Tratamento conservador de trauma renal grave após litotripsia extracorpórea por ondas de choque / Conservative treatment of severe renal trauma after extracorporeal shockwave lithotripsy

Subcapsular and perinephric hematomas are relatively common after shock-wave lithotripsy, but high-grade kidney injuries are extremely rare. We present the first case of a high-grade kidney injury after shock-wave lithotripsy managed conservatively. A 57-year-old white female patient with left 1.5cm superior ureteral calculi was submitted to shock-wave lithotripsy.

[Conservative treatment of severe renal trauma after extracorporeal shockwave lithotripsy]. / Tratamento conservador de trauma renal grave após litotripsia extracorpórea por ondas de choque.

Subcapsular and perinephric hematomas are relatively common after shock-wave lithotripsy, but high-grade kidney injuries are extremely rare. We present the first case of a high-grade kidney injury after shock-wave lithotripsy managed conservatively. A 57-year-old white female patient with left 1.5cm superior ureteral calculi was submitted to shock-wave lithotripsy.

Comparison of virtual cystoscopy and transabdominal ultrasonography with conventional cystoscopy for bladder tumor detection.

PURPOSE: We compare virtual cystoscopy (VC) and transabdominal ultrasonography (US) with conventional cystoscopy (CC),the gold standard, for detection of bladder tumors. PATIENTS AND METHODS: Forty-five patients suspected to have bladder neoplasms were evaluated prospectively.They underwent transabdominal US, followed by VC and CC. We compared sensitivity and specificity of US and VC and their positive and negative likelihood ratios. US and VC detection rates for tumors

Testicular schistosomiasis caused by Schistosoma mansoni: a case report from Brazil.

Testicular schistosomiasis by Schistosoma mansoni is exceedingly rare, with only 11 cases reported in PubMed. We report a new case from Brazil. A 31-year-old man from the northeast region of the country presented with a 2 cm nodule in the right testis. Ultrasonography showed a well-delimited hypoechoic tumor, suggestive of a granulomatous lesion. Magnetic resonance imaging revealed an irregular tunica albuginea signal. A biopsy showed interstitial tissue with schistosome ova and granuloma formation. The nodule was excised, and the patient was treated with oxamniquine. He has remained symptom free for 10 years. A testicular nodule should raise suspicion of numerous pathologies, including schistosomiasis. Treatment should include therapy with oxamniquine or praziquantel, and nodule excision should be done whenever possible.

Testicular schistosomiasis caused by Schistosoma mansoni: a case report from Brazil

Testicular schistosomiasis by Schistosoma mansoni is exceedingly rare, with only 11 cases reported in PubMed. We report a new case from Brazil. A 31-year-old man from the northeast region of the country presented with a 2 cm nodule in the right testis. Ultrasonography showed a well-delimited hypoechoic tumor, suggestive of a granulomatous lesion. Magnetic resonance imaging revealed an irregular tunica albuginea signal. A biopsy showed interstitial tissue with schistosome ova and granuloma formation. The nodule was excised, and the patient was treated with oxamniquine. He has remained symptom free for 10 years. A testicular nodule should raise suspicion of numerous pathologies, including schistosomiasis. Treatment should include therapy with oxamniquine or praziquantel, and nodule excision should be done whenever possible.

Abscesso perineal por ingestão acidental de palito de dente / Perineal abscess for accidental ingestion of toothpick

Palitos de dente são itens domésticos comuns e a maioria das pessoas subestima a gravidade das lesões que podem ocorrer com a ingestão acidental de palitos. Nós apresentamos um caso de abscesso perineal causado pela ingestão de um palito de dente. Um homem de 55 anos apresentou-se com quadro de dor perianal há um mês. Ao exame físico, notou-se abscesso perineal. Leucocitose com desvio à esquerda foi observada e a tomografia pélvica demonstrou um corpo estranho na região perineal. A remoção cirúrgica do corpo estranho e a drenagem adequada do abscesso foram realizadas, revelando um palito de dente. O paciente evoluiu bem após a abordagem cirúrgica. O abscesso perineal pode progredir para gangrena de Fournier e, portanto, a abordagem de abscessos perineais deve ser agressiva, com drenagem adequada e remoção do corpo estranho (sempre que presente).

Prostatectomia radical: correlaçao entre o numero de intervençoes realizadas e a preservaçao da potencia sexual e da continencia urinaria / Radical prostatectomy: correlation between surgical skill and rates of post-operative sexual potency and urinary continence

Oitenta e cinco pacientes portadores de cancer da prostata submetidos a prostatectomia radical foram divididos em tres grupos de estudo, em funçao da epoca da intervençao, correlacionando-se os indices de preservaçao da potencia sexual e da continencia urinaria com a tecnica e o momento da intervençao. Todos os pacientes foram tratados pelo mesmo cirurgiao, 55 deles foram acompanhados por pelo menos 12 meses e 36 destes referiam funçao sexual preservada no pre-operatorio. Nos pacientes operados pela tecnica de Campbell no periodo de 1980-1984, os indices de incontinencia urinaria e de preservaçao da potencia sexual foram, respectivamente, de 25 por cento e 0 por cento. Por outro lado, os pacientes submetidos a prostatectomia radical pela tecnica de Walsh no periodo de 1985-1986, evidenciaram indices de incontinencia urinaria e de preservaçao da funçao sexual, respectivamente, de 9 por cento e 25 por cento. Finalmente, nos pacientes tratados pela tecnica de Walsh com pequenas modificaçoes, no periodo de 1987-1990, observou-se incontinencia urinaria e potencia sexual em, respectivamente, 6 por cento e 55 por cento dos casos. De acordo com estes resultados, as chances de incontinencia urinaria e, principalmente, de impotencia sexual apos prostatectomia radical atenuam-se com a aquisiçao de maior experiencia cirurgica pelo operador, existindo uma curva de aprendizado que exige pelo menos 20 intervençoes para que a capacidade erectil possa ser preservada em um contigente mais significativo de pacientes