[Sugar: treatment of choice in irreducible paraphimosis]. / Azúcar: tratamiento de elección en la parafimosis irreductible.

PURPOSE: To evaluate the effectivity of granulated sugar in the treatment of irreductable paraphimosis. CLINICAL CASES: During last year three patients have been treated by application of granulated sugar on prepuce and glands penis during 1-2 hours until edema reduction was observed. Paraphimosis could be reducted in all three cases. CONCLUSIONS: Sugar application reduce local edema permitting reduce paraphimosis in an incruent, cheap and without side effects way.

[Urologic disease emergency. Clinico-epidemiologic analysis at a district hospital]. / Patología urológica urgente. Análisis clínico-epidemiológico en un hospital comarcal.

OBJECTIVE: To present the results of a one-year retrospective study that analyzed the clinical and epidemiological aspects of urological emergencies, which is not a negligible percentage of all hospital emergencies. METHODS: Data on all the urological emergencies of the emergency department of our hospital were collected during a one-year period by filling out a form that included sex, age, whether referred or not, disease, etc. RESULTS: There were 1504 urological emergencies; the urologist was required in 458 of these cases (30.45%). There were more men (837) than women (667). Patient ages ranged from 1-101 years (mean 53 years); a higher incidence was found for those aged 65 years. By age groups, there were more patients aged 61-80 years (575 patients). Most of the patients came to the hospital on their own initiative (1114) and 390 had been referred by their primary care physician. Renal colic (670 cases) was the most common diagnosis in both males and females, followed by cystitis, which was prevalent in the females (67.35%). Other conditions seen were urinary retention, hematuria, etc. CONCLUSIONS: There was a higher prevalence of males that consulted for urological conditions at the emergency department and there was a higher incidence in patients in the 6th and 7th decades of life, which is similar to the findings reported in other studies. Renal colic was the main reason for consultation for both genders and for all age groups, except those younger than 20 who presented more scrotal and penile involvement. Infective conditions involving the lower urinary tract (cystitis) and pyelonephritis were prevalent in the females. The large number of patients that were discharged from the emergency department and who consulted on their own initiative shows their confidence in the emergency services and that they could have been attended to at other health centers and did not have to come and unnecessarily strain the hospital emergency services.

[Reabsorption syndrome. Report of a case]. / Síndrome de reabsorción. Presentación de un caso.

OBJECTIVE: To report a case of TURP syndrome and emphasize the importance of early diagnosis. METHODS: A case of reabsorption syndrome in a patient that underwent transurethral resection under spinal anesthesia is presented. RESULTS: Reabsorption syndrome (TURP syndrome) is manifested by neurological and hemodynamic changes resulting from absorption of irrigating fluid used during transurethral resection of the prostate. This complication presented in a patient undergoing elective surgery and with no additional risk factors. CONCLUSIONS: Since it is impossible to prevent this complication of TUR, spinal anesthesia should be utilized whenever possible because it permits early detection before important complications develop.

[Scrotal leiomyoma]. / Leiomioma de escroto.

A case of a 32-year-old patient with a diagnosis of leiomyoma of the scrotum was studied. Histologic analyses did not yield evidence of malignancy. Full excision of tumor was achieved and the postoperative period was uneventful.

Azúcar: tratamiento de elección en la parafimosis irreductible / Sugar: elective treatment of irreducible para phimosis

PROPÓSITO: Evaluar la efectividad del uso del azúcar granulado en el tratamiento de la parafimosis irreductible. CASOS CLÍNICOS: Durante el último año han sido tratados 3 pacientes mediante la aplicación de azúcar sobre glande y prepucio durante 1-2 horas, hasta observar la reducción del edema. Se ha conseguido la reducción de la parafimosis en todos los casos. CONCLUSIONES: La aplicación de azúcar local reduce el edema de la parafimosis permitiendo reducir ésta de forma incruenta, barata y carente de efectos secundarios (AU)

Leiomioma de escroto / Leiomyoma of the scrotum

Se presenta un caso de leiomioma escrotal en un paciente de 32 años que consultó por masa escrotal. El estudio histológico no demostró signos de malignidad. El tumor fue extirpado por completo, con evolución posterior favorable (AU)

[Renal infarct in the adult: apropos of a case]. / Infarto renal en el adulto: a propósito de un caso.

OBJECTIVE: To report a case of renal infarction in a patient on anticoagulant therapy for aortic and tricuspid valvulopathy, with special reference to the diagnostic difficulty. METHODS: The most common causes of this condition, its forms of presentation, diagnostic methods, and therapeutic approaches are discussed. RESULTS/CONCLUSIONS: Renal infarction should be suspected in the presence of abdominal pain of sudden onset that is refractory to treatment with analgesics, especially in patients with a history of embolism, recent surgery or trauma. It is frequent to find increased levels of SGOT, SGPT, LDH, alkaline phosphatase and micro or gross hematuria and proteinuria. Arteriography or isotopic renogram is utilized to confirm the diagnosis, although IVP or CT is useful if the foregoing are not available. Early treatment is important for achieving recovery of the compromised renal parenchyma. In recent years, surgery has been displaced by the good results obtained with intraarterial infusion of fibrinolytics.

[Penile primary melanoma; report of a case]. / Melanoma primario de pene; a propósito de un caso.

OBJECTIVE: An uncommon variant of penile tumor associated with chronic lymphoid leukemia is presented. METHODS/RESULTS: A case of primary melanoma of the penis associated with chronic lymphoid leukemia is presented. Diagnosis was based on the anatomopathological findings. Lymph node involvement could not be determined due to the associated leukemia. Conservative management was instituted due to the patient's age. CONCLUSIONS: Primary melanoma of the penis is a very aggressive and uncommon tumor. To our knowledge, less than 140 cases have been reported. Hyperpigmented lesions must be biopsied to rule out melanoma.

[Lipoma of spermatic cord; report of a case]. / Lipoma de cordón espermático; presentación de un caso.

OBJECTIVE: To report an additional case of lipoma of the spermatic cord, an uncommon, silent tumor. METHODS: A case of lipoma of the spermatic cord is described. The patient had presented with an enlarged scrotum with no symptoms. The literature on lipoma of the spermatic cord is briefly reviewed, with special reference to its diagnosis, forms of presentation and treatment. RESULTS: US evaluation demonstrated a mass adhered to the epididymis. An epididymal tumor was suspected and surgical exploration by the inguinal approach was performed. CONCLUSIONS: Lipoma is the most common tumor of the spermatic cord. Its etiology is unknown. It frequently appears in the fourth and fifth decades of life and usually involves the left hemiscrotum. It is silent and is detected by enlargement of the scrotum. The diagnosis is histological supported by US, which offers a reliability of 80%-100%. Treatment is by surgery in all cases.

Síndrome de tietze en la infancia. Revisión clínicoepidemiológica en el Área de Salud del Bierzo / Tieze's Syndrome in childhood. Clinico-epidemiological review in the Health Care Area of Bierzo

El síndrome de Tietze es una inflamación benigna localizada en la unión esternocostal o condrocostal de causa desconocida y raro en niños. Se realizó un estudio para la detección de esta entidad en nuestro medio, retrospectivamente durante un año en el Servicio de Urgencias hospitalario y durante el mismo período, uno prospectivo en una consulta de pediatría en Atención Primaria. Como criterios de inclusión se han utilizado la presencia de dolor costal o costocondral localizado y tumoración en la zona. Sólo se encontró el síndrome de Tietze en mayores de 10 años, siendo más frecuente en cartílagos costales bajos. Las pruebas complementarias fueron normales. El tratamiento consiste en analgésicos y/o AINEs, con resolución favorable aunque un caso requirió esteroides y terapia no farmacológica: estimulación nerviosa eléctrica transcutánea (TENS).Este síndrome debe de ser tenido en cuenta para evitar estudios y pruebas diagnósticas sofisticadas e invasivas, siendo la clínica el elemento más útil cuando se sospecha (AU)

[Spermatic cord torsion in the Comarca del Bierzo. Clinico-epidemiological analysis of the 5-year period 1994-1998]. / Torsiones de cordón testicular en la Comarca del Bierzo. Análisis clínicoepidemiológico del quinquenio 1994-1998.

OBJECTIVE: To review the cases of torsion of the spermatic cord diagnosed at the emergency and urology services of our hospital over the last 5 years and analyze the clinical and epidemiological features. METHODS: The cases of torsion of the spermatic cord diagnosed at our hospital from 1994-1998 were reviewed. Age, reason for consultation, time from onset of symptoms to consultation, location of the torsion, final diagnosis, treatment, and other data were analyzed. RESULTS: There were 20 cases of torsion of the spermatic cord in patients aged 1 to 25 years, with the highest incidence at age 14 years. The left testis was more frequently compromised. Six patients had a history of testicular pain and/or inflammation. The mean time from presentation of symptoms to consultation was 13.5 hours (range 1 hour to 7 days). The diagnosis was torsion of the spermatic cord in 14 cases and hydatid torsion in 6. Treatment was fundamentally by surgery (orchidopexy), except in three cases that spontaneously resolved or were detorsioned by manipulation. Two patients underwent excision of the compromised testis. CONCLUSIONS: Torsion of the spermatic cord is a urological emergency due to the high risk of complications that may even require orchidectomy. The epidemiological findings for our area are similar to those reported in other series.

[Mumps orchitis; review of 8 cases]. / Orquitis urliana; revisión de 8 casos.

OBJECTIVE: To determine the incidence of mumps orchitis in young males in the area of El Bierzo (Ponferrada, Spain) and the complications arising from this condition. METHODS: The cases of mumps orchitis referred by the primary care services to the emergency services of Hospital del Bierzo referral center were reviewed. We analyzed patient age, unilateral or bilateral testicular involvement, whether the patients had been vaccinated against mumps and the changes observed in the semen analysis. RESULTS: The diagnosis of mumps orchitis was confirmed in 8 patients, aged 15 to 19 years. Two patients had bilateral testicular involvement. Seven patients had not been vaccinated against parotiditis. Three patients had oligoasthenospermia and are currently being followed at the Urology services. CONCLUSIONS: The utility of large scale vaccination against mumps is emphasized. Long-term follow-up is recommended for all patients with abnormal semen analysis, particularly those with bilateral testicular involvement, since they may develop oligoasthernospermia several years after the infection or improve with item. A high incidence of mumps orchitis was found for this 12-month study period.