[Clinical cases about secondary sterility caused by obstructive azoospermia with surgical repair possibilities]. / Casos clínicos de esterilidad secundaria por azoospermia obstructiva subsidiaria de reparación quirúrgica.

Secondary sterility in male patients is due to sperm alterations in a high proportion of cases. But, obstructive azoospermia set up a very important cause of sterility, because a surgical repair is possible. Some of the factors cause obstructive azoospermia are the herniorrhaphy intervention, including secondary inflammatory reaction, and epididymal lesion or epididymitis. Currently, both cases are important due to high frequency of these aetiologies. Besides we should identified obstructive cause to provide a surgical repair.

Casos clínicos de esterilidad secundaria por azoospermia obstructiva subsidiaria de reparación quirúrgica / Clinical cases about secondary sterility caused by obstructive azoospermia with surgical repair possibilities

La esterilidad secundaria masculina es debida en una elevada proporción de casos a alteraciones en el esperma. Por otro lado, la azoospermia obstructiva constituye una causa importante de esterilidad, al ser subsidiaria de reparación quirúrgica. Entre los factores que intervienen en la azoospermia obstructiva encontramos la cirugía tras herniorrafia, en donde cabe destacar los procesos inflamatorios subsiguientes, y la lesión epididimaria o epididimitis previa. La importancia de los casos presentados radica actualmente, en la elevada frecuencia de dichas etiologías y en la identificación de causas obstructivas, dado que son potencialmente resolubles (AU)

Secondary sterility in male patients is due to sperm alterations in a high proportion of cases. But, obstructive azoospermia set up a very important cause of sterility, because a surgical repair is possible. Some of the factors cause obstructive azoospermia are the herniorrhaphy intervention, including secondary inflammatory reaction, and epididymal lesion or epididymitis. Currently, both cases are important due to high frequency of these aetiologies. Besides we should identified obstructive cause to provide a surgical repair (AU)

[Ureteral lesions caused by external trauma: diagnosis and treatment]. / Lesiones ureterales por traumatismo externo: diagnóstico y tratamiento.

OBJECTIVES: We report our experience in the diagnosis and treatment of ureteral injury. METHODS: Review of the experience in our hospital. RESULTS: We describe two cases of complete rupture of the ureter from blunt and penetrating abdominal trauma that had been recognized late. A urinoma was the presenting feature in both cases. Treatment was by end-to-end anastomosis in the first case and by appendix interposition in the other case. CONCLUSIONS: Ureteral injuries owing to abdominal trauma are usually silent. Veriform appendix interposition of the ureter is, in selected cases, a therapeutic option.

[Quinolone-resistant Escherichia coli in the health area of a 650-bed hospital]. / Escherichia coli resistente a quinolonas en el area sanitaria de un hospital de 650 camas.

Report of a retrospective study to evaluate susceptibility of Escherichia coli to quinolones covering the March-December 1992 interval. During this time, intra and extra-hospital strains were indistinctly studied in patients with urinary infections seen in a health district serving a total of 200.000 inhabitants. Resistance to Pipemidic acid, Norfloxacin and Ciprofloxacin was evaluated. The values found were 14.8% resistance to Pipemidic acid, 11.1% to Norfloxacin and 8.5% to Ciprofloxacin. It seems necessary to develop and apply methods addressed to minimize the appearance of quinolone resistance, which should be implemented in order to preserve the usefulness of these drugs.

[Is urogenital tuberculosis a current disease still?]. / Es todavía la tuberculosis urogenital una enfermedad actual?

In 1991, the epidemiology service of the health department of La Rioja announced that the number of deaths and new cases were higher than the national average (45/100,000 in 1991). Our service detected 16 new cases of urogenital tuberculosis during 1990-1991. The most common clinical symptoms being urgency and frequency. The bacteriological diagnosis using the Lowenstein-Jensen culture medium was positive in 87.50% of the cases. Anomalies were detected in 87.50% of the urographic analyses, the more frequently observed being infundibular involvement. Polychemotherapy consisting of rifampicin, ethambutol and isoniazid was administered for a period of 9 months in all of the cases, which resulted in negative cultures in 100% of the patients. Control evaluation was performed every 3 months, including CBK and serial bacilloscopy, biochemical assays, renal ultrasound, examination of eye grounds (1st trimester), chest X-ray and sputum bacilloscopy. Only endourological methods were utilized, except in one patient with coexisting congenital stricture of the pyeloureteric junction.

Blunt traumatic rupture of the high right ureter, repaired with appendix interposition.

We report the first case of upper lumbar ureteral replacement with the vermiform appendix, in a blunt traumatic ureter rupture with important urinoma. In selected cases, in which the appendix has a required caliber and length, the vermiform appendix is a very good autograft for ureteral substitution. The vermiform appendix must be preserved if possible in the abdominal surgery.

[Non-stenotic anterior urethral lesions. Diagnosis by echographic urethrography]. / Lesiones de uretra anterior no estenóticas. Diagnóstico por uretrografía ecográfica.

The results of a study using sonographic urethrography, radiologic retrograde urethrography and urethroscopy to evaluate 11 different types of non-stenotic lesions of the urethra are presented. Sonographic urethrography accurately diagnosed all of the findings and radiologic retrograde urethrography had 7 false negatives. Based on the foregoing results, we advocate the use of sonographic urethrography as a valid alternative in the evaluation of non-stenotic urethral lesions.

[Complete separation between epididymis and testis associated with cryptorchism. Presentation of a case and review of the literature]. / Desunión completa epidídimo testicular asociada a criptorquidia. Presentación de un caso y revisión de la literatura.

We report a case of complete separation of the epididymis and testis discovered during surgery for cryptorchidism. The epididymis was found in the scrotum and the testis in the inguinal canal. Although this malformation has been reported sporadically, the incidence in patients with cryptorchidism may be higher. These cases support the hypothesis that testicular descent is guided by the tail of the epididymis.

[Diagnostic efficacy of echographic urethrography in the study of urethral stenosis. Comparison with radiologic retrograde urethrography]. / Eficacia diagnóstica de la uretrografía ecográfica en el estudio de estenosis uretrales. Comparación con la uretrografía retrógrada radiológica.

Presentation of the first study on the diagnostic efficacy in the study of stenosis with ultrasound urethrography (U.U.) as compared to X-ray retrograde urethrography (X.R.U.). Sensitivity of U.U. in anterior bulbar urethra is, in general, higher than that of X.R.U. (100 U.U. > 88 X.R.U.) while X.R.U. specificity is higher in the posterior bulbar urethra (100 X.R.U. > 97 U.U.). In penile urethra both techniques showed a 100% diagnostic efficacy. Stenosis located in the posterior bulbar urethra are the most difficult to diagnose with ultrasound techniques.

[Obstruction of double-J catheter. Obstruction of urinary drainage in the renal unit with double-J catheter. Two different concepts]. / Obstrucción de catéter doble "J". Obstrucción del drenaje urinario en la unidad renal portadora de catéter doble "J". Dos conceptos diferentes.

We report on three patients with a functioning solitary kidney that required placement of a double-J catheter. All three patients presented with obstruction of urinary drainage within three weeks. In one patient clots were observed inside the catheter. The catheters of the other two patients, however, showed no signs of obstruction. Two patients presented symptoms and signs of reduced volume of diuresis and the other a deteriorated general condition. In patients with a normally functioning contralateral renal unit, deterioration of renal function of the unit with an indwelling double-J catheter may probably go undetected. A compromised urinary drainage of the renal unit with an indwelling double-J catheter is not necessarily associated with obstruction of the catheter lumen. Urinary drainage around an obstructed double-J catheter is not sufficient in all cases.