Biomedical subjects
Publications and source records attributed to J M Soler Fernández.
We report on a patient with congenital renal arteriovenous fistula whose only clinical manifestation was hematuria. The diagnosis was confirmed by arteriography and treatment was by percutaneous embolization. Hematuria resolved immediately after treatment and most of the renal parenchyma was preserved. The patient has moderate arterial hypertension as a sequela, although it is currently controlled by drug therapy.
Serum prolactin (PRL) levels were measured in 147 males. All patients had no known tumor, endocrine disorder, or symptoms or signs of hyperprolactinemia. All patients denied taking any medication or agents that could alter PRL levels. Semen analyses revealed 34 patients were normospermic, 69 were oligospermic, 26 were azoospermic, and 18 were purely astenzoospermic. PRL levels for the patient groups were not statistically significantly different. PRL values were higher than the normal ranges in 12.2% of the overall study population. A lower incidence (6.19%) was observed for hyperprolactinemia in the normospermics. These findings are comparable to those described elsewhere. Serum testosterone did not drop significantly in the hyperprolactinemics. Similarly, the FSH and LH values did not change significantly. The possible role of PRL in male infertility and the effect of hyperprolactinemia of varying degrees and etiology on sperm count and motility are discussed.
A ureterocele in an adult patient is described. The characteristic clinical features of this condition associated with pyeloureteral duplicity and several secondary disorders make it an unusual case. The clinical features and treatment are described. The etiologic aspects are discussed, highlighting the acquired factors, as well as the diagnostic and therapeutic procedures.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Presentation of a new case of cyst of the seminal vesicle in one patient with ipsilateral renal agenesis, stressing the frequency of this association. The cyst become evident following confirmation of renal agenesis, and presented an unusual communication to the bladder due to previous surgery (transurethral resection). This diagnosis was only suspected in the computerized tomography and cystoscopy and later confirmed by deferentovesiculography. The relevance of exploring any possible dysplasia of the seminal tract in the presence of renal agenesis is stressed. From an embryological point of view, the close relationship during development of both urinary and reproductive systems appear to explain the coexistence of these two anomalies. The primary symptoms of the condition, including the unspecific ones, as in the present cases, are discussed. Differential diagnosis from other deep pelvic cysts is referred. Following a literature review and based in our personal experience, already published, our views on the different embryological, clinical, diagnostic and therapeutic considerations are established.
Discussion of a retrospective study in our unit of two cases of vesical tumours of mesenchymal origin, in adult patients and with different maturation behaviour. The first patient started with haematuria and after an extensive follow-up period is now free from the disease. The second patient was an accidental finding causing death in the course of the immediate postoperative.
Renal arteriovenous fistulae (AVF) conform a pathology the urologist is not used to see. The basic purpose of this paper is to collect and update the current knowledge of this renal-vascular disorder, quite frequently forgotten when establishing the likely causes of haematuria. The paper describes the etiology of renal AVF and their generation mechanisms, as well as clinical presentations they can have. A most appropriate diagnostic method is still selective renal arteriography, which usually evidences the anomaly through indirect arteriographic signs. However, when the lesion is small it can be difficult to detect it. Finally, a discussion of therapeutical possibilities, both conservative and radical, and a case recently treated in out unit are presented.
A new case of ureter ectopic abouchement in seminal vesicle with cystic dysplasia is presented in one asymptomatic male attending the clinic on an infertility consultation. Suspected diagnosis was based on right kidney absence observed on abdominal echography, associated to severe oligoastenozoospermia seminograms and decrease in ejaculation volume. The computerized axial tomography revealed changes of the ipsilateral seminal vesicle. Diagnosis was confirmed by deferentovesicullography. Malformation embryological and anatomical aspects, as well as accompanying ipsilateral kidney dysplasia are commented. A review of both national and international literature is made supporting the unusual character of the clinical case presented.
Massive polyuria existing in congenital nephrogenic diabetes insipidus can cause a more or less severe dilatation of the urinary tract in absence of obstruction. Clinical and diagnostic aspects of this pathology are presented relating then with other types of diabetes insipidus. One case of bilateral severe dilatation with evolution towards renal atrophia is presented. Mechanical obstruction was discarded. The disease was refractory to urinary concentration tests and therapy to reduce urine volume. The possible etiopathological mechanisms of functional obstruction and surgical alternatives directed to preserve the kidney function are explained and discussed. The current literature is reviewed but the cases reported are few due to the low incidence of urological affectation. Presence of kidney atrophia is exceptional.
This paper is a review of 63 cases of congenital Pyeloureteral Union Syndrome. A total of 47 patients were treated using the Anderson-Hynes reconstructive technique with 3-4 years follow-up. Incidence was analyzed by sex, age and side affected, without a clear predominance of one over the others being shown. Mean age at the time of diagnosis was 39-43 years. The predominant symptom is the presence of lumbo-abdominal pain (36.5%) but the lack of clinical symptoms is also frequent (25.3%). Pyelocalyceal lithiasis is the most frequent secondary pathology (28.5%). U.I.V. appears to be an irreplaceable means for diagnosis, achieving with this technique 93.6% of diagnosis. Hydronephrosis, in different degrees, and absence of ureteral contrast are the urographic signs most commonly found: 66% and 61% respectively. Using the Anderson-Hynes technique a rete of 85% good results can be obtained, with few complications and achieving disappearance of clinical symptoms and morphofunctional normality in a high percentage. Anderson-Hynes dismembered ureteropyeloplasty seems to be the choice technique for conservative surgical treatment of the P.U.U. syndrome.
We present a clinical study of 29 patients with macroscopic hemospermia. The associated symptoms prevailed over monosymptomatic presentation. Urethral-prostate-vesicular inflammation was the most common etiology (55%). We single out the presence of a seminal vesicle cyst, two malignant urogenital tumours and one patient with presentation of the post-radiotherapy symptom. In 24% of the cases the cause was unknown. Diagnosis was done preferably by means of case clinic and sexual history, physical exploration, prostate/seminal vesicle echography and bacteriological-cytological study of the urine fraction plus semen. We carried out other diagnostic explorations on a selective basis. We consider hemospermia to be a benign symptom, although its presence requires the carrying out of a methodical series of explorations to rule out other pathologies of very diverse condition worthy to being taken into account.
Another two cases of bladder adenocarcinoma (ADC), seen in 1988, are described herein. The most important aspects relative to tumor origin--urothelial and embryonal--are discussed. We review its clinical features and diagnosis, not unlike those of transitional cell tumors, although histologically different. We underscore the therapeutic aspects and poor prognosis in most of the cases.
We present a case of seminal vesicle cyst in a fertile patient. Sporadically appearing hemospermia was the only symptom. We single out thiss pathology and the clinical procedure of this case as being uncommon. Transabdominal echography revealed the presence of the cyst. The T.A.C. did not offer further data. The Deferento vesiculograph was demonstrative. We consider other diagnostic methods and a differential diagnosis is made with other deep pelvis cysts.
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