[Association of renal carcinoma and the exposure to ionizing radiation after the Chernobyl accident]. / Asociación de carcinoma renal y la exposición a radiaciones ionizantes después del accidente de Chernobyl.

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.

Asociación de carcinoma renal y la exposición a radiaciones ionizantesdespués del accidente de Chernobyl / Association of renal cell carcinoma and radiation exposure after the Chernobyl accident

Después del accidente nuclear de Chernobyl, en la población de zonas contaminadas la incidencia de carcinoma renal se incrementó de 4,7 a 7,5 por 100.000 habitantes. La elevada concentración corporal de Cesium 137 (137Cs) así como su eliminación por vía renal los convierte en pacientes de alto riesgo. Presentamos un caso de una paciente, residente en la zona contaminada que acudió a nuestro hospital por dolor abdominal y sensación de masa en flanco izquierdo. Realizamos una revisión de la literatura y analizamos el manejo en este tipo de pacientes (AU)

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 (AU)

[Renal abscess in patients with HIV infection in the era of highly active antiretroviral therapy]. / Absceso renal en el paciente con infección por VIH en la era de la terapia antiretroviral de alta eficacia.

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.

Absceso renal en el paciente con infección por VIH en la era de la terapia antiretroviral de alta eficacia / Renal abscess in the patient with HIV infection in the era of highly antiretroviral therapy

El absceso renal es una rara complicación en la infección por VIH y normalmente ocurre en pacientes con severa inmunodeficiencia. El estado inmunitario del paciente es el factor determinante de la progresión 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 debutó con una masa en flanco derecho y fiebre. Realizamos una revisión de la literatura y analizamos el manejo en este tipo de pacientes (AU)

[Pneumocysts, unusual infective complication in diabetics]. / Pneumocistos, una rara complicación infecciosa en diabéticos.

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.

Pneumocistos, una rara complicación infecciosa en diabéticos / Pneumositos, a rare infectious complication in diabetics

Publicamos un caso en el cual la luz vesical aparece completamente ocupada por gas en ausencia de gas intramural, fístula con tracto gastrointestinal o instrumentación previa, en una paciente afectada por vejiga neurógena diabética. Comentamos las causas de esta rara complicación infecciosa y su relación con la cistitis enfisematosa, más frecuente (AU)

[Surgical treatment of hydrocele with local anesthesia: 10-year experience]. / Tratamiento quirúrgico del hidrocele con anestesia local: 10 años de experiencia.

OBJECTIVE: To review our experience with surgical management of hydrocele under local anesthesia. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

[Incidence of high grade prostatic intraepithelial neoplasia in urologic practice]. / Incidencia de la neoplasia intraepitelial prostática de alto grado en la práctica urológica.

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.

[Wolfram syndrome. Urologic implications]. / Síndrome de Wolfram. Implicaciones urológicas.

OBJECTIVES: We report on four new cases of Wolfram's Syndrome. We emphasize in urological aspects of this disease. PATIENTS AND METHODS: 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. CONCLUSIONS: 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.

[Malignant fibrohistiocytoma of the bladder]. / Fibrohistiocitoma maligno de vejiga.

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.

Fibrohistiocitoma maligno de vejiga / Malignant fibrous histiocytoma of the bladder

Aportamos un nuevo caso de un tumor cuya localización primaria en vejiga es extremadamente rara. Destacamos la importancia de apoyar el diagnóstico histológico con la inmunohistoquímica y/o el estudio ultraestructural para llegar a la certeza de encontrarnos ante un fibrohistiocitoma maligno. Existen en la literatura sólo 16 casos publicados de este tumor. Sin embargo sólo existen cuatro casos, con el que aportamos suman cinco, que documenten un completo estudio inmunohistoquímico y por microscopía electrónica. En conclusión, la rareza de la localización vesical del fibrohistiocitoma maligno hace esquivo su diagnóstico, que debe apoyarse en la inmunohistoquímica y el estudio estructural, para diferenciarlo del carcinoma sarcomatoide y del leiomiosarcoma de vejiga. Tras el diagnóstico se aconseja cirugía radical y terapia adyuvante. Los resultados de supervivencia son malos, con una media de 5.3 meses tras el inicio del tratamiento (AU)

Incidencia de la neoplasia intraepitelial prostática de alto grado en la práctica urológica / Incidence of high grade intraepithelial neoplasia of the prostate in the urologic practice

La neoplasia intraepitelial prostática de alto grado (PIN AG) es un probable precursor del adeno-carcinoma de próstata (AP) por su asociación con el mismo. Su hallazgo obliga a una búsqueda intensa de AP, ya que incrementa el riesgo de padecer éste último en relación a los pacientes sin PIN AG previo. Revisamos nuestra incidencia de PIN AG en 499 estudios histológicos correspondientes a biopsias transrectales de próstata, especímenes de RTU de próstata y adenomectomía y piezas de prostatectomía radical (PR).Se evalúan los datos obtenidos, su tipo de presentación asi como su asociación con carcinoma de próstata, mostrando la actitud posterior a tomar en los diferentes casos (AU)

Síndrome de wolfram. Implicaciones urológicas / Wolfram´s syndrome. Urological implications

OBJETIVOS: Presentamos cuatro nuevos casos de enfermos afectados por el llamado síndrome de Wolfram, resaltando la importancia de sus implicaciones urológicas. PACIENTES Y MÉTODOS: Tres hermanos varones y otro enfermo no emparentado. Los cuatro pacientes presentan distintos estadios de enfermedad urológica, principalmente dilatación de vía urinaria y alteraciones en la contractilidad del detrusor. CONCLUSIONES: La afectación urológica se debe considerar un factor cardinal en el contexto de este síndrome, debido tanto a su frecuencia como a su importancia pronóstica. Concluimos que las características de la enfermedad urológica la introducen en el contexto de una afectación neurológica general de etiología aún desconocida (AU)

Eliminación renal de contraste tras uretrocistografía retrógrada / Renal excretion of contrast media following a retrograde urethrocystography

Describimos un caso de extensa eliminación de contraste a través de uretra tras una uretrocistografía retrógrada. El medio de contraste dibuja los cuerpos cavernosos, los vasos ilíacos y la cava inferior. Placas posteriores muestran normal eliminación de contraste por ambas vías urinarias (AU)

[Renal elimination of contrast after retrograde urethrocystography]. / Eliminación renal de contraste tras uretrocistografía retrógrada.

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.

[Extragonadal germ tumor]. / Tumor germinal extragonadal.

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.

[Tuberculous orchiepididymitis as clinical onset of human immunodeficiency virus (HIV) infection]. / Orquiepididimitis tuberculosa como inicio clínico de infección por el virus de inmunodeficiencia humana (VIH).

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.