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Biomedical subjects

J García Alonso

Publications and source records attributed to J García Alonso.

At least 19 recordsLinked to original sources
PubMed2000

[Transvesical repair of non-complicated vesicovaginal fistula].

OBJECTIVE: The management of vesicovaginal fistula still remains controversial in regard to the timing of repair and type of approach. We review the relevant literature and describe our experience with the transvesical management of uncomplicated vesicovaginal fistulas after gynecological surgery. MATERIAL AND METHODS: We reviewed retrospectively 6 consecutive women who presented with uncomplicated vesicovaginal fistula, repaired at our institution between 1995 and 1998. Four cases underwent early repair after a trial of conservative management. One case underwent intraoperative repair and another case after 19 months because of delayed diagnosis. Postoperative follow up ranges from 4 to 35 months. RESULTS: All patients were cure. The fistula tract was excised totally in all patients. There were no postoperative complications. CONCLUSIONS: Early repair of uncomplicated vesicovaginal fistulas after gynecological surgery offers reliable success, according with literature records and our own experience. On the other hand, transvesical repair offers an easy operative approach, with a high successful rate.

Adult↗
PubMed2000

[Extra-adrenal pheochromocytoma. Report of a case].

OBJECTIVE: To report a case of extraadrenal pheochromocytoma with special reference to the diagnostic and therapeutic aspects. METHODS: A case of extraadrenal pheochromocytoma in a 20-year-old female with severe hypertension is presented. The clinical and biochemical aspects are reviewed with special reference to the diagnostic imaging methods. RESULTS: Plasma noradrenaline and urinary normetanephrine levels were elevated. CT and MRI showed a well-defined mass, 6 cm in diameter, adjacent to the left kidney, abdominal aorta and psoas muscle. Angiography demonstrated a high vascularization in the area of the tumor. MIBG scintigraphy revealed a well-defined mass, but no other distant lesions. Surgical treatment was performed with preoperative alpha and beta adrenergic blockade. Currently the patient has a normal blood pressure and catecholamine levels, with no evidence of lesions on the MIBG scintiscan. CONCLUSIONS: Plasma catecholamine and urinary normetanephrine levels levels confirmed the presumptive diagnosis of pheochromocytoma. MIBG is the technique of choice for the localization of the mass and suspected metastases. CT, MRI and angiography demonstrated the anatomic relationships of the tumor. The best results are achieved with complete resection and preoperative adrenergic blockade.

Adult↗
PubMed2000

[Penile primary melanoma; report of a case].

OBJECTIVE: An uncommon variant of penile tumor associated with chronic lymphoid leukemia is presented. METHODS/RESULTS: A case of primary melanoma of the penis associated with chronic lymphoid leukemia is presented. Diagnosis was based on the anatomopathological findings. Lymph node involvement could not be determined due to the associated leukemia. Conservative management was instituted due to the patient's age. CONCLUSIONS: Primary melanoma of the penis is a very aggressive and uncommon tumor. To our knowledge, less than 140 cases have been reported. Hyperpigmented lesions must be biopsied to rule out melanoma.

Aged↗
PubMed1999

[Spermatic cord torsion in the Comarca del Bierzo. Clinico-epidemiological analysis of the 5-year period 1994-1998].

OBJECTIVE: To review the cases of torsion of the spermatic cord diagnosed at the emergency and urology services of our hospital over the last 5 years and analyze the clinical and epidemiological features. METHODS: The cases of torsion of the spermatic cord diagnosed at our hospital from 1994-1998 were reviewed. Age, reason for consultation, time from onset of symptoms to consultation, location of the torsion, final diagnosis, treatment, and other data were analyzed. RESULTS: There were 20 cases of torsion of the spermatic cord in patients aged 1 to 25 years, with the highest incidence at age 14 years. The left testis was more frequently compromised. Six patients had a history of testicular pain and/or inflammation. The mean time from presentation of symptoms to consultation was 13.5 hours (range 1 hour to 7 days). The diagnosis was torsion of the spermatic cord in 14 cases and hydatid torsion in 6. Treatment was fundamentally by surgery (orchidopexy), except in three cases that spontaneously resolved or were detorsioned by manipulation. Two patients underwent excision of the compromised testis. CONCLUSIONS: Torsion of the spermatic cord is a urological emergency due to the high risk of complications that may even require orchidectomy. The epidemiological findings for our area are similar to those reported in other series.

Adolescent↗
PubMed1999

[Bladder endometriosis].

OBJECTIVE: To describe an additional case of endometriosis of the bladder and to review the diagnostic and therapeutic aspects. METHODS/RESULTS: A case of endometriosis of the bladder in a 30-year-old female with a long history of dysuria, pollakiuria and suprapubic pain during menstruation is described. The endoscopic findings indicated endometriosis of the bladder. Gn-Rh analogues and anovulatories were administered, but were poorly tolerated. Resection of the bladder endometrioma was performed. The patient is asymptomatic at two years' follow-up. CONCLUSION: Transurethral resection of the endometriotic plaque may be a valid therapeutic option in selected cases of endometriosis of the bladder.

Adult↗
PubMed1998

[Mumps orchitis; review of 8 cases].

OBJECTIVE: To determine the incidence of mumps orchitis in young males in the area of El Bierzo (Ponferrada, Spain) and the complications arising from this condition. METHODS: The cases of mumps orchitis referred by the primary care services to the emergency services of Hospital del Bierzo referral center were reviewed. We analyzed patient age, unilateral or bilateral testicular involvement, whether the patients had been vaccinated against mumps and the changes observed in the semen analysis. RESULTS: The diagnosis of mumps orchitis was confirmed in 8 patients, aged 15 to 19 years. Two patients had bilateral testicular involvement. Seven patients had not been vaccinated against parotiditis. Three patients had oligoasthenospermia and are currently being followed at the Urology services. CONCLUSIONS: The utility of large scale vaccination against mumps is emphasized. Long-term follow-up is recommended for all patients with abnormal semen analysis, particularly those with bilateral testicular involvement, since they may develop oligoasthernospermia several years after the infection or improve with item. A high incidence of mumps orchitis was found for this 12-month study period.

Adolescent↗
PubMed1998

[Multilocational cystic nephroma. Review of a case with reference to echographically observed changes].

OBJECTIVE: To describe an additional case of multilocular cystic nephroma, with special reference to the sonographic features of a renal cystic lesion. METHODS: The clinical and radiological features of a kidney tumor in a 61-year-old female patient were retrospectively analyzed. RESULTS: The preoperative diagnosis was that of a complex multicystic renal mass suggestive of a renal carcinoma. Radical nephrectomy was performed; histopathological analysis of the surgical specimen disclosed a multilocular cystic nephroma. An ultrasound scan 18 months earlier had demonstrated a simple renal cyst in the same site. CONCLUSIONS: Multilocular cystic nephroma is a tumor that is difficult to diagnose preoperatively. Making an accurate differential diagnosis is of interest, since it will permit conservative treatment. The case described herein supports the hypothesis with regard to the pathogenesis of this lesion, since it had previously showed sonographic features of a simple renal cyst.

Female↗
PubMed1998

[Hemangioma of the spermatic cord. Presentation of a case with review of the literature].

OBJECTIVE: To describe a rare variety of spermatic cord tumor, with special reference to the differential diagnosis. The literature is briefly reviewed. METHODS: The clinical and pathological features of a tumor located in the right inguino-scrotal region of a 27-year-old male patient are described. RESULTS: The preoperative evaluation disclosed an irregular mass in the right hemiscrotum that was unconnected to the testis. The patient underwent orchidectomy and resection of the tumor. Pathological analysis of the surgical specimen revealed a hemangioma of the spermatic cord. CONCLUSIONS: Hemangioma of the spermatic cord is a very uncommon tumor, it is a slow growing, indolent, benign scrotal lesion that must be distinguished from other paratesticular masses or tumors with similar clinical features. Ultrasound and other diagnostic imaging techniques are not useful in making the preoperative differential diagnosis.

Adult↗
PubMed1998

[Suprarenal cysts].

OBJECTIVE: To emphasize that adrenal cysts are an uncommon finding and in most cases incidentally discovered during evaluation for nonspecific abdominal pain or even at outopsy. METHODS: We report a case of a non-hypers-creting right adrenal cyst in a middle-aged woman. RESULTS: A complete hormone, radiological and sometimes isotopic evaluation are required to make an accurate diagnosis and to determine the adequate treatment. CONCLUSION: Surgical resection is usually prompted by an inaccurate diagnosis and failed conservative treatments.

Adrenal Gland Diseases↗
PubMed1998

[Transitional cell bladder carcinoma in patients younger than 40 years of age].

OBJECTIVE: The clinical and pathological characteristics of bladder cancer in young patients were analyzed to determine if patients with bladder cancer under the age of 30 have a better prognosis than older adults and if transitional cell carcinoma of the bladder in patients aged 30 to 40 years has a similar behaviour to that observed in the higher risk population. METHODS: A retrospective review of transitional cell carcinoma of the bladder in patients less than 40 years old that had been treated between January, 1993 to August, 1997 was undertaken. RESULTS: We found 8 patients (5 men and 3 women) with urothelial tumor, accounting for an incidence of 4%. Four cases were diagnosed and staged TaG1, 2 T1G1 and 2 T1G2. Recurrence was observed in one case (12.5%) and progression in none. CONCLUSIONS: Transitional cell carcinoma of the bladder in patients under the age of 40 is usually associated with low grade and low stage tumors. The foregoing finding is certainly observed in those aged less than 30 years old. Bladder cancer is relatively rare in this age group, although we have found a higher incidence than that reported elsewhere. Treatment and follow-up depend on tumor grade and stage, regardless of age.

Adolescent↗
PubMed1997

[Perineal tuberculous abscess. Presentation of a clinical case].

OBJECTIVE: To describe a case of perineal abscess caused by Koch's bacillus in a patient with a history of bladder tumor. METHODS/RESULTS: The patient described herein had consulted at the emergency services for perineal abscess. He had previously undergone transurethral resection of a bladder tumor and had received prophylactic intravesical BCG instillation thereafter. A culture of the exudate led to the diagnosis of tuberculosis, with no microbiological relation to BCG therapy. During the course of the disease, the patient developed a urethrocutaneous fistula which resolved after specific medical treatment. CONCLUSIONS: In a patient with clinical features of tuberculosis and a recent history of exposure to BCG, it does not necessarily follow that this bacillus is the cause of the tuberculosis. Furthermore, not all tuberculous fistulas progress to chronicity or require surgical treatment.

Abscess↗
PubMed1996

[Bilateral obstructive uropathy secondary to encrusted cystitis. Report of a case].

OBJECTIVES: Bilateral urinary obstruction is usually secondary to tumors or bilateral lithiasis. A rare case of encrusted cystitis causing bilateral hydronephrosis is described. METHODS/RESULTS: A 70-year-old woman presented with severe dysuria and vesical tenesmus. She had previously undergone pelvic surgery and received radiotherapy for a gynecological tumor. She was diagnosed as having encrusted cystitis. Treatment with urinary acidification and antibiotics achieved complete radiological and functional recovery. CONCLUSIONS: Some cases of urinary obstruction can be managed conservatively. An accurate diagnosis is necessary to avoid surgery in these cases.

Aged↗
PubMed1996

[Adenomatoid tumor of the epididymis. Report of a new case].

OBJECTIVES: To report on an additional case of adenomatoid tumor of the right epididymis, a rare benign intrascrotal mass. METHODS/RESULTS: A 41-year-old man consulted for severe scrotal pain. Physical examination disclosed a mass in the right epididymis which was confirmed by scrotal ultrasound. A right orchidectomy was performed. Histological analysis of the surgical specimen disclosed a benign adenomatoid tumor of the epididymis. CONCLUSIONS: Although most scrotal solid masses are malignant tumors, those arising in the epididymis are frequently benign; therefore a conservative approach is recommended.

Adult↗
PubMed1995

[Epidermoid cancer of the penis: our experience].

OBJECTIVES: We reviewed our series of epidermoid penile cancer to determine the predictive index of lymph node invasion and the incidence of phimosis in these patients. METHODS: We reviewed the records of 11 patients with epidermoid cancer of the penis. Six patients had been evaluated according to a protocol that included preoperative biopsy of the lesion, penile and abdominal ultrasound evaluation, CT and diagnostic lymphadenectomy for those cases suspected as having lymph node invasion. The predictive index (PI) was determined in relation to the grading of cell differentiation (G) and tumor stage (S) [PI = G+T] and the incidence of phimosis was sought during the interview. RESULTS: Lymph node invasion was confirmed in 2 patients with PI = 6 and in 1 patient with PI = 5. Diagnostic lymphadenectomy showed no evidence of lymphatic spread in 1 patient with PI = 3 and in another patient with PI = 4. The remaining 6 patients with PI < 2 did not undergo lymphadenectomy. Phimosis was associated in 73% of the cases. CONCLUSIONS: PI is a reliable index for lymph node invasion. Patients with PI < 4 do not require therapeutic lymphadenectomy. Phimosis should be operated early in childhood.

Adult↗
PubMed1995

[Splenic abscess secondary to xanthogranulomatous pyelonephritis].

OBJECTIVE: We report another case of splenic abscess after nephrectomy, a condition which must be considered in the differential diagnosis of post-operative fever. METHODS/RESULTS: A 20-year-old man presented with lumbar pain and fever. A diagnosis of xanthogranulomatous pyelonephritis was made and he was treated by subcapsular nephrectomy. Thirty days later the patient presented with a lumbar fistula from a splenic abscess and was treated by splenectomy. CONCLUSIONS: Fistulas and abscesses are more common after nephrectomy for xanthogranulomatous pyelonephritis. In our view, the subcapsular approach is an additional risk factor for the foregoing complications.

Abscess↗