RESUMEN
Between december 1983 and april 1989, percutaneous retrograde sclerotherapy of varicocele was successfully performed on 364 patients. A 5% solution of sodium morrhuate and benzylic alcohol (Varicocid) was administered through a coaxial balloon catheter inserted into the spermatic vein. 10 of the patients had relapses after surgery. Long-term follow-up was available for 268 patients (73.6%). Three of them had incomplete relapses after sclerotherapy. In terms of spermatologic improvement, sclerotherapy appeared to be effective in the treatment of varicoceles. In our experience, sclerotherapy is a safe effective procedure to be preferred to surgery in the management of varicocele.
Asunto(s)
Alcoholes Bencílicos/uso terapéutico , Escleroterapia/métodos , Morruato de Sodio/uso terapéutico , Varicocele/terapia , Adolescente , Adulto , Niño , Preescolar , Estudios de Seguimiento , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Flebografía , Recurrencia , Recuento de Espermatozoides , Motilidad Espermática , Varicocele/diagnósticoRESUMEN
The cytologic findings in the urinary sediment of 13 patients with tuberculosis (TB) of the bladder were compared with the histologic findings. TB was cytologically recognized in 11 patients because of the presence of epithelioid and/or Langhans' giant cells. The morphologic deviations of the urothelial cells and the urothelium were classified according to the criteria of Koss. The type I atypical urothelial cells found in ten patients were correlated to the urothelial hyperplasia found at histology; the follow-up data documented the benign reversible nature of the urothelial hyperplasia as the focal expression of the reactive potential of urothelium to various forms of inflammatory processes. The presence of type II atypical urothelial cells reflected moderate and severe atypia of the urothelium at biopsy. In order to assess the reactive, reversible or precancerous nature of these forms of atypia associated with TB, an accurate follow-up is necessary. Since TB of the bladder may cause the presence of atypical cells in the urine, this lesion is of special interest in the differential diagnosis between inflammatory processes and carcinoma.
Asunto(s)
Tuberculosis Urogenital/patología , Enfermedades de la Vejiga Urinaria/patología , Vejiga Urinaria/patología , Orina/citología , Adulto , Anciano , Biopsia , Citodiagnóstico , Diagnóstico Diferencial , Epitelio/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tuberculosis Urogenital/diagnóstico , Tuberculosis Urogenital/orina , Enfermedades de la Vejiga Urinaria/diagnóstico , Enfermedades de la Vejiga Urinaria/orina , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
From March 1977 to December 1982, 142 patients with varicocele of various sizes underwent preoperative antegrade or retrograde phlebography of the left spermatic vein. In 8 of them both procedures were carried out. A retrospective analysis of 68 preoperative antegrade venographies in supine (0 degree) and upright (30 degrees, 45 degrees and 90 degrees) positions was made and compared with 66 retrograde venograms. The preoperative 'dynamic' antegrade phlebography has been performed in order to study the hemodynamic conditions of the varicocele, avoiding any pressure interference on the valvular function of the venous renospermatic area. This technique has allowed us to get useful anatomoradiological and physiopathological information about the spontaneous reflux into the internal spermatic vein by its positional filling and emptying. It has also permitted a good visualization of collateral channels, particularly in the pelvic, femorosaphenous and scrotal areas. We could, at the same time, simultaneously sample blood from the cubital and intrascrotal spermatic veins to determine the testosterone, cortisol and serotonin levels, in different positions; the evaluation of these biochemical data is being pursued. In our opinion, this diagnostic procedure is easy to perform and inexpensive. The procedure and the results are discussed in detail.
Asunto(s)
Flebografía , Cordón Espermático/irrigación sanguínea , Testículo/irrigación sanguínea , Varicocele/diagnóstico por imagen , Adolescente , Adulto , Humanos , Masculino , Persona de Mediana Edad , Flebografía/métodos , Cuidados Preoperatorios , Varicocele/fisiopatología , Venas/fisiopatologíaRESUMEN
An unusual cytologic presentation of spermatic hydrocele fluid is reported. The aspirate contained highly atypical cells, exhibiting marked anisocytosis and nuclear abnormalities strongly suggestive of cancer. On histologic examination the lesion displayed pseudosarcomatous fasciitis in the cyst wall and foci of atypical reactive mesothelial hyperplasia in the lining. This case illustrates a potential pitfall in the cytology of spermatic hydrocele fluid.