Biomedical subjects

Jesús García Alonso

Publications and source records attributed to Jesús García Alonso.

14 recordsLinked to original sources

PubMed2005

[Fournier's gangrene secondary to urethral catheterization].

OBJECTIVES: We report one case of Fournier's gangrene secondary to urethral catheterization. METHODS: We describe the clinical case, in which the initial cause was identified, and perform a short bibliographic review. RESULTS: Although Fournier's gangrene was initially considered as idiopathic in etiology, currently it is possible to identify the entrance site of the infection. In the present case the insertion of a urethral catheter was the starting mechanism, associated with factors such as diabetes and alcoholism which favour its development. The patient was treated by surgical debridement and partial urethrectomy but finally died. CONCLUSIONS: We want to point out that urethral instrumentation should be done by expert hands due to the severity of possible complications. We should insist in the need of precocious treatment with wide spectrum antibiotics, radical debridement and complete urologic evaluation.

Fournier Gangrene↗

PubMed2005

[The treatment of bladder endometriosis. Spanish literature review].

OBJECTIVES: To perform a comprehensive, up-to-date review of the treatment of all cases of bladder endometriosis published in Spanish language journals in our country, including those published in non-urological scientific journals. METHODS: We identified 28 cases of bladder endometriosis published in the Spanish literature. The treatment performed in each case has been studied, as well as the treatment of relapses and follow-up after definitive treatment. Age and history of caesarean section were registered. RESULTS: Mean patient age was 35 years, with a median of 34 years and limits of 27 and 48. The history of caesarean section is present in 11 cases (39%). Several therapeutic regiments have been followed. Watchful waiting was only undertaken in one case due to the absence of urinary symptoms. Three patients received medical therapy initially. Only one of them had a favourable response. The other two underwent partial cystectomy and transurethral resection (TUR) respectively due to negative response. Transurethral resection was the most frequently used therapeutic modality; it was performed in 19 patients in addition to the aforementioned case. Bladder endometriosis recurred in 7 cases after TUR. Four of these cases underwent partial cystectomy, one of them laparoscopic, and three a second transurethral resection. Partial cystectomy was the initial therapeutic option in 5 cases. 4 of them were open and 1 laparoscopic. No recurrences have been described after partial cystectomy, including those performed for TUR failures. Mean follow-up was 37 months and median follow-up 12 months, being the limits 3 and 192 months. CONCLUSIONS: To date most published cases of bladder endometriosis appear in urologic journals. The most common therapeutic modality is transurethral resection, carried out in 20 cases (71%). However, it is necessary to inform the patient about the chances of treatment failure after TUR, around 35% after this review. Finally, the reported cases treated by laparoscopic partial cystectomy have been published by gynaecologists.

Endometriosis↗

PubMed2004

[Seminal vesicle cyst and ipsilateral renal agenesis].

OBJECTIVES: To report one case of seminal vesicle cyst with renal agenesis. To describe its clinical, radiological and therapeutic characteristics. METHODS/RESULTS: 42-year-old male presenting with irritative voiding symptoms. Digital rectal examination revealed a soft irregular mass over the prostate. Diagnostic imaging tests showed an enlargement of the left seminal vesicle and ipsilateral renal agenesis. Surgery was carried out with excision of the seminal vesicle cyst by an extravesical and extraperitoneal approach. Two years later the patient remains asymptomatic. CONCLUSIONS: Cystic pathology of the seminal vesicle is rare. Diagnosis is based on clinical symptoms, digital rectal examination and imaging studies. Surgery is necessary for symptomatic cases.

Adult↗

PubMed2004

[Conservative treatment of a seminal vesicle abscess. Report of one case].

OBJECTIVE: To describe the clinical conditions, the radiological findings and the management of a case of seminal vesicle abscess. METHODS: A 47-year old man presented with irritative voiding symptoms, fever, diminished ejaculated volume, hematuria and testicular pain. Diagnosis was made with digital rectal examination, ultrasound and CT. RESULTS: The patient was managed with antibiotic therapy alone for 4 weeks. Clinical and radiological resolution was achieved. CONCLUSIONS: Seminal vesicle abscess is a rare condition. Diagnosis is based on clinical data and radiological findings. Conservative treatment could be effective in selected cases.

Abscess↗

PubMed2004

[Bladder perforation as a complication of uterine curettage after spontaneous abortion].

OBJECTIVE: To present a case of bladder and uterine perforation following curettage for first-trimester abortion. METHODS: A 30 years-old female, pregnant of 19 week of gestation had undergone a therapeutic abortion for fetal death. Following the procedure, she presented hematuria and vaginal bleeding. A vesico-uterine perforation was achieved. An exploratory laparatomy was performed with repair of the bladder and the uterus. RESULTS: There were no surgical complications. Eleven days after the laparatomy a cistography demonstrated closure of the perforation. The patient did well postoperatively. Two years later the patient was pregnant. A caesarean procedure with tubaric ligation was performed without complications. CONCLUSIONS: Bladder perforation following uterine curettage is rare. Surgical management is necessary with bladder and uterus repair.

Abortion, Spontaneous↗

PubMed2004

[Urinary stone in a Bricker's ileal conduit].

OBJECTIVES: To report one case of urinary stone as a relatively frequent complications of urinary diversion using bowel loops. METHODS: We perform a short bibliographic review using the case report format. RESULTS: Stone formation in Bricker's type urinary diversion is secondary to various factors such as urinary stasis, bacteriuria, presence of intestinal mucus, metallic sutures, metabolic disturbances, etc. CONCLUSIONS: Periodic control by radiological studies is recommended due to the high frequency of this complication in patients with urinary diversion. Treatment is usually conservative or minimally invasive, being surgery reserved for those cases in which stone extraction is not safe using other methods.

Humans↗

PubMed2003

[Necrosis of the penis in a diabetic patient: presentation of a case].

OBJECTIVES: To present a short review of the diagnosis, clinical features, and treatment of male genitalia necrosis under the format of a case report. METHODS: We review the case of a diabetic patient without good blood sugar control who suffered from various diabetic complications diagnosed and treated at our hospital of a penile necrosis. We perform a bibliographic review about male genitalia necrosis regarding its etiology, diagnosis and treatment. RESULTS: Male genitalia necrosis is a rare disease but it is associated with high morbidity and mortality. The present case was diagnosed at the emergency room at our Hospital. Conservative treatment with antibiotic therapy and corticosteroid ointments was undertaken successfully. CONCLUSIONS: To perform an etiologic evaluation of the necrosis (dry or infectious) is important to select the right treatment. The high mortality of these diseases requires a precise and early diagnosis, since this influences the good or bad evolution of the disease.

Adult↗

PubMed2003

[Ovarian vein syndrome. Report of 2 cases].

OBJECTIVES: To report the clinicae characteristics and treatment of the ovarian vein syndrome. METHODS: We studied two cases of female patients with obstructive uropathy secondary to ovarian vein syndrome cared for at our department over the last 4 years. RESULTS: Both cases were treated surgically. Postoperative outcomes were satisfactory. CONCLUSIONS: The ovarian vein syndrome is rare. Surgery is the treatment of choice for symptomatic cases.

Adult↗

PubMed2002

[Implementation of a clinical pathway for transurethral resection in benign prostatic hyperplasia].

OBJECTIVE: Clinical pathways constitute a powerful tool for reducing the variability that occurs in clinical practice. The results obtained with the use of a clinical pathway for patients undergoing transurethral resection for benign hyperplasia of the prostate (BPH) are presented. METHODS: A prospective study was carried out on a cohort of 80 consecutive patients that had undergone transurethral resection for BPH after the application of a clinical pathway (5 days hospitalization) and compared with the results of a historical cohort of 80 consecutive patients that had been treated before the application of the clinical pathway. The exclusion criteria were diabetes mellitus, anticoagulation therapy with dicoumarin and other pathologies that changed the length of the preoperative stay established in the clinical pathway. For the evaluation of the degree of satisfaction, patients were asked to fill out a questionnaire included in the pathway documents. RESULTS: 73 patients met the inclusion criteria of the clinical pathway. 67 of the 80 patients that underwent surgery before the application of the clinical pathway were valid for comparative analysis. No statistically significant differences were found between both groups for age, prostate volume measured by DRE and US, previous treatment for prostatism, anesthetic risk and weight of the resected specimen. With the application of the pathway, the mean duration of hospital stay was reduced from 6 (SD 1.7; range 4-15) to 4.9 (SD 1.4; range 3-13) days (p < 0.0001) and the duration of urethral catheterization from 4.5 (SD 1.4; range 3-13) to 3.8 (SD 1.3; range 2-11) days (p < 0.01). Statistically significant differences were found before and after the application of the clinical pathway for degree of compliance of the preestablished antimicrobial prophylaxis guidelines during hospitalisation and after discharge, and thromboembolic prophylaxis. The relative risk of complications after discharge was less after the application of the clinical pathway (RR = 0.66), although it was not statistically significant (CI: 0.41-1.05). 63 of the 73 patients included in the clinical pathway submitted the questionnaire without identifying themselves. Duration of hospitalization was considered adequate by 89%, and coincided with the programmed and actual duration according to 82.5%. CONCLUSIONS: The application of a clinical pathway for patients undergoing transurethral resection for BPH has reduced costs by reducing the length of hospital stay and adverse effects. Furthermore, reducing the variability of medical care has improved its quality.

Aged↗

PubMed2002

[Lymphoma and kidney: report of 5 cases].

OBJECTIVE: To describe 5 cases of renal lymphoma. METHODS/RESULTS: A retrospective study was conducted on 5 cases of renal lymphoma that had been diagnosed at our institution in 1999. Of these 5 cases, one was considered to be primary renal lymphoma. The characteristics, treatment and outcome are discussed. CONCLUSIONS: Secondary kidney involvement from systemic lymphoma is common, but primary renal lymphoma is a rare and controversial entity.

Aged↗

PubMed2002

[Preputial neurilemoma].

OBJECTIVE: To present a case of preputial neurilemoma. METHODS: A 23-year-old man presented with a small, nodular, preputial mass that he had noted three years earlier. RESULTS: The tumor was excised under local anesthesia without complications. Currently, no evidence of tumor recurrence has been observed. CONCLUSIONS: Preputial nuerilemoma is rare. Diagnosis is based on the findings of the pathological study.

Adult↗

PubMed2002

Incidental pelvic mass identified during ultrasound-guided transrectal needle biopsy of the prostate.

OBJECTIVE: Herein we report an additional case of a seminal vesicle cyst with ipsilateral renal agenesis and ectopic ureter in an asymptomatic individual with a normal examination. METHODS: We review the literature on retrovesical mas regarding the embryology, evaluation, management and treatment.. RESULTS/CONCLUSIONS: Seminal vesicle cysts with ipsilateral renal agenesis and ectopic ureter may appear as an incidental mass by transrectal ultrasound.

Abnormalities, Multiple↗

PubMed2002

[Intra-scrotal lithiasis. Crystallographic analysis].

OBJECTIVE: To present two cases of intrascrotal lithiasis associated with hydrocele and the results of the crystallographic study. METHODS: Three intrascrotal calculi in two patients aged 72 and 75 years that underwent surgery for hydrocele were analyzed. Two 2-mm. calculi were incidentally discovered during surgery for a right hydrocele in one patient. An ultrasound scan of the other patient showed a left hydrocele with a free-floating, round, hyperechoic, 6-mm. calculus, with posterior acoustic shadow. None of the patients had a previous history of trauma. The 3 calculi were white and smooth, but turned yellow and rough after removal. Scanning electron microscopy and x-ray dispersion studies were performed. RESULTS: All 3 calculi had a center comprised of hydroxyapatite and white organic matter, and an exterior of yellow organic matter. The mineral portion of the center of the 6-mm. calculus and one of the 2-mm. calculi was composed of 33% phosphorus and 67% calcium, and the other 2-mm. calculus contained 32% phosphorus and 68% calcium by x-ray dispersion analysis. CONCLUSIONS: Intrascrotal lithiasis is rare. In the two cases described herein, we observed abundant organic matter, particularly on the stone surface, and hydroxyapatite, particularly in the center. Among the possible etiologic causes, the deposit of organic matter in the presence of high oversaturation of calcium phosphates and absence of crystallization inhibitors, can initiate calcification and the subsequent collection of organic matter makes the process irreversible.

Aged↗

PubMedDate not supplied

[Fixed drug-induced exanthema of the glans].

OBJECTIVES: To claim attention on an relatively frequent adverse reaction to drugs affecting genitalia, therefore a reason for consultation to the Urology Department. METHODS: We report a clinical case and a bibliographic review of this disease. RESULTS: Fixed drug eruption is a cutaneous eruption secondary to drug intake that appears every time the drug is taken, always in the same location, being more common in hands and feet. The course of the disease is usually progressive with increasing number of lesions after each dose of drug taken. CONCLUSIONS: Relapsing lesions in the same spot is key for the proper diagnosis of this eruption. To forbid causing drug intake is the treatment of choice, although it may be necessary to administer local or even oral corticosteroids.

Adolescent↗