1
|
March-Villalba JA, López Salazar A, Romeu Magraner G, Serrano Durbá A, Valero Escribá ML, Ortega Checa M, Domínguez Hinarejos C, Boronat Tormo F. Analysis of pain perception associated with urodynamic testing in children over 3 years old. Actas Urol Esp 2021; 45:232-238. [PMID: 33632554 DOI: 10.1016/j.acuro.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/26/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To measure the tolerance of urodynamic testing (UDT) in the pediatric patient by means of the Visual Analog Scale (VAS). To analyze which clinical and UDT-related variables influence pain perception. MATERIAL AND METHODS Cross-sectional study of 139 pediatric patients undergoing UDT (December 2013 - May 2018). INCLUSION CRITERIA understanding and expressing their experience after UDT (preschool and school age). No adolescents were included. Measurement instrument Visual Analog Scale (0-10). Other clinical and UDT-associated variables were obtained. STATISTICAL ANALYSIS Mann-Whitney U test, Kruskal Wallis test. Spearman's rank correlation analysis (rs). Multivariate analysis through ordinal logistic regression. Significance p < 0.05. RESULTS Mean age 7.7 years (SD 2.4), median VAS score, 2 (2-6). In 41% (n = 57), the score was ≥ 4 (moderate pain). Multivariate analysis. Explanatory variables for obtaining a high VAS score: high APUDT score (identifying patient anxiety prior to UDT), sensory-motor alteration in the lower limbs, difficult bladder catheterization and the appearance of pain during the filling phase. Age and duration of the UDT have not influenced the VAS score. CONCLUSIONS Although the UDT has resulted in 40% of the pediatric patients in our study expressing discomfort or pain, it is a well-tolerated test. The variables that have influenced on pain perception were patient's anxiety prior to UDT, a sensory-motor alteration located in the lumbosacral metameres, difficult bladder catheterization and the appearance of pain during bladder filling.
Collapse
Affiliation(s)
- J A March-Villalba
- Sección de Urología Pediátrica. Hospital Universitario y Politécnico de la Fe, Valencia, España.
| | - A López Salazar
- Sección de Urología Pediátrica. Hospital Universitario y Politécnico de la Fe, Valencia, España
| | - G Romeu Magraner
- Sección de Urología Pediátrica. Hospital Universitario y Politécnico de la Fe, Valencia, España
| | - A Serrano Durbá
- Sección de Urología Pediátrica. Hospital Universitario y Politécnico de la Fe, Valencia, España
| | - M L Valero Escribá
- Enfermería de la Sección de Urología Funcional y Reconstructiva. Hospital Universitario y Politécnico de La Fe, Valencia, España
| | - M Ortega Checa
- Enfermería de la Sección de Urología Funcional y Reconstructiva. Hospital Universitario y Politécnico de La Fe, Valencia, España
| | - C Domínguez Hinarejos
- Sección de Urología Pediátrica. Hospital Universitario y Politécnico de la Fe, Valencia, España
| | - F Boronat Tormo
- Servicio de Urología. Hospital Universitario y Politécnico de La Fe, Valencia, España
| |
Collapse
|
2
|
Martínez Cayuelas L, March-Villalba J, Valencia Guadalajara V, Serrano Durbá A, Conca Baenas M, Polo Rodrigo A, Domínguez Hinarejos C, Boronat Tormo F. Evaluation of sleep hygiene and prevalence of sleep disorders in patients with monosymptomatic enuresis. Usefulness of the BEARS sleep screening tool. Actas Urol Esp 2020; 44:477-482. [PMID: 32600875 DOI: 10.1016/j.acuro.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 05/02/2020] [Accepted: 05/07/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze if there is a higher prevalence of sleep disturbances and hygiene disorders in patients with monosymptomatic enuresis (MEN) with respect to general population and to patients with corrected MEN. Assess the usefulness of the BEARS sleep disorder screening tool for children with MEN. MATERIAL AND METHODS Transverse observational study (n=341) classified as: MEN (n=122), corrected MEN (≥ 1 one year without recurrence) (ANTENUR) (n=47) and controls (n=172). The BEARS childhood sleep disorder screening questionnaire was used. Clinical variables were collected, as well as variables related to sleep hygiene. STATISTICS Chi-square, Student's t, ANOVA, Mann-Whitney U and Kruskal-Wallis. Significance p<.05. RESULTS Mean age 9.7±3.0 years. There were no statistically significant differences in terms of age, sex, BMI, history of tonsillectomy, asthma and sleep time hours. With respect to sleep hygiene, patients with MEN presented a higher percentage of alterations than controls. As for the BEARS questionnaire, it showed a higher prevalence of sleep disorders in the group of patients with MEN, with respect to the other two groups: 60.7% (n=74) versus 18.6% (n=32) and 38.3% (n=18) of controls and ANTENUR, respectively (p<.05). CONCLUSIONS Children with MEN had a higher prevalence of sleep disturbances and sleep disorders than controls. The BEARS questionnaire is a useful clinical tool in the detection of sleep disorders in children.
Collapse
|
3
|
Pérez-Ardavín J, Serrano Durbá A, Miró I, Conca Baena MA, March-Villalba JA, Polo Rodrigo A, Sangüesa CC, Domínguez Hinarejos C. Spontaneous spermatic vein thrombosis in pediatric patients: A condition to be considered. Cir Pediatr 2020; 33:99-101. [PMID: 32250075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Spermatic vein thrombosis is a very rare pathology, with 25 cases published only, 6 of which in patients under 15 years of age. We present the case of a male patient, as well as a review of the literature. A 12-year old boy presented at emergency with 3-day progressive testicular pain. Following abdominal Doppler ultrasound imaging, he was diagnosed with left spermatic vein thrombosis and nutcracker syndrome. Admission and enoxaparin treatment were decided upon. Patient evolution was satisfactory, with subsequent ultrasound imaging demonstrating the absence of thrombus. The patient is currently under follow-up and without treatment. Various treatments are mentioned in the literature, with conservative management being the treatment of choice.
Collapse
Affiliation(s)
- J Pérez-Ardavín
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - A Serrano Durbá
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - I Miró
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - M A Conca Baena
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - J A March-Villalba
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - A Polo Rodrigo
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - C C Sangüesa
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| | - C Domínguez Hinarejos
- Servicio de Urología. Unidad de Urología Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia
| |
Collapse
|
4
|
Marzullo-Zucchet L, March-Villalba JA, Domínguez Hinarejos C, Polo Rodrigo A, Serrano-Durbá A, Boronat Tormo F. Usefulness of the classification of urinary dysfunction for the prognosis of the first endoscopic treatment of vesicoureteral reflux in children over the age of 3. Actas Urol Esp 2019; 43:212-219. [PMID: 30833101 DOI: 10.1016/j.acuro.2018.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the diagnostic performance of urinary dysfunction patterns associated with vesicoureteral reflux (VUR) in children over the age of 3 according to the result of the first endoscopic treatment (ENDT1), grouped into a classification designed by our group (CMD.URI-La Fe). Comparison with other current classifications such as that of Van Batavia et al. MATERIAL AND METHODS: Ambispective cross-cutting study of a sample of 50 children. EXCLUSION CRITERIA previous ENDT, age ≤ 3 years, anatomical or neurological anomalies and a history of ureteral or abdominopelvic surgery. Prior to the ENDT1, a bladder voiding function assessment by uroflowmetry+electromyography (UF-EMG) and post-mictional residue (ultrasound). Other variables from the bladder diary, pre-mictional bladder wall thickness and other clinical variables. The correction of VUR was assessed by isotope cystography 3 months after the treatment. Urinary patterns were classified according to the significant variables (URI-La Fe), and the diagnostic performance of this classification was assessed, comparing it to the classification of patients as proposed by Van Batavia et al. RESULTS: Mean age: 6.8±2.28 years. Males/females (44%/56%). Grades of VUR (mild/moderate/severe). ENDT1 VUR correction rate: 77% (n=38). Diagnostic performance (Van Batavia; URI-La Fe): correct prediction (37.5%; 75%), sensitivity (32.4%; 87.8%), specificity (54.5%; 46.6%), positive predictive value (70.6; 78.3%) and negative predictive value (19.4%; 63.6%). CONCLUSIONS Our results show the usefulness of the non-invasive test and the classification of urinary dysfunction in children aged over 3 years prior to the first endoscopic treatment of VUR.
Collapse
Affiliation(s)
- L Marzullo-Zucchet
- Sección de Urología Infantil, Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - J A March-Villalba
- Sección de Urología Infantil, Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, España.
| | - C Domínguez Hinarejos
- Sección de Urología Infantil, Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - A Polo Rodrigo
- Sección de Urología Infantil, Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - A Serrano-Durbá
- Sección de Urología Infantil, Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - F Boronat Tormo
- Sección de Urología Infantil, Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, España
| |
Collapse
|
5
|
Rodríguez Iglesias P, Polo Rodrigo A, Serrano Durbá A, Rodríguez Caraballo L, March Villalba JA, Domínguez Hinarejos C. [Experience in the conservative treatment of renal trauma]. Cir Pediatr 2019; 32:6-10. [PMID: 30714694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The management of renal trauma has been changing in recent years so that nowadays, even in high grades, an initial conservative treatment is advocated. The aim of this work is to review the presentation, initial attitude and evolution of the renal traumas treated in our institution. MATERIAL AND METHODS Retrospective review of patients with renal trauma treated at our institution in the last 10 years. Epidemiological variables, production mechanism, pediatric trauma index (PTI), treatment and evolution were analyzed. RESULTS We studied 26 patients, 18 men (69.3%). The most frequent mechanism was the direct hit in 11 patients (42.31%). The most frequently side affected was the right one in 14 patients (53.85%). The grade III traumatism according to American Association for the surgery of Trauma (AAST) was the most repeated, 11 patients (42.31%). Nine patients (44.55%) presented concomitant injuries in other solid organs. In 24 patients (92.30%) the initial treatment was conservative with supportive measures. One patient presented with hemodynamic instability and an urgent intervention was conducted, performing a supraselective embolization with immediate control of the active bleeding. In another patient, a double J catheter was placed due to disruption of the excretory tract. Of the patients treated conservatively initially, only one patient (4.1%) required secondary surgical maneuvers due to a complication. CONCLUSIONS In patients with renal trauma, non-surgical treatment is safe and effective. In case of hemodynamic instability or complication, interventional radiological techniques have been demonstrated to be safe and effective in the pediatric population.
Collapse
Affiliation(s)
- P Rodríguez Iglesias
- Servicio de Cirugía Pediátrica. Hospital Universitari i Politècnic la Fe. Valencia
| | - A Polo Rodrigo
- Servicio de Urología infantil. Hospital Universitari i Politècnic la Fe. Valencia
| | - A Serrano Durbá
- Servicio de Urología infantil. Hospital Universitari i Politècnic la Fe. Valencia
| | | | - J A March Villalba
- Servicio de Urología infantil. Hospital Universitari i Politècnic la Fe. Valencia
| | | |
Collapse
|
6
|
Rodríguez Iglesias P, Serrano Durbá A, Rodríguez Caraballo L, Balaguer Guill J, Povo Martín I, Domínguez Hinarejos C, Boronat Tormo F. [Nephroblastoma. Long-term experience in the multidisciplinary approach]. Cir Pediatr 2018; 31:46-51. [PMID: 29419959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Main objective: to perform a descriptive study of patients with nephroblastoma, diagnostic tests, medical and surgical treatment. Secondary objective: to evaluate the rate of relapse and 5-year survival and risk factors for relapse and death. MATERIALS AND METHODS Retrospective study of patients with nephroblastoma treated according to the protocol of the SIOP-2001. Demographic variables, comorbidities and associated syndromes were collected. Other data were tumor location, size, extent and stage. The relapse rate and the development of other secondary tumors as well as the long-term survival were also studied. RESULTS We collected 33 patients with nephroblastoma. A biopsy was performed in 7 patients (21.2%). The Kaplan-Meir curve for event-free survival (tumor recurrence) was 84% with a 95% CI = [0.73-0.98] and the Kaplan-Meier overall survival curve was 0.93 95% CI [0.85-1]. Recurrence occurred in all patients before the first year. CONCLUSIONS Nephroblastoma is a tumor with a favorable prognosis. The unfavorable histology as well as advanced stages are factors of a poor prognosis. The follow-up must be exhaustive during the first year after the diagnosis.
Collapse
Affiliation(s)
- P Rodríguez Iglesias
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| | - A Serrano Durbá
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| | - L Rodríguez Caraballo
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| | - J Balaguer Guill
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| | - I Povo Martín
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| | - C Domínguez Hinarejos
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| | - F Boronat Tormo
- Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia
| |
Collapse
|
7
|
Martínez Ruiz J, Serrano Durbá A, Domínguez Hinarejos C, Boronat Tormo F, Estornell Moragues F, García Ibarra F. [Urethral polyposis in adolescence]. Cir Pediatr 2011; 24:59-61. [PMID: 23155654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Polyps in the urinary tract are a rare entity in infants and children. The most frequent location when they appear is the ureter. These benign lesions with no malignant potential have a varied form of presentation and in most cases must be distinguished from malignancy. The suspected diagnosis is due to urinary obstruction; nevertheless radiological evidence played a key role in the final diagnosis. The management is as less invasive as possible, with endoscopy resection or minimally invasive surgery.
Collapse
Affiliation(s)
- J Martínez Ruiz
- Servicio de Urología Pediátrica, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
8
|
March Villalba J, Domínguez Hinarejos C, Serrano Durbá A, García Ibarra F. Hemangioma cavernoso vesical causante de hematuria en un niño. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000300018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
9
|
March Villalba J, Domínguez Hinarejos C, Serrano Durbá A, García Ibarra F. Hemangioma cavernoso vesical causante de hematuria en un niño. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2010.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
March Villalba JA, Domínguez Hinarejos C, Serrano Durbá A, García Ibarra F. [Bladder cavernous hemangioma as a cause of hematuria in a child]. Actas Urol Esp 2010; 34:299-301. [PMID: 20416254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
11
|
Carrión López P, Domínguez Hinarejos C, Serrano Durbá A, Estornell Moragués F, Martínez Verduch M, García Ibarra F. [Congenital fibroepithelial polyps of the urethra]. Cir Pediatr 2010; 23:7-9. [PMID: 20578569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Urethral polyps are a rare pathology that is usually diagnosed in childhood hematuria and obstructive urinary symptoms are the most common findings and transurethral resection is the best choice of the treatment. We report three cases, a 6-years-old boy and 9-years-old boy diagnosed and treated of posterior urethral polyp after showing hematuria and obstructive urinary symptoms, and a 2-years-old girl that showed to prolapse of urethral polyp.
Collapse
Affiliation(s)
- P Carrión López
- Sección de Urología Infantil, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
12
|
Serrano Durbá A, Pacheco Bru JJ, Domínguez Hinarejos C, Estornell Moragues F, Nome C, Martínez Verduch M, García Ibarra F. [Hypospadias repair with Snodgrass' technique]. Actas Urol Esp 2007; 31:528-31. [PMID: 17711172 DOI: 10.1016/s0210-4806(07)73677-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Retrospective study of 124 patients (average age: 3.8 years) with midpenile hypospadias: 48.3% (60 children), distal penile: 45.9% (57) and coronal 5.6% (7), of which the 25.8% (16) presented ventral curvature and the 4.8% (6) resulting from the complication of another previous technique. All of them were operated according to Snodgrass' technique, removing the catheter between the 6th and 7th day in most of them. The global rate of complications was of 12%: 9 fistulae (7.2%) and 6 meatal stenosis (4.8%). Aesthetic result was satisfactory in all cases, getting glans covered by foreskin in 57.3%.
Collapse
Affiliation(s)
- A Serrano Durbá
- Unidad de Urología Infantil, Hospital Infantil La Fe, Valencia.
| | | | | | | | | | | | | |
Collapse
|
13
|
Serrano Durbá A, Pacheco Bru J, Domínguez Hinarejos C, Estornell Moragues F, Nome C, Martínez Verduch M, García Ibarra F. Reparación de hipospadias mediante la Técnica de Snodgrass. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000500013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
Domínguez Hinarejos C, Bonillo García MA, Alapont Alacreu JM, Serrano Durbá A, Estornell Moragues F, García Ibarra F. [Assesmment urethrorrhagia in childhood]. Actas Urol Esp 2007; 31:29-32. [PMID: 17410983 DOI: 10.1016/s0210-4806(07)73590-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE [corrected] To review urethrorrhagia cases, the need of complementary test, its management and natural history. MATERIAL AND METHOD A retrospective analysis was carried out for the 12 patients who suffered from urethrorrhagia, consecutively diagnosed in our department. Parameters as age, and micturitional habit were evaluated. In this way, we described the diagnostic techniques used, assessment and the follow-up of each patient. RESULTS All cases correspond to male children with an average age of 8.7 years (range: 18 months-14 years). Urethrorrhagia appears in 100% of the patients, episodes which were daily in 58.4%. 33% (4/12) of them also present other micturitional symptoms. 75% (9/12) had a lazy micturitional habit. Among the urological backgrounds we found: 1 patient was circumcised 3 years ago, a meatotomy was done in other due to meatus stenosis 2 years before, and a last one had an electrocoagulation of a urethral polyp just 1 month before. 83.4% (10/12) of urine cultures were negative. An urethrocystoscope was done in 9 patients finding a verum hypertrophy in 4, inflammatory changes next to membranous urethra in 3, scar at the bulbar urethra in 1 and in a last one no abnormalities were found. Out of 8 patients with lazy micturitional habit, 75% (6/8) resolve spontaneously once they correct their habits after a mean follow-up of 9 months. Only 2 patients needed surgery (TUR). In the other 2 patient, symptoms. CONCLUSIONS Urethrorrhagia in childhood is a benign condition in most cases, which is almost always cured spontaneously during the first 2 years of follow-up. Radiological studies as well as endoscopic procedures are unnecessary in the early management of these patients thus being relegated to recurrent or persistent bleeding.
Collapse
|
15
|
Abstract
Torsion of a cryptorchidid testicle presents a non-specific symptomatology. Clinical suspicion indicates surgical exploration, irrespective of Doppler ultrasound with its inherent false negative results. With regards to treatment, an orchiectomy is performed when the testis is necrotic. Management of the contralateral testis is controversial. Our policy is not to fix them systematically because we believe that a healthy education of parents and children is more important, so as to obtain an earlier diagnosis of a future torsion.
Collapse
Affiliation(s)
- C Domínguez Hinarejos
- Departamento de Cirugía Pediátrica, Sección de Urologia Infantil. Hospital Infantil La Fe, Valencia.
| | | | | | | | | |
Collapse
|
16
|
Delgado Oliva FJ, Domínguez Hinarejos C, Serrano Durbá S, Estornell Moragues F, Martínez Verduch M, García Ibarra F. [Congenital megaprepuce: diagnosis and terapeutic management]. Actas Urol Esp 2007; 30:1038-42. [PMID: 17253074 DOI: 10.1016/s0210-4806(06)73582-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE [corrected] To analize the clinical presentation, diagnosis and surgical management of congenital megaprepuce (CM). MATERIAL AND METHODS We have made a retrospective study of four cases of CM diagnosed and treated in our centre between october 1997 and april 2005. We studied the diagnosis and surgical treatment. CONCLUSIONS CM is an infrecuent condition that can be confused with others pathologies. It's necessary to diagnose and treat it correctly.
Collapse
Affiliation(s)
- F J Delgado Oliva
- Unidad de Urología Pediátrica, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
17
|
Domínguez Hinarejos C, Bonillo García M, Alapont Alacreu J, Serrano Durbá A, Estornell Moragues F, García Ibarra F. Valoración de la uretrorragia en el niño. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
18
|
Abstract
INTRODUCTION Testicular microlithiasis (TM) represents an uncommon occurrence at paediatrics with a radiological incidence between 0.16 to 0.6% according to reports. The greater use of ultrasound as well as the availability of high-frequency probes has increased the number of incidental TM being diagnosed. MATERIAL AND METHOD From January 1998 to October 2002 seven children, aged 9 to 13 years (average 11 years and 1 months), were diagnosed of MT in our department. Sonographic appearance was hyperechogenic multiple small foci of 1-3 mm without acoustic shadowing of the testicular parenchyma. AIM To evaluate sonographic patterns of TM, their associations, clinical consequences and to determine their management. RESULTS All children were asymptomatic and the reasons for the ultrasound were: cryptorchism (3), short height (1), gynecomastia (1), varicocele (1) and scrotum trauma (1). It should be noted that 3 of the cases showed bilateral TM. Out of 10 testicles with TM, 8 met classic testicular microlithiasis (CTM) criteria (at least one image that showed five or more microliths in either or both testes) and 2 had limited testicular microlithiasis (LTM) (to have at least one microlith). Clinical and radiological follow-up is being performed annually, ranging from 18 months to 6 years, during which there hasn't been progression or regression in the number of TM or in their distribution. In none of these cases there has been shown a related testicular cancer. CONCLUSIONS In other broad reviews it has been shown that there is no evidence to suggest that the TM have to be considered as premalignant lesions by themselves. However, the association among TM and cancer exists. Because of that, and due to the lack of consensus, we recommend annual clinical and radiological (ultrasound) follow-up until puberty, and thereafter the patient should be informed of unknown natural history of this condition. We do not recommend more invasive procedures such as biopsy except: 1) apart form the TM there is a change in the echogenicity or 2) if there is a change in the number or distribution of the TM.
Collapse
|
19
|
García Serrado D, Domínguez Hinarejos C, Martínez Verdú M, Serrano Durbá A, Estornell Moragues F, García Ibarra F. Quistes uretrales parameatales. 3 nuevos casos pediátricos y revisión de la literatura. Actas Urol Esp 2007; 31:61-3. [PMID: 17410990 DOI: 10.1016/s0210-4806(07)73597-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We present 3 new cases of urethral parameatal cysts in paediatric age. Literature is reviewed and histological data and ambulatory management are discussed.
Collapse
Affiliation(s)
- D García Serrado
- Servicio de Urología Pediátrica, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
20
|
García Serrado D, Domínguez Hinarejos C, Martínez Verdú M, Serrano Durbá A, Estornell Moragues F, García Ibarra F. Quistes uretrales parameatales: 3 nuevos casos pediátricos y revisión de la literatura. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
21
|
Domínguez Hinarejos C, Bonillo García M, Sangüesa C, Serrano Durbá A, García Ibarra F. Calcificaciones intratesticulares en la edad pediátrica. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
22
|
Domínguez Hinarejos C, Vivancos Garbayo S, Bonillo García M, Serrano Durbá A, García Ibarra F. Torsión testicular en testes no descendidos. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
23
|
Gimeno Argente V, Domínguez Hinarejos C, Serrano Durbá A, Estornell Moragues F, Martínez Verduch M, García Ibarra F. Quiste de uraco infectado en edad infantil. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006001000011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
24
|
Delgado Oliva F, Domínguez Hinarejos C, Serrano Durbá S, Estornell Moragues F, Martínez Verduch M, García Ibarra F. Megaprepucio congénito: diagnóstico y manejo terapéutico. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006001000012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
25
|
Serrano Durbá A, Gómez Pérez L, Estornell Moragues JF, Domínguez Hinarejos C, Martínez Verduch M, García Ibarra F. [Efficacy in endoscopic treatment of secondary vesicoureteral reflux with polydimethylsiloxane]. Actas Urol Esp 2006; 30:692-7. [PMID: 17058614 DOI: 10.1016/s0210-4806(06)73519-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To value the efficacy in endoscopic treatment of the vesicoureteral reflux (VUR). MATERIAL AND METHOD We have realized a prospective study in patients with RVU treated with endoscopic polydimethylsiloxane, from January 1999 until December 2001, analyzing the results after an average pursuit of 30 months. We included 144 patients, 92 girls and 52 children, with 213 VUR (124 primary ones and 89 of secondary etiology). The initial efficacy of the treatment was defined as the finished absence of RVU in the isotopic cystography, realized three months after the puncture. RESULTS The global efficacy of the endoscopic treatment in secondary etiology reflux was lower than the reached one in the treatment of the primary RVU (77.7% against 86.2%) but the differences did not reach statistical significance (p=0,226). We do not also find significant differences on having compared the injected volume and the valuation of resolution of the ebb between the different causes of secondary RVU (p=0.361). We found recurrence in patients with RVU due to lower urinary tract dysfunction (4.34%). CONCLUSIONS Endoscopic treatment of the secondary VUR is a minimally invasive skill, presents scarce morbidity and it is effective in chosen patients. The risk of a long term recurrence is grater in VUR secondary to functional alterations (neurogenic bladder and functional instability), for what, pursuit has to be established according to the base pathology.
Collapse
Affiliation(s)
- A Serrano Durbá
- Servicio de Urología Infantil, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
26
|
Serrano Durbá A, Gómez Pérez L, Estornell Moragues J, Domínguez Hinarejos C, Martínez Verduch M, García Ibarra F. Eficacia a largo plazo del tratamiento endoscópico en el reflujo vesicoureteral de etiología secundaria con polidimetilsiloxano. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006000700007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
27
|
Serrano Durba A, Bonillo García MA, Domínguez Hinarejos C, Sanguesa C, Muro D, García Ibarra F. [Ultrasound role in assessment of vesicoureteral reflux endoscopic treatment results]. Actas Urol Esp 2006; 30:402-5. [PMID: 16838612 DOI: 10.1016/s0210-4806(06)73464-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Since the beginning of the application of the RVU treatment, the use of the ultrasound was used taking into account two main indications/symptoms: a) identification of the complications; b) assessment of the result (visualization of the implanted material and the presence of the "uretheral jet" by means or through/of ecodoppler-color). OBJECTIVE To determine the value of the ultrasound in the assessment of the result of the endoscopic treatment of the RVU and in the detection of its complications. MATERIAL AND METHOD From 2001-2002 we have carried out the endoscopic treatment to an overall of 261 ureteral units of all degree and etiology. 246 were assessed post-operation with an ultrasound per month and all of them were evaluated with a cistography after 3 months. In a random sample of 92 units, the result of the isotopic cistography has been compared with the visualization of the implanted material in the bladder; and in a random sample of 56 units, the result of the isotopic cistography has been compared with the presence of ureteral jet in the study with ecodoppler-color after moisturizing of the patient. In order to do, we have done two corresponding comparative charts 2 x 2 and we have calculated the Sensibility and Specificity of the tests, as well as their predictive positive and negative values, the degree of similarity of both tests with the Kappa index, and the degree of statistical relevance with Chi squared. RESULTS The ultrasound did not show significant changes if compared to previous studies in 213 units (86,58 %) although in 5 patients an ectasia has been identified as attributed to the treatment. 3 of this patients have developed renoureteral pain, and in 2 pain has spontaneously disappeared as shown in later tests. The S and the E of the presence of implanted material is 94% and 10%respectively and its VPP and VPN of 80% and 10% and estadistical. The S and E of the jet visualization is 82% and 30%, with a VPP of 84% and a VPN of 27%, a level of statistical relevance of 0.836 and a degree of correlation of 0.121. CONCLUSIONS Ultrasound is not a useful technique in the assessment of the result of the endoscopic treatment of the RVU. The role it plays in the assessment of complications is a small one and its use is only indicated to confirm the suspicion of ectasia in those patients that present renoureteral pain.
Collapse
|
28
|
Serrano Durba A, Bonillo García M, Domínguez Hinarejos C, Sanguesa C, Muro D, García Ibarra F. Papel de la ecografía en la valoración del resultado del tratamiento endoscópico del RVU. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006000400008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
29
|
Serrano Durba A, Bonillo García M, Moragues Estornell F, Domínguez Hinarejos C, Sanguesa C, Martínez Verduch M, García Ibarra F. Complicaciones del tratamiento endoscópico del reflujo vesicoureteral en la infancia. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006000200009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
30
|
Serrano Durba A, Bonillo García MA, Moragues Estornell F, Domínguez Hinarejos C, Sanguesa C, Martínez Verduch M, García Ibarra F. Complicaciones del tratamiento endoscópico del reflujo vesicoureteral en la infancia. Actas Urol Esp 2006; 30:170-4. [PMID: 16700207 DOI: 10.1016/s0210-4806(06)73419-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Nowadays, around 1% of children suffer from vesicoureteral reflux (VUR), which represents a risk factor for long-term kidney damage. In the last decade, development in this field has shown that subureteric endoscopic injection of bulking agents for childhood VUR is an acceptable alternative unlike long-term antibiotic prophylaxis and open surgery. OBJECTIVE To establish the complications of childhood VUR endoscopic treatment. MATERIAL AND METHODS A retrospective analysis was carried out for every patient treated endoscopically in our department from January 1999 to September 2003, with a total amount of 516 implants of submucous bulking agents. All patients were assessed with an ultrasound as a first diagnostic technique so as to establish the complications associated with it, especially ureteral obstruction and injected agent migration. RESULTS Out of 516 cases, Macroplastique was used in 455, Deflux in 44 and Polytef in 17. 10 patients (1.9%) (5 girls/ 5 boys), with ages ranging from 15 months to 11,4 years, presented some kind of complications (Macroplastique was used in 8cases and Deflux in 2). Among them, 5 were remarkable due to an ureterohydronefrosis, 2 of which needed a nephrostomy. 3 patients presented an implant migration, 1 epididymitis and 1 bladder edema. CONCLUSIONS Endoscopic bulking agent injection has become a safe alternative to open surgery in childhood VUR management.
Collapse
|
31
|
Gimeno Argente V, Domínguez Hinarejos C, Serrano Durbá A, Estornell Moragues F, Martínez Verduch M, García Ibarra F. Quiste de uraco infectado en edad infantil. Actas Urol Esp 2006; 30:1034-7. [PMID: 17253073 DOI: 10.1016/s0210-4806(06)73581-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Urachal cysts are congenital anomalies detected predominantly during the childhood. They are often diagnosed when an infection occur mimicking a variety of acute intra-abdominal or pelvic processes. We present a case in a 7-year-old female infant, diagnosed of infected urachal cyst. The embryologic origin of this anomaly, clinical features, diagnosis and treatment are discussed.
Collapse
Affiliation(s)
- V Gimeno Argente
- Servicio de Urología Infantil, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
32
|
Coronel Sánchez B, Domínguez Hinarejos C, Serrano Durbá A, Martínez Verduch M, Estornell Moragues F, García Ibarra F. Infarto hemorrágico testicular en neonato: presentación de un caso. Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004000500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
33
|
Beltrán Armada J, Serrano Durbá A, Coronel Sánchez B, Domínguez Hinarejos C, Estornell Moragues F, García Ibarra F. Síndrome de Berdon (megavejiga, microcolon, hipoperistalsis): Presentación de nuestros casos. Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004000500013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
34
|
Beltrán Armada J, Serrano Durbá A, Coronel Sánchez B, Domínguez Hinarejos C, Estornell Moragues F, García Ibarra F. Duplicidad pieloureteral y riñón intratorácico. Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004000300010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
35
|
Beltrán Armada JR, Serrano Durbá A, Coronel Sánchez B, Domínguez Hinarejos C, Estornell Moragues F, García Ibarra F. Duplicidad pieloureteral y riñón intratorácico. Actas Urol Esp 2004; 28:249-51. [PMID: 15141425 DOI: 10.1016/s0210-4806(04)73069-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Intrathoracic ectopia is an unusual ectopia that represents less than 5% of renal ectopia. The association of a duplex system and an intrathoracic renal ectopia is very rare. We report a case of a girl affected from these two anormalities, being the first case published in the literature reviewed. Presentation, diagnosis and therapeutic aspects are discussed.
Collapse
|
36
|
Coronel Sánchez B, Domínguez Hinarejos C, Serrano Durbá A, Martínez Verduch M, Estornell Moragues F, García Ibarra F. Infarto hemorrágico testicular en neonato: presentación de un caso. Actas Urol Esp 2004; 28:393-5. [PMID: 15270003 DOI: 10.1016/s0210-4806(04)73096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hemorrhagic infarction of the testicle is an unusual occurrence in the newborn infant. It usually develops as a consequence of torsion of the spermatic cord. We report a case of global testicular infarction in a newborn associated with a tense hydrocele.
Collapse
|
37
|
Beltrán Armada JR, Serrano Durbá A, Coronel Sánchez B, Domínguez Hinarejos C, Estornell Moragues F, García Ibarra F. Síndrome de berdon (megavejiga, microcolon, hipoperistalsis). presentación de nuestros casos. Actas Urol Esp 2004; 28:405-8. [PMID: 15264686 DOI: 10.1016/s0210-4806(04)73099-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Berdon syndrome is a rare congenital malformation that consists in megacystis and severe intestinal malformations that condition the prognosis in most of the cases. We report the three cases diagnosticated between 1976-2003. Diagnosis, therapeutics aspects and evolution are discussed.
Collapse
|
38
|
Alapont Alacreu J, Domínguez Hinarejos C, Serrano Durbá A, Estornell F, Martínez Verduch M, Vera Sempere F, Moreno F, García Ibarra F. Quiste epidermoide testicular bilateral en un paciente pediátrico con síndrome de Klinefelter. Actas Urol Esp 2003. [DOI: 10.4321/s0210-48062003000900015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
39
|
Queipo Zaragozá J, Domínguez Hinarejos C, Serrano Durbá A, Estornell Moragues F, Martínez Verduch M, García Ibarra F. Vesicostomía en la edad pediátrica: Nuestra experiencia en 43 pacientes. Actas Urol Esp 2003. [DOI: 10.4321/s0210-48062003000100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
40
|
Queipo Zaragozá JA, Domínguez Hinarejos C, Serrano Durbá A, Estornell Moragues F, Martínez Verduch M, García Ibarra F. [Vesicostomy in children. Our experience with 43 patients]. Actas Urol Esp 2003; 27:33-8. [PMID: 12701496 DOI: 10.1016/s0210-4806(03)72873-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Cutaneous vesicostomy (CV) is a choice temporary urinary diversion technique for patients with upper urinary tract (URT) dilation, secondary to vesical o infravesical disease. The objective of this study is to share our experience in children undergoing such diversion, analysing its efficacy to prevent urinary infections, improve or resolve the ureterectasia, and stabilise or improve renal function; in short the functional and morphological recovery of URT. MATERIAL AND METHODS 43 children, mean age 2.5 years (range: 1 month-14 years) with ureterohydronephrosis grade IV-V, persistent urinary infection and/or renal function impairment underwent cutaneous vesicostomy (Blocksom's technique in 36 and Lapides' procedure in the rest). Thirty subjects had neuropathic bladder (26 with secondary vesicoureteral reflux), 7 massive primary vesicoureteral reflux, and 6 posterior urethral valve. RESULTS All children (100%) with neurogenic bladder (30 cases), showed improvement of ureteral-pyelic-calyceal ectasia after the diversion, and 90% improved renal function with disappearance of vesiculoureteral reflux in 65%. Augmentation cystoplasty with gut was performed in 12 patients during vesicostomy closure, using Mitrofanoff's type diversion in 5 of them. The same continent diversion with cecal appendix was used in another 7 children as the only procedure. The remaining 11 children still retain their vesicostomy. In 5 of the 7 children with primary vesicoureteral reflux, the reflux disappeared and so the vesicostomy was closed. Reflux correction during the same surgical procedure was required for the other 2 children. Of the 6 children with posterior urethral valves, 2 received a renal transplant, one is in waiting list and the rest (50%) maintain an acceptable renal function. In the first year of follow-up, 4 patients developed symptomatic urinary infection that later disappeared. The rest had occasional asymptomatic bacteriuria that required no treatment. Complications included vesical prolapse due to ostomy in 4 patients, lithiasis in 3 and stomal stenosis in 2. CONCLUSIONS We consider vesicostomy to be the choice urinary diversion technique in cases of common section obstruction and/or non-obstructive ureterohydronephrosis in new-borns who do not improve with conservative treatment.
Collapse
Affiliation(s)
- J A Queipo Zaragozá
- Servicio de Urología Infantil, Hospital Infantil Universitario La Fe de Valencia, Valencia
| | | | | | | | | | | |
Collapse
|
41
|
Alapont Alacreu JM, Domínguez Hinarejos C, Serrano Durbá A, Estornell F, Martínez Verduch M, Vera Sempere F, Moreno F, García Ibarra F. Quiste epidermoide testicular bilateral en un paciente pediátrico con síndrome de klinefelter. Actas Urol Esp 2003; 27:742-4. [PMID: 14626688 DOI: 10.1016/s0210-4806(03)73008-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Epidermoid cysts of the testis are rare in children (3% of all the testicular tumors). Bilateral appearance has only been described in the pediatric age in 2 cases and none associated to Klinefelter's syndrome. We present, for our knowledge, the first case of bilateral epidermoid testicular cyst associated to klinefelter's syndrome in a boy, highlighting its management and therapeutic approach. We analyze the different kinds of treatment.
Collapse
|
42
|
Abstract
Testicular dislocation after blunt scrotal trauma is a rare event. This injure must be recognized and treated promptly to maximize the likelihood of testicular salvage. We describe a new case of unnoticed traumatic testicular dislocation with secondary testicular lost. We discuss the chain of events leading toward the correct diagnosis and treatment based on a review of published reports.
Collapse
|
43
|
Ibáñez Pradas V, Serrano Durbá A, Domínguez Hinarejos C, Estornell Moragues F, Reig Ruiz C, Martínez Verdú M, García Ibarra F. [Diagnostic attitude in a patient with kidney trauma]. An Esp Pediatr 1999; 51:136-8. [PMID: 10495498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE Our aim was to assess our results in the management of renal trauma patients. PATIENTS AND METHODS A retrospective review of medical charts from 1989 to 1997 was carried out. RESULTS Twenty-seven cases involving 27 kidneys were treated during the study period, with 16 grade II injuries, 8 grade II and 3 grade III. Ultrasound was the most used diagnostic tool, followed by computerized tomography (CT) and intravenous pyelography (IVP). Falls and traffic accidents were the main etiologic agents (48 and 41%, respectively). Eight out of 11 patients with grade II/III injuries received surgical treatment. Three cases required early surgery immediately after arrival and 5 cases had planned surgery. After a mean follow-up period of 16 months, renal function has remained above 40% in all patients, excluding 3 cases treated with partial nephrectomy. CONCLUSIONS A conservative attitude is of choice in children with renal trauma. CT is the main diagnostic tool except in patients suspected of isolated grade I injury. Ultrasound followed by IVP is a valid choice for these cases and especially helpful for preschool patients which require general anesthesia for CT exploration.
Collapse
Affiliation(s)
- V Ibáñez Pradas
- Departamento de Cirugía Pediátrica, Hospital Infantil La Fe, Valencia
| | | | | | | | | | | | | |
Collapse
|
44
|
Estornell Moragues F, Reig Ruiz C, Domínguez Hinarejos C, Martínez Verduch M, García Ibarra F. [Primary vesicoureteral reflux in childhood. The current aspects and future outlook]. ARCH ESP UROL 1998; 51:616-24. [PMID: 9773592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To discuss the current aspects and the impact of innovations on the clinical, diagnostic and therapeutic aspects of vesicoureteral reflux (VUR). METHODS The literature on Medline over the last five years are reviewed and the urodynamic findings in our series of children with VUR are analyzed. RESULTS Fetal VUR and those diagnosed in children with a family history are currently considered to be the most interesting study groups from the clinical perspective. Renal scintiscanning, isotope-labelled cystography and urodynamic evaluation are well-established diagnostic methods that permit selecting the most appropriate treatment for patients with this anomaly. In our experience, 50.8% of the 128 patients in whom a urodynamic study was performed, showed changes in lower urinary tract function. Innovations in open surgery have been scanty and endoscopic treatment is increasingly utilized, although the search continues for the ideal biological material. CONCLUSIONS The new diagnostic methods utilized in the evaluation of children with VUR will permit a better understanding of the natural history of this anomaly lead to changes in the protocols that are currently used.
Collapse
|
45
|
Serrano Durbá A, Domínguez Hinarejos C, Reiz Ruíz C, Estornell Moragues F, Martínez Verduch M, García Ibarra F. [Renal adenocarcinoma in children]. Actas Urol Esp 1998; 22:508-11. [PMID: 9734128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Contribution of two cases of renal adenocarcinoma in pediatric patients. Comments on the most updated and relevant aspects of epidemiology, clinical manifestations, diagnosis, treatment, prognosis and follow-up. Comparison to nephroblastoma and renal adenocarcinoma of the adult.
Collapse
Affiliation(s)
- A Serrano Durbá
- Unidad de Urología Infantil, Hospital Universitario La Fe, Valencia
| | | | | | | | | | | |
Collapse
|
46
|
Pérez Aytés A, Bernáldez Torralva C, Ortolá Feliu C, Domínguez Hinarejos C, Muro Velilla MD. [Abdominal palpation in the screening of urinary tract anomalies: still helpful?]. An Esp Pediatr 1997; 47:319-21. [PMID: 9499288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- A Pérez Aytés
- Servicio de Neonatología, Hospital Infantil La Fe, Valencia
| | | | | | | | | |
Collapse
|
47
|
Estornell Moragues F, Nieto García A, Mazón Ramos A, Reig Ruiz C, Martínez Verduch M, Domínguez Hinarejos C, García-Ibarra F. [Latex allergy in children with myelomeningocele. Incidence and associated factors]. Actas Urol Esp 1997; 21:227-35. [PMID: 9324888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
RATIONALE The purpose of our work is to know the prevalence of allergies to latex in patients with myelomeningocele (MMC) and to evaluate any potential factors influencing its development. METHODS The study included 100 children with mean age 7.5 +/- 4.8 years, diagnosed with MMC by skin tests and total and latex-specific IgE determination. The results were compared to those obtained in three "control" groups: atopic patients, patients undergoing their first operation and multi-operated patients. The relationship between the different variables analyzed was assessed using univariant and multivariant statistical studies. RESULTS 29 were sensitized (15 symptomatic and 14 asymptomatic) and 8 doubtful. Results showed statistically significant (p < 0.05) differences for atopic and first operation groups and non significant differences for the multi-operation group. The multivariant study selected the followed as the most relevant variables: number of surgical interventions, total IgE levels in z units, ventricle-peritoneal by-pass carriers and atopy background. Also in the multivariant study, the following showed statistically significant results: age, Cums' number, inclusion in intermittent catheterism program and total IgE levels. Neither sex or familial background of atopy showed statistical significance. CONCLUSIONS Allergy to latex in MMC patients is related to multiple antigen contacts, the numerous manipulations and operations undertaken throughout the patient's life plus a personal propensity to allergies. It is essential that this group should adopt certain standards to minimize contact with the antigen and undergo an allergological study so as to detect those who are sensitized, which in nearly half our series has not yet exhibited symptomatology in contact with latex utensils. All diagnostic and therapeutical procedures should be conducted in latex-free environments.
Collapse
|
48
|
Lluna González J, Domínguez Hinarejos C, Estornell Moragues F, Martínez Verduch M, García Ibarra F. [Vesicostomy in children]. ARCH ESP UROL 1995; 48:1023-6. [PMID: 8588719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To evaluate the upper urinary tract morphology and function in children undergoing vesicostomy for different causes. METHODS We report on 27 children aged 1 month to 12 years who had undergone a Blocksom vesicostomy procedure. Twenty had a neuropathic bladder and 3 had posterior urethral valves. RESULTS In the 20 children with neuropathic bladder, renal function improved in 95% and the associated vesicoureteral reflux improved in 56%. The morphology of the upper urinary tract returned to normal prior to the definitive operation in all cases. Only one of the patients with posterior urethral valves has preserved satisfactory renal function two years following vesicostomy. The most common complication was prolapse (14.8%). CONCLUSIONS In our view, vesicostomy is the best urinary diversion procedure in the cases described herein. Vesicostomy closure must be performed following definitive treatment of the underlying condition, except in those cases with neuropathic bladder who require augmentation cystoplasty to keep upper urinary tract pressures low.
Collapse
Affiliation(s)
- J Lluna González
- Unidad de Urología Pediátrica, Hospital Infantil La Fe, Valencia, España
| | | | | | | | | |
Collapse
|
49
|
Reig Ruiz C, García Ibarra F, Domínguez Hinarejos C, Estornell Moragues F, Martínez Verduch M, Castell Sánchez V. [Tumor of the testicular vitelline sac in children: clinical course and treatment]. Actas Urol Esp 1995; 19:59-63. [PMID: 7717160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Presentation of a review of 10 paediatric patients with tumour of the testis vitelline sack, to report our experience in the management of this pathology. Mean age was 20 months (14-32), and the interval of the study was from 1970 to 1994. After orchiectomy, 7 children were included in stage I, 1 in stage II, and 2 in stage III. Four underwent Retroperitoneal Lymphadenectomy. All patients in stage I are currently free of disease, with a mean follow-up of 132 months, regardless the type of treatment employed (vigilance in 2 cases, chemotherapy in 2, and chemotherapy plus Retroperitoneal Lymphadenectomy in 3). On the contrary, the 3 children with extratesticular disease died 15, 18 and 15 months after orchiectomy. In conclusion, we believe that patients included in stage I should undergo only a strict vigilance, based on the excellent prognosis of this group and the lack of differences between the survival time obtained with the various therapeutical approaches followed. On the other hand, patients with stage II or stage III disease should receive from the beginning chemotherapy, thus saving the Retroperitoneal Lymphadenectomy for the residual disease.
Collapse
Affiliation(s)
- C Reig Ruiz
- Servicio de Urología Pediátrica, Hospital Infantil, Hospital Universitario La Fe, Valencia
| | | | | | | | | | | |
Collapse
|
50
|
Merenciano Cortina FJ, Martínez Verdúch M, Domínguez Hinarejos C, Estornell Moragues F, Reig Ruiz C, Barrios Fontoba JE, García Ibarra F. [Conservative approach in total multicystic renal dysplasia. Our experience]. Actas Urol Esp 1994; 18:945-8. [PMID: 7856482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Contribution of 14 patients with Unilateral Total Multicystic Renal Dysplasia treated with conservative criteria, with particular emphasis in the absence of clinical complications, as well as the natural tendency to involution of the affected organs. Five dysplastic kidneys disappeared in the ultrasound, 4 decreased in size, 3 remained the same and 2 have been removed. Review of the literature and discussion of all the reasons why nephrectomy was traditionally indicated, explaining the reasons why we support an expecting attitude.
Collapse
|