[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.

[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.

[Matrix lithiasis. Apropos a case of staghorn lithiasis]. / Litiasis blandas. A propósito de un caso de litiasis coraliforme.

Presentation of one case of soft lithiasis in a child which was treated by pyelolithectomy with good results and which has not relapsed after a 20-year follow-up. A commented revision is made of related literature.

[Invasive angiomyxoma of the scrotum]. / Angiomixoma invasivo de escroto.

Herein we report on a 70-year-old patient with invasive angiomyxoma of the scrotum that had evolved for more than 30 years. The tumor's enormous size (4.225 gms.), its rarity and clinical behaviour are highlighted. There was no distant metastasis and tumor recurrence was by local infiltration. Its histologic features, which are like those of myxomatous tumors, are described.

[Late adrenal gland metastasis of contralateral renal adenocarcinoma]. / Metástasis suprarrenal tardía por adenocarcinoma renal contralateral.

A case of adrenal gland metastasis caused by contralateral adenocarcinoma of kidney nephrectomized 11 years previously in a 68 years old patient is presented. The rarity of the case due to its limited frequency and the long disease-free interval is emphasized, and the possible routes of metastatic affectation of the adrenal gland by renal tumors discussed.

[Superficial bladder carcinoma: clinical and epidemiological analysis of 250 patients]. / Carcinoma superficial de la vejiga urinaria: análisis clinicoepidemiológico de 250 pacientes.

The neoplasms of bladder are an important part of genitourinary tumors. Superficial forms represent 70-80% of their overall number. We have carried out a retrospective clinical and epidemiological study of 250 patients seen in our service during a 12-year period. We found that the disease was more common in males aged 60-70 years, usually being multiple tumors and mostly in the lateral walls of the bladder. Most tumors were in grades 1 and 2 of UICC and in stage O of Jewett's classifications, with a clear association between the degree of cell differentiation and the stage of infiltration. There was no correlation of age and sex with the number of tumors, their localization, cellular degree and tumor stage. There was a correlation between the number of tumors and their localization; thus, single tumors had a preference for lateral walls, while multiple tumors predominated in the bladder fundus.

[Crossed renal ectopy without fusion. Case report]. / Ectopia renal cruzada sin fusión. Presentación de un caso.

We report a case of crossed renal ectopia without fusion in a 30-year-old patient who had consulted for unspecific abdominal pain and micturition syndrome from an unstable detrusor and urethra. We underscore the rarity of this malformation in comparison with crossed fused renal ectopia, a condition reported to account for almost 90% of crossed renal ectopias. The embryogenic hypotheses that have been put forward relative to this malformation are presented, and the urinary and other system malformations frequently associated with this condition are discussed.

[Duodenal obstruction: first manifestation of giant hydronephrosis]. / Obstrucción duodenal: primera manifestación de una hidronefrosis gigante.

We report a case of giant hydronephrosis from lithiasis and xanthogranulomatous pyelonephritis in a 69-year-old patient, whose presenting symptoms were those of duodenal obstruction.

[Cytology by lavage in the follow-up of bladder neoplasms]. / Citología por lavado en el seguimiento de las neoplasias vesicales.

We evaluated the results of urinary cytology, obtained from bladder washing, in the follow-up of patients with superficial bladder tumors. For the study, we used 545 samples. These were compared with the cystoscopic findings when cytology was negative, and with the biopsy findings when positive. We observed that the sensitivity of cytology increased with tumor grade, stage and number. The highest sensitivity rate was observed for carcinoma "in situ". However, a low specificity rate was observed for single, low grade/stage lesions. False-positives diminished inversely with cytologic grading, which was only 8% for cytology grade 3. There were more false-positives in patients that were on prophylactic therapy with thiotepa. The foregoing increased with the duration of treatment. Bladder lithiasis, abacterial cystitis, urinary infection, adenoma and prostatic cancer found to yield falsely positive results. False-negatives appeared principally in single, low grade/stage tumors. We underscore the low number of false-negatives observed in patients on thiotepa or those with bladder diverticulum. Follow-up of patients with true-negative or false-positive cytology showed a higher incidence and earlier tumor recurrence in the latter patient group. We discuss all the foregoing findings and present a protocol for patient follow-up.

[Prognostic factors in superficial bladder carcinoma. Analysis of 250 cases]. / Factores pronósticos en el carcinoma vesical superficial. Análisis de 250 casos.

Surface vesical tumors constitute 80% of transitional cell tumors. They are neoplasms of slow evolution, but characterized by their tendency to recur and progress in time. The prognostic factors, as regards recurrence and progression, are going to depend on a series of macroscopic or microscopic anatomic characteristics. We present our observations on some prognostic aspects in surface vesical carcinoma obtained from a study of 250 patients. By way of conclusion, from our observations we may infer that neither age, nor sex nor location, save in the case of patients under the age of 40, have prognostic value in the evolution of the primary tumor, which will be noticeably better (lower percentage of relapses and longer illness-free period) in patients with a single tumor of low grade and state, and in general in patients receiving intravesical prophylactic chemotherapy treatment, and no difference is found between thio-tepa and adriamycin.

[Value of postoperative cytology for the early diagnosis of incomplete resection of bladder tumors]. / Valor de la citología postoperatoria como diagnóstico precoz de resección incompleta de tumores vesicales.

The possibility that after T.U.R. of superficial bladder tumors, some fragments remain unresected, or that local metastases may have gone unnoticed during surgery which may later be interpreted as early relapses of the original tumor, has led us to assess urine cytology taken through early bladder lavage after T.U.R. as a means to control complete removal of tumors during endoscopic surgery. After comparing cytologic results with cystoscopic and biopsy findings, it was found that the sensitivity of the method increased progressively with the degree and staging of the original lesion, with "in situ" carcinomas presenting the highest percentages relating to low grade cytology due to the great similarity these cells have with those of urothelial repair. The best time to obtain samples for cytologic study is at the withdrawal of the catheter, coinciding with cessation of hematuria.

[Benign unilateral hematuria causing anemia by mesangial deposit of IgM]. / Hematuria benigna unilateral anemizante por depósito mesangial de IgM.

We present a case of benign unilateral persistent hematuria, due to nephrectomy due to important anemia and requiring several blood transfusions. The only pathological finding obtained during the study of the kidney was the presence of mesangial deposits of IgM. This process is very rare due to its unilateral feature, relevance of the hematuria and from the paradoxical finding that a percutaneous biopsy revealed a normal kidney during a study prior to nephrectomy.

[Comparative study of adriamycin and thiotepa in the chemoprophylaxis of superficial bladder tumors]. / Estudio comparativo entre adriamicina y thiotepa en la quimioprofilaxis de los tumores vesicales superficiales.

We present a comparative study of the evolution of 250 patients with primary surface tumour, analysing the percentages of relapses and period free of illness according to the type of endovesical chemoprophylactic treatment administered. In 103 cases no chemotherapy treatment at all was administered, whilst in 90 cases thiotepa was applied and in 57 adriamycin. We have studied the evolution of these patients in accordance with the number of tumours, location, cell grade and stage, assessing the progression in grade and state of the primary tumours. After analysing the results, we observe that relapses are significantly more numerous and more precocious in patients receiving no chemotherapy treatment at all, and differences may be seen on an overall basis between adriamycin and thiotepa. In grade 1, stage 0 and single tumours, though they displayed a longer period free of illness in treated patients, the relapses were similar to those of non-treated patients. In this type of tumour thiotepa proved more effective than adriamycin, although the latter provides a longer period free of illness. Patients with high grade and stage tumours do indeed relapse significantly less and later when they receive treatment, and adriamycin achieves better results. As regards location, save in the case of tumours located on the cupula and front face, where relapses were the same between groups of treated and non-treated patients, in the rest the evolution of the tumours was better in treated patients irrespective of location.(ABSTRACT TRUNCATED AT 250 WORDS)

[Calcification of the intrarenal excretory tract in a transplanted kidney]. / Calcificación de la vía urinaria excretora intrarrenal en riñón transplantado.

We present a clinical case of calcification of the intrarenal excretory tract as a complication of kidney transplant. Its etilogic study indicates infection by urea splitting germs as the main cause. In the literature reviewed we found renal lithiasis as an uncommon complication. However, we found no case of urothelial mucus coating by mineral apposition as in the case described.

[Diagnostic and therapeutic value of puncture nephrostomy. Review of 45 cases]. / Valor diagnóstico y terapéutico de la nefrostomía por punción. Revisión de 45 casos.

The present study reports our experience in 45 patients submitted to percutaneous nephrostomy. We describe the indications of this procedure and highlight its efficacy in making etiologic diagnosis and recovering renal function. Similarly, we underscore its efficacy in the treatment of sepsis, anuria, and dissolution of uric acid calculi. The low incidence rate of complications and no mortality from this procedure, and its diagnostic and therapeutic efficacy make it a common procedure in day-to-day urological practice.

[Puncture of urinary tract for the diagnosis of its obstruction. Review of 60 cases]. / Punción de vías urinarias como medio diagnóstico de obstrucción de las mismas. Revisión de 60 casos.

We present the results of percutaneous translumbar puncture (PTP) performed in 60 patients diagnosed as having urinary tract obstruction in whom the urographic, ultrasonographic, arteriographic work up and placement of a ureteral catheter for ascending pyelography failed to determine the exact level or nature of the obstruction. We emphasize the fact that PTP revealed the site of obstruction or showed the urinary tract was normal in 86.6% of the cases. The level of obstruction was undetermined in 8.3%, and in 5% of the cases PTP could not be performed. In 75% of the cases, the diagnosis of the nature of the obstruction yielded by PTP was confirmed medically or surgically. This was unconfirmed in 11.6%. Minor complications, most of which were due to extravasation of the contrast medium, were observed in only 18.3%.