Kelley-Seegmiller syndrome (KSS) is a disorder that occurs when there is a partial deficiency of the enzyme hypoxanthine guanine phosphoribosyl transferase. It is involved in the metabolism of purines, clinically manifesting as hyperuricemia, hyperuricosuria, gout arthritis, and urolithiasis. The aim of this article is to present the case of a 33-year-old male with KSS, with left ureteral colic, and a 5-mm, 323-HU ureteral calculi, successfully managed with conservative management. It is critical to recognize that most urologists are not familiar with this inborn metabolic error and 75% of these patients will be affected by urolithiasis, thus making it a very critical and significant disease in our practice.
Urolithiasis can result as a complication of urinary diversión, favored by urinary stasis, intestinal mucus, urinary tract bacteriuria, the metabolic derangements and the presence of foreign bodies. We present a 52- year-old male who underwent radical cystectomy with construction of a Bricker uretero-ileostomy. 5 years later he was found with a forgotten ureteral stent, a 6 cm calculi occupying the whole ileal conduit and a 13 mm calculi in the left renal pelvis. We present our experience in the successful endourological management of an encrusted neglected ureteral stent in an ileal conduit, achieving a stone-free status without complications.
Mondor penile disease is the thrombophlebitis of the superficial dorsal penile vein. The incidence is 1.39% with a prevalence of 1.4%. The most common risk factor for this entity is mechanical trauma through sexual activity. Due to its low incidence, this entity is still unknown for many physicians including urologists. Our aim is to describe the case of a 22-year-old male with a clinical and ultrasonographic diagnosis of Mondor penile disease and review the initial evaluation, pathogenesis, risk factors, diagnosis, and treatment. A 22-year-old male, whose chief complaint was a 12-h duration of pain in the dorsal face of the penis after a robust sexual activity. At physical exam, it was evident the painful in the duration of the superficial dorsal penile vein pathway. A color Doppler ultrasound was performed with evidence of low venous flow and a hypoechogenic image in the superficial dorsal vein, confirming the diagnosis of Mondor disease. He received expectant treatment, with partial recanalization 6 weeks after the event, without any adverse effect on his sexual function. Mondor disease is an undiagnosed pathology due to the fear of the patient to consult, or the medical team is unaware of the condition. Is very important to be familiarized with this pathology, so an accurate diagnosis and treatment are provided, avoiding unnecessary procedures. Is important to give education to decrease the anxiety related to the diagnosis and avoid performance issues.
Introducción y Objetivos La biopsia transrectal de la próstata (BTRP), fue propuesta por primera vez en 1937 y hasta 1981 se realizó la primera biopsia ecodirigida, actualmente es la vía de acceso a la próstata más utilizada por su fácil curva de aprendizaje como por el alto rendimiento diagnóstico, sin embargo, en el Reino Unido, el 68% de los urólogos no realizan BTRP porque consideran que no han recibido suficiente entrenamiento. El objetivo de este estudio es describir las diferentes técnicas utilizadas en la actualidad, las complicaciones del procedimiento y aportar una guía de consejos y trucos implementada en varios centros de referencia a la hora de realizar una BTRP para prevenir complicaciones, mejorar el desempeño de la prueba y del urólogo y estandarizar el método de toma de la BTRP.
Materiales y Métodos Realizamos una búsqueda en las bases de datos de PubMed, MEDLINE, SciELO utilizando las palabras claves “Transrectal ultrasound biopsy of the prostate” “tips and tricks” “Transperineal biopsy of the prostate” “Magnetic resonance imaging targeted biopsy” “MRI/US fusion biopsy”, basados en la literatura y en la experiencia de los autores de más de 1100 biopsias anuales entre los diferentes centros de referencia. Brindamos una guía práctica de consejos y trucos para facilitar el desempeño del urólogo en la BTRP.
Resultados La biopsia transrectal de próstata ecodirigida continúa siendo la primera opción para el abordaje diagnóstico del paciente con sospecha clínica de cáncer de próstata, es de gran importancia estandarizar el esquema de toma de la biopsia, y en nuestro caso recomendamos utilizar un esquema de 12 cores, definir la profilaxis antibióticas y la duración del tratamiento, y el uso de analgesia o anestesia local. Presentamos los consejos y trucos que hemos utilizado en nuestra práctica clínica en varios centros de referencia.
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