RESUMEN
A surgical technique for correction of hypospadias with chordee in one stage is described. This technique which brings the ectopic meatus up to the tip of the glans was successfully applied in 3 cases of penoscrotal and in 8 cases of penile hypospadias.
Asunto(s)
Hipospadias/cirugía , Humanos , Masculino , Métodos , Uretra/cirugíaRESUMEN
A retrospective analysis of clinical and pathologic data of 100 patients with germ cell testicular tumors is presented. The presenting symptoms and their duration prior to orchiectomy are analyzed and categorized. The duration of symptoms correlated with the stage of disease for each tumor. Seventy-five per cent of locally invasive lesions were found in patients with Stage II or III disease.
Asunto(s)
Disgerminoma/patología , Teratoma/patología , Neoplasias Testiculares/patología , Humanos , Masculino , Invasividad Neoplásica , Estadificación de Neoplasias , Pronóstico , Factores de TiempoRESUMEN
Burkitt's lymphoma presenting as an intrinsic ureteral mass is rare. We report on an immunocompromised patient with hydronephrosis secondary to direct involvement of the ureter by this non-Hodgkin's lymphoma. This case illustrates one of the manifestations of AIDS and the treatment of this manifestation. The relationship of AIDS and its sequela to the genitourinary system is discussed.
Asunto(s)
Linfoma de Burkitt/complicaciones , Linfoma Relacionado con SIDA/complicaciones , Obstrucción Ureteral/etiología , Adulto , Linfoma de Burkitt/patología , Humanos , Linfoma Relacionado con SIDA/patología , Masculino , Radiografía , Obstrucción Ureteral/diagnóstico por imagenRESUMEN
Three cases of anterior urethral valves, a rare congenital anomaly are reported. Anterior urethral valves probably represent an attempt at duplication of the urethra in the first twelve to fourteen weeks of intrauterine life. The most common type is cusp-like and most frequently located in the bulbar urethra. The presenting complaints are lower tract symptoms, and the diagnosis is usually made by a voiding urethrogram.
Asunto(s)
Uretra/anomalías , Adulto , Niño , Humanos , Masculino , Radiografía , Uretra/diagnóstico por imagen , Obstrucción Uretral/etiologíaRESUMEN
Two cases of sacrococcygeal teratomas are presented. One case illustrates the long course of urologic problems produced by a "successful" removal of the tumor. The literature is reviewed, and the characteristics of this congenital tumor are discussed.
Asunto(s)
Región Sacrococcígea , Teratoma/congénito , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Nefrectomía , Teratoma/complicaciones , Teratoma/cirugía , Trastornos Urinarios/etiologíaRESUMEN
The other testicle was involved in 6 of 235 patients (2.69 per cent) with a history of testicular germ cell tumor. It occurred more often following seminoma (4 of 113, 3.5 per cent cases). The mean age at occurrence of the first tumor (twenty-five years) was earlier than expected, and the mean interval between tumors was 8.8 years. Accurate clinical staging of second tumors is impeded by alteration in the routes of metastatic dissemination, and treatment options are limited by previous therapy for the first tumor.
Asunto(s)
Disgerminoma/patología , Neoplasias Primarias Múltiples/patología , Teratoma/patología , Neoplasias Testiculares/patología , Adulto , Antineoplásicos/uso terapéutico , Castración , Disgerminoma/terapia , Humanos , Escisión del Ganglio Linfático , Masculino , Estadificación de Neoplasias , Neoplasias Primarias Múltiples/terapia , Dosificación Radioterapéutica , Riesgo , Teratoma/terapia , Neoplasias Testiculares/terapia , Factores de TiempoRESUMEN
The technique for the Bellevue Pouch, another continent intestinal reservoir, is described. A large-capacity low-pressure reservoir is created from detubularized ascending colon, cecum, and terminal ileum. Continence is achieved by means of an intussuscepted segment of ileum and a modulating colonic pressure cuff wrapped around it. The operation has been performed on 19 patients, all of whom achieved satisfactory continence. Two patients were converted to free drainage systems at a later date. Average follow-up was twenty-five months.
Asunto(s)
Reservorios Urinarios Continentes/métodos , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Presión , Reservorios Urinarios Continentes/efectos adversosRESUMEN
Fourteen patients with anaplastic seminoma were analyzed retrospectively. At the time of presentation anaplastic seminoma has similar prognosis stage for stage as the classic seminoma. However, the distinctive histologic findings and the high rates of local invasion and of elevations of serum beta-subunit human chorionic gonadotropin serve to distinguish anaplastic seminoma from the classic seminoma. These features, suggesting a possibly greater metastatic potential for anaplastic seminoma, warrant its continued identification as a distinct pathologic subtype.
Asunto(s)
Disgerminoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Adulto , Anciano , Disgerminoma/terapia , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Testiculares/terapiaRESUMEN
A retrospective analysis of 27 cases of primary carcinoma of the ureter is presented. The ages of the patients ranged from forty-two to eighty-three years, with the highest incidence between the fifth and seventh decades. Males were more frequently affected than females, and the tumors were usually found in the lower third of the ureter. Hematuria and flank pain were the presenting symptoms in the majority of cases. Poorly differentiated invasive tumors had poor prognosis when compared to well-differentiated noninvasive lesions. Total nephroureterectomy with excision of bladder cuff is the preferred treatment for ureteral carcinoma in view of the high rate of ipsilateral tumor recurrence.
Asunto(s)
Carcinoma de Células Transicionales/patología , Neoplasias Ureterales/patología , Adulto , Factores de Edad , Anciano , Carcinoma de Células Transicionales/complicaciones , Carcinoma de Células Transicionales/epidemiología , Carcinoma de Células Transicionales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Factores Sexuales , Neoplasias Ureterales/complicaciones , Neoplasias Ureterales/epidemiología , Neoplasias Ureterales/cirugía , Neoplasias de la Vejiga Urinaria/complicacionesRESUMEN
A technique for ureteroileal anastomosis with an antireflux extraluminal seromuscular ureteral tunnel was evaluated in 9 dogs. Evidence will be presented to show that this approach is effective in preventing reflux while preserving the integrity of the renal units.
Asunto(s)
Derivación Urinaria/métodos , Reflujo Vesicoureteral/prevención & control , Animales , Perros , Íleon/cirugía , Técnicas de Sutura , Derivación Urinaria/efectos adversosRESUMEN
Forty-six patients with histologically proved adenocarcinoma of the prostate underwent pelvic lymphadenectomy after CAT scanning. The accuracy, specificity, and sensitivity of the CAT scan in detecting nodal metastasis were 70, 93 and 30 per cent, respectively; this compares favorably with pedal lymphangiography. Seventeen of the patients had radical prostatectomy. The accuracy, specificity, and sensitivity of the CAT scan in depicting local extent of the tumor were 47, 100, and 18 per cent, respectively; although low, no other clinical or biochemical method provides a better result.
Asunto(s)
Neoplasias de la Próstata/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Estudios de Evaluación como Asunto , Humanos , Escisión del Ganglio Linfático , Linfografía , Masculino , Estadificación de Neoplasias , Probabilidad , Prostatectomía , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/cirugíaRESUMEN
Surgical extirpation of the primary tumor together with the involved regional nodes has been considered ineffective treatment for locally disseminated prostatic carcinoma. We retrospectively reviewed our experience with 42 patients with Stage D1 disease who underwent radical prostatectomy and bilateral pelvic lymphadenectomy and who had a follow-up of one to thirteen years (mean 5 years). The following variables affecting survival and tumor progression were analyzed: (1) tumor grade and local extent; (2) number of positive lymph nodes, and (3) adjuvant therapy. The overall five- and ten-year survival was 79.5 per cent and 28 per cent compared with the expected survival of an age-matched control group of 88 per cent and 28 per cent, respectively. The degree of tumor differentiation had no effect on prognosis, but local tumor bulk and the number of involved lymph nodes significantly changed the disease progression and survival rate. Patients with low local tumor bulk and one positive node survived as long as the age-matched male population group. Our data suggest that radical prostatectomy may represent a valuable treatment in selected patients with Stage D1 prostate carcinoma.
Asunto(s)
Adenocarcinoma/cirugía , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Terapia Combinada , Estudios de Seguimiento , Humanos , Escisión del Ganglio Linfático , Masculino , Estadificación de Neoplasias , Pelvis , Pronóstico , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Factores de TiempoRESUMEN
A case of a duplicated collecting system with an ectopic ureter draining into the ipsilateral vas deferens is presented. The embryology of this entity is reviewed.
Asunto(s)
Uréter/anomalías , Conducto Deferente/anomalías , Adulto , Humanos , Riñón/anomalías , Masculino , Radiografía , Ultrasonografía , Uréter/diagnóstico por imagen , Conducto Deferente/diagnóstico por imagenRESUMEN
Quantitative computerized tomography (QCT) of vertebral bodies could reveal metastatic spread of prostatic cancer before such lesions are seen with standard examinations. Focal increase in the density of the spongious bone in face of normal bone scan and serum acid phosphatase is suggestive of metastasis, but certitude is gained only if further increase in density or structural bone changes are demonstrated on follow-up studies. QCT also may provide an objective measurement of tumor response to therapy.
Asunto(s)
Adenocarcinoma/secundario , Vértebras Lumbares/diagnóstico por imagen , Neoplasias de la Próstata/patología , Neoplasias de la Columna Vertebral/secundario , Tomografía Computarizada por Rayos X/métodos , Adenocarcinoma/diagnóstico por imagen , Humanos , Masculino , Neoplasias de la Columna Vertebral/diagnóstico por imagenRESUMEN
Three hundred twenty-six patients treated at New York University from 1970 to 1982 were studied for survival in relationship to surgical stage, type of therapy, and pathologic characterization of the primary tumor. At the time of diagnosis 25.5 per cent of tumors were Stage I, 15 per cent Stage II, 28.5 per cent Stage III, and 31 per cent Stage IV. The retrospective study showed that patients with tumor confined within the capsule achieved the highest five- and ten-year survivals of 88 per cent and 66 per cent, respectively. Survivals decreased as tumor invaded perirenal fat (67% and 35%) or regional lymph nodes (17% and 5%). Tumor invasion into the renal vein alone did not significantly change five-year survival (84%) but lowered ten-year survival to 45 per cent. Patients with metastases at the time of nephrectomy did poorly regardless of site of metastases or kind of adjuvant therapy, except for those managed by surgical extirpation of the secondary lesion. Certain tumor characteristics were associated with a better prognosis, e.g., size below 5 cm in diameter, lack of invasion of collecting system, perirenal fat or regional lymph nodes, and predominance of clear or granular cells growing into a recognizable histologic pattern.
Asunto(s)
Carcinoma de Células Renales/mortalidad , Neoplasias Renales/mortalidad , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Femenino , Humanos , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Invasividad Neoplásica , Estadificación de Neoplasias , Nefrectomía , New York , Pronóstico , Venas Renales , Estudios Retrospectivos , Riesgo , Factores SexualesRESUMEN
A review of sixty-two technetium scrotal scans performed over a one-year period has led to a classification of pathologic states based on the degree of uptake of the radioactive isotope. Absent uptake, or a "cold" scan, is present only with testicular torsion, and rarely with avascular tumors. Increased uptake, or a "hot" scan, is most commonly seen with inflammatory conditions such as acute epididymitis and orchitis, and less commonly with tumor. "Mixed" scans can be associated with abscess, tumor with necrosis, trauma, and late torsion.
Asunto(s)
Enfermedades de los Genitales Masculinos/diagnóstico por imagen , Escroto/diagnóstico por imagen , Epididimitis/diagnóstico por imagen , Hematoma/diagnóstico por imagen , Humanos , Masculino , Cintigrafía , Torsión del Cordón Espermático/diagnóstico por imagen , Enfermedades Testiculares/diagnóstico por imagen , Neoplasias Testiculares/diagnóstico por imagen , Varicocele/diagnóstico por imagenRESUMEN
A retrospective study of efficacy of radioisotopic renal scan intravenous urogram in 10 infants with various urologic diseases showed the scan to be more rapid and accurate in depicting the lesions. Since the radioisotopic renal scan requires less irradiation than the intravenous pyelogram, it should be used first as a screening test in infants suspected of having urologic problems.
Asunto(s)
Enfermedades del Recién Nacido/diagnóstico , Cintigrafía , Urografía , Enfermedades Urológicas/diagnóstico , Medios de Contraste , Diatrizoato , Humanos , Recién Nacido , Enfermedades del Recién Nacido/diagnóstico por imagen , Estudios Retrospectivos , Tecnecio , Enfermedades Urológicas/diagnóstico por imagenRESUMEN
Studies to detect ultrastructural changes in testicular tissues after a fifteen-minute exposure to ultrasonic waves were done in 10 men undergoing bilateral orchiectomies for prostatic carcinoma. Examination of Sertoli cells and germ cells in different stages of differentiation failed to reveal significant differences between exposed and control testes.