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R Espuela Orgaz

Publications and source records attributed to R Espuela Orgaz.

At least 19 recordsLinked to original sources
PubMed1992

[Embryonal carcinoma in the cryptorchid testis: apropos a case].

We report a case of testicular embryonal carcinoma in a patient with bilateral cryptorchidism. The diagnostic and therapeutic aspects of this disease entity are discussed. Although scrotal ultrasound constitutes an effective diagnostic method, it does not provide pathognomonic images that permit determining tumor histology as shown in the present case. Treatment of this tumor type depends on the degree of tumor spread: for stage I: inguinal orchidectomy and stage II: orchidectomy+lymphadenectomy. The need for adjuvant chemotherapy in these cases is discussed. In our view, it must depend on each specific case.

Adolescent↗
PubMed1992

[Integral urologic echography: retrograde sonourethrography].

Herein we describe a new technique for urethral exploration which replaces conventional radiological urethrography to a large extent. Retrograde sonourethrography is capable of providing data different from those of radiology, eliminates most of the inconveniences of the radiologic techniques and provides images of the entire trajectory of the urethra. Because this procedure can be repeated as often as necessary, it is the diagnostic procedure of choice in urethral stricture, a persistent and recurrent pathological condition. The results of a study conducted in 30 patients with different urethral pathologies are presented.

Humans↗
PubMed1992

[Bladder tumors: false recurrences].

The use of the new cytostatics for prophylactic therapy of superficial bladder tumor recurrence has been associated with fibrino-necrotic ulcers and eosinophilic cystitis. We underscore the problems in making the differential diagnosis which sometimes present with true tumor necrosis. We describe the characteristic features of both pathological conditions which permit these to be recognized before endoscopic maneuvers are performed. Their presenting features and course are analyzed.

Antineoplastic Agents↗
PubMed1992

[Echodensitometry: a new echographic diagnostic possibility].

The determination and quantification of grey levels in the echography scale, designated by some authors Echodensitometry, is viewed as a new method for diagnosis using ultrasound techniques. This paper advances the results from a study conducted with an echographer equipped with an echographic density measuring device. This model analyzes the number of pixels in the image showing the most frequent level of grey. Normal and pathological parenchymatous urological organs (kidney, prostate and testicle) have been examined. Normal organs show a gaussian distribution of grey with a predominant level of typical grey for each of them. When affected by an acute inflammatory process the organs maintain their gaussian distribution but the predominant grey is lower (darker) due to the edema and the hyperaemia. When the inflammatory process becomes chronic, distribution, although somewhat irregular, is still gaussian but with higher predominance of grey (lighter) probably due to the fibrosis. The tumoral cases of our study also showed a gaussian curve even more irregular and with levels of variable grey. When specific areas of the tumour are analyzed the findings are very distinct depending on whether the areas are hypo or hyperechoic. Hyperechoic areas produce highly irregular maps. Research should be directed to provide more complex, although easy to perform systems of analysis which can correlate adequately with the histological study. It would be desirable that the equipment would be standardized to allow analysis of 'in vitro' images. If and when these objectives can be accomplished we would be able to venture into an echography histological diagnosis, something nowadays yet impossible.

Densitometry↗
PubMed1992

[Is the early diagnosis of prostatic cancer possible using transrectal echography?].

One of the major challenges of using prostate transrectal ultrasound scanning as a procedure to diagnose through images is the theoretical possibility of reaching an early diagnosis of prostate cancer. This paper compiles the author's experience in this field. Based on 142 established diagnosis of prostate cancer since 1984, the conclusion being reached is that prostate cancer has no pathognomonic signs, and therefore it is impossible to make an early diagnosis just by using the images obtained with transrectal ultrasound scanning. This procedure could be used, however, to select patients with scan abnormalities (Alarm signs) who should have a biopsy performed. The support of ultrasound-led transperineal biopsy of the prostate is currently indispensable to achieve an early diagnosis. This paper suggests that a biopsy should be done at the appearance of just one alarm sign, although this may involve a large number of cancer negative biopsies. The almost null incidence of complications from transperineal biopsies enhances this reasoning.

Humans↗
PubMed1992

[Incidence and characteristics of multiple neoplasms in urologic patients].

The incidence and features of malignant primary multiple (MPM) neoplasias found in clinical urological patients have been analyzed so as to determine the actual magnitude of the problem and to obtain a better knowledge of this disease. For this reason, case histories of patients with MPMN, where at least one of the involved neoplasia was urological, were retrospectively studied. The study included a 9-year follow-up period and followed the Warren and Gates inclusion criteria. The number of MPMN patients was 23, representing an incidence of 6.1% among patients with urological neoplasias. Mean age at the time of discovery of the second tumour was 77.1 years. In the 15 patients with metachronic tumours, the time interval between the first and second tumours ranged between 1 to 25 years (average 5.4 years). The most frequently observed tumour association was bladder transitional carcinoma and prostate adenocarcinoma. The cause of death was always the second neoplasia.

Adolescent↗
PubMed1991

[Postoperative sclerosis of the bladder neck: pathogenic mechanisms].

A study was conducted in 69 patients with postoperative sclerosis of the vesical neck to analyze the different pathogenic mechanisms that have been put forward. This complication, however, could not be ascribed to any underlying cause. It presents in patients who undergo surgery of the prostate early, when their adenoma is generally small and frequently with inflammatory lesions as those of chronic prostatitis. Surgery appears to be the triggering mechanism in these patients who are likely to be predisposed to developing this condition as some patients are predisposed to develop keloid from cicatricial hypertrophy.

Adult↗
PubMed1991

[Paraneoplastic syndromes in urology].

The paraneoplastic syndromes in patients with malignant urological tumors are reviewed herein. Some general aspects of these syndromes are briefly described and discussed. Similarly, the different urological tumors in which paraneoplastic syndromes have been observed are briefly reviewed. These are very common in renal cancer and cancer of the prostate, uncommon in bladder cancer and rare in testicular cancer.

Female↗
PubMed1991

[Postoperative sclerosis of the bladder neck: surgical treatment].

We analyzed the results of surgical treatment of vesical neck sclerosis in 81 patients who underwent 97 procedures. Most of these patients had post-operative sclerosis of the vesical neck. The different surgical techniques and their results are reviewed. Excision of the sclerotic tissue by transurethral encircling resection has been the most widely used and has achieved better results. It is frequently necessary, however, to use it together with other complementary techniques such as retrograde resection, knife incision, or combined procedures. Knife incision of the diaphragm has achieved the worst results. Overall, the results have been poor (approximately 36% poor results). The results achieved by these procedures are even worse (75% poor results) in recurrence.

Adult↗
PubMed1991

[Fever and leukemoid reaction in bladder cancer: report of a case].

The authors present a unique case of bladder cancer that presented as paraneoplastic syndrome of fever and leukemoid reaction. Furthermore, the patient had a left renal tumor histologically similar to the bladder tumor. We discuss whether the foregoing was a metastatic or a primary tumor coexisting with a bladder tumor. The neoplastic syndromes affecting patients with bladder neoplasms are briefly discussed.

Carcinoma, Squamous Cell↗
PubMed1990

[Transrectal echography of the prostate: current evaluation].

Our results with transrectal ultrasonography of the prostate are updated herein. Since the specifically urologic ultrasound (Aloka SSD 520) equipped with a sectorial transrectal probe of 5 MHz, became available in our service in 1984, we have performed over 1,700 transrectal ultrasound procedures. From the outset, we established several lines of investigation whose partial results have been published over these past years. Our main interest has been and continues to be that of describing an unequivocal echo pattern that would define prostate cancer in any stage, particularly in its early stages. To date, no finding has proved to be pathognomonic. However, we believe that we have encountered some aspects that have been poorly described to date that allow us to determine the current role of transrectal US in the urologic setting. We support the concept of integral urologic ultrasonography, one that encompasses all of our activities. The present article is a synthesis of a major part of our investigative effort and includes our statistical data and current points of view. Our own experience has taught us that things may turn out to be different from what they initially appear to be. Thus, we cannot rule out that our views will not change in the future. We have therefore attempted not to be rigid with respect to our claims. We must add, however, that except for numerical changes and variations in the degree of significance of specific findings, no major modifications have had to be made during this period. We have divided the study into various parts. Each one reviews a specific pathology (cancer, prostatitis, adenoma...), some procedures (biopsy, puncture, sonometry), and a comparative study between classical and transrectal US (digital rectal examination and US). In all of the foregoing, we have presented our results and some considerations in the discussion. Finally, our current views regarding transrectal US are presented succinctly in the conclusions.

Diagnosis, Differential↗
PubMed1990

[Transrectal echography and cancer of the prostate. III. Monitoring of the treatment response].

The role of transrectal ultrasonography in monitoring response of prostate cancer to treatment with ciproterone acetate is described. In our therapeutic protocol for prostate cancer, those included between categories 7 and 9 are submitted to antidrogen therapy, regardless of the type of surgical procedure indicated in each case. Fifty-one patients submitted to this treatment modality were followed using transrectal ultrasound 3 months following diagnosis and every 6 months thereafter. The mean follow-up was 2 years Using the intrinsic and morphologic ultrasound parameters we have developed at our department, we can conclude that the changes in prostate size or volume and the changes in the intensity of brightness are the most reliable parameters in assessing the response to treatment. A good response to treatment is manifested by the reduced size of prostate and reduced intensity of brightness ("dark prostate").

Antineoplastic Agents↗
PubMed1990

[Transrectal echography and cancer of the prostate. I. Echographic characteristics].

Our diagnostic criteria in prostatic cancer using transrectal ultrasonography are described herein. A prospective study was undertaken since 1984 in a total of 1,512 patients. 75 of whom had cancer of the prostate. For the present study, we analyzed a series of ultrasonographic parameters that we have termed "intrinsic parameters" (IP) and "morphologic parameters" (MP). IP refer to the echo characteristic of the area within the prostate (intensity of brightness and size of granules) whereas MP refer to the general aspects of the prostate gland (ratio of transverse to anteroposterior diameter, shape deformity and rupture of capsule). The MP have proved to have a more diagnostics capacity; thus, when present, a diagnosis of prostatic cancer is made. IP changes alert us to suspect this condition. A T/AP ratio less than l, a "bell-shaped" prostate, is almost pathognomonic of prostate cancer since the foregoing has not been observed in benign conditions.

Aged↗
PubMed1990

[Transrectal echography and cancer of the prostate. II. Comparison with digital examination of the rectum].

A comparative study was performed to determine the usefulness and diagnostic capacity in cancer of the prostate afforded by two different techniques: digital examination and transrectal ultrasonography. Our experience in 69 cases of prostate cancer show that more information is provided by transrectal ultrasound. Thus, the diagnostic capacity and usefulness of transrectal ultrasonography in the management of prostate cancer is greater than that of digital examination. However, on the sole basis of the number of cancers diagnosed, both techniques have very similar values for specificity, while transrectal ultrasonography is slightly superior with respect to sensitivity. The foregoing findings simply show that although both techniques have a similar diagnostic capacity, transrectal ultrasonography provides further important information (size, bladder involvement, graphic representation, etc.) that make it overall more useful and superior to the other technique in the management of prostate cancer.

Aged↗
PubMedDate not supplied

[Total ureteral rupture caused by closed abdominal injury in polytraumatized patients].

The authors present a case of complete ureteral rupture, after closed, abdominal traumatism in a patient suffering from multiple traumatisms. They point out the slight number of cases published in the literature as well as the frequency of its delayed diagnosis due to few or no symptoms, particularly when associated with visceral ruptures or bone fractures which may conceal the picture. They recommend the I.V.U. for all patients with multiple traumatisms once they have recovered from the state of shock, as a simple exploration but which provides a great deal of information. They also advise conservative treatment even in cases with a delayed diagnosis.

Abdominal Injuries↗