J M Diez Rodríguez | PubMed Health

PubMed1997

[Meconial hydrocele].

Presentation of one case of meconial hydrocele, a very infrequent disease that should be taken into account in all newborns presenting intrascrotal mass. Ultrasonography performed to a 29 year-old female during the 36th week of pregnancy, demonstrated in the fetus the presence of an enlarged right hemiscrotum with homogenous material inside, which was diagnosed as an intrascrotal haematoma due to a likely intrauterine spermatic cord torsion. After eutocic delivery, within one month from birth the newborn developed signs and symptoms which were compatible with acute scrotum and the emergency surgical exploration showed meconial hydrocele secondary to patency of peritoneal-vaginal duct with associated inguinal hernia. The causes, forms of presentation, differential diagnoses and therapeutical options of meconial peritonitis, a rare condition with favourable evolution in most cases, are analyzed showing that, under certain circumstances, treatment is controversial.

Female↗

PubMed1997

[Epidemiologic indicators of adenocarcinoma of the prostate. Results on 436 patients].

OBJECTIVE: To conduct a populational study by analyzing the major epidemiological indicators in a group of 436 patients with prostate adenocarcinoma. MATERIAL AND METHODS: The population reference for the study involves a total of 396,294 people, of which 197,500 are male. Between 1983 and 1996, 436 patients were diagnosed with prostate adenocarcinoma in the Urology Service of Mostoles Hospital. Gleason Index has been used to determine the histological grade, while the 1992 TNM rating was used for staging purposes. Gleason rating is known for 395 patients, distribution being as follows: 26.6% with Gleason 2, 3 or 4; 44.6% with 5, 6 or 7 and 28.9% with 8, 9 or 10. T1 tumours accounted for 21.1% cases; T2: 45.6%; T3: 22.2% and T4: 11%. There were 58.3% M0: 32.8% M1 and 8.9% Mx tumours. Approach for local disease: radical prostatectomy or radiotherapy. Approach for disseminated disease; hormonal blockade. Deaths: 130 (29.8%); cancer related deaths: 91 (70%). Mean follow-up of survivors: 3.4 years (0.25-14 years). Major variables analyzed: age, incidence, prevalence, mortality, Gleason's evolution and overall and specific survival. RESULTS: Mean age: 71.3 years. Prior to 1990 there were 55.5% patients under 70 years old; in 1995-96 there are 39.4%. Incidence has increased up to 36.5% per 100,000 people/year in 1996. Mean mortality in 1993-1996: 5.6 per 100,000 people/year. Prevalence in 1996: 155 per 100,000 people/year. Family background for prostate cancer: 8%. Incidence of second tumours: 10.5%. Increased proportion of patients with moderate to high versus low Gleason grades. Overall survival at 5 years: 53%, at 10 years: 33%. Tumour related survival at 5 years: 65%; at 10 years: 48%. Older age, higher PSA, higher Gleason, advanced stages and metastasis are all unfavourable prognostic factors for both overall and specific survival (p = 0.000). Significant prognostic factors in multivariate analysis have been a higher Gleason grade and non metastatic tumour at diagnosis. CONCLUSIONS: Incidence of prostate adenocarcinoma has increased in our milieu, reaching 36.5 per 100,000 people/year in 1996, far from the figures in the US. Actual mortality in our series is somehow lower than data published in other national series. This condition shows very high prevalence rates which results in increasingly growing and highly significant economic costs.

Adenocarcinoma↗

PubMedDate not supplied

[Treatment approach for vesicogenital fistula. Retrospective analysis of our data].

The vesicogenital fistula are abnormal communications between female genitalia and urinary bladder. We recorded all the vesicogenital fistula diagnosed since 1986, analyzing aetiology, treatment applied, complications and results. Total number of fistula have been 20 (18 vesicovaginal and 2 vesicouterine). The distribution in vesicovaginal fistula was iatrogenic in 15 cases (83%) and tumoral in 3 cases (17%). Vesicouterine fistula were due to cesarean. The initial treatment of the iatrogenic fistula was conservative using foley catheter. Twenty percent of the patients were cured with this treatment (3 cases). Surgical repair was necessary for the other patients, using different surgical approach according to the type of the fistula, intensity and patient age. It was successful in 91% of the patients. The results shows that simple surgical approach generate less morbidity and the early intervention is not less efficient.

Adult↗