ABSTRACT
Presentamos el caso de un paciente que acudió al servicio de urgencias con un cuadro de oclusión intestinal de cuatro días de evolución. En este servicio se llegó al diagnóstico de divertículo vesical gigante secundario a un adenoma de próstata grado II. Éste se realizó mediante ecografía abdominal en la sala de urgencias y posteriormente, se confirmó por cistografía realizada de forma programada. En la cistografía se observó una vejiga de lucha y un divertículo en cara posterior en el que un cuello estrecho, impedía el vaciado y hacía compresión sobre el recto. La clínica de obstrucción intestinal mejoró al realizar el sondaje vesical, que se produjo tras la ecografía en la sala de urgencias. Por la sonda se consiguieron unos 800 cc de orina que fueron suficientes para conseguir la desobstrucción del recto y, por tanto, el paso de aire distal, lo que se documenta con radiología simple. Se presenta el caso haciendo hincapié en lo poco frecuente de este tipo de presentación en un divertículo gigante, y se revisa la literatura en Medline desde 1966 sin encontrar ningún caso similar al expuesto (AU)
Subject(s)
Aged , Male , Humans , Diverticulum , Acute Disease , Intestinal Obstruction , Urinary Bladder DiseasesABSTRACT
OBJECTIVES: To present the results obtained in patients with stress urinary incontinence treated with periurethral collagen injection. METHODS: 26 female patients with stress urinary incontinence were treated with bovine collagen injection; mean volume 10.8 cc. The results achieved by this therapeutic modality are described herein. RESULTS: Control evaluations performed during a period of one year showed highly satisfactory results had been achieved initially and the success rate gradually increased over the 12 months follow-up. Overall the final results showed a success rate of 34.6%, 38.4% showed frank improvement and 26.9% had a failed procedure. There were no significant differences in the results for both types of stress urinary incontinence. The results correlated with the severity of incontinence; the success rate was higher in the patients with low grade incontinence. CONCLUSIONS: Periurethral collagen injection is indicated in patients with type I and type III stress urinary incontinence who cannot benefit from surgery. Patients with type II stress urinary incontinence, however, do not benefit from this therapeutic modality.
Subject(s)
Biocompatible Materials/administration & dosage , Collagen/administration & dosage , Urinary Incontinence, Stress/therapy , Adult , Aged , Female , Follow-Up Studies , Humans , Middle Aged , UrethraABSTRACT
It is now one year since we started our microsurgical venture. The idea was to round-off the care coverage of our Reproduction Unit since, in June 92, we had launched the FIV-TE program. The Unit Incorporates professionals from different services (urology, gynaecology, laboratory) imbued by the notion that it is not the isolated individual but the couple who, at any particular time, have a fertility problem. Approach to the study is, therefore, done in an integrate and concurrent way to both members of the couple, progressing then to establishment of diagnosis and the outline of a therapeutic alternative. We introduce below the case of a couple which may well be an example of the above statements. The couple refers a 4-year evolution of primary sterility. The 34-year-old male is a long-evolution insulin-dependent diabetic with erectile dysfunction and backward ejaculation. The erectile dysfunction is successfully managed with PGE1 self-injections. In their wish for fertility and after failure of spermatozoa recovery both in urine following orgasm and intravesical Menezo, we attempt MAE (12 million of spermatozoa with motility, after swim-up) + FIC-TE in a FSHp- and HCG-induced cycle, securing the uptake, by ultrasound-guided follicular puncture under local anaesthetics, of 5 mature ovocytes 4 of which were fertilized; the same four undergoing intrauterine transferral with the result of pregnancy, this being the second one to be accomplished in the country and the first one In our Unit, by microaspiration of spermatozoa at the deferent level In a situation of primary sterility by plain male factor.
Subject(s)
Pregnancy , Spermatozoa , Adult , Female , Fertilization in Vitro/methods , Humans , Infertility, Male/surgery , Male , Microsurgery , Suction , Vas Deferens/surgeryABSTRACT
Focal acute bacterial nephritis is an uncommon form of renal acute infection with a clinical presentation that, although similar to other acute infections of the renal parenchyma, must be taken into account in order to reach a correct differential diagnosis with other processes which have very similar radiological images but highly different management approaches, such as the renal carcinoma. This paper present one case in which the sings and symptoms were crucial to establish the diagnosis.
Subject(s)
Kidney Neoplasms/diagnosis , Nephritis/diagnosis , Acute Disease , Adult , Diagnosis, Differential , Female , Humans , Nephritis/microbiologyABSTRACT
Percutaneous nephrostomy has emerged as a substitute for surgical nephrostomy. The complication rate is low, hematuria being one of the most common. Treatment should be conservative while possible since the clot plays an important role in the tamponade of hemorrhage. Arteriovenous fistulas following percutaneous nephrostomy are rare. Diagnosis is by arteriography and treatment is by selective embolization.
