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J M Diez Cordero

Publications and source records attributed to J M Diez Cordero.

8 recordsLinked to original sources
PubMed2005

[Primary seminal vesicle abscess: diagnosis and treatment by transrectal ultrasound].

A 38 years old man with the only past medical history of bilateral orchiopexy 15 years ago is diagnosed of left primary seminal vesicle abscess. The patient is sent to our emergency service with an ultrasound finding of either dilated vas deferent or seminal vesicle abscess with hiperecogenic material inside it. The examination was performed after a 5 month history of purulent ejaculation. The diagnose of seminal vesicle abscess is confirmed by TRUS and, in the same procedure, drainage of the abscess was completed by needle-aspiration puncture. After this treatment the patient stay 12 hours at the observation room with intravenous antibiotics and is discharged home with oral antibiotics. We are interested in this case because of the low incidence of this pathology and the easy diagnosis and treatment by TRUS.

Abscess↗
PubMed1997

[Yield of transrectal ultrasonography in the diagnosis of prostatic cancer in symptomatic patients with normal rectal digital test].

The purpose of this retrospective study is to evaluate the incidence of prostate cancer in symptomatic patients with non-suspect rectal examination and its correlation to PSA, PSAD levels and ultrasound findings. A total of 235 patients with non-suspect rectal examination underwent transrectal ultrasound and echo-guided prostate biopsy to assess an echographic node, PSA > 10 ng/mL and/or PSAD > 0.15 Incidence of prostate cancer was 16% and no correlation was seen to either PSA (95CI = 5%, 14.9%) or the existence of ecographic nodes (95CI = 5.2%, 22.2%), mainly in the subgroup of patients with PSA > 10 ng/mL and no identifiable echographic node (95CI = 5.5%, 29.5%). A PSA > 10 ng/mL or identifiable echographic nodes in symptomatic patients with non-suspect rectal examination did not involve a risk factor for prostate cancer, however a PSAD > 0.15 within the group with PSA > 10 ng/mL with no echographic nodes did involve a risk factor.

Aged↗
PubMed1996

[Clinical and neuro-urodynamic assessment of radical prostatectomy].

OBJECTIVES: To study the clinical and urodynamic parameters after radical prostatectomy in order to standardize the management of these patients in the medium-term. METHODS: 35 cases submitted to radical prostatectomy from February, 1989 to March, 1994 were retrospectively evaluated clinically and urodynamically using a clinical questionnaire, free flowmetry, cystometry, pressure/flow voiding test with simultaneous videocystography and sacral-evoked potentials. The mean age was 65 years and mean follow-up was 14 months. RESULTS: 80% (28) were continent or minimally incontinent on exertion, 9% (3) required the use of some absorbent system and 11% (4) were completely incontinent and required the use of a collecting system. No statistical differences were observed between continence status and tumor stage, patient age or neurovascular preservation. Overall the urodynamic parameters fell within the normal ranges, except for a reduced maximum cystometric capacity. A significant difference (p = 0.05) was found in those patients with significant incontinence vs those who did not for maximum free flow, which disappeared on flowmetry with transducer catheter. Seventy per cent of the incontinent cases were evident on evaluation; 60% had stress incontinence and 40% had instability waves with differential pressure over 80 cm H2O. Six per cent met the criteria for obstruction, whose localization was done during videocystography. Eleven per cent showed non inhibited contractions and 6% showed diminished bladder compliance. The sacral reflex arch was normal in all patients. CONCLUSIONS: The urodynamic study was found to be normal in the majority of patients submitted to radical prostatectomy; therefore performing the study routinely is not justified. However, incontinent patients and those with disturbances on free flowmetry may show incontinence due to instability or obstruction of the urethrovesical junction. We therefore advocate performing a complete study on all patients with significant incontinence and free flowmetry for the rest at least three months after surgery and a complete study should be done if disturbances are found.

Aged↗
PubMed1996

[Multicentricity in renal adenocarcinoma: its incidence and the therapeutic implications].

Unsuspected multicentricity in single Renal Adenocarcinoma (RAC) together with the prospects of incomplete neoplasia removal are the 2 major disadvantages for the acceptance of traditional renal surgery in birenal carriers of medium size, low grade single RAC. This paper is a retrospective review of our series of RAC patients who underwent radical nephrectomy between January 1986 and October 1994 with the following purpose: 1) To evaluate our incidence of unsuspected multicentricity. 2) To evaluate the characteristics of such multicentricity. 3) To evaluate, in the assumption that traditional surgery had been indicated for patients with small size RAC, in how many patients tumoral resection would have been incomplete due to existence of satellite tumoral nodes in the preserved renal parenchyma. Of 110 patients undergoing radical nephrectomy, 11.8% (13/110) had unsuspected multicentricity. In 10 patients there was multiple satellite nodes with size ranging from 0.3 to 3 cm. We conclude that there is not relationship between multicentricity and size or stage of primary tumour and that, by applying strict criteria (size, location, well defined tumoral wall and form of presentation) to select the patients who can be candidates to traditional renal surgery, the probability to perform it in patients with multicentric RAC would be considerably reduced.

Adult↗
PubMed1996

[Performance+ of transrectal ultrasonography in the diagnosis of prostatic cancer in patients with abnormal digital examination].

OBJECTIVES: To determine the incidence of prostatic cancer in patients with abnormal digital rectal examination (DRE) and its correlation with PSA levels and US findings. METHODS: A retrospective study was conducted on 167 patients with abnormal DRE that had been evaluated by PSA, US and prostate biopsy from January, 1994 to September, 1995. The 95% confidence interval was estimated (C195) for the differences observed. RESULTS: Biopsy demonstrated cancer in 73% of the patients; 67.7% of the patients with DRE classification of T2 versus 88.4% of those with T3 (C195 = 8%-33.3%); 81.4% of patients with PSA > 10 ng/ml had cancer versus 60.5% of patients with PSA > 4 and < 10 ng/ml (CI95 = 3%-37.9%); 79.5% of the cases with ultrasound nodes had cancer vs 43.3% of those without (CI95 = 17.3%-55.2%). In patients with PSA > 4 and < or = 10 ng/ml, 71% of the cases with ultrasound nodes had cancer versus 14.3% with no nodal involvement (CI95 = 26.2%-87.1%). In patients with PSA > 10 ng/ml, 83.2% of the patients with ultrasound evidence of node involvement had cancer versus 70.6% of the patients with no node involvement (CI95 = -10.3%-35.4%). CONCLUSIONS: The incidence of prostatic cancer in patients with abnormal DRE was 73%; 81.4% of patients with PSA > 10 ng/ml and 79.5% of patients with ultrasound evidence of node involvement and 83.2% of those with both of the foregoing characteristics. Biopsy of both prostatic lobes should be performed routinely in all patients with abnormal DRE.

Adult↗
PubMed1995

[The reliability of computed tomography (CT) in the local (T) and lymph node (N) staging of kidney adenocarcinoma].

OBJECTIVES: We investigated the reliability of local (T) and lymph node (N) category staging of renal adenocarcinoma by CT in patients submitted to radical nephrectomy. MATERIAL AND METHODS: The study comprised 109 patients with renal adenocarcinoma who had undergone radical nephrectomy from 1986-1994. The preoperative staging was done using dynamic CT. Clinical staging was based on the CT data and pathological staging was determined by the pathological findings. All patients had a transperitoneal radical nephrectomy. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for tumors localized to the kidney, perirenal fat invasion, central venous and lymphatic invasion were analyzed. RESULTS: The overall sensitivity rate was 67%; the sensitivity and specificity rates were 77% and the PPV and NPV were 89.5% and 67%, respectively, for tumors localized to the kidney. The sensitivity rate was 66%, specificity was 76% and the PPV and NPV were 48.5% and 87.5%, respectively, for those with perirenal fat invasion. Tumors with venous spread showed a sensitivity of 90%, specificity of 92%, PPV 53% and NPV 99%. Concerning lymph node invasion, the sensitivity was 50%, specificity 96%, PPV 50%, NPV 96%. CONCLUSIONS: CT has a very low sensitivity and specificity in detecting fat invasion, a very high sensitivity and specificity for venous invasion and a low sensitivity, but high specificity in detecting lymphatic spread.

Adenocarcinoma↗
PubMedDate not supplied

[Genito-urinary tuberculosis in acquired immunodeficiency syndrome].

Tuberculosis is being described as a highly associated entity with the acquired immunodeficiency syndrome (AIDS) in countries or geographical areas where this entity is endemic, even becoming its first clinical manifestation. Two cases of prostatic abscess are presented in patients with anti-HIV antibodies, who are parenteral drug users. In one of them, his genitourinary tuberculous infection was the first sign of AIDS. In the other, a previous association with tuberculous meningitis was found. The evolution and pathogenicity of tuberculous genitourinary in AIDS patients is discussed.

Abscess↗