Search

Resumen El absceso renal es una rara complicacion en la infeccion por VIH y normalmente ocurre en pacientes con severa inmunodeficiencia. El estado inmunitario del paciente es el factor determinante de la progresion de la enfermedad. La terapia antiretroviral de alta eficacia (HAART) mejora el recuento de subpoblaciones linfocitarias CD4. Presentamos un caso de absceso renal por Aspergillus niger en un paciente VIH+, que debuto con una masa en flanco derecho y fiebre. Realizamos una revision de la literatura y analizamos el manejo en este tipo de pacientes

Resumen Objetivos Presentamos cuatro nuevos casos de enfermos afectados por el llamado sindrome de Wolfram, resaltando la importancia de sus implicaciones urologicas Pacientes Y Metodos Tres hermanos varones y otro enfermo no emparentado. Los cuatro pacientes presentan distintos estadios de enfermedad urologica, principalmente dilatacion de via urinaria y alteraciones en la contractilidad del detrusor Conclusiones La afectacion urologica se debe considerar un factor cardinal en el contexto de este sindrome, debido tanto a su frecuencia como a su importancia pronostica. Concluimos que las caracteristicas de la enfermedad urologica la introducen en el contexto de una afectacion neurologica general de etiologia aun desconocida

Resumen La neoplasia intraepitelial prostatica de alto grado (PIN AG) es un probable precursor del adenocarcinoma de prostata (AP) por su asociacion con el mismo. Su hallazgo obliga a una busqueda intensa de AP, ya que incrementa el riesgo de padecer este ultimo en relacion a los pacientes sin PIN AG previo. Revisamos nuestra incidencia de PIN AG en 499 estudios histologicos correspondientes a biopsias transrectales de prostata, especimenes de RTU de prostata y adenomectomia y piezas de prostatectomia radical (PR). Se evaluan los datos obtenidos, su tipo de presentacion asi como su asociacion con carcinoma de prostata, mostrando la actitud posterior a tomar en los diferentes casos.

Resumen Aportamos un nuevo caso de un tumor cuya localizacion primaria en vejiga es extremadamente rara. Destacamos la importancia de apoyar el diagnostico histologico con la inmunohistoquimica y/o el estudio ultraestructural para llegar a la certeza de encontrarnos ante un fibrohistiocitoma maligno. Existen en la literatura solo 16 casos publicados de este tumor. Sin embargo solo existen cuatro casos, con el que aportamos suman cinco, que documenten un completo estudio inmunohistoquimico y por microscopia electronica. En conclusion, la rareza de la localizacion vesical del fibrohistiocitoma maligno hace esquivo su diagnostico, que debe apoyarse en la inmunohistoquimica y el estudio estructural, para diferenciarlo del carcinoma sarcomatoide y del leiomiosarcoma de vejiga. Tras el diagnostico se aconseja cirugia radical y terapia adyuvante. Los resultados de supervivencia son malos, con una media de 5.3 meses tras el inicio del tratamiento.

Resumen Describimos un caso de extensa eliminacion de contraste a traves de uretra tras una uretrocistografia retrograda. El medio de contraste dibuja los cuerpos cavernosos, los vasos iliacos y la cava inferior. Placas posteriores muestran normal eliminacion de contraste por ambas vias urinarias. Abstract We describe a case report in which is shown an extensive extravasation of contrast media from urethra lumen following a retrograde urethrocystography. It is shown filling of cavernous system and, at once, iliac vessels and inferior cava. Later X ray plates demonstrates entire collecting system due to the renal contrast excretion.

After the nuclear accident of Chernobyl, in the population of zones contaminated the malignant renal tumors was increased from 4.7 to 7.5 per 100,000 of total population. Cesium 137 (137Cs) constitutes 80-90% of the internal exposure of these people as well as eliminated through kidneys becomes an important risk factor. We present a case of a patient, residing in radiocontamined area, who consulted for abdominal pain and left flank mass. We review relevant literature and the management of these patients.

Resumen Despues del accidente nuclear de Chernobyl, en la poblacion de zonas contaminadas la incidencia de carcinoma renal se incremento de 4,7 a 7,5 por 100.000 habitantes. La elevada concentracion corporal de Cesium 137 (137Cs) asi como su eliminacion por via renal los convierte en pacientes de alto riesgo. Presentamos un caso de una paciente, residente en la zona contaminada que acudio a nuestro hospital por dolor abdominal y sensacion de masa en flanco izquierdo. Realizamos una revision de la literatura y analizamos el manejo en este tipo de pacientes.

To review our experience with surgical management of hydrocele under local anesthesia.From January 1991 to March 2001, 76 patients with hydrocele (6 bilateral) were treated in our department. Patients were monitored in the OR (EKG, BP and pulseoxymetry); a peripheral line was inserted. Twenty minutes before the procedure, midazolam (5 mg), meperidine (50 mg) and atropine (0.5 mg) were administered i.m. for sedation. The spermatic cord and the area of the scrotal wall to be incised were injected with 2% mepivacaine (10-20 cc). Dissection and excision of the vaginalis sac was performed.Anesthetic tolerance was very good in 71 patients (93%) and unsatisfactory in 5 (7%). The following complications were observed: scrotal hematoma (4 cases; 5%), infection (3 cases; 4%), bradycardia and hypotension (2 cases; 3%). Only 5 patients (7%) required hospitalization for more than 24 hours.Surgical management of hydrocele can be performed under local anesthesia, thereby avoiding the morbidity of more aggressive anesthetic techniques. This treatment procedure should be considered in the smaller departments with limited resources.

We report on a case of fully gas-filled bladder with no evidence of intramural gas, fistula between bladder and gastrointestinal tract or instrumentation. The patient is diagnosed of a diabetic neurogenic bladder. We comment the causes of this rare finding and its relation with emphysematous cystitis.

We report on new case of a rare vesical tumour. We result the importance of immunohistochemistry and ultrastructural study to support the diagnosis of malignant fibrous histiocytoma of the urinary bladder. There has been described another 16 cases of this tumour in the literature, however, only four of them -five with ours- reports an extensive immunohistochemical and ultrastructural study. The rarity of vesical localization of this tumour may delay its diagnosis. It must be supported by a immunohistochemistry and/or ultrastructural study, in order to differentiate from other tumours with fibrohistiocytoma-like pattern: leiomyosarcoma and sarcomatoid carcinoma of the bladder. After radical removal of tumour, adjuvant therapy is recommended both systemic chemotherapy and local radiotherapy, although survival rates are over 5.3 months after first therapeutical actuation.

We report on a case of fully gas-filled bladder with no evidence of intramural gas, fistula between bladder and gastrointestinal tract or instrumentation. The patient is diagnosed of a diabetic neurogenic bladder. We comment the causes of this rare finding and its relation with emphysematous cystitis.

The emergence of acquired immunodeficiency syndrome has changed the natural history of tuberculosis which has now become the second most common infection associated to human immunodeficiency virus infection. It is only rarely that a tuberculous infection has an urogenital location, and extrapulmonary locations are generally related to severe immunosuppression. This paper presents one case of tuberculous orchitis that presented as the clinical onset of acquired immunodeficiency syndrome. Discussion of the clinical evolution and the therapeutic approach that consisted in orchiectomy associated to treatment with tuberculostatics.

Extragonadal primary tumors are uncommon and account for 3 to 5% of all germ cells neoplasias. Preferentially found in middle line structures, such tumors are frequently in an advanced stage when diagnosed. Differentiation between primary extragonadal tumors and metastasis of testicular primary tumors is essential, but may be difficult in many instances.

We report on four new cases of Wolfram's Syndrome. We emphasize in urological aspects of this disease.Three male siblings. The other patient is also a male, without familiar relation with the other ones. All four patients presents different levels of urological alterations, mainly urinary collecting system dilation and decrease in detrusor muscle contractility.Urological findings are cardinal aspects in Wolfram syndrome. Due to its high frequency and prognostic value in natural history of disease. Urological disease seems to be within a systemic neurological tissues affectation of etiology that remains unknown.

Renal abscess is a very rare complication of HIV infection, usually occurs in patients with severe immune deficiency. The immune status is the main factor that predict disease advancement. Highly activate antiretroviral therapy (HAART) improve the CD4 cell count. We present a case of renal abscess for Aspergillus niger in a HIV+ patient who complained of right flank mass and fever. We review relevant literature and the management of these patients.

The emergence of acquired immunodeficiency syndrome has changed the natural history of tuberculosis which has now become the second most common infection associated to human immunodeficiency virus infection. It is only rarely that a tuberculous infection has an urogenital location, and extrapulmonary locations are generally related to severe immunosuppression. This paper presents one case of tuberculous orchitis that presented as the clinical onset of acquired immunodeficiency syndrome. Discussion of the clinical evolution and the therapeutic approach that consisted in orchiectomy associated to treatment with tuberculostatics.

We describe a case report in which is shown an extensive extravasation of contrast media from urethra lumen following a retrograde urethrocystography. It is shown filling of cavernous system and, at once, iliac vessels and inferior cava. Later X ray plates demonstrates entire collecting system due to the renal contrast excretion.

High grade (PIN AG) intraepithelial neoplasia of the prostate is a likely precursor of prostate adenocarcinoma (PA) because of their association. Since the risk to suffer PA increases in patients with no previous PIN AG, its finding requires an arduous search for PA. This paper reviews the incidence of PIN AG in 499 histological studies in prostate transrectal biopsies, prostate TUR and adenomectomy specimens and radical prostatectomy (RP) sections. Evaluation of data obtained, type of presentation and association to prostate carcinoma, indicating the approach taken in the various cases.