Testicular tumour diagnosis and its management are widely known by urologists, although there are some exceptional diagnoses with rare clinical profiles. We report the unusual case of a young man ...presenting neuropsychiatric symptoms with no evidence of neurological disease and increased serum anti-Ma2 antibodies, which are associated with germ cell tumours. Our patient was finally diagnosed with a likely left testicular tumour, an orchidectomy was performed and the symptoms disappeared. Only four cases with a similar clinical background and evolution have been reported in the literature.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
OBJETIVOS: Ante una entidad infrecuente como es el adenocarcinoma de uretra femenina, deseamos aportar dos casos y revisar las últimas publicaciones. Además queremos recordar de forma breve, la ...clasificación y el tratamiento de este tipo de tumor. MÉTODOS/RESULTADOS: Presentamos dos mujeres diagnosticadas de adenocarcinoma de uretra, describiendo la presentación clínica, métodos diagnósticos empleados, tratamiento utilizado y características histológicas. CONCLUSIONES: Los adenocarcinomas de uretra femenino constituyen un tipo tumoral infrecuente, originados a partir de diferentes estructuras. Los carcinomas de uretra distal tienen mejor pronóstico por su diagnóstico precoz, al contrario que los de uretra proximal y los que afectan a toda la uretra, que suelen ser de diagnóstico tardío, en estadio avanzado.
To analyze the efficacy of varicocele treatment, either surgical or endovoscular radiological occlusion, on pregnancy rates of infertile couples in which the male had clinically. patent left ...varicocele, and to identify which factors are associated with the probability of obtaining pregnancy in such cases.
This study is part of a more ample one described in previous article: "The treatment of varicocele in the infertile male I: Results on semen quality". Overall, 183 couples were included. 157 males received treatment (131 radiological occlusion and 26 open surgery), the remaining 26 did not received the treatment indicated. Couples underwent periodic follow-up during the first year, evaluating two parameters: 1) normalization of semen analysis parameters, and 2) pregnancy during the following 12 months after indication of treatment.
Overall, 41 couples (22.4%) achieved pregnancy during first year, 35/157 (22%) in the group of treated patients, and 6/26 (23%) in the non treatment group. In the treatment group, surgical ligature achieved higher pregnancy rates than radiological occlusion (35% vs. 20%), but the difference was not statistically significant (p = 0.255). No association was demonstrated between male age, female age, varicocele clinical grade, degree of semen quality abnormalities, or duration of infertility and pregnancy rates. The FSH value was significantly lower (p 0.0006) in patients who achieved pregnancy.
The degree of semen quality abnormality, which so closely correlated to normalization of seminal parameters, locked of prognostic significance in terms of achievement of pregnancy. The FSH value was the only factor with certain prognostic value, although it did not reach significance in logistic regression analysis.
To assess the level of satisfaction with the care provided to hospitalized patients in the Department of Urology at 12 de Octubre Hospital and analyze demographic and clinical factors influencing ...satisfaction.
A cross-sectional study was carried out using the SERVQHOS questionnaire, delivered at the time of discharge. A data sheet for each patient was collected, which included if they undergone surgery, type of surgery and whether or not presented postoperative complications, rated by the Clavien scale.
479 surveys were collected, with a participation of 92%. 95.4% of patients rated their overall level of satisfaction with the care received as "satisfied" or "very satisfied". Top-rated aspects were the kindness of the staff and personalized attention. The worst rated issue was the condition of the rooms, but this did not influence perceived quality. Variables related to greater overall satisfaction were male gender, shorter hospital stay, knowing the name of the nurse, the information received and subjective factors such as personalized service and willingness to help.
Our patients show a high level of satisfaction, which is mainly dependent on subjective factors. The negative issues related to the facilities do not mean lower satisfaction.
To review the literature and analyze the main contributions in molecular markers in renal adenocarcinoma.
We reviewed the literature over the last 10 years on molecular markers in renal ...adenocarcinoma (Medline 1991-2001). Outstanding papers published before 1991, included in the references of the selected articles, were also reviewed.
A large number of biomolecular markers have been studied in renal adenocarcinoma with results that are often contradictory. Some proteins have been associated with different histopathological parameters and with tumor prognosis, although their clinical importance has yet to be established.
Although the traditional prognostic factors, such as tumor grade and stage, provide important information on the outcome of renal adenocarcinoma, they are insufficient to predict the clinical behavior of this tumor type with absolute certainty. The foregoing has prompted the study of a variety of biomolecular markers that might predict the biological behavior of the tumor and identify the patients at a higher risk for tumor recurrence or death from the tumor. Despite the promising results obtained with biomolecular markers in renal adenocarcinoma, further studies are warranted to determine the prognostic value of these markers.
Primary adenocarcinoma of the female urethra is a rare malignancy. We report two cases and a review of the latest articles focused on classification and treatment of this kind of neoplasm.
We present ...two females diagnosed of urethral adenocarcinoma, describing clinic and pathological features, diagnosis and treatment.
Female urethral adenocarcinoma is an uncommon neoplasm with a heterogeneous histogenesis. The distal urethral carcinoma is more amenable to treatment, and the prognosis is better than that of proximal or entire urethral carcinoma, which is often associated with extensive local invasion and metastasis.
Retroperitoneal abscesses: Analysis of a series of 66 cases CAPITAN MANJON, Carlos; TEJIDO SANCHEZ, Angel; PIEDRA LARA, Jose D ...
Scandinavian journal of urology and nephrology,
2003, 2003-00-00, 20030101, Volume:
37, Issue:
2
Journal Article
To analyze our experience with the management of retroperitoneal abscesses.
A retrospective study was made of 66 patients with retroperitoneal abscesses treated at our hospital from January 1975 to ...July 2001 for the purpose of analyzing the diagnosis and treatment of these rare infections. In each case, we analyzed patient characteristics, abscess location and origin, predisposing factors, clinical presentation, microbiology, radiographic findings, treatment, and outcome.
In our series, the most frequent type of abscess was perinephric (45.4%), and the most frequent origin was the kidney (72.7%), generally renal lithiasis or previous urological surgery. Gram-negative bacilli were the microorganisms most often involved as causal agents of abscesses. CT had the best diagnostic performance (95%). Percutaneous drainage resolved the abscess in 86.3% of the patients in which it was used, compared with 87.5% for traditional surgical drainage. In 4 cases, the only treatment was administration of antibiotics. In all these cases the abscesses were smaller than 3 cm and patients were in good general condition. The mortality rate was excellent (1.5%), probably due to the low rate of comorbidity in our patients.
Gram-negative bacilli were the most frequent microorganisms in our retroperitoneal abscesses. CT was the imaging technique that produced the most reliable and rapid diagnosis. Radiographically-guided percutaneous drainage was a safe and effective therapeutic alternative when used as definitive treatment or preoperatively.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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Encrusted pyelitis in patients with urinary diversion Martínez Silva, Victor Manuel; Villacampa Aubá, Felipe; Tejido Sánchez, Angel ...
Archivos españoles de urología,
2003 Jan-Feb, Volume:
56, Issue:
1
Journal Article
Peer reviewed
This is a case of Encrusted Pyelitis (EP) caused by Corynebacterium urealyticum (CU) in a patient who had undergone a cystectomy and Bricker type urinary diversion 28 months beforehand.
After the ...immediate post-operative period no urinary catheterisation or any other urological procedure was performed on the patient. Before surgery, the patient presented non functional of the right kidney, secondary to a lithiasic obstructive uropathy. Clinical symptoms were deteriorated renal function, anuria, haematuria, pyrexia and left lumbar pain. It was suspected that the patient had this pathology and this was fundamental in diagnosis. Helicoid CT was the principal method used to show calcification plaques on the wall of the left renal pelvis, and selective culture of CU confirmed the diagnosis. Early commencement of treatment with vancomycin at an initial dosage of 500 mg/12 hours, and subsequent adjustment of dosage according to blood drug levels, achieved negative urine culture within a fortnight. Oral acidification was effected using acetohidroxamic acid 125 mg/12 hours, and it was continued until CT confirmed the disappearance or considerable reduction of the pyelic calcification plaques.
The presence of EP in patients with urinary diversion is a matter worthy of consideration, even in patients who have not undergone recent urological procedures. Awareness of risk factors and early commencement of effective treatment may improve the prognosis of these patients.
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