ABSTRACT
OBJECTIVE: To present a case of solitary pelvic kidney with congenital absence of the vagina. METHODS: A patient with solitary pelvic kidney and vaginal aplasia is described. Patient evaluation included hematological, hormonal, cytogenetic, laparoscopic and imaging studies. RESULTS: Blood, hormone and cytogenetic studies were normal. Laparoscopy showed absence of the uterus and both tubes and ovaries, which was confirmed by pneumopyelography. IVP showed absence of renal shadows and a solitary pelvic kidney. CONCLUSIONS: Congenital absence of the vagina should be suspected in a patient with a pelvic solitary kidney consulting for primary amenorrhea.
Subject(s)
Abnormalities, Multiple/diagnosis , Kidney/abnormalities , Vagina/abnormalities , Adult , Female , HumansABSTRACT
OBJECTIVES: To describe a 41-year-old, white, male patient with a previous history of rectal pain. He was diagnosed as having a prostatic tumor and was treated with antiandrogens and irradiation, which temporarily achieved temporary symptomatic relief. When the symptoms reappeared, the patient consulted at our hospital. A multinodular tumor was detected in the rectum. Transrectal ultrasound-guided biopsy disclosed adenoid cystic carcinoma of the prostate or adjacent structures. METHODS/RESULTS: The characteristics of the lesion prompted tumor excision alone. Since the integrity of the rectal and prostatic urethra could not be preserved, a recto-urethral fistula was done, which was subsequently closed via the transrectal approach. The clinical characteristics of the tumor and the surgical procedure performed required treatment with an antitumoral immunomodulator (recombinant a-interferon) for one year. CONCLUSIONS: One and a half years postoperatively, no signs of tumor recurrence or distant metastasis have been observed. To our knowledge, this is the seventh case reported in the world literature and the first in the Spanish literature.
Subject(s)
Carcinoma, Adenoid Cystic , Prostatic Neoplasms , Adult , Carcinoma, Adenoid Cystic/diagnosis , Carcinoma, Adenoid Cystic/surgery , Humans , Male , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/surgeryABSTRACT
OBJECTIVE: To describe a case of crossed testicular ectopia that was diagnosed in a 52-year-old patient who had consulted for infertility associated with a genital anomaly. METHODS: Patient evaluation included hematological, hormonal, cytogenetic and imaging studies. An exploratory operation was also performed. RESULTS: The hematological, hormonal and cytogenetic studies gave normal results. There were no urinary tract abnormalities in the intravenous urography; retrograde urethrography disclosed a narrow duct behind the urethra that ascended towards the left inguinal duct and divided into two epididymides after reaching the scrotum. Surgical exploration showed two testes in the left scrotal pouch that were biopsied. Histological examination revealed an almost complete hyalinization of the tubular wall with no germ cells within the tubules. CONCLUSIONS: Crossed testicular ectopia is one of the most uncommon testicular anomalies and is often associated with other disorders such as inguinal hernia, hypospadias, pseudohermaphroditism and scrotal abnormalities. Like all dysgenetic testes, progression to malignancy is relatively frequent. The foregoing should be remembered when dealing with these patients.
Subject(s)
Testis/abnormalities , Disorders of Sex Development/diagnosis , Gynecomastia/diagnosis , Humans , Infertility, Male/diagnosis , Male , Middle Aged , Oligospermia/diagnosisABSTRACT
Our modifications to the Stamey, Guittes and Raz procedures are described and discussed. Our own experience of seven years and the experience reported by other authors in the world literature demonstrate the usefulness of the vagina in endoscopic percutaneous surgical treatment of female stress urinary incontinence. The complication rate is reduced, efficacy is enhanced and different alternatives are possible depending on the anatomic and functional characteristics of each case.
