Urachal xanthogranulomatous disease.
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Biomedical subjects
Publications and source records attributed to B Umbert.
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Two new cases of seminal vesicle abscess diagnosed by computerized tomography and treated with percutaneous drainage are reported. A review of the 8 cases published so far is also presented.
Intermittent hydronephrosis is a frequent cause of obstruction in the ureteropelvic junction in the adult. Diagnosis is based on intravenous pyelography, echography and renal scintigraphy with or without hyperdiuresis. We report a case of intermittent hydronephrosis successively affecting both kidneys.
Behavior of transitional cell carcinoma of the bladder during the third decade of life remains a controversial subject. During the period 1980-1988, we treated 7 patients (4 male and 3 female), 25 years of age or less (mean age 19.3, range 14-25), with transitional cell carcinoma of the bladder. Until now, all patients are alive and without disease during 12-50 months after surgery. In 6 of the 7 patients, endoscopic resection was the choice treatment for superficial stage A/O. The seventh patient underwent a partial cystectomy for a B1 Jewet stage cell carcinoma. We conclude that transitional cell carcinoma of the bladder in patients under 25 years of age has a less aggressive biological behavior. Therefore, ultrasonographic examinations and serial urine cytology represent the elective test for follow-up. Cystoscopy would only be performed in doubtful cases.
Serum prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) levels were measured in 70 patients with benign prostatic hypertrophy (BPH) and in 70 patients with prostatic cancer. PSA was increased above the cutoff level of 10 ng/ml in 13% of patients with BPH and in 87% of patients with prostatic cancer. In contrast, abnormal PAP levels were found in 14 and 76% of patients, respectively. We concluded that, due to its high specificity, PSA is a useful marker in the management of patients with prostatic carcinoma and that it surpasses PAP in this regard.
The squamous cancer of the penis has a very low incidence in our environment which means that very few centres have any cases and therefore lack any major experience. This handicap together with their treatment being divided between Urologists and Dermatologists decreases even more the number of cases seen and precludes the obtention of valid considerations. This report presents 15 cases of squamous cancer of the penis seen and followed-up for at least 5 years, and which were treated according to an established protocol in which the differential element, based in our results, is that ilial lymphadenectomy does not offer better results than chemotherapy in high-stage disease, with 33% survival, whereas in low-stage disease the use of surface and deep bilateral inguinal lymphadenectomy, in conjunction with micrographic surgery achieves survival rates of 100%. Morbidity in this case is standard (transient lymphedema, 100% patients; inguinal skin necrosis, 4% patients), while ilial lymphadenectomy has a high morbidity and some mortality.
The present paper analyzes the incidence of vascular complications and their treatment, in a series of 500 consecutive Heterotopical Kidney Transplants (KT), performed in our Service between January 1978 and December 1988. There was a total of 14 (2.8%) complications of which 8 (1.6%) correspond to renal artery stenosis. Of the 8 cases with renal artery stenosis, in 2 of them primary surgical treatment was indicated. The first one was a transplantectomy (TRX) and the second one reconstructive direct surgery. In the 6 remaining patients a Percutaneous Transluminal Angioplasty (PTA) was indicated. In three of these patients the stenosis resolved although one of them needed a second dilatation. In the last three there was: a thrombosis requiring TRX, a post dilatation anuria added to failure in the treatment of HT and which, finally, had to undergo surgery, and a third failure that could not be resolved by surgery and had to be subjected to graft nephrectomy. One of the patients in the surgical group died.