[Descriptive study of bladder tumors in the district of Levante-Alto Almanzora]. / Estudio descriptivo de los tumores vesicales en la comarca del Levante-Alto Almanzora.

We present our series of operater bladder cancers in this District and the annual incidence in the period 1996 at 1998, as web as they are distributed by sex, age and smoking in the population; neoplasic stage and relapse were also studied. 61 patients were treated and un found global half incidence of 19.8 for 10(5) inhabitant-year (h-a), while for sexes it was of 4.22 for 10(5) h-y for women and of 15.58 for 10(5) h-y males. 78.69% was male with a masculinity rate of 3.69. The most frequent age group was starting from the seventh decade with 50.81% of our series. There was 36% of intervened patients that they were smoking, while 29.5% had relationship with other factors of risk like hydrocarbons and pesticidas. The superficial tumors were the most frequent with 86.88% of the cases, on the other hand the undifferentiated neoplastics was not very frequent with 13.21%, increasing these neoplastics with the age. In the follow up there were relapses in 36% of the people, being bigger in the T1 of our series. The occupational factors in this district can explain the high frequency in the female sex, although analytic studies are needed to check it.

Estudio descriptivo de los tumores vesicales en la Comarca del Levante-Alto Almanzora / Descriptive study ob bladder cancer in District the Levant-High Alamanzora

Se presentan los tumores vesicales intervenidos en esta Comarca y la incidencia anual en el periodo 1996 a 1998, así como se distribuyen por sexo, edad y hábito tabáquico en la población; también se estudiaron el estadio tumoral y la recidiva. Se han tratado 61 pacientes con una incidencia media global de 19,8 por 10 5 habitantes-año (h-a), mientras que por sexos fue de 4,22 por 10 5 h-a para mujeres y de 15,58 por 10 5 h-a para varones. El 78,69 por ciento fue-ron varones, con una razón de masculinidad de 3,69. El grupo de edad más frecuente fue a partir de la séptima década con un 50,81 por ciento de nuestra serie. Hubo un 36 por ciento de pacientes intervenidos que eran fumadores, mientras que un 29,5 por ciento habían estado expuestos a otros factores de riesgo como hidrocarburos y pesticidas. Los tumores superficiales fueron los más frecuentes con el 86,88 por ciento de los casos, por el contrario aquellos con histología indiferenciada fueron poco frecuentes con el 13,21 por ciento, aumentando estas neoplasias con la edad. En el seguimiento hubo recidivas en el 36 por ciento de los sujetos, siendo mayor en los T1 de nuestra serie. Los factores ocupacionales en esta zona pueden explicar la elevada frecuencia en el sexo femenino, aunque se necesitan estudios analíticos para comprobarlo (AU)

[Sertoli cell tumor of the testis]. / Tumor testicular de células de Sertoli.

Sertoli cell tumors (TCS) derivated from sex-cord estroma cells, are an uncommon variety of testicles neoplasms. A 66 year-old patient that came to the consultation for an increased scrotum of size present. Ultrasound viewed a hipoecoic nodule capable with testicular tumor, more secondary hidrocele. After undergoing the standard treatment, by means of groin radical orchiectomy, its pathologic analysis identified the lesion as Sertoli cell tumor conventional. The pathologic features that best correlate with a clinically benign course are as follows: a lower size tumor to 5 cm, mild nuclear atypia, a mitotic rate of less than 5 mitosis per 10 high power fields, and absent necrosis. Our case presented with these features. Follow-up of these neoplasms should be prolonged by the unusual of its presentation and a small percentage of cases are clinically malignant.

Tumor testicular de células de Sertoli / Sertoli's cell testicle tumour

Los tumores de células de Sertoli (TCS) derivados de los cordones sexuales del estroma gonadal, son una variedad infrecuente de las neoplasias testiculares. Presentamos un paciente de 66 años que vino a la consulta por un escroto aumentado de tamaño. En la exploración ecográfica presentó un nódulo hipoecoico compatible con tumor testicular, más hidrocele secundario. Después de someterse al tratamiento estándar, mediante orquiectomía radical inguinal, el informe histopatológico fue de TCS clásico. Existen criterios histopatológicos que informan de la benignidad de estas lesiones, como son: un tamaño tumoral inferior a 5 cm, atipia nuclear leve, índice mitótico inferior a 5 por 10 campos de gran aumento y no existir necrosis. Nuestro paciente se presentó con estas características. El seguimiento de estas neoplasias debe ser prolongado por lo inusual de su presentación y porque existe el riesgo de malignización en un porcentaje pequeño de enfermos (AU)

[Effect of potassium citrate in the prophylaxis of urinary lithiasis]. / Efecto del citrato potásico en la profilaxis de la litiasis urinaria.

OBJECTIVE: The physiologic effects of potassium citrate on urinary solubility have led to their use to facilitate stone passage after lithotripsy. The aim of our study is to evaluate the foregoing effects and the efficacy of long-term treatment with potassium citrate to prevent stone recurrence in patients undergoing extracorporeal shock wave lithotripsy. METHODS: A prospective study was conducted on 100 patients with calcium oxalate or calcium phosphate nephrolithiasis that had undergone treatment by extracorporeal shock wave lithotripsy (ESWL). The patients were divided into 4 groups: patients that were stone-free treated with potassium phosphate (25 cases) or fluid diet (25 cases) and patients with persistent residual lithiasis treated with potassium citrate (25 cases) or fluid diet (25 cases). Calculi were classified according to the changes observed during the study compared with the pre-study status as stable (no changes from the pre-study status, with or without residual stone), increased (increase in number or size of the residual stone or recurrence), and decreased (decrease in number or size or passage of the residual stone). RESULTS: Of the 50 patients treated with potassium citrate, 35 (70%) remained stable, 10 cases (20%) showed a decrease and 5 (10%) showed an increase. Of the 50 patients on fluid diet, 19 (38%) remained stable throughout the study, 4 (8%) showed a decrease and 27 (54%) showed an increase in stone size or number. The number of stone recurrence throughout the study in the 100 patients was 25 (25%); of these, 8 were in patients treated with potassium citrate and 17 of those that did not receive potassium citrate. CONCLUSIONS: Potassium citrate therapy has been found to be statistically significantly effective in the control of post-lithotripsy residual stone and stone recurrence.

[The adverse effects of the water-soluble iodinated contrast media used in excretory urography in the canine species]. / Efectos secundarios de los medios de contraste iodados hidrosolubles utilizados en la urografía excretora en la especie canina.

In five dogs with normal renal function, doses of 200, 400, 600 and 800 mg of iodine/kg bodyweight of iohexol (350 mg of iodine/ml) were assessed in comparison to a dose of 880 mg of iodine/kg bodyweight of meglumine-sodium amidotrizoate (370 mg of iodine/ml) to determine the hematologic and biochemical parameters, urinalysis and urinary osmolality, pulse and respiratory rates, and adverse effects were determined. The such clinical secondary effects as tachycardia, muscular contractions and tremors took place in the animals with the contrast Iohexol, these were transitory and without vital repercussion. There was no significant difference between groups and times in any of the biochemical and hematological parameters analyzed. A decrease in urine creatinine was observed on Amidotrizoate group 24 hours after administration of the contrast agent while an increased was observed on Iohexol 600 mg of iodine/kg in that time.

[Bromocriptine monotherapy of a prolactinoma causing erectile dysfunction]. / Monoterapia con bromocriptina de prolactinoma causante de disfunción eréctil.

OBJECTIVE: A case of erectile dysfunction in a patient with prolactinoma is described herein. METHODS/RESULTS: The literature on the incidence, diagnosis and therapeutic management of this condition is reviewed. Impotence may arise from several causes. It is widely accepted that 30-50% have an organic etiology, with vascular involvement being more prevalent than other causes (neurological, endocrinological, urological, iatrogenic, pharmacological, systemic diseases). Hyperprolactinemia, arising from a prolactinoma, is one of the endocrinological conditions causing impotence. In men, this endocrinological disorder is rarely accompanied by other clinical anomalies, such as gynecomastia, galactorrhea or signs of a pituitary tumor. The patient described herein presented with erectile dysfunction. During evaluation, he was found to be hyperprolactinemic. Subsequent assessment disclosed a pituitary adenoma. The patient was successfully treated with bromocriptine. CONCLUSION: Erectile dysfunction arising from hyperprolactinemia is uncommon. Serum prolactin levels, a lateral skull x-ray and CT/MRI are essential in the diagnosis and treatment of this condition. Treatment must be directed at the underlying cause. Bromocriptine has proved to be effective and carries a low risk of undesired effects.

[Bladder tumor. Presentation of 2 patients with soft tissue involvement]. / Tumor vesical Presentación de dos pacientes con extensión a tejidos blandos.

OBJECTIVE: To describe two uncommon cases of bladder tumor metastasizing to soft tissues. METHODS/RESULTS: Two patients with bladder tumor and cystic metastases in the abdominal wall are described. The cysts were easily palpable and were confirmed histologically. CONCLUSION: Soft tissues, like the abdominal wall, are unusual sites of metastasis of bladder tumor. The foregoing, however, should be considered in order to make an early diagnosis.

Corino-Andrade disease (familial amyloidotic polineuropathy type I) in Spain: urological and andrological disorders.

In our hospital, we have followed a group of patients with familial amyloidotic polyneuropathy (FAP), type I. This disease is characterized by a progressive sensitive-motor and autonomic polyneuropathy. The amyloid fibrils of FAP I contain a mutant transthyretin (TTR) molecule. More than 90% of TTR production occurs in the liver. Thus, therapy with liver transplantation has proved useful. All our patients received this treatment. In this study we describe the urological and andrological disorders caused by FAP type I in 12 patients with low bladder pressure and bladder neck obstruction with micturition disorders. In some males, it was accompanied by impotence and retrograde ejaculation produced by autonomic neuropathy. We believe hepatic transplantation may be the best treatment for this disease.

Primary retroperitoneal tumors. Comments on 22 cases. / Tumores retroperitoneales primarios. Comentarios sobre 22 casos.

Primary retroperitoneal tumours represent a very uncommon group of neoplasias that account for 0.1%-0.6% of all tumours. Interest in these tumorations arises from the therapeutical and diagnostic concerns they rise. These tumorations are of late diagnosis due to the high insidiousness of their symptoms and, generally, are quite large in size. Widespread use of echography and CAT, however, have increased the possibilities of an occasional asymptomatic diagnosis. Treatment is basically surgical, very much depending on the prognosis of the surgery aggressiveness and the degree of radicality achieved. This paper presents our series of primary retroperitoneal tumours diagnosed between 1978 and 1994.

[Local anesthesia in inguinoscrotal pathology]. / Anestesia local en patología inguinoescrotal.

Surgery, requiring the use of general orotracheal anaesthesia, has been the traditional treatment for many inguino-scrotal conditions. Over a number of years a gradual implementation of an alternative procedure consisting in the adoption of locoregional anaesthetic techniques has taken place, allowing to shorten hospital stays with the subsequent benefit for both the society at large, due of lower costs, and the patient through avoidance of general orotracheal anaesthetics and a faster discharge and return home. Based on these premises, 54 procedures were performed (16 inguinal varicocelectomies, 6 transinguineal orchiectomies, 21 hydrocelectomies, 3 spermatic cord cyst removals, 6 orchidopexy and 2 orchiectomies in patients diagnosed with testicular torsion). Our results demonstrate that this is an excellent technique which allows a ruled surgical procedure well tolerated by the patient and which allows to perform surgery without need of hospital stay.

[Eosinophilic cystitis: a single anatomopathologic entity and three different presentation forms. Proposed classification]. / Cistitis eosinofílica: un único cuadro anatomopatológico y tres diferentes formas de presentación. Propuesta de clasificación.

The present work was intended to be a revision of our series of Eosinophilic Cystitis and we have found that, from one single anatomicopathological picture three different clinical pictures emerge with different treatments and prognosis. Group I is constituted by young people and children with a profuse background of atopy and parasitosis, which develop mictional syndrome and haematuria and show good response to steroids. Group II includes middle-aged women, with development of chronic recurrent cystopaty and a poor response to treatment. Group III comprises elderly patients with a history of vesical injury or chronic vesical irritation, with no separate clinical signs and symptoms and requiring no treatment.

[Wünderlich syndrome. Review of its diagnosis and therapy. Report of 7 cases]. / Síndrome de Wünderlich. Revisión diagnóstica y terapéutica. A propósito de siete observaciones.

Spontaneous renal haemorrhage in the subcapsular and perirenal regions of non-traumatic etiology, or Wünderlich syndrome, is an uncommon but significant condition consisting in the sudden formation of an haematic collection in the renal cell. A retrospective evaluation of clinical data and radiological findings in 7 patients with spontaneous subcapsular and/or perirenal haemorrhage seen in our service between 1991 and 1995 has been conducted excluding from the study all those patients with a history of trauma, renal biopsy, anticoagulant therapy or renal failure undergoing treatment with haemodialysis or renal transplantation. The etiology of Wünderlich syndrome in our patients was heterogeneous but basically responded to a tumoral cause. CT was the method most frequently used and the one providing more information. The conservative approach appears to be the most acceptable option, unless malignant tumoral pathology can be demonstrated.

[Leydig cell tumor. Comments on 5 cases]. / Tumor de células de Leydig. Comentarios sobre cinco casos.

Leydig's cells tumours are a variant of testicular tumours. Its has a low incidence, accounting for just 1-3% of all testicular tumours. This tumour is characterized by its endocrine manifestations, and it is an element in the differential diagnosis of many endocrine sexual dysfunctions both in adults and children, due to the tumour's capacity to secrete hormones. This paper contributes 5 cases of Leydig's cells tumours diagnosed in our hospital between 1977 and 1993.

[Malignant fibrohistiocytoma coexisting with papillary tumor of the kidney pelvis: report of a case]. / Fibrohistiocitoma maligno coexistente con tumor papilar de pelvis renal: a propósito de un caso.

Presentation of one case of malignant fibrohistiocytoma in one patient seen for gross clotting haematuria during the study of which the coexistence of this tumour with a renal pelvis papillary one was discovered. The disease's clinical and diagnostic aspects are commented, with special emphasis on histological diagnosis. A review of the existing literature is also made.

[Inguinal bladder hernia. Report of 4 cases]. / Hernias vesicales inguinales. A propósito de cuatro casos.

Vesical hernias are, in general, a rare condition, except when they have an inguinal location. These are common, although their diagnosis is not so, and it is not infrequent that they are a chance finding of an inguinal herniorrhaphy procedure, during which relevant, but rare, complications have been described when the bladder has not been suitably identified. We present four cases of inguino-vesical hernia (three, massive hernia), and include a literature review.