5%) of the patients were hospitalized and 5 (1.4%) were reoperated. The degree of patient satisfaction was over 90%. CONCLUSIONS: 1. MAS is efficacious in providing care and efficiently resolves difficult urological cases. 2. Patient satisfaction is very high and there were only a few complications in the patients treated in this unit.
Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , Urology , Adolescent , Adult , Aged , Child , Child, Preschool , Genital Diseases, Male/surgery , Humans , Infant , Male , Middle Aged , Patient Satisfaction/statistics & numerical data , Reoperation/statistics & numerical data , Spain , Urology/statistics & numerical dataABSTRACT
OBJECTIVE: Although it is not the treatment of choice, conservative surgery by segmental resection of the ureter has achieved very good results in a patient with transitional cell carcinoma of the ureter. These results prompted us to report on the present case. METHODS/RESULTS: Diagnosis was fundamentally by IVP. Treatment by partial resection of the ureter achieved good results as shown by the postoperative control evaluation and follow up. CONCLUSIONS: Although nephroureterectomy continues to be the treatment of choice in transitional cell carcinoma of the urinary tract, conservative treatment (endoscopic resection of the tumor) may achieve good results in some selected cases. If conservative surgery is performed, the patient must be followed very closely using urine cytology, IVP or ureteroscopy.
Subject(s)
Carcinoma, Transitional Cell/surgery , Ureter/surgery , Ureteral Neoplasms/surgery , Hematuria/surgery , Humans , Male , Middle Aged , Prostatectomy , Prostatic Hyperplasia/surgeryABSTRACT
OBJECTIVES: The diagnostic and therapeutic aspects of endometriosis of the bladder is reviewed. Although it is relatively uncommon, it should be taken into account when making the differential diagnosis in young females presenting with dysuria. METHODS/RESULTS: A young female patient with dysuria and hypogastric pain caused by endometriosis of the bladder is described. CONCLUSIONS: Diagnosis is basically by cystoscopic exploration and histological analyses of the specimens obtained by electrofulguration. Hormone therapy with Danazol may be effective in some cases. The most effective treatment is excision of the lesion by TUR or conventional surgery. Furthermore, laser could be useful in the treatment of this pathology.
Subject(s)
Endometriosis/diagnosis , Urinary Bladder Diseases/diagnosis , Adult , Biopsy , Diagnosis, Differential , Endometriosis/pathology , Endometriosis/surgery , Female , Humans , Urinary Bladder/pathology , Urinary Bladder/surgery , Urinary Bladder Diseases/pathology , Urinary Bladder Diseases/surgeryABSTRACT
Wilms' tumour represents 8% of tumours appearing during childhood, and it is the more frequent malignant tumour of the urinary tract in children. A review of 7 tumours occurring in our Hospital Area over the last 11 years is made, evaluating their incidence, clinical presentation, diagnosis as well as therapeutical approaches and complications. We also conducted a review of the most recent related literature, paying special attention to the new lines of research in the field of the genetics. Likewise, we contribute the latest guidelines and suggestions by the NWTS with regard to diagnosis and treatment of Wilms' tumour.
