[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.

[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.

[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.

[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.

[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.

[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.

[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.

[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.

[Echodensitometry: a new echographic diagnostic possibility]. / Ecodensitometría: una nueva posibilidad diagnóstica ecográfica.

The determination and quantification of grey levels in the echography scale, designated by some authors Echodensitometry, is viewed as a new method for diagnosis using ultrasound techniques. This paper advances the results from a study conducted with an echographer equipped with an echographic density measuring device. This model analyzes the number of pixels in the image showing the most frequent level of grey. Normal and pathological parenchymatous urological organs (kidney, prostate and testicle) have been examined. Normal organs show a gaussian distribution of grey with a predominant level of typical grey for each of them. When affected by an acute inflammatory process the organs maintain their gaussian distribution but the predominant grey is lower (darker) due to the edema and the hyperaemia. When the inflammatory process becomes chronic, distribution, although somewhat irregular, is still gaussian but with higher predominance of grey (lighter) probably due to the fibrosis. The tumoral cases of our study also showed a gaussian curve even more irregular and with levels of variable grey. When specific areas of the tumour are analyzed the findings are very distinct depending on whether the areas are hypo or hyperechoic. Hyperechoic areas produce highly irregular maps. Research should be directed to provide more complex, although easy to perform systems of analysis which can correlate adequately with the histological study. It would be desirable that the equipment would be standardized to allow analysis of 'in vitro' images. If and when these objectives can be accomplished we would be able to venture into an echography histological diagnosis, something nowadays yet impossible.

[Is the early diagnosis of prostatic cancer possible using transrectal echography?]. / Es posible el diagnóstico precoz del cáncer de próstata mediante ecografía transrectal?

One of the major challenges of using prostate transrectal ultrasound scanning as a procedure to diagnose through images is the theoretical possibility of reaching an early diagnosis of prostate cancer. This paper compiles the author's experience in this field. Based on 142 established diagnosis of prostate cancer since 1984, the conclusion being reached is that prostate cancer has no pathognomonic signs, and therefore it is impossible to make an early diagnosis just by using the images obtained with transrectal ultrasound scanning. This procedure could be used, however, to select patients with scan abnormalities (Alarm signs) who should have a biopsy performed. The support of ultrasound-led transperineal biopsy of the prostate is currently indispensable to achieve an early diagnosis. This paper suggests that a biopsy should be done at the appearance of just one alarm sign, although this may involve a large number of cancer negative biopsies. The almost null incidence of complications from transperineal biopsies enhances this reasoning.

[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.

[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.

[Incidence and characteristics of multiple neoplasms in urologic patients]. / Estudio de la incidencia y características de las neoplasias múltiples en pacientes urológicos.

The incidence and features of malignant primary multiple (MPM) neoplasias found in clinical urological patients have been analyzed so as to determine the actual magnitude of the problem and to obtain a better knowledge of this disease. For this reason, case histories of patients with MPMN, where at least one of the involved neoplasia was urological, were retrospectively studied. The study included a 9-year follow-up period and followed the Warren and Gates inclusion criteria. The number of MPMN patients was 23, representing an incidence of 6.1% among patients with urological neoplasias. Mean age at the time of discovery of the second tumour was 77.1 years. In the 15 patients with metachronic tumours, the time interval between the first and second tumours ranged between 1 to 25 years (average 5.4 years). The most frequently observed tumour association was bladder transitional carcinoma and prostate adenocarcinoma. The cause of death was always the second neoplasia.

[Blue nevus of the prostate]. / Nevus azul de la próstata.

The presence of melanin in the prostatic gland's stroma is a histopathological finding of extreme rarity. It receives the name of blue nevus as a result of its similitude to the skin's blue nevus. The paper describes the finding of melanin stores in the fibromuscular stroma of a patient's prostate and reviews the theories on its source.

[Simple calculation of prostatic weight with transrectal echography]. / Cálculo sencillo del peso prostático mediante ecografía transrectal.

The appraisal of the prostate weight with transrectal ultrasound scanning is simplified with the use of a simple mathematical formula of an ovoid volume. Such a method does not prolong the examination time but provides an acceptable reliability, and therefore it can be used as a substitute to planimetry, more subject to the observer's error and more time consuming for the physician, even when part of the examination can be made by replaying the video.

[Surgical wound infection in urological patients. a four-year review]. / Infección de herida quirúrgica en pacientes urológicos. Revisión de los casos registrados en cuatro años.

INTRODUCTION: Surgical site infection (SSI) is a constant concern for health care professionals. OBJECTIVE: To ascertain the accumulated incidence (CI) rates of SSI, overall and by surgical procedure, at our department of urology, and to find areas for improvement. MATERIALS AND METHODS: A retrospective and analytical study was conducted (January 2004/December 2007) of 91 patients. Variables examined included age, sex, mean hospital stay, diagnosis, surgical procedure, infection site, organism, and department and hospital rates. Procedures performed in more than 2 patients were analyzed. Patients with SSI caused by an infectious condition were excluded. A descriptive statistical analysis, comparison of percentages, Chi-square test were performed as appropriate. RESULTS: Eighty-five males and 6 females with a mean age of 64.3+/-13.6 years were analyzed. The AI rate for the department was 1.99%, lower than for the rest of the hospital. Mean hospital stay was 22.4+/-17.9 days. According to the CDC criteria, there were 56 superficial (61.5%), 10 deep (10.9%) and 25 organ/space (27.4%) infections. Cultures were performed in 54infections (59.4%, lower than the hospital rate). Fifty percent of cultures were positive. Very high rates were found in cystectomy (25, 26.04%), adenomectomy (21, 16.00%) and urethroplasty (4; 10.26%), while the rates found for other procedures were lower than reported in the literature. CONCLUSIONS: Our overall SSI rates were similar to those of other urology departments and lower than the hospital rate. SSI rates in adenomectomy were very high and a study should be conducted to find areas for improvement. SSI rates in cystectomy were also very high, in agreement with previous reports, and must also be improved, as well as the percentage of wound cultures.

[Postoperative sclerosis of the bladder neck: surgical treatment]. / Aportaciones al conocimiento de la esclerosis post-operatoria del cuello vesical: tratamiento quirúrgico.

We analyzed the results of surgical treatment of vesical neck sclerosis in 81 patients who underwent 97 procedures. Most of these patients had post-operative sclerosis of the vesical neck. The different surgical techniques and their results are reviewed. Excision of the sclerotic tissue by transurethral encircling resection has been the most widely used and has achieved better results. It is frequently necessary, however, to use it together with other complementary techniques such as retrograde resection, knife incision, or combined procedures. Knife incision of the diaphragm has achieved the worst results. Overall, the results have been poor (approximately 36% poor results). The results achieved by these procedures are even worse (75% poor results) in recurrence.