[Melanoma of the penis].
We present a case of penile malignant melanoma. Its rarity of less than 1% of masculine genital malignant neoplasms, the absence of standardised protocols as for other neoplasms, impel us to its publication.
Humans↗
Biomedical subjects
J M Monge Mirallas
Publications and source records attributed to J M Monge Mirallas.
[Report of 2 new cases of bladder inverted papilloma, one with them complicated with acute urinary obstruction].
Inverted papilloma is a rare tumour (2.2% of urothelial tumours) considered to be benign. The bladder is the most frequent site and growth tends to be endophytic towards the submucosa. Haematuria and obstruction symptoms appear to be the most typical clinical manifestations. Contribution of two cases of inverted bladder papilloma; one showing very unusual clinical development with relapsing acute urinary obstruction. Strict follow-up is recommended in spite of its benign behaviour as it may become associated to transitional cell carcinoma. Literature review on this tumoral entity in terms of etiology, clinical manifestations, diagnosis and treatment.
Acute Disease↗
[Paratesticular lipoma].
Among the neoplasias affecting the scrotum and other elements contained within, testicular tumours are the most common; paratesticular neoplasias account for about 2%. 70% of them are benign tumours, lipoma being one the most frequent types. We contribute a new case of paratesticular lipoma in a 45-year old patient, who presented with scrotal complaints. Physical examination found fibroelastic scrotal tumoration; diagnosis being aided with ultrasound and CAT that showed fat tissue radiographic patterns. Complete removal of tumoration and subsequent pathoanatomical study confirmed the diagnosis of paratesticular lipoma. A literature review on the subject is included with reflections on the clinical, diagnostic and therapeutical aspects.
Humans↗
[Metanephric adenoma of the kidney and chronic myeloproliferative syndrome. An unusual association].
The metanephric adenoma is an uncommon tumour included in the class of benign renal epithelial tumours. This paper presents the case of a 64-year old female with incidentally diagnosed renal tumoration affecting the patient concomitantly to a chronic myeloproliferative syndrome with myelofibrosis. Left kidney ultrasound and CAT findings suggested a diagnosis of renal cell carcinoma. Left radical nephrectomy was performed. The pathoanatomical study confirmed the diagnosis of a renal metanephric adenoma 9 x 7.5 cm in size. Although some cases of metanephric adenoma have been described in patients with haematological conditions, polycythemia being specially frequent, no case associated to chronic myeloproliferative syndrome has been found in the literature.
Adenoma↗
[Acute pyelonephritis as presentation form of renal angiomyolipoma with large granulomatous component].
Angiomyolipoma is a benign tumour of the kidney; is most cases is a finding during radiologic studies (ultrasound and CAT) and therefore asymptomatic. Due to their histologic features, these tumours show characteristic ultrasound and CAT patterns. This paper presents one case of angiomyolipoma in a 26-year old female patient who presented with a clinical picture of acute pyelonephritis. The tumour features in both ultrasound and CAT were not the typical ones for this kind of tumour. The surgical piece removed corresponded to an angiomyolipoma with a large granulomatous reaction.
Adult↗
[Review of 42 cases of penile carcinoma].
OBJECTIVES: 42 cases of penile carcinoma were retrospectively analyzed to determine the overall survival and the influence of treatment and inguinal lymph node metastasis on survival. METHODS: The clinical records of 42 patients with penile carcinoma that had been treated at our hospital over a 17-year period were reviewed, with special reference to the epidemiological aspects, diagnosis, staging, treatment and overall survival. RESULTS: The overall 5 and 10-year survival were 73% and 43%, respectively. Inguinal dissection was performed in 24% of the patients. The overall survival was better in those with no lymph node involvement. CONCLUSIONS: Following local surgery of penile cancer, inguinal lymphadenectomy of palpable nodes is recommended to improve survival, if antibiotic treatment is not effective. Randomized and cooperative studies are necessary to assess the efficacy of prophylactic lymph node dissection and its influence on survival.
Adult↗
[Epidemiologic study of the factors influencing renal trauma in Cantabria].
OBJECTIVE: In this study, the most important factors that influence renal trauma (RT) were evaluated in patients that had suffered different types of accidents. METHODS: Data from 340 cases of RT that were seen over a period of 15 years were obtained. This was performed in two stages: first, data were obtained during this time period; secondly, the patients were followed after discharge from hospital. RESULTS: All this information was filed in a data base specifically for this purpose and were statistically analyzed to determine and quantify the types of RT and their incidence in relation to demographic and temporal factors, type of accident, etc. CONCLUSIONS: Weekends, alcohol, age, road traffic accidents, type of road, etc., are the most important factors that influence the development of RT. The incidence of RT in Cantabria is similar to that of the US and European countries.
Adolescent↗
[Epidemiologic study of the clinical features, diagnosis, and treatment of kidney trauma in Cantabria].
OBJECTIVE: This study reviews the clinical features, methods and treatment of renal trauma (RT). METHODS: The epidemiological study was conducted using data from 340 cases of RT that had been treated in the Department of Urology of the Marqués de Valdecilla University Hospital in Santander. All the information was filed in a data base specifically for the purpose. RESULTS: Statistical analyses of the data showed the incidence of the symptoms, diagnosis and treatment of RT. CONCLUSIONS: Radiological and ultrasound evaluation are still fundamental for the diagnosis of RT. Only 4% of these patients have died. Abdominal, thoracic and cranial injuries cause the most severe lesions. Concerning treatment, only 17% of the cases with RT required surgery.
Adolescent↗
[Clinical trial with intravesical alfa-2b interferon for the prevention of T1 transitional carcinoma of the bladder: preliminary results. Review of the bibliography].
OBJECTIVE: To assess the efficacy of 60 MU intravesical alpha-2b interferon (IFN) in preventing recurrence of transitional cell carcinoma of the bladder. METHODS: A prospective, randomized double-blind study was conducted to assess the efficacy of 60 MU intravesical alpha-2b IFN compared to a control group. T1G2-G3 and the G1 recurrent tumors were included in the study (30 in each group). Instillation was started 2-3 weeks after complete TUR and administered once weekly for 12 weeks and once monthly thereafter for one year. RESULTS: The distribution according to sex and age of the patient, tumor size, grade and classification as primary or secondary was the same for both groups. Multiple tumors were prevalent in the IFN-treated group. During the first year of follow up, the tumor recurrence rate was 23.3% for the IFN-treated group and 36.6% for the control group. At 22.4 months mean follow up, the rate of recurrence was 40% for the IFN-treated group and 46.6% for the control group. Of these recurrences, 8.3% of tumors in the IFN group showed progression in grade and/or stage versus 35.7% for the control group. The disease-free interval averaged 8.5 months; 10.5 for the treated group and 6.9 months for the control group. Local or systemic toxicity was negligible. CONCLUSIONS: Alpha-2b IFN is well-tolerated at a dose of 60 MU. It prolongs the disease-free interval and while throughout the follow up period the recurrence rate is similar to that of the control group, it does seem to markedly slow progression in the grade and/or stage of the tumor.
Administration, Intravesical↗
[Bladder pheochromocytoma].
OBJECTIVES: The present study reports on a case of paraganglioma of the urinary bladder and briefly reviews the literature. METHODS/RESULTS: The patient presented with gross hematuria and no history of hypertension. The pathological findings were diagnostic of paraganglioma of the urinary bladder. CONCLUSIONS: Extra-adrenal pheochromocytoma is uncommon. Although it usually presents with typical symptoms, these are also determined by tumor location. Currently, there are no anatomopathological criteria to distinguish the benign from the malignant form.
Adult↗
[Substitutive orthotopic ileocystoplasty. The Studer's technique].
OBJECTIVES: The results of the Studer enterocystoplasty technique is analyzed, with special reference to the early and late complications and urinary continence. METHODS: We reviewed the records of 20 patients that underwent bladder substitution according to the Studer technique due to bladder carcinoma from 1990-1993. Patient follow-up ranged from 6-36 months. The ureteroileal anastomosis was done by the single stitch technique onto a tubularized ileal chimney. RESULTS: The median age was 57.2 +/- 11.86 yrs (range 33-73). The preoperative stay for intestinal preparation ranged from 1-29 days (median 4.4 +/- 5.84) and the postoperative stay ranged from 1-60 days (median 26 +/- 11.44). The average operating time was 5.30 +/- 0.7 hours (range 4.15-7). There were two postoperative deaths; one from acute myocardial infarction and the other from pulmonary embolism. Three patients died from tumor progression during follow-up and one from leg ischemia 17 months postoperatively. Early complications: 2 cases of prolonged ileus, 1 wound infection, 7 urinary infections, 1 low debit intestinal fistula which resolved with parenteral nutrition, 3 patients had leakage at the ileourethral anastomosis which resolved with prolonged catheter drainage of 3-15 days, 1 hemorrhage from acute lesions to the gastric mucosa, 3 fascial dehiscence and 1 ureteroileal fistula that required reimplantation into the neobladder. Late complications: 1 ureteroileal stenosis that progressed to renal atrophy, 1 enterourethral stenosis that resolved with internal urethrotomy and 2 cases of severe metabolic acidosis and dehydration that resolved with fluid therapy. No differences were observed between the creatinine, pH and ion levels preoperatively and during follow-up. Continence was assessed in 17 cases: 100% were continent during the day, 41.2% were continent during the night, 4 had occasional nocturnal leakage and 6 required collecting devices during the night. CONCLUSIONS: The Studer technique provides good results and quality of life to patients undergoing cystectomy. Although it carries a high morbidity, conservative management will suffice in a high percentage of cases.
Adult↗
[Stress urinary incontinence. Our experience with its treatment using the transvaginal colposuspension technique (Raz I and II)].
Presentation of our experience in the surgical treatment of urinary stress incontinence, with transvaginal colposuspension techniques, specifically those described by S. Raz and known as Raz I and Raz II. Over a 24-month period, 25 transvaginal colposuspensions (22 Raz I and 3 Raz II) were performed. The results achieved were 21 patients (84%) have recovered, while 4 (16%) remain incontinent, 3 of them referring improvement and 1 without improvement, after a follow-up of 12 to 36 months. With regard to complications, there has been 5 cases (20%) of postoperative retention, one vesical perforation while passing the needles, and a vesicle perforation during vaginal dissection of the retropubic space.
Adult↗
[Stress urinary incontinence. Comparative study of suprapubic and vaginal surgical techniques].
We compared the results achieved by the suprapubic techniques of bladder neck suspension (Marshall-Marchetti-Krantz and Burch) and the vaginal techniques (Raz I and II) in 31 patients. Although no significant difference was observed in the results achieved, the vaginal techniques require a shorter operating time and hospitalization. There were 5 cases of inability to void (3 for the suprapubic and 2 for the vaginal techniques). The following complications were observed in the Burch colposuspension technique: 1 bladder fistula, 1 ureteral obstruction, 1 incisional hernia and 1 pulmonary embolism. We can conclude that although both techniques achieve good results, the vaginal techniques are easy to perform and require a shorter operating time and hospitalization.
Adult↗
[Kidney transplantation in patients over 60 years of age. Study of 37 patients].
Between February 1975 and September 1993, 735 renal transplantations have been performed 37 of which took place in 60+ year-old subjects. All grafts were from corpse donors. 34 were first time transplants and 3 were re-transplants. In general, immunosuppression has been accomplished with Cyclosporin, Azathioprine, and Prednisone. Annual patient and graft survival is 87% and 69%, respectively. A review is made of the complications developed and the success rate with and without a functioning graft. Considering long-term results, many patients lead a normal live with stable renal function.
Age Factors↗
[Ureteral reimplantation with single point on tubularized ileal chimney in Studer's substitution enterocystoplasty. Preliminary results in 12 cases].
Herein we describe our preliminary experience in ureteral reimplantation by fixation of the ureter with a single suture directly onto a detubularized ileal chimney in 12 cases with infiltrating bladder carcinoma who underwent a Studer enterocystoplasty procedure. Follow up ranged from 3 to 24 months. Patient control evaluation included urography and CUMS 3 months postoperatively and ultrasonography every 6 months. The following complications were observed: ureteral fistula above the site of anastomosis (1 case, 4.16%), ureteroenteric stricture (1 case, 4.16%) and grade 2 reflux (2 cases, 9.08%) with no effects on renal morphology or function. The foregoing results show the usefulness of this simple procedure which prevents reflux and carries a low complication rate.
Adult↗
[Leiomyoma of the epididymis. Report of a case and review of the literature].
Leiomyoma of the epididymis is a benign tumor that is rarely diagnosed and is second only to epididymal adenomatoid lesions in frequency. A case of leiomyoma of the epididymis in a 62-year-old patient is described. The patient presented with a tumor in the tail of the left epididymis which was definitively diagnosed following surgical resection and subsequent anatomopathological analysis. The classification, clinical features, diagnosis and treatment of this tumor type are briefly discussed.
Epididymis↗
[Extravesical ureteroneocystostomy in renal transplantation. Comparative study of the Campos Freire's and the Taguchi's techniques (single point)].
We compare the results of two extravesical ureteroneocystostomy techniques, the Campos Freire technique (47 cases) and the single stitch modified Taguchi technique (58 cases), in 105 kidney transplants during a period of 19 months (August 1991 to April 1993). There were no differences between donor and recipient characteristics in both groups. Concerning complications, we observed vesical fistula in the patient group submitted to the Taguchi technique and 1 uretero-vesical stenosis in the patient group that underwent the Campos Freire technique. Although both techniques achieve good results, we advocate the use of the Taguchi technique because it is easy to perform and the operating time is shorter.
Adolescent↗
[Single-stitch extravesical ureteroneocystostomy in kidney transplantation (Taguchi's technic)].
Presentation of our experience with single access extravesical ureteroneocystostomy in 79 renal transplants performed over a 2-year interval. Description of the surgical technique, a modification of that described by Taguchi in 1968. The complications were 2 urinary fistulae (2.52%), one ureteral and one vesical, both at the beginning of the series and related to technical errors. There were no stenosis and in the 4 cases where CUMS was conducted no reflux vas noted. We conclude that this technique is useful for its simplicity, speed and good results.
Adult↗