Biomedical subjects

L Parra Muntaner

Publications and source records attributed to L Parra Muntaner.

At least 19 recordsLinked to original sources

PubMed2002

[Ectopic prostatic tissue in the bladder].

We report the case of a 58-year-old man with ectopic prostatic tissue at the bladder trigone. The diagnosis was by chance during study and treatment of benign prostatic hyperplasia. The appearance was pseudocystic. It occupied completely the bladder trigone. On histology, the lesion was formed by prostatic type-glands, which were positive for the presence of prostatic specific antigen by using inmunoperoxidase technique. It was partially covered by normal urothelium. Ten months later, no trace of recurrence has been evidenced.

Choristoma↗

PubMed2001

[Scrotal leiomyoma].

A case of a 32-year-old patient with a diagnosis of leiomyoma of the scrotum was studied. Histologic analyses did not yield evidence of malignancy. Full excision of tumor was achieved and the postoperative period was uneventful.

Adult↗

PubMed2001

[Sugar: treatment of choice in irreducible paraphimosis].

PURPOSE: To evaluate the effectivity of granulated sugar in the treatment of irreductable paraphimosis. CLINICAL CASES: During last year three patients have been treated by application of granulated sugar on prepuce and glands penis during 1-2 hours until edema reduction was observed. Paraphimosis could be reducted in all three cases. CONCLUSIONS: Sugar application reduce local edema permitting reduce paraphimosis in an incruent, cheap and without side effects way.

Administration, Topical↗

PubMed2001

[Prevalence and risk factors for erectile dysfunction in the Region of Bierzo].

OBJECTIVE: To analyze the prevalence and risk factors for erectile dysfunction in Bierzo (León, Spain). METHODS: A study was conducted based on a self-administered survey in males aged 19 to 90 years that consulted at the urology and family medicine services of 10 health centers in Bierzo (León, Spain). To determine the existence or absence of erectile dysfunction, the male sexual health questionnaire (SHIM) was included, and those with a score of 21 or less were considered to have some degree of erectile dysfunction. Distribution of the questionnaire began in September 1999 and ended in May 2000. Submission of the questionnaires concluded on May 31, 2000. Of 935 questionnaire that were received, 830 were valid. RESULTS: The overall prevalence of erectile dysfunction in this study was 63.9%, which increased with age and was markedly higher after age 50 years (38.6% for age 41-50 years and 72.6% for age 51-60 years). The age-adjusted analysis showed the risk factors for erectile dysfunction were depression and arterial hypertension on treatment with drugs. Diabetes mellitus on treatment with oral glucose lowering agents or insulin, heart disease and hypercholesterolemia were also associated with the more severe forms. CONCLUSIONS: The prevalence of erectile dysfunction in patients consulting at the primary care and general urological services in Bierzo (León, Spain) was outstandingly high. The present study showed erectile dysfunction to be an age-dependent disease that caused concern in slightly more than half of the patients with this condition. Apart from age, depression and vascular disease were found to be risk factors.

Adolescent↗

PubMed2001

[Reabsorption syndrome. Report of a case].

OBJECTIVE: To report a case of TURP syndrome and emphasize the importance of early diagnosis. METHODS: A case of reabsorption syndrome in a patient that underwent transurethral resection under spinal anesthesia is presented. RESULTS: Reabsorption syndrome (TURP syndrome) is manifested by neurological and hemodynamic changes resulting from absorption of irrigating fluid used during transurethral resection of the prostate. This complication presented in a patient undergoing elective surgery and with no additional risk factors. CONCLUSIONS: Since it is impossible to prevent this complication of TUR, spinal anesthesia should be utilized whenever possible because it permits early detection before important complications develop.

Absorption↗

PubMed2001

[Urologic disease emergency. Clinico-epidemiologic analysis at a district hospital].

OBJECTIVE: To present the results of a one-year retrospective study that analyzed the clinical and epidemiological aspects of urological emergencies, which is not a negligible percentage of all hospital emergencies. METHODS: Data on all the urological emergencies of the emergency department of our hospital were collected during a one-year period by filling out a form that included sex, age, whether referred or not, disease, etc. RESULTS: There were 1504 urological emergencies; the urologist was required in 458 of these cases (30.45%). There were more men (837) than women (667). Patient ages ranged from 1-101 years (mean 53 years); a higher incidence was found for those aged 65 years. By age groups, there were more patients aged 61-80 years (575 patients). Most of the patients came to the hospital on their own initiative (1114) and 390 had been referred by their primary care physician. Renal colic (670 cases) was the most common diagnosis in both males and females, followed by cystitis, which was prevalent in the females (67.35%). Other conditions seen were urinary retention, hematuria, etc. CONCLUSIONS: There was a higher prevalence of males that consulted for urological conditions at the emergency department and there was a higher incidence in patients in the 6th and 7th decades of life, which is similar to the findings reported in other studies. Renal colic was the main reason for consultation for both genders and for all age groups, except those younger than 20 who presented more scrotal and penile involvement. Infective conditions involving the lower urinary tract (cystitis) and pyelonephritis were prevalent in the females. The large number of patients that were discharged from the emergency department and who consulted on their own initiative shows their confidence in the emergency services and that they could have been attended to at other health centers and did not have to come and unnecessarily strain the hospital emergency services.

Aged↗

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↗

PubMed2000

[Solitary pulmonary nodule in a patient with treated carcinoma of the renal pelvis: metastatic disease?].

OBJECTIVE: To describe a case of a solitary pulmonary nodule in a patient that had been treated for carcinoma of the renal pelvis. METHODS: A solitary pulmonary nodule was detected on the chest film of a patient that had been treated for carcinoma of the renal pelvis. The characteristics of the nodule are described and its diagnosis, with special reference to metastasis and primary pulmonary carcinoma, is discussed. RESULTS: The anatomopathological study demonstrated a chondroid hamartoma. CONCLUSIONS: A metastatic or a primary tumor is suspected when a solitary pulmonary nodule is detected in a patient that has been previously treated for urothelial carcinoma. However, other types of lesions with a more favourable outcome cannot be discarded, such as chondroid hamartoma as in the case described herein.

Humans↗

PubMed2000

[Renal infarct in the adult: apropos of a case].

OBJECTIVE: To report a case of renal infarction in a patient on anticoagulant therapy for aortic and tricuspid valvulopathy, with special reference to the diagnostic difficulty. METHODS: The most common causes of this condition, its forms of presentation, diagnostic methods, and therapeutic approaches are discussed. RESULTS/CONCLUSIONS: Renal infarction should be suspected in the presence of abdominal pain of sudden onset that is refractory to treatment with analgesics, especially in patients with a history of embolism, recent surgery or trauma. It is frequent to find increased levels of SGOT, SGPT, LDH, alkaline phosphatase and micro or gross hematuria and proteinuria. Arteriography or isotopic renogram is utilized to confirm the diagnosis, although IVP or CT is useful if the foregoing are not available. Early treatment is important for achieving recovery of the compromised renal parenchyma. In recent years, surgery has been displaced by the good results obtained with intraarterial infusion of fibrinolytics.

Abdominal Pain↗

PubMed2000

[Epidermoid carcinoma of the penis].

OBJECTIVE: To analyze our series and review the prognostic factors in the treatment of epidermoid carcinoma of the penis. METHODS: Age, time to consultation, circumcision, form of presentation, local treatment, tumor stage and grade, lymph node involvement and outcome were analyzed in 27 cases of carcinoma of the penis diagnosed at our hospital from 1981 to 1999. RESULTS: The incidence rate was 1.8 cases/100,000 men/year. No patient had been circumcised, except one who was circumcised in the adult age. The median time to consultation was 24 months (interquartile range: 60-7.75). The median follow-up was 37 months (interquartile range: 84-12). All patients with pT1GI-II and pT2G-II primary tumor (n = 21; 78% of the series) and with no lymphadenopathy were disease-free at 6 months' minimum follow-up [17 of the 21 patients (81%) had more than 32 months' follow-up]. Only one patient with pT1-GII tumor, but with a vertical growth pattern, had positive inguinal lymph nodes (pN2). The remaining patients with lymph node involvement showed infiltration of the erectile tissue and moderately or poorly differentiated tumors. Only two prophylactic lymphadenectomy procedures were performed (pN0). Regardless of treatment, 5 of the 6 patients with lymph node involvement died within one year after diagnosis. CONCLUSIONS: Given the demonstrated relationship between carcinoma of the penis and hygiene, and phimosis which makes hygiene difficult, circumcision should be performed in childhood. Furthermore, circumcision at this age has been demonstrated to have a prophylactic value that disappears in the adult age.

Adult↗

PubMed2000

[Lipoma of spermatic cord; report of a case].

OBJECTIVE: To report an additional case of lipoma of the spermatic cord, an uncommon, silent tumor. METHODS: A case of lipoma of the spermatic cord is described. The patient had presented with an enlarged scrotum with no symptoms. The literature on lipoma of the spermatic cord is briefly reviewed, with special reference to its diagnosis, forms of presentation and treatment. RESULTS: US evaluation demonstrated a mass adhered to the epididymis. An epididymal tumor was suspected and surgical exploration by the inguinal approach was performed. CONCLUSIONS: Lipoma is the most common tumor of the spermatic cord. Its etiology is unknown. It frequently appears in the fourth and fifth decades of life and usually involves the left hemiscrotum. It is silent and is detected by enlargement of the scrotum. The diagnosis is histological supported by US, which offers a reliability of 80%-100%. Treatment is by surgery in all cases.

Genital Neoplasms, Male↗

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

[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↗