Biomedical subjects

C Bernuy Malfaz

Publications and source records attributed to C Bernuy Malfaz.

At least 19 recordsLinked to original sources

PubMed1997

[Advanced tubercular disease of urogenital tract].

OBJECTIVE: The genitourinary tract is one of the most common sites of extrapulmonary tuberculosis (30%-33%), followed by the lymphatic tissue, skeletal system and gut. Due to the diagnostic methods and therapeutic modalities currently available, it is infrequent to find advanced tuberculosis with extensive genitourinary involvement. METHODS/RESULTS: Herein we describe a patient with advanced genitourinary tuberculosis characterized by loss of right renal unit, left hydronephrosis due to ureterovesical junction stricture, contracted bladder, prostatic caseation and urethral stricture. Right nephrectomy and bladder substitution ileocystoplasty were performed. The clinical features, diagnostic and therapeutic aspects are discussed and the literature briefly reviewed. CONCLUSION: Extensive genitourinary tuberculosis is uncommon. The importance of early diagnosis and treatment is emphasized in order to avoid the irreversible sequelae.

Adult↗

PubMed1997

[Mixed urogenital schistosomiasis].

Urinary schistosomiasis is a parasitosis caused by Schistosoma Haematobium which affect in a diffuse manner all the genitourinary tract. Presentation of 5 patients (4 male, 1 female) with mixed Bilharziosis that was detected after the study of a young male that came to the clinic with a complaint of haematuria and who underwent transurethral resection under the suspicion of a vesical urothelial neoformation. Sch. Hameatobium eggs were detected in the urine and Sch. Mansoni in the semen of all 4 male. All of them evolved favourably with Praziquantel. Considering the rarity of schistosomiasis in our environment and its increased incidence in endemic areas, this process should be included in the algorithm of differential diagnosis in young patients reporting dysuric syndromes associated to haematuria; the relevance of an epidemiological anamnesis so as to institute early treatment and avoid the consequences of chronic infection is pointed out.

Adult↗

PubMed1997

[Ureteral obstruction secondary to inflammatory iliac aneurysm].

Inflammatory iliac aneurysms are uncommon and account for 1-2% of total abdominal aneurysms. These aneurysms are more susceptible to present urological symptoms and are difficult to diagnose because of their uncommon incidence and location in the deep pelvis which makes them little accessible to physical examination. This case report presents one patient with right obstructive uropathy secondary to extrinsic ureteral trapping due to inflammatory iliac aneurysm which evolved favourably after ureterolysis, endoaneurysmectomy and interposition of aortoiliac graft. A brief review of diagnostic and therapeutic aspects in the literature is included. The relevance of a high degree of suspicion to diagnose this entity in patients with otherwise explainable vesical irritative symptoms, haematuria or renal failure is highlighted.

Adult↗

PubMed1997

[Primary prostatic infiltration by Burkitt's lymphoma].

OBJECTIVE: Genitourinary tract involvement arising from non-Hodgkin lymphoma occurs in 10% of patients; prostatic infiltration is uncommon and accounts for less than 0.1%. The uncommon clinical onset of this infrequent condition prompted us to report on the present case. METHODS/RESULTS: A 41-year-old male patient with lower urinary tract outflow obstruction arising from prostatic enlargement secondary to non-Hodgkin lymphoma (Burkitt's lymphoma) is described. Treatment with chemotherapy achieved good results. The clinical features, diagnostic and therapeutic aspects are discussed and the literature briefly reviewed. CONCLUSION: The present case emphasizes the need to include non-Hodgkin lymphoma in the differential diagnosis of lower urinary tract outflow obstructive symptoms in young men with prostatic enlargement.

Adult↗

PubMed1996

[Multiple giant ureteral lithiasis].

OBJECTIVES: Ureteral calculi are usually small and arise from the kidney. The term 'giant' has been applied to ureteral stones that are more than 5 cms in length and/or 50 gms or more in weight. The low incidence of this condition prompted us to report this case. METHODS/RESULTS: Herein we describe a patient with multiple giant ureteral calculi with no evidence of underlying ureteral lesion, who required nephroureterectomy due to the damage caused to the renal unit by the obstructive uropathy. The literature is briefly reviewed, with special reference to the diagnostic and therapeutic aspects. CONCLUSIONS: Giant ureteral calculi are uncommon. They may cause scanty urological symptoms and might therefore be missed. If undiagnosed, renal function may be compromised by the obstructive uropathy.

Humans↗

PubMed1995

["Sand-clock" lithiasis on prostatic transurethral resection bed].

OBJECTIVES: Although uncommon, prostatic surgical bed lithiasis may present among post-TURP complications. The present study underscores the importance of diagnosis and treatment. METHODS/RESULTS: We report on a patient with magnesium ammonium phosphate hourglass lithiasis in the prostatic surgical bed one year and a half following transurethral resection due to adenomyomatous prostatic hyperplasia that was successfully treated by intracorporeal lithotripsy with the Lithoclast. The physiopathological, clinical, diagnostic and therapeutic aspects are discussed. CONCLUSIONS: This condition should be suspected in patients with dysuric syndrome post-TURP. The importance of simple complementary diagnostic procedures as DRE and plain abdominal films in discarding lithiasis in underscored. We consider retrograde endoscopic manipulation and ultrasonic lithotripsy or penumatic lithotripsy with the Lithoclast to be the safest procedures for this type of lithiasis.

Aged↗

PubMed1995

[Metachronous metastasis in ureteral stump secondary to ipsilateral renal adenocarcinoma].

OBJECTIVES: Ureteral metastasis from renal adenocarcinoma is uncommon. The rarity of this disease prompted us to report on the present case, with special reference to diagnosis. METHODS/RESULTS: A patient with metachronous metastasis in the ureteral stump from clear cell renal adenocarcinoma resected three years earlier is described. The etiopathogenic, clinical, diagnostic and therapeutic aspects are briefly reviewed. CONCLUSIONS: Ureteral metastases, although uncommon, are generally ipsilateral to the renal tumor and arise from aggressive renal carcinomas that are locally advanced with vascular and/or lymphatic spread. We underscore the importance of retrograde pyelography and ureterorenoscopy in the diagnostic workup of all patients with gross hematuria following nephrectomy due to hypernephroma.

Adenocarcinoma, Clear Cell↗

PubMed1995

[Multiple matrix lithiasis: integral endourological treatment].

OBJECTIVES: Matrix stone, characterized by mucoproteic urinary deposits, is an uncommon lithiasic disease. The low frequency of this disease and the interest in its therapeutic management prompted us to report on the present case. METHODS/RESULTS: A case of multiple nephroureteral matrix calculi is described. Treatment was by integral strategic lithoreductive therapy: ureterorenoscopy, percutaneous nephrolithotomy and N-acetylcysteine prophylactic chemolysis. The clinical features, diagnostic and therapeutic aspects described in the literature are briefly reviewed. CONCLUSIONS: Complete stone removal to avoid recurrence is emphasized. Regular follow up and adequate treatment of the urinary infections are recommended.

Adult↗

PubMed1995

[Ureteral endometriosis].

OBJECTIVES: Ureteral involvement due to endometriosis is uncommon. Its silent onset and the progression of ureteral obstruction, if undiagnosed, can lead to the loss of the renal unit. The present case is described to underscore the importance of early diagnosis. METHODS/RESULTS: We report on a patient with obstructive uropathy secondary to intrinsic ureteric endometriosis that had undergone nephrectomy due to parenchymal destruction. One year following resection of the endovesical portion, recurrence in the ureteral stump was observed. The clinical features, the diagnostic and clinical aspects are briefly discussed. CONCLUSIONS: Although ureteric involvement is uncommon, renal function of patients with pelvic endometriosis must be followed closely by analyses, ultrasound and/or intravenous urography for early detection of this condition.

Adult↗

PubMed1995

[Cystic pyeloureteritis. A diagnosis to keep in mind].

OBJECTIVES: Cystic pyeloureteritis is a disease entity of unknown etiology and unspecific symptoms. It is incidentally detected and is difficult to distinguish from other disorders showing filling defects on urographic evaluation. All the foregoing prompted us to report the present case. METHODS/RESULTS: We report a case of cystic pyeloureteritis that had been diagnosed during ureterorenoscopy in a patient with lithiasis and recurrent urinary tract infection. The etiopathogenesis, diagnostic and therapeutic aspects described in the literature are briefly reviewed. CONCLUSIONS: We underscore the importance of confirming the diagnosis by endoscopic and cytological studies. Conservative management is advocated. Patient follow up should include urinalysis, urine culture and cytology twice yearly and intravenous urography once a year.

Aged↗

PubMed1995

[Megacalycosis and lithiasis].

OBJECTIVES: Megacalycosis or Puigvert's disease is a clinical entity characterized by dilatation of all renal calyces without dilatation of the renal pelvis or ureter in the absence of any obstructive factor. To date, its pathogenesis remains unclear. The rarity of this disease and the importance of making a correct differential diagnosis prompted us to report on the present case. METHODS/RESULTS: Two patients with urolithiasis associated with ipsilateral megacalyces who were successfully treated by ESWL are described. The clinical, diagnostic and therapeutic aspects reported in the literature are briefly reviewed. CONCLUSIONS: There is a greater lithogenic predisposition in these patients. Intravenous urography has proved to be very accurate in making the differential diagnosis from other disorders such as obstructive uropathy and intermittent hydronephrosis. The efficacy of ESWL in the treatment of lithiasis associated with megacalycosis is underscored. A yearly control follow up by analyses and intravenous urography is advocated.

Chronic Disease↗

PubMed1995

[Renal hydatidosis: importance of preoperative diagnosis].

OBJECTIVE: We report on a patient who underwent a right nephrectomy for a mass suggesting hypernephroma, which was shown to be renal hydatid disease on pathological examination. METHODS/RESULTS: The epidemiological, diagnostic and therapeutic aspects described in the literature are briefly reviewed. CONCLUSIONS: Although uncommon, renal cystic lesions should be suspected in the presence of a renal mass and a differential diagnosis should be made. CT is the most useful diagnostic imaging technique. The importance of preoperative diagnosis for the surgical strategy is underscored.

Echinococcosis↗

PubMed1995

[Ectopic ureter in prostatic urethra. Unusual discovery in an adult].

OBJECTIVE: Ectopic ureter is a congenital anomaly more frequent in the female, in the pediatric age and is commonly left-sided. The present article reports an uncommon case without the common features of this anomaly. METHODS/RESULTS: We report on a 67-year-old man with complete duplex system and ectopic obstructive megaureter in the prostatic urethra with a silent onset. The diagnostic and therapeutic aspects in the literature are briefly discussed. CONCLUSION: Because this anomaly is asymptomatic and incidentally discovered because of contralateral disease, the approach is conservative.

Age Factors↗

PubMed1995

[Cryptorchidism and testicular cancer].

OBJECTIVE: This report underscores the higher risk of testicular cancer in cryptorchidism. METHODS/RESULTS: A patient undergoing evaluation for sterility, who was submitted to orchidopexy 15 years earlier for cryptorchidism, developed a seminoma-like tumor one year following a testicular biopsy that was compatible with testicular atrophy, but with no signs of dysplasia. The literature on the epidemiology, pathogenesis, diagnosis, and treatment is briefly reviewed. CONCLUSIONS: Cryptorchidism is the single factor that carries a higher risk of testicular cancer. This condition has been reported to have 3.5 to 5 times greater risk of progressing to malignancy compared to normal descended testes. Although orchiopexy does not prevent the risk of malignancy, it permits earlier detection. The need to follow these patients closely is underscored.

Adult↗

PubMed1995

[Late metastasis in thyroid gland after nephrectomy for renal clear cell carcinoma].

Renal carcinoma natural history is unpredictable. Spontaneous metastases regression after nephrectomy, as well as late recurrence are suggestive of this peculiar human neoplasm. tumor metastases localized to thyroid gland are uncommon in clinical practice; and carcinoma of the kidney, breast, lung, melanoma and gastrointestinal tract tumors are responsible for the majority of them. This paper reports on a patient with metachronous thyroid gland metastases after fourteen years of renal carcinoma nephrectomy, with one year after hemithyroidectomy recurrence on cervical striated muscle followed by surgical excision. Therapeutical aspects are briefly reviewed in literature, emphasizing surgical treatment and the need of all-life follow-up, with more alert attitude toward thyroid gland after renal cell carcinoma nephrectomy.

Aged↗

PubMed1995

[Inappropriate antidiuretic hormone secretion syndrome: a rare manifestation of prostatic adenocarcinoma].

OBJECTIVE: Prostatic cancer can produce signs and symptoms by local growth, direct invasion or distant metastases. In rare occasions, these tumors can show a clinical variance due to trophic factors, biologically active, secreted in neoplastic environment but with systemic relevance. These syndromes are called paraneoplastic syndromes. This uncommon condition is described herein. METHOD/RESULTS: We report a case of inappropriate antidiuretic hormone secretion as the presenting feature of advanced prostatic carcinoma. The pathogenic features, diagnostic and therapeutic aspects are reviewed. CONCLUSIONS: Although its frequency is low, we must consider prostatic carcinoma in patients with inappropriate antidiuretic hormone secretion syndrome. When the acute situation is resolved, hormonal treatment in disseminated carcinomas will return to normal the clinical and analytical parameters derived from this syndrome.

Adenocarcinoma↗

PubMed1995

[Synchronous manifestation of bladder inverted papilloma and transitional carcinoma of the renal pelvis].

OBJECTIVE: To review briefly the histological and biological aspects of inverted papilloma and to determine whether it is a benign tumor or low-grade malignant lesion. METHOD/RESULTS: We report a patient with synchronous presentation of bladder inverted papilloma and renal pelvis transitional cell carcinoma. After endoscopic resection of the bladder tumor and left ureteral meatus, a radical nephroureterectomy was carried out with success. The clinical features, diagnostic and therapeutic aspects are briefly reviewed. CONCLUSIONS: Inverted papilloma accounts for 2.2% of all urothelial tumors; the bladder is most commonly involved. It is frequently a single lesion with endophytic growth pattern. The clinical significance remains a controversy. Most investigators consider them as benign neoplastic tumors, although in one third of the patients it may be associated with synchronous urothelial carcinomas, implying a malignant condition. Therapeutic management and follow-up are emphasized.

Aged↗

PubMed1995

[Obstructive uropathy secondary to genitourinary prolapse].

Genital prolapse is associated to a greater concurrence of repeat urinary infections, stress urinary incontinence, arterial hypertension and obstructive uropathy with a higher or lower degree of renal impairment. Incidence of uropathy in the genital prolapse setting ranges between 4 and 13%. This paper presents a female patient with renal insufficiency secondary to bilateral obstructive uropathy caused by a concomitant genital prolapse. A brief revision is made of the pathophysiological, diagnostic and therapeutic aspects in the literature. The need to perform both prone and standing urographic studies is emphasized; also a study of the renal function should be performed in these patients in order to establish the appropriate treatment and avoid major complications and renal function impairment.

Acute Disease↗