Biomedical subjects

G Server Pastor

Publications and source records attributed to G Server Pastor.

At least 19 recordsLinked to original sources

PubMed2001

[Can PSA density predict the response to alpha-blockers in benign prostatic hyperplasia?].

INTRODUCTION AND OBJECTIVES: In BPH there is a growth of both glandular and stromal components. Most of adrenoceptors sites are in the fibromuscular stroma. So the higher is the stromal/epithelial ratio, the more effective will alpha-blockers be. There in an indirect way of stimating this ratio without performing a biopsy. Bearing in mind that PSA is produced by the prostatic epithelium, the lower PSA density (PSAd), the higher the stromal/epithelial ratio and the higher alpha-blocker activity. We pretend to study if PSAd is useful for predicting the response to alpha-blockers in BPH. MATERIAL AND METHODS: We studied 75 patients suffering from prostatism and diagnosed of bladder outlet obstruction secondary to BPH through IPSS symptom score, digital rectal examination, PSA, uroflowmetry, and transrectal ultrasound. All of them received Alfuzosin, 5 mg twice daily during 3 months, and then were evaluated again with IPSS and uroflowmetry. RESULTS: A statistically significant improvement was appreciated of the two studied parameters and in both groups of patient with regard to the pretreatment situation. A statistically significant better answer was also appreciated in the group of patient with smaller PSAd in comparison with the higher PSAd patients. CONCLUSIONS: Our results show that PDAd is usefu to estimate the stroma/epithelium ratio, and therefore the clinical response to alpha-blockers.

Adrenergic alpha-Antagonists↗

PubMed2001

[Brucellar orchiepididymitis].

The brucellosis is an unusual entity whose incidence has diminished due to the improvement in preventive measures. We have carried out a retrospective study of all the patients admitted in our service between 1996 and 1998, with diagnosis of orchitis. Two of the 31 patients admitted for this reason presented a final diagnosis of brucellar orchiepididymitis. Both patients presented clinic of affectation from the general state accompanied by resistance to habitual antibiotic treatment. The patient's epidemic antecedents, accompanied by the suitable clinical evolution took to the suspicion of orchiepididymitis of brucellar etiology, with change in the antibiotic rule. The diagnosis of the process was obtained by means of serologic tests and blood cultures.

Adult↗

PubMed2001

Oat-cell carcinoma of the prostate. Diagnosis, prognosis and therapeutic implications.

BACKGROUND: Any carcinoma of prostatic origin which is not an acinary adenocarcinoma of the prostate is considered to be an atypical carcinoma. One member of this group of atypical prostatic tumors is the oat-cell carcinoma, or small cell carcinoma (SCC) of the prostate. This variety of carcinoma constitutes the histologic basis of <1% of all prostatic neoplasms. METHODS: Between 1992 and 1997, four patients were diagnosed with SCC of the prostate at our hospital. In 3 of the 4 cases, the histopathological diagnosis was pure SCC, and in the 4th case there was a component of prostatic adenocarcinoma associated with the SCC. At the time of diagnosis, extracapsular extension of the tumor was present in all 4 cases, with T3 or higher stages in all of them (T(3A)N(0)M(1), T(3A)N(0)M(0), T(3B)N(0)M(1), and T(4)N(0)M(0)). Because of the presence of extracapsular extension, radiotherapy and radical surgery were ruled out for all 4 patients. They were all offered systemic chemotherapy with cyclophosphamide (1 g/m(2)), doxorubicin (50 mg/m(2)) and vincristine (1.2 mg/m(2)). This therapeutic protocol was carried out in only 2 cases. RESULTS: Survival was <1 year in the 3 patients with pure SCC, and the patient with a mixed tumor is alive with detectable disease 9 months after diagnosis. CONCLUSIONS: This poor vital prognosis in SCC stresses the need for early diagnosis a timely and appropriate therapeutic intervention in this condition.

Adult↗

PubMed2001

[Simple syringocele of Cowper's glands].

OBJECTIVE: To describe an additional case of simple syringocele of Cowper's glands and review the literature. METHODS: An additional case of simple syringocele of Cowper's glands is presented and the literature over the last 10 years is reviewed. RESULTS/CONCLUSIONS: The treatment most commonly utilized is marsupialization to the urethra by endoscopy. The foregoing was performed in our patient with satisfactory results.

Adult↗

PubMed2001

[Abscess of seminal vesicle: conservative treatment].

OBJECTIVE: To describe a case of primary seminal vesicle abscess that was managed conservatively. METHODS: Antibiotics, according to the urine culture and antibiotic profile, were administered for four weeks. Outpatient follow-up was carried out with digital rectal examination, urine culture and ultrasound. RESULTS: A favorable clinical response was observed at day three. The patient was discharged from hospital on day 7. DRE, urine culture and ultrasound findings were normal after 4 weeks. CONCLUSIONS: Primary abscess of the seminal vesicle can be successfully treated with antibiotics. Percutaneous drainage of the abscess should be reserved for those cases that do not respond to conservative management with antibiotics.

Abscess↗

PubMed2001

[Malignant melanoma of the penis].

OBJECTIVE: To report a case of malignant melanoma of the penis, a rare malignant neoplasm whose aggressive behaviour carries a poor prognosis. METHODS: A 58-year-old male consulted for a pigmented elevated lesion in the balanopreputial sulcus. The biopsy was positive for melanoma. Complementary studies did not demonstrate disseminated disease. RESULTS: Partial resection of the penis and bilateral inguinal lymphadenectomy were performed. Histological analysis showed two positive nodes in the same lymphatic chain. Interferon was administered for 6 months. The patient remains disease-free at 35 months' follow-up. CONCLUSIONS: Although surgery is the treatment of choice, adjuvant therapy (chemotherapy and immunotherapy) should be considered in those patients without localized disease.

Humans↗

PubMed2000

[Bladder compression by collateral veins].

Many space-filling injuries (e.g. haematoma, abscess, aneurysm, lymphocele, neoplasia etc.) may result in extrinsic compression of the bladder. We contribute one case report of compression of the bladder from collateral venous circulation in a patient who came for a left varicocele.

Humans↗

PubMed2000

[Intraperitoneal bladder perforation in emphysematous cystitis].

Contribution of one case report of a 69-year old diabetic male patient with neurogenic bladder. The patient developed emphysematous cystitis and peritonitis secondary to intraperitoneal perforation of the bladder. Emphysematous cystitis is an uncommon clinico-radiologic entity more frequent in diabetic and female patients and the elderly. Early diagnosis and treatment may avoid a fatal outcome. The paper includes a review of this condition.

Cystitis↗

PubMed2000

[Malignant neoplasms of the penis].

OBJECTIVE: To assess the behaviour and management of these uncommon neoplasias. MATERIAL AND METHODS: Between March 1975 and July 1999, a total of 95 malignant neoplasias of the penis were diagnosed and treated by our unit. Patients mean age was 62 years (28 to 87 years). A retrospective analysis of any associated lesions, biological behaviour of the various neoplasias, as well as therapies used is carried out. RESULTS: The squamous carcinoma of the penis (SCP) is the most frequent pathohistological entity entailing 78 cases (82%), followed by verrucous carcinoma (VC) 13 cases (13.5%), basal cells carcinoma 1 case, and melanoma, lymphoma and penile metastasis 1 case each. There is a significant presence of associated lesions with marked predominance of phimosis. The most frequent reason for the call is an injury of the penis (74 cases; 78%). Treatment was mainly partial penectomy (51 patients; 53.7%), followed by conservative treatment in 28 cases (30%). Inguinal lymphadenectomy was performed in 13 patients (14%), due to either a positive nodular biopsy or a persistent adenopathy following antibiotic therapy. CONCLUSIONS: Neoplasias showing superior biological behaviour are basal cell carcinoma of the penis, and verrucous carcinoma. Prognosis in SCP is based on pathological status and node involvement. Patients with pT1 tumours showed no metastatic adenopathies after follow-up regardless of cytological grading, and are therefore candidates to watchful waiting with regular monitoring. Melanoma of the penis is a highly aggressive tumour due to its high metastatic capacity with a poor prognosis.

Adult↗

PubMed2000

[Squamous carcinoma of the penis].

OBJECTIVE: To present our experience with squamous cell carcinoma of the penis. METHODS: We reviewed our series of 73 squamous cell carcinoma of the penis over the last 23 years. Patient mean age was 65.7 years. All lesions had been previously biopsied. Patient records were reviewed for a history of phimosis and related lesions. The histological, clinical and therapeutic aspects, and survival are analyzed. RESULTS: Most of the squamous cell carcinoma of the penis were superficial lesions (pT1). Treatment was by partial penile resection in 42 cases, total penile resection in 9, and emasculation in 2 cases. Conservative surgery was performed in 20 cases (tumor excision in 14 and posthectomy in 6 cases). Lymphadenectomy was performed in 11 patients. Eight patients received radiotherapy to the inguinal region. The rate of recurrence after surgery was 11% (8 cases). Five of the 8 patients with tumor recurrence had been treated by conservative surgery. The 5-year survival rate was 78%. CONCLUSIONS: Penile cancer is uncommon and accounts for less than 1% of tumors in the male in our setting. A higher incidence has been found in men with phimosis, poor hygiene and low sociocultural level. Partial penile resection is the treatment of choice for the primary lesion. The outcome is worse in patients with invasive tumor, poor cell differentiation, ulceroendophytic morphology, and above all in patients with metastatic adenopathy. Radiotherapy provided no benefits, made inguinal evaluation difficult and increased the morbidity in some cases. Patients with pT1 tumor and good cell differentiation showed no metastatic adenopathy during follow-up. Patient follow-up is fundamental to detect recurrence or metastatic adenopathy and to institute treatment immediately.

Adult↗

PubMed2000

[Basal cell carcinoma of the penis].

OBJECTIVE: To report an uncommon case of basal cell carcinoma of the penis. METHODS: A case of basal cell carcinoma of the penis is presented. This has been the only case of this tumor type detected in our setting. The literature is briefly reviewed. RESULTS/CONCLUSIONS: Basal cell carcinoma of the penis is rare. To date only 20 cases have been reported in the literature. To our knowledge, no case of distant metastasis has been documented. Diagnosis by gross examination may be difficult due to the broad polymorphism of this lesion and must be confirmed by histological analysis.

Basal Cell Carcinoma↗

PubMed2000

[Giant fibroepithelial polyp of the ureter].

OBJECTIVE: To report a case of giant fibroepithelial polyp of the ureter and review the literature with special reference to the diagnosis and treatment of this benign condition. METHODS: A young male patient with a nonfunctioning left kidney caused by a giant fibroepithelial polyp of the ureter is presented. The diagnostic methods and treatment options are discussed. RESULTS: Following the diagnosis of obstructive uropathy with loss of left renal unit function, a left nephroureterectomy was performed which revealed a giant polypoid mass. CONCLUSION: Fibroepithelial polyp of the ureter is a benign condition that is difficult to diagnose with current endoscopic techniques. Endoscopy should be the first therapeutic option if loss of renal function is not irreversible.

Adult↗

PubMed1999

[Management of obstructive uropathy in pregnancy].

INTRODUCTION: Obstructive uropathy in pregnant women is a relatively common condition. It can be difficult to assess due to the frequency with which physiologic dilation of the upper urinary tract is seen in pregnant women. PATIENTS AND METHOD: Over the past 3 years 40 pregnant women with symptomatic obstructive uropathy were seen in our service. RESULTS: Most pregnant women responded to conservative treatment (pain killers and antibiotics). In the remaining group, instrumentation was necessary through the urinary route: double J ureteral catheterism (10 patients: 6 due to uterine compression and 4 to lithiasis), percutaneous nephrostomy (4 patients: 2 due to ureteral catheter obstruction impossible to replace, and two due to urinary sepsis), or ureterorenoscopy (1 patient with lithiasis). CONCLUSIONS: The single most common cause for obstructive uropathy in our experience is ureteral compression due to a gravid uterus. Choice therapy in most cases is conservative treatment. When in spite of conservative treatment signs and symptoms persist, urinary by-pass with antibiotic prophylaxis must be performed. Ureterorenoscpy as a diagnostic and therapeutical approach should be taken into consideration in pregnant women with ureteral lithiasis. Incidence of pre-term labour was not higher than usual.

Adult↗

PubMed1999

[Penile injuries: our experience].

Trauma of the penis is relatively uncommon. Not many centres and even less urologists have extensive experience in the comprehensive management of this type of injury. Revision of the series accrued in our hospital over 20 years, in each case explaining the mechanism of occurrence, treatment applied and results obtained.

Humans↗

PubMed1999

[Penile verrucous carcinoma].

OBJECTIVE: To report our experience with verrucous carcinoma of the penis. METHODS: Our series of penile carcinoma over the last 25 years were reviewed; 13 cases of verrucous carcinoma were found. The histological and clinical features, course and treatment of these patients are discussed and current literature reviewed. RESULTS: Of 95 cases of penile carcinoma diagnosed in our hospital, 13 were verrucous carcinoma of the penis (13.7%). Patient mean age was 64.7 years (range 33 to 93). The urethra was compromised in 2 (15.4%) and the corpora cavernosa in 4 (30.7%) patients. Five patients presented with inguinal lymphadenopathy. Treatment was by posthectomy in 3, resection of the glans penis in 2, partial penectomy in 6 and total penectomy in 2. One patient showed local recurrence at a mean follow-up of 7 years. No lymph node or distant metastasis from the primary penile tumor was observed. CONCLUSION: Verrucous carcinoma of the penis shows an aggressive behavior locally, but not biologically. Treatment continues to be by surgery. Patients undergoing surgery aimed at organ preservation should be carefully followed. In most of the patients, early diagnosis could have avoided more aggressive surgical techniques.

Adult↗

PubMed1998

Renal vein thrombosis caused by laparoscopic cholecystectomy.

A 48-year-old woman was diagnosed with right renal vein thrombosis (RVT) 2 weeks after a laparoscopic cholecystectomy. The patient had none of the major risk factors for RVT or deep vein thrombosis. She was treated with long-term anticoagulation. Complete dissolution of the thrombi was reached 1 month after diagnosis.

Cholecystectomy↗

PubMed1998

[Incidence and risk factors for calculi formation in patients treated with augmentation cystoplasty or intestinal substitution].

OBJECTIVE: Bladder stones have been observed more frequently in patients undergoing bladder augmentation or substitution than in the normal population. We analyzed the etiological factors influencing bladder stone formation in patients submitted to the foregoing procedures. METHODS: Between December 1986 and October 1994, 12 augmentation cystoplasties with detubularized ileum or colon (group I) and 24 substitution ileocystoplasties (group II) were performed. None of the patients were known to have urinary stone formation. The possible causes of bladder stone formation were analyzed in both patients groups. The patients were evaluated for urinary infection, post micturition bladder residue, urinary pH, and stone forming metabolic alterations in blood or urine. The latter consisted in determining the blood levels of creatinine, calcium, uric acid and phosphorus and the 24-hr urine levels of calcium uric acid, phosphorus, creatinine, urea, oxalic acidi citric acid and magnesium. The statistical analysis consisted of an unweighted logistic regression test and a chi square test between each of the above variables and the existence of bladder stones. RESULTS: In group I, 10 patients revealed recurrent urinary infections, 0 showed a significant post-micturition bladder residue, a pathologically alkaline pH was observed in 2 and the metabolic study of blood and urine revealed alterations in 9 patients. In group II, 18 patients revealed recurrent urinary infection, 13 patients had post-micturition bladder residue, a pathologically alkaline pH was observed in 1, and the metabolic study of blood and urine revealed alterations in 13 patients. The statistical analysis using the unweighted logistic regression test showed no significant relation between any of the parameters and the presence of stones, for the substitution group pr augmentation group. However, the chi-square test to determine the relation between the different varikables and the existence of stones, showed a statistically significant relation between an elevated urinary pH, recurrent urinary infection, post-micturition bladder residue and bladder stone formation for groups I. Concerning the type of suture employed, some degree of relation between the use of non-resorbable suture and stone formation was found, although it was not statistically significant. CONCLUSION: We can therefore conclude that urinary pH, recurrent urinary infection annd post-micturition bladder residue, and probably use of nonreabsorbable suture, are among the etiological factors that we should avoid and treat in order to prevent the formation of bladder stones in patients undergoing augmentation or substitution cystoplasty.

Adolescent↗

PubMed1998

[Right varicocele as first manifestation of situs inversus].

Traditionally, right varicoceles have been considered a rare entity nearly always secondary to a neoplastic or retroperitoneal disease. There are other possible etiologies for right varicoceles such as the venous disease of the large veins and visceral malposition syndromes. This paper presents one case report of right varicocele as the only clinical sign of situs inversus. Revision of the literature and nomenclature of these syndromes.

Adult↗