[Urologic disease emergency. Clinico-epidemiologic analysis at a district hospital]. / Patología urológica urgente. Análisis clínico-epidemiológico en un hospital comarcal.

OBJECTIVE: To present the results of a one-year retrospective study that analyzed the clinical and epidemiological aspects of urological emergencies, which is not a negligible percentage of all hospital emergencies. METHODS: Data on all the urological emergencies of the emergency department of our hospital were collected during a one-year period by filling out a form that included sex, age, whether referred or not, disease, etc. RESULTS: There were 1504 urological emergencies; the urologist was required in 458 of these cases (30.45%). There were more men (837) than women (667). Patient ages ranged from 1-101 years (mean 53 years); a higher incidence was found for those aged 65 years. By age groups, there were more patients aged 61-80 years (575 patients). Most of the patients came to the hospital on their own initiative (1114) and 390 had been referred by their primary care physician. Renal colic (670 cases) was the most common diagnosis in both males and females, followed by cystitis, which was prevalent in the females (67.35%). Other conditions seen were urinary retention, hematuria, etc. CONCLUSIONS: There was a higher prevalence of males that consulted for urological conditions at the emergency department and there was a higher incidence in patients in the 6th and 7th decades of life, which is similar to the findings reported in other studies. Renal colic was the main reason for consultation for both genders and for all age groups, except those younger than 20 who presented more scrotal and penile involvement. Infective conditions involving the lower urinary tract (cystitis) and pyelonephritis were prevalent in the females. The large number of patients that were discharged from the emergency department and who consulted on their own initiative shows their confidence in the emergency services and that they could have been attended to at other health centers and did not have to come and unnecessarily strain the hospital emergency services.

[Renal infarct in the adult: apropos of a case]. / Infarto renal en el adulto: a propósito de un caso.

OBJECTIVE: To report a case of renal infarction in a patient on anticoagulant therapy for aortic and tricuspid valvulopathy, with special reference to the diagnostic difficulty. METHODS: The most common causes of this condition, its forms of presentation, diagnostic methods, and therapeutic approaches are discussed. RESULTS/CONCLUSIONS: Renal infarction should be suspected in the presence of abdominal pain of sudden onset that is refractory to treatment with analgesics, especially in patients with a history of embolism, recent surgery or trauma. It is frequent to find increased levels of SGOT, SGPT, LDH, alkaline phosphatase and micro or gross hematuria and proteinuria. Arteriography or isotopic renogram is utilized to confirm the diagnosis, although IVP or CT is useful if the foregoing are not available. Early treatment is important for achieving recovery of the compromised renal parenchyma. In recent years, surgery has been displaced by the good results obtained with intraarterial infusion of fibrinolytics.

[Lipoma of spermatic cord; report of a case]. / Lipoma de cordón espermático; presentación de un caso.

OBJECTIVE: To report an additional case of lipoma of the spermatic cord, an uncommon, silent tumor. METHODS: A case of lipoma of the spermatic cord is described. The patient had presented with an enlarged scrotum with no symptoms. The literature on lipoma of the spermatic cord is briefly reviewed, with special reference to its diagnosis, forms of presentation and treatment. RESULTS: US evaluation demonstrated a mass adhered to the epididymis. An epididymal tumor was suspected and surgical exploration by the inguinal approach was performed. CONCLUSIONS: Lipoma is the most common tumor of the spermatic cord. Its etiology is unknown. It frequently appears in the fourth and fifth decades of life and usually involves the left hemiscrotum. It is silent and is detected by enlargement of the scrotum. The diagnosis is histological supported by US, which offers a reliability of 80%-100%. Treatment is by surgery in all cases.

[Spermatic cord torsion in the Comarca del Bierzo. Clinico-epidemiological analysis of the 5-year period 1994-1998]. / Torsiones de cordón testicular en la Comarca del Bierzo. Análisis clínicoepidemiológico del quinquenio 1994-1998.

OBJECTIVE: To review the cases of torsion of the spermatic cord diagnosed at the emergency and urology services of our hospital over the last 5 years and analyze the clinical and epidemiological features. METHODS: The cases of torsion of the spermatic cord diagnosed at our hospital from 1994-1998 were reviewed. Age, reason for consultation, time from onset of symptoms to consultation, location of the torsion, final diagnosis, treatment, and other data were analyzed. RESULTS: There were 20 cases of torsion of the spermatic cord in patients aged 1 to 25 years, with the highest incidence at age 14 years. The left testis was more frequently compromised. Six patients had a history of testicular pain and/or inflammation. The mean time from presentation of symptoms to consultation was 13.5 hours (range 1 hour to 7 days). The diagnosis was torsion of the spermatic cord in 14 cases and hydatid torsion in 6. Treatment was fundamentally by surgery (orchidopexy), except in three cases that spontaneously resolved or were detorsioned by manipulation. Two patients underwent excision of the compromised testis. CONCLUSIONS: Torsion of the spermatic cord is a urological emergency due to the high risk of complications that may even require orchidectomy. The epidemiological findings for our area are similar to those reported in other series.

[Mumps orchitis; review of 8 cases]. / Orquitis urliana; revisión de 8 casos.

OBJECTIVE: To determine the incidence of mumps orchitis in young males in the area of El Bierzo (Ponferrada, Spain) and the complications arising from this condition. METHODS: The cases of mumps orchitis referred by the primary care services to the emergency services of Hospital del Bierzo referral center were reviewed. We analyzed patient age, unilateral or bilateral testicular involvement, whether the patients had been vaccinated against mumps and the changes observed in the semen analysis. RESULTS: The diagnosis of mumps orchitis was confirmed in 8 patients, aged 15 to 19 years. Two patients had bilateral testicular involvement. Seven patients had not been vaccinated against parotiditis. Three patients had oligoasthenospermia and are currently being followed at the Urology services. CONCLUSIONS: The utility of large scale vaccination against mumps is emphasized. Long-term follow-up is recommended for all patients with abnormal semen analysis, particularly those with bilateral testicular involvement, since they may develop oligoasthernospermia several years after the infection or improve with item. A high incidence of mumps orchitis was found for this 12-month study period.