[Tridimensional echography: a new urologic challenge]. / Ecografía tridimensional: nuevo reto urológico.

OBJECTIVE: To describe the urological applications of three-dimensional ultrasonography, a new method that basically transforms the two-dimensional into three-dimensional images through complex data processing for enhanced imaging. METHODS: Since the technology for three-dimensional studies was incorporated into our US equipment a few months ago, we have performed three-dimensional US after the conventional two-dimensional study in 30 renal units, 15 bladders and 15 prostates, using the same well-established procedures for ultrasound assessment. The images obtained by both methods were compared to determine the diagnostic enhancements, if any, afforded by this new technology. RESULTS: Three-dimensional US offers more possibilities for renal cortical volume measurement and determination of the extent of the tumor. It also appears to be promising in regard to its capacity to determine the degree of tumor infiltration in the bladder and permits even more precise measurements of residual volume or bladder content. Transrectal ultrasound of the prostate may benefit more since three-dimensional US permits analysis of focal changes from different perspectives and planes without difficulty. CONCLUSIONS: Three-dimensional US was developed recently. It has been utilized in gynecology and cardiology, but there is limited experience in urology. We have started a clinical study to determine its possibilities and main applications in our field. Its impact on other diagnostic parameters or biopsy selection criteria are other interesting areas of research.

[Prostate leiomyosarcoma with perineal exophytic mass]. / Leiomiosarcoma prostático con masa exofítica perineal.

Report on one case of prostate leiomyosarcoma, an infrequent and usually highly aggressive urologic neoplasia. Emphasis on the imaging and pathoanatomical diagnosis, highlighting the high value of the later as immunohistochemistry is usually essential to establish its nature. Choice treatment is oncologically radical surgery. Quite often this is impossible to carry out and so chemo- and radiotherapy schedules are commonly associated as neoadjuvant, adjuvant or palliative therapies. The reported case showed aggressive evolution unresponsive to management. Also, during the condition development a rare complication such as occurrence of an exophytic tumoral mass in the perineum appeared.

[Natural history of cancer of the kidney: iconographic follow-up]. / Historia natural del cáncer de riñón: seguimiento iconográfico.

OBJECTIVE: To describe the natural history of renal cancer based on the images obtained in a case with more than 11 years' follow-up, from the initial stages of the disease to its outcome. METHODS/RESULTS: The history of a female patient in whom a renal mass had been detected at age 25 years is described. The patient died 11 years later due to metastasis. The images obtained throughout follow-up clearly illustrate the natural course of the disease, which could not be changed because the patient had refused surgery. CONCLUSIONS: The observation of a small renal mass in young patients is an indication for early surgery. The natural course of this disease is predictably fatal, its benign behaviour being highly questionable. Because pregnancy does not appear to accelerate the course of the disease, patient assessment can be completed and treatment can be instituted after delivery.

[Impact of Spanish-language urological publications in periodicals in the English language]. / Impacto de las publicaciones urológicas en lengua española en revistas en lengua inglesa.

OBJECTIVE: A study was conducted to analyze the impact of the articles published by Spanish authors in the English language urological journals and those published in Spanish journals in the bibliography referenced in the English language urological literature. METHODS: We randomly analyzed volumes 147, 39 and 69 of the Journal of Urology, Urology and the British Journal of Urology, respectively. All articles in the foregoing volumes were reviewed and analyzed as follows: sections, country, no of references, no of Spanish publications referenced, no of references of Spanish publications and the number of Spanish references cited in these. RESULTS: 356 articles were published in the Journal of Urology: of these, 59% were by American and only 6 (1.68%) were by Spanish authors, which ranked 8th according to number. These 6 articles by Spanish authors cited 84 references; of these, only 3 were Spanish publications. Overall, there were 6,708 references (mean 18.8); 6 (0.11%) were articles published by Spanish authors. In Urology, 140 articles were published: of these, 75% were by American and only one (0.71%) by Spanish authors, which ranked 6th according to number. This article by Spanish authors cited 38 references; of these, only 3 were Spanish publications. Overall, there were 2,055 references (mean 14.6); only 8 (0.38%) were articles published by Spanish authors. In the British Journal of Urology, 177 articles were published: of these, 96 (54.2%) were by British authors and only one (0.56%) by Spanis authors, which ranked 9th according to number. This article by Spanish authors cited 11 references; none of them were Spanish publications. Overall, there were 1,988 references (mean 11.2); 14 (0.7%) were articles published by Spanish authors. CONCLUSION: Spanish authors are not worse off than those of other neighbouring countries in regard to the number of articles published (1.18%) in the three journals analyzed, where most of the articles were chiefly by American or British authors. Spanish publications have no impact in the English-speaking countries, although the number of Spanish publications has been slowly but steadily growing and currently account for 1.21% of the publications worldwide: 41.5% of these are referenced in the Science Citation Index and the Uro-Andrological publications rank 6th (4.2%). Moreover, when Spanish authors are able to publish articles in the English-language journals, they rarely reference Spanish publications. However, in proportion, these have more impact than the Spanish publications. The current trend in the prevalence of the English language in the scientific field is probably the cause of the nonexistent impact outside Spain, where they are hardly-read by the Spanish-speaking communities. The foregoing situation is further assisted by the fact that indexing is also done in the English language. Spanish authors are encouraged to increase the number of Spanish publications referenced, particularly those publishing articles in the foreign journals.

[Fracture of the penis: two new cases. Review of the literature. Usefulness of echography]. / Fractura de pene: dos nuevos casos. Revisión de la literatura. Utilidad de la ecografía.

OBJECTIVE: To analyze the diagnostic and therapeutic difficulties in rupture of the albuginea penis and review the literature. METHODS/RESULTS: Two additional cases of penile rupture are described. Penile ultrasound evaluation disclosed a hematoma in the corpus cavernosum in one case and hematoma and a probable rupture of the albuginea penis in the other case. Treatment was by immediate surgery which achieved good cosmetic and functional results. CONCLUSIONS: Penile fracture is an uncommon condition which occurs when the penis is in erection. Ultrasound is useful in its diagnosis, but MRI is more precise. Treatment is by immediate surgery to avoid sequelae, which are common in cases treated conservatively.

[Diagnosis of leukemic infiltration of the prostate p6ompted by PSA elevation]. / Diagnóstico de infiltración leucémica de la próstata motivado por elevación del P.S.A.

Presentation of one case-report of leukaemic infiltration of the prostate. Interestingly, the biopsy was only performed after finding distinctly elevated PSA levels and not because of the clinical findings, whether exploratory or echographic.

[Abscessed brucellar prostatitis. An infrequent location]. / Prostatitis brucelar abscesificada. Una localización poco frecuente.

Explanation of one case of abscessified brucellar prostatitis in a 44-year old patient. The emphasis is placed on the high incidence of brucellosis in the province of Soria and the rarity of the prostatic location of this condition. Also, a revision is made of the diagnostic methodology and current therapeutical approaches. The crucial role of the endocavitary ultrasound techniques both for diagnosis as well as treatment and case follow-up is highlighted.

[Renal brucelloma. A rare possible diagnosis]. / Bruceloma renal. Una rara posibilidad diagnóstica.

Presentation of one case of renal Brucelloma in a 61-year old patient. The emphasis is placed in the pathophysiology of the condition and the extraordinary rarity of its renal location. Also an explanation is proposed for the diagnostic methodology and the dissociation, typical in chronic brucellosis, of the different serologic testing. Finally, the increased incidence experimented by this condition in our environment, which involves the reappearance of clinical pictures today thought eradicated, is pointed out.

[Brucellar orchitis. Report of a series of 16 cases]. / Orquitis brucelar. Aportación de una serie de 16 casos.

A retrospective study of orchiepididymitis, diagnosed and admitted to our Unit over the 1989-94 period was conducted. there were 125 orchiepididymitis, of which 16 (12.8%) had a brucellar etiology, and three had simultaneously become abscessified (18.75%). Considering that our working area is located within an endemic region, and even more, our province has the country's highest incidence rate (112.8/100000 inh.), this prompted us to study the conditions' morbidity in the testicular location, while we make a superficial revision of this disease. Brucellar orchitis is a diagnostic option to be taken into account in endemic regions, and the clinical picture associated to the orchiepididymal process should make us suspect its diagnosis and trigger follow-up of these patients.

[The role of video voiding cystourethral sonography in the study of the urethrovesical anastomosis following radical prostatectomy]. / El papel de la vídeo cisto-uretro sonografía miccional en el estudio de la anastomosis uretro-vesical tras prostatectomía radical.

OBJECTIVE: The sonographic anatomy of the urethrovesical anastomosis in patients submitted to radical prostatectomy is described herein. METHOD: Video sonographic voiding cystourethrography was performed using a 7.5 MHz linear-array transrectal probe. RESULTS: The longitudinal ultrasound scans of the urethrovesical anastomosis during the different phases of micturition are shown. CONCLUSION: Video sonographic voiding cystourethrography is useful in the evaluation of the urethrovesical anastomosis after radical prostatectomy, at rest and during micturition. It also permits detecting any postoperative complication as hematoma, abscess or early recurrence.

[Adrenal myelolipoma: apropos a case with urologic symptomatology. A review of the literature]. / Mielolipoma suprarrenal: a propósito de un caso con sintomatología urológica. Revisión bibliográfica.

Presentation of a new case of Suprarenal Myelolipoma, its singularity being the urinary clinical presentation. Brief review of the literature, placing special emphasis on the Spanish references.

[Do patients want to know the truth of their disease? Study on urologic patients]. / Desean los pacientes conocer la realidad de su enfermedad? Estudio en pacientes urológicos.

Presentation of a study, based on a survey conducted among urology patients on the extend of their wish to know the truth of their illness. The results indicate that the majority of patients DO want to know the truth, although such option is mediated by many environmental factors (such as age, sex, place of residence, education level, etc.). Some remarks are made on the lack of literature on the subject and the belief that awareness of this fact may be useful in the currently difficult physician-patient relationship.

[Osteoblastic differentiation in primary renal tumor: a rare histologic finding]. / Diferenciación osteoblástica en tumor renal primario: una rareza histológica.

Presentation of one case of renal carcinoma which interest lies in the osteoblastic differentiation presented by the sarcomatoid component. The rarity of this tumour type in major series of sarcomatoid renal carcinomas published is emphasized. Also, a description of its most relevant singularities is made.

[Ultrasonography diagnosis of ureteral ectopy in prostatic urethra]. / Diagnóstico ecográfico de ectopia ureteral en uretra prostática.

A 54-year-old male who consulted for an episode of right-sided nephric colic is described. A urological ultrasound scan disclosed grade I hydronephrosis in the upper half of the right kidney and an anechoic tubular image ending in the prostate gland. A subsequent urographic evaluation confirmed the diagnosis of ectopic ureter in prostatic urethra.

[Renoduodenal fistula secondary to pyonephrosis]. / Fístula renoduodenal secundaria a pionefrosis.

Presentation of one case of renoduodenal fistula due to pyonephrosis in an oligophrenic female patient. In view of the patient's characteristics, the clinical picture was highly developed at presentation which resulted in failure of the conservative treatment. We emphasize the diagnostic and therapeutical methodology followed. Also, we include a literature review on this disease.

[Fibrino-necrotic ulcers in endovesical chemoprophylaxis in superficial bladder carcinoma: our case histories]. / Ulceras fibrinonecróticas en la quimioprofilaxis endovesical en el carcinoma superficial de vejiga: nuestra casuística.

Presentation of one study on the incidence of fibrino-necrotic ulcers in patients undergoing endovesical chemoprophylaxis with mitomycin C. A description is made of these lesions evaluating their likely relationship to infectious processes. The paper concludes stating the need of endoscopic monitoring and the absence of proven prognostic factors.

[An evaluation of the diagnostic efficacy of video cystourethrosonography]. / Valoración de la eficacia diagnóstica de la vídeo cisto-uretro sonografía.

Evaluation of the diagnostic capacity of lineal ultrasound examination of a male's vesical neck and urethra, known as video cysto-urethro-sonography. The tests has been shown to have high diagnostic accuracy (93.6%), with 93.4% overall sensitivity and 94.4% specificity, in a selected group of men with suspicion disease in the cervico-prostate-urethral area (prevalence, 80.9%). The technique, nevertheless, is not exempt from limitations, including anal or ureteral meatus stenosis, as well as highly obstructive prostate adenoma (where maximal vesical repletion necessary to carry out the examination may decompensate the picture, and lead to retention), or the inhibition of the voiding urge referred by certain individuals when they have to urinate in uncomfortable circumstances.

[The technical aspects of video cystourethrosonography]. / Aspectos técnicos de la vídeo cisto-uretro sonografía.

Analysis of major methodological aspects of real time ultrasound examination of a male's vesical neck and urethra, known as video cysto-urethro-sonography (VCUS). Consideration must be given, when studying the posterior urethra, to the need of suitable vesical repletion, as well as to the existence of two likely limitations for conducting the test, such as: major anal stenosis, which would prevent introduction of the transrectal transducer; and inhibition of the voiding urge referred by some patients when they have to urinate in uncomfortable circumstances. As for the study of the anterior urethra, the most interesting technical items are: avoidance of air bubbles entering with the physiologic serum, which could artefact the examination; nonexertion of excessive compression on the urethra with the transducer, which may lead to false stenosis; and understanding that a major meatus stenosis may preclude test completion due to impossibility of introduction of Foley's catheter, necessary to obtain backward urethral distension with physiologic serum.

[Spontaneous bladder rupture: report of a case]. / Rotura vesical espontánea: a propósito de un caso.

Contribution of one case of spontaneous vesical fracture in a patient with no urinary pathological background. Presentation of this picture is highly uncommon. In this case, a major alcoholic intake stands out as the unleashing factor which provoked vesical overdistension with an intraperitoneal posterior fracture. A review is made of the various etio-pathogenic mechanisms which can originate this pathology, as well as the diagnostic and therapeutic methodology.