Bibliographic review about the usefulness of ultrasound contrast media in the study of renal masses.

Objectives: The microbubbles enhanced ultrasound contrast is a novel technique that informs us in real time of renal perfusion and microcirculation.

Method: We reviewed the literature about its use in the study of renal masses in order to show their actual clinical performance in this condition.

Result: This technique is useful in the differential diagnosis of pseudotumors, characterization and monitoring of small renal masses, the study of complex renal cysts and controlling the progression of renal masses that underwent ablative treatments.

[Testicular ultrasonography].

Objectives: To review the contribution of ultrasound to the differential diagnosis of scrotal pathology, both testicular and adnexal.

Methods: We performed a bibliographic review on the topic, adding the experience of our Unit over the years; we classified the pathology in testicular and extratesticular, separating liquid and solid lesions, and a miscellaneous group of unclassifiable cases.

Results: Currently, ultrasonography with high frequency equipment allows not only to differentiate between intra and extratesticular lesions, but also to identify specific lesions, the manage of which may include follow-up without need of unavoidable surgery.

[Ultrasound for the diagnosis of female urinary incontinence].

Objectives: The value of ultrasonography for the study of female urinary incontinence has been redefined over the last years.

Methods: We review the literature about the value of ultrasound in the workup of females with urinary incontinence, mainly transperineal ultrasound for the female stress urinary incontinence (SUI).

Results: Many papers have been published over the last few years.

[Transrectal ultrasound-guided prostatic biopsy: contribution of an ultrasound diagnostic unit after ten years of experience].

Objectives: Although transrectal ultrasound-guided (TRUS) prostatic biopsy is the procedure of choice for the diagnosis of prostate cancer (PC), neither the ideal number of cores nor the number of repeated biopsies, nor the required diagnostic yield have been established. After our experience of ten years with TRUS biopsy we perform a review of the technique and its indications.

Methods: PSA, ultrasound features, and pathologic data of 6000 patients undergoing modified sextant TRUS biopsy between 1994 to December 2002 were collected.

[Diagnosis and follow-up of benign prostatic hyperplasia by ultrasound].

Objectives: The aim of the study is to analyze the utility of ultrasound in the evaluation and treatment selection of patients with benign prostatic hyperplasia (BPH).

Methods: A total of 5000 patients older than 50 years and with prostatic symptoms were evaluated with abdominal ultrasound and in selected cases with transrectal ultrasound.

Results: The first ultrasonographic sign of BPH is the increase of anteroposterior and longitudinal diameters.

[Ultrasonography for the study of small renal masses].

Objectives: To perform an update on the usefulness of ultrasound in the study of small size renal tumors and its current possibilities.

Methods: We review the results of ultrasound in this pathology with the addition of the most recent technological advances such as a harmonic digital converters and power color Doppler. We analyze its contribution to the differential diagnosis of the cystic pathology, to the definition of solid masses, to the detection and characterization of small size masses, and to the definition of the vascular patterns of various tumors.

[Diagnostic yield of the extended prostatic biopsy with 10 cores. Prospective study on 222 patients].

Objectives: The number of biopsy samples for a proper prostate cancer diagnosis has not yet been established. We report our experience with the 10-sample extended biopsy.

Methods: We collected the results of a group of 222 patients undergoing extended ultrasound guided prostate biopsy with 10 samples.

[Tolerability and complications of the ultrasound guided transrectal biopsy of the prostate extended to 10 cores. The role of neurovascular bundle blockage with lidocaine].

Objectives: The growing interest on increasing the number of biopsy samples during ultrasound guided prostatic biopsies moved us to evaluate the tolerability and complications of the extensive biopsy with/without blockage of neurovascular bundles.

Methods: A group of 222 patients underwent prostatic biopsy with the aim to obtain 10 cores on each. After evaluation of the first 50 cases performed without anesthesia, decision was taken to proceed with neurovascular blockage with 2% lidocaine, comparatively evaluating both groups for results on tolerability, complications and global adverse events.

[The role of prostate volume in ultrasound guided transrectal prostate biopsy: is it as important as a marker as PSA?].

Objectives: The limitations of PSA to identify patients with prostate cancer prompted the definition of different parameters trying to increase specificity without reducing sensitivity. This paper studies the relationship of volume and presence of prostate cancer in sextant biopsies.

Methods: We collected the results of prostate biopsies performed to 6000 patients between 1994 and 2002.

[Results of a series of transrectal ultrasound guided biopsy of the prostate in 6000 patients. Part II: PSA derived parameters].

Objectives: We review the results of 6000 patients with the clinical suspect of prostate cancer who underwent one or more prostate, biopsies, analyzing the role of PSA derived parameters in the probability of having prostate cancer in the TRUS biopsy.

Methods: We selected 6000 patients who under- went TRUS biopsy between 1994 and 2002. 861 of them underwent more than one is biopsy, adding up to a total of 7127 biopsies.

[Results of a series of transrectal ultrasound guided biopsy of the prostate in 6000 patients. Part I: pathology, digital rectal examination, transrectal ultrasound, and PSA].

Objectives: To analyze the results of transrectal ultrasound (TRUS) guided biopsy of the prostate in 6000 patients, and their relation to common-use clinical parameters.

Methods: We collected PSA, digital rectal examination, TRUS characteristics, and pathology report in a data- base including 6000 patients who underwent sextant TRUS biopsy from 1994 to December 2002. 861 of them underwent more than one biopsy, accounting for a total of 7127 biopsies.

[Current status of high-resolution scrotal echography].

Objectives: To review the main images that can be observed by ultrasound, trying to highlight what decision to take after their finding: exploratory surgery, orchyectomy, or follow-up.

Methods: We performed a bibliographic review about the topic and incorporated our personal experience with scrotal ultrasound. Given that there is an extensive variety of anomalies that can be observed we divide them in liquid and solid lesions, and these in intra or extratesticular, plus a group of lesions that do not qualify in the previous groups.

[Adrenal cysts: presentation of 6 cases].

Objectives: We report six cases of adrenal cyst, a rare pathologic entity which poses diagnostic problems and therapeutic controversies.

Methods: We report six cases of adrenal cysts in 4 female and 2 male patients ages 26 to 68 years. All cases underwent surgical treatment.

[Can indexes based on PSA determine which patients should undergo repeated ultrasound-guided transrectal prostatic biopsy? Study on 546 patients who underwent repeated biopsy].

Objectives: Ultrasound guided prostate biopsy is the most effective test for prostate cancer diagnosis, but its sensitivity is not higher than 80% so that biopsy repetition must be considered in patients with persistent diagnostic doubts after a previous negative one. However, the majority will be negative as it happened in the first biopsy and the percentage of normal biopsies increases successively. Various indexes based on PSA are proposed to determine which patients have a higher risk of cancer detection by biopsy.

[Comparison of prostate volume measured by transrectal and abdominal echography and its implication for the measurement of the PSA density for the diagnosis of prostate cancer].

Objective: To compare PSA density (PSAD) results based on prostate volume measurements obtained by either transrectal or abdominal ultrasound (US) in the diagnosis of prostate cancer.

Methods: We prospectively selected 420 consecutive subjects whom at the time of a transrectal US (TRUS) guided biopsy or an abdominal US had the other US evaluation done within the previous 6 months and who did not undergo hormonal, surgical o radiotherapeutic therapy. For both abdominal and transrectal US PSAD (PSA/volume) were obtained from this data and compared, with volumes calculated using the formula: V = antero-posterior diameter2 x transverse diameter/2.

[Complications of prostatic echo-guided transrectal biopsy and tolerance depending on the patient and the operator. Study of 205 patients].

Objective: Ultrasound-guided transrectal biopsy of the prostate is generally considered to be well-tolerated and with few complications. The results of a prospective study that evaluated patient and biopsy performer's perception of the foregoing aspects are presented.

Methods: The records of 305 consecutive patients submitted to ultrasound-guided transrectal biopsy were analyzed.