1
|
The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure. ESC Heart Fail 2022. [PMCID: PMC9288794 DOI: 10.1002/ehf2.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aims Estimating the prognosis in heart failure (HF) is important to decide when to refer to palliative care (PC). Our objective was to develop a tool to identify the probability of death within 6 months in patients admitted with acute HF. Methods and results A total of 2848 patients admitted with HF in 74 Spanish hospitals were prospectively included and followed for 6 months. Each factor independently associated with death in the derivation cohort (60% of the sample) was assigned a prognostic weight, and a risk score was calculated. The accuracy of the score was verified in the validation cohort. The characteristics of the population were as follows: advanced age (mean 78 years), equal representation of men and women, significant comorbidity, and predominance of HF with preserved ejection fraction. During follow‐up, 753 patients (26%) died. Seven independent predictors of mortality were identified: age, chronic obstructive pulmonary disease, cognitive impairment, New York Heart Association class III–IV, chronic kidney disease, estimated survival of the patient less than 6 months, and acceptance of a palliative approach by the family or the patient. The area under the ROC curve for 6 month death was 0.74 for the derivation and 0.68 for the validation cohort. The model showed good calibration (Hosmer and Lemeshow test, P value 0.11). The 6 month death rates in the score groups ranged from 6% (low risk) to 54% (very high risk). Conclusions The EPICTER score, developed from a prospective and unselected cohort, is a bedside and easy‐to‐use tool that could help to identify high‐risk patients requiring PC.
Collapse
|
2
|
3D printing utility for surgical treatment of acetabular fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2018; 62:231-239. [PMID: 29807784 DOI: 10.1016/j.recot.2018.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/11/2018] [Accepted: 02/16/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure. MATERIAL AND METHODS We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computarized tomography (CT) scan. The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker®) that matched the characteristics of the fracture and the approach to be used. RESULTS Printing the moulds took a mean of 385minutes (322-539), and 238grams of plastic were used to print the model (180-410). In all cases, anatomic reduction was obtained and intra-operative changes were not required in the initial contouring of the plates. The time needed to perform the full osteosynthesis, once the fracture had been reduced was 16.9minutes (10-24). In one case fixed with two plates, a postoperative CT scan showed partial contact of the implant with the surface of the quadrilateral plate. In the remaining cases, the contact was complete. CONCLUSIONS In conclusion, our results suggest that the use of preoperative planning, by printing 3D mirror imaging models of the opposite hemipelvis and pre-contouring plates over the mould, might effectively achieve a predefined surgical objective and reduce the inherent risks in these difficult procedures.
Collapse
|
3
|
[Are there any differences between the characteristics and the behavior of bladder cancer according to the age of presentation? Our experience]. Actas Urol Esp 2007; 31:825-30. [PMID: 18020206 DOI: 10.1016/s0210-4806(07)73736-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Owing to the different results from the series that evaluate the behavior of the bladder cancer according to the age at the moment of the diagnosis, our objective is based on valuing the characteristics and behaviour according to age of appearance. METHODS A retrospective study of bladder cancer diagnosed in our area during decade 1993-2003, distributed in 3 intervals of age and some characteristics and behaviour are valued. RESULTS Elderly patients present greater tumors, non differentiated and with greater rate of progression to infiltrated. Moreover the age, the pathological stage and the tumorlike degree appear as independent significant factors in the multivariant study. CONCLUSIONS In our experience, the patients greater than 70 years present neoplasms of similar clinical characteristics, although pathologically more aggressive, with greater percentage of progression and worse survival.
Collapse
|
4
|
¿Existen diferencias en las características y en el comportamiento del tumor vesical según edad de presentación?: Nuestra experiencia. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000800005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
5
|
|
6
|
Cáncer de próstata incidental: T1a-T1b. Nuestra experiencia tras observación/intervención radical y revisión de la literatura. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006000800002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
7
|
Tumores de vejiga pT0 tras cistectomía radical: análisis de nuestra serie. Actas Urol Esp 2006. [DOI: 10.4321/s0210-48062006000800004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
8
|
Abstract
It is known the greater probability appearance of malignancy injuries in patients with renal graft due to its inmunosupresión. We expose a case in which after thirteen years of correct operation of the renal transplant a tumor is diagnosed of accidental form by means of ultrasonography of graft's control. It was demonstrated by percutaneous biopsy that it was a carcinoma to papilar and later transplanctectomy was made. We raised a reflection about the novo tumors on renal graft given to the high number of patients with funcionante transplant during long years and the little evidence in Literature, proposing a possible registry of such valuing its behavior and comparing it with the well-known ones on native kidneys without inmunosupresión situation.
Collapse
|
9
|
Cáncer de próstata incidental: T1a-T1b. Nuestra experiencia tras observación/intervención radical y revisión de la literatura. Actas Urol Esp 2006; 30:749-53; discussion 753. [PMID: 17078571 DOI: 10.1016/s0210-4806(06)73531-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To analyse the progress of T1a and T1b prostate cancer diagnosed in our hospital. MATERIAL AND METHODS Retrospective study of 40 patients in T1a-T1b clinical stage diagnosed with prostate adenocarcinoma in our hospital, from 1986 to 1999. A restaging biopsy was performed on the 16 T1a patients after initial diagnosis and control. A radical prostatectomy was performed on the 24 T1b patients. They were all monitored every six months with rectal exam and PSA. We analysed biological and/or clinical progression, time to progression, mortality caused by the tumour and survival. RESULTS None of the 16 patients with T1a clinical stage presented tumour progression, with a median follow-up of 90 months. 12,5% of the 24 T1b cases presented tumour progression, with a median follow-up of 70 months. Cancer-specific mortality was one patient (4,16 %) in the T1b group. CONCLUSIONS Observation and follow-up with PSA and rectal exam appears to be a good option for T1a clinical stage, given the good prognosis. Our results show that patients with T1a clinical stage and good prognostic factors could be at a similar risk of suffering from a new prostate cancer as the normal population, although prospective studies are required to validate these results. T1b cases require active treatment and closer monitoring.
Collapse
|
10
|
Abstract
OBJECTIVES To evaluate the data of progression and survival in 43 patients who underwent cystectomy with stage pT0 according to classification TNM-2002. MATERIALS AND METHODS between 1988 and 2003 in our center had realized 420 cystectomies, 43 patients (10.2%) had not tumor in the cystectomy specimen. RESULTS In these 43 cases the initial clinical stage (in the transuretral resection of bladder) was T1 in 10 cases (23,3 %), T2 in 31 cases (72%) and T3 in 2 cases. As far as the degree 24 patients presented G2 (55.8%) and 19 (44.2%) were G3. Median time from the transuretral resection to the cistectomy was of 44 days at a median follow-up of 89.3 months. Progression-free survival in the 43 patients was of 180,6 months, but during the follow-up it appeared progression in 7 patients, with disease free survival at 36 months (3-126), since the date of the cistectomia. During the follow up, 5 patients died. When we analyzed the cancer-specific survival according to tumor stage, for the T2 with an average cancer-specific survival is of 180 months, decreasing to 35 months considerably for T3. Similar it happens with the degree of differentiation, significantly diminishing as it advances the degree, with an average of cancer-specific survival for the G3 at 122.6 months. In the same way it happens with pathological positive lymph nodes in the radical cistectomy, with a cancer-specific survival of 188 months when it is N0 and of 54 months if the adenopathy was positive (N+). CONCLUSION In our experiencie urothelial carcinoma pT0 present a prolonged free period of disease (medium of 180 months). The associated factors of risk to a smaller free period of disease are high degree of differentiation (G3, 116 months), the infiltration of deep layers in the transuretral resection (T3, 32 months) and the ganglionary affectation (pN+ 45 months).
Collapse
|
11
|
[Differential diagnosis in ureteral repletion defect]. Actas Urol Esp 2005; 29:240. [PMID: 15881928 DOI: 10.1016/s0210-4806(05)73232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
12
|
Diagnóstico diferencial en defecto de repleción ureteral. Actas Urol Esp 2005. [DOI: 10.4321/s0210-48062005000200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
13
|
Tratamiento de la cistitis hemorrágica por ciclofosfamida: Revisión de la literatura a propósito de un caso. Actas Urol Esp 2005. [DOI: 10.4321/s0210-48062005000200015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
[Epidermoid carcinoma of the urethra and glans penis: two independent tumors?]. Actas Urol Esp 2005; 28:781-4. [PMID: 15666524 DOI: 10.1016/s0210-4806(04)73183-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A 64 years-old man is treated in our hospital presenting a big tumor in glans penis. During the surgical act, another neoplasm is detected in the urethra. The microscopic study showed a concomintant epidermoid carcinoma of glans penis and urethra with non-affected tissue between both tumors.
Collapse
|
15
|
Tratamiento de la cistitis hemorrágica por ciclofosfamida. Revisión de la literatura a propósito de un caso. Actas Urol Esp 2005; 29:230-3. [PMID: 15881925 DOI: 10.1016/s0210-4806(05)73229-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are extreme situations in the clinical treatment of intractable hematuria (fortunately not a common disease nowadays), in which even benign process may represent a serious risk to the life of the patient and where certain aggressive procedures like cystectomy have to be considered. Our objective in this paper is to review the different existing therapeutic alternatives for the treatment of an intense type of hematuria which does not yield to continuous saline serum irrigation. This study is partly based on a recent real clinical case in which, after the administration of cyclophosphamide to a young patient with recurrent and intense hematuria, the excretion was controlled through intravesical alum irrigation of thus avoiding cystectomy, a very aggressive surgical procedure with many after-effects.
Collapse
|
16
|
Vena renal retroaórtica. Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004001000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
17
|
Carcinoma epidermoide de uretra y glande ¿dos tumores independientes? Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004001000013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
18
|
Carcinoma transicional primario puro de próstata. Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004000500006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Vena renal retroaórtica. Actas Urol Esp 2004. [DOI: 10.1016/s0210-4806(04)73187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
20
|
Abstract
Primary prostate transitional cell carcinoma is a very uncommon tumor, that represents about 1% of all prostate tumours. In our institution, only six patients have been diagnosed with pure transitional cell prostate carcinoma until 2002. Bladder origin of the neplasic was ruled out in all cases. We report a study about the progression and survival of prostate transitional cell carcinoma. These prostatic tumours carry a poor prognostic (median survival is 4.6 months) with a strong tendency to metastatic spread. Therefore, we suggest a radical prostatectomy (without cystectomy) when it rules out bladder origin tumour.
Collapse
|
21
|
Imágenes de RNM en el Síndrome de Ormond. Actas Urol Esp 2003. [DOI: 10.4321/s0210-48062003001000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
22
|
Trasplante renal: Técnica y complicaciones. Actas Urol Esp 2003. [DOI: 10.4321/s0210-48062003000900002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
23
|
Imágenes de rnm en el síndrome de ormond. Actas Urol Esp 2003. [DOI: 10.1016/s0210-4806(03)73026-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
24
|
[Post-traumatic hematoma in pathologic kidney]. Actas Urol Esp 2003; 27:65-7. [PMID: 12701502 DOI: 10.1016/s0210-4806(03)72879-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We want to present a case of postraumatic hematoma in a tumoral kidney. The diagnosis of the hematoma was made by abdominal scanner but not the tumor type. It was necessary the chirurgycal review and pathological study to demonstrate an angiomyolipoma as the cause of the kidney hematoma.
Collapse
|
25
|
Hematoma postraumático en riñón patológico. Actas Urol Esp 2003. [DOI: 10.4321/s0210-48062003000100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
26
|
Abstract
We want to make in this article, a deep review of our experience in kidney transplantation since the moment we started the technique in 1986 to the end of the year 2000. We also want to make a compilation of the most important points of the surgical technique, patients selection criteria, and the most common and uncommon complications that can appear in kidney transplantation, analizing our results all along this time.
Collapse
|
27
|
Abstract
Mucous cystadenomas are benign epithelial tumours with great mucous content inside. Despite being non-malignant, they acquired great size, compressing and displacing important structures and organs of the zone, with theirs unlucky outcomes. Surgical exeresis is very difficult, being almost impossible its total exeresis, showing great frequency of relapse. We present an appendix mucous cystadenoma case in a 54 years old patient.
Collapse
|
28
|
Poliquistosis renal autosómica dominante con gran afectación reno-hepática en paciente con trasplante renal iterativo. Actas Urol Esp 2002. [DOI: 10.1016/s0210-4806(02)72766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
29
|
Abstract
Localized amyloidosis of the urethra is a rare pathological entity. Biopsy is required to make the appropriate diagnosis. Although localized therapy is available for obstructing, symptomatic lesions, asymptomatic lesions may be followed with conservative management and spontaneous regression has been reported. An appropriate medical evaluation should be performed to determine the presence of systemic amyloidosis.
Collapse
|
30
|
[Urethral nephrogenic adenoma in a young male. Report of a case]. Actas Urol Esp 2001; 25:452-4. [PMID: 11512515 DOI: 10.1016/s0210-4806(01)72651-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Nephrogenic adenoma is a rare urothelial neoformation. It is well known the association to infective diseases and stones; the most common localization is in the bladder. We report the case of a young male without previous disease who showed a nephrogenic adenoma in the urethra, it was managed with transurethral resection and surveillance.
Collapse
|
31
|
Abstract
We report a case of female 24 years old who had a blunt abdominal trauma. The immediate consequence was the radiological evidence of a left kidney abolition, secondary to a renal artery thrombosis. The treatment was conservative, and there was not a surgical procedure.
Collapse
|
32
|
Abstract
We report the case of a 31 year old male, with lower urinary tract symptoms. We achieved the diagnosis of an prostate angiosarcoma. The treatment was a retropubic radical prostatectomy and partially resection of bladder neck, followed by chemotherapy with Ifosfamide and Adriamycin. At least 36 months up to surgery the patient is alive and free of symptoms and radiological signs of recurrence.
Collapse
|
33
|
Abstract
The indications for repeat prostate needle biopsy after a previous biopsy are not defined. We examined 107 prostate biopsies (in 98 patients) without a diagnosis of malignancy, which we repeat. Carcinoma was detected in 31 patients (31.6%). We didn't find statistic relationship between the repeat biopsy's outcome and: interval between biopsy and repeat biopsy, PSA value, PSA density (biopsy), PSAD of the transitional area (PSAD ad., on repeat biopsy). We found relationship with: prostatic weight (p = 0.002 on the biopsy, p = 0.0002 on the repeat biopsy), volume of the transitional area (p = 0.02 on the biopsy, p = 0.0001 on the repeat biopsy), PSA value (p = 0.02, on the repeat biopsy), PSAD ad. (p = 0.002, on the repeat biopsy), and with PSA velocity (p = 0.008). We only found clinic usefulness for the PSA velocity: patients with PSA velocity greater than 1 ng/ml/year are at high risk for prostate carcinoma on the repeat biopsy, specially in small prostates.
Collapse
|
34
|
Abstract
PURPOSE To analyse progression and survival after radical prostatectomy in patients with stage pT3 carcinoma of the prostate. MATERIAL AND METHODS Between 1986 and November 1998, we performed 372 radical prostatectomies, 74 of which were pT3N0 (19.8%), 43 pT3a and 31 pT3b (TNM 97). RESULTS In patients with pathological stage pT3, we found any progression in 24 patients (32%), 8 in pT3a, and 16 in pT3b. In 10 of 24 pT3, there was local relapse or distant metastases. About the freedom from biochemical relapse survival rate, we found statistically differences between pT3a and pT3b (p < 0.0001). In pT3a patients, we found no differences between PSA levels > 20 ng/ml, versus < 20 (p = 0.415), and statistically differences between pathological Gleason 6 or greater, versus < 6 (p = 0.048). However, we found no differences when we used both criteria (PSA and Gleason) (p = 0.195). CONCLUSIONS We support for early adjuvant hormonal therapy in pT3b patients. In pT3a, the hormonotherapy may be used if appears biochemical failure, specially with adverse prognostic factors (PSA and Gleason).
Collapse
|
35
|
[Penile fracture: report of a case]. Actas Urol Esp 2000; 24:272-4. [PMID: 10870239 DOI: 10.1016/s0210-4806(00)72446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Traumatic rupture of the corpus cavernosum of the penis is rare, and has been reported infrequently. We present a case with this type of trauma, with immediate surgical management, with good morphologic and functional results.
Collapse
|
36
|
[Early versus late hormonal treatment in advanced prostate cancer]. Actas Urol Esp 1999; 23:557-64. [PMID: 10488608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
37
|
[Chromophobe renal carcinoma. Case report]. Actas Urol Esp 1998; 22:602-6. [PMID: 9807873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Human chromophobe renal cell carcinoma is an infrequent neoplasm, recently descripted (1985). It is very important to separate it from the renal cell carcinoma due to its better prognosis. Presentation of the clinical, radiographic and histological features of two cases of chromophobe renal cell carcinoma, diagnosed and treated in our Centre.
Collapse
|
38
|
[Analysis of our series of kidney transplants: urologic complications and survival]. Actas Urol Esp 1998; 22:326-35. [PMID: 9658644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To review our series of 416 renal transplants, with special reference to the surgical complications and their management. METHODS From June, 1986 to October 1997, we are performed 416 heterotopic renal transplants, harvested from cadavers. Reconstruction of the urinary tract reconstruction was by ureteroneocystostomy in practically all the cases. RESULTS There were some urological complications in 80 patients (19.2%). The most common urological complication was obstruction of the urinary tract arising from stenosis (3.3%), lymphocele (4.3%) and clotting (1.2%). 78.1% of these urological complications were resolved by endourological techniques. Urinary fistula was observed in 12 cases (2.8%). Vascular complications in 22 (6.9%), lithiasis in 5 (1.2%), and eventrations in 11 (2.6%). The treatment of these complications is described. The actuarial survival rates were 87.8% and 77.3% at one and five years respectively for the graft, and 92.4% and 83.5% for the patients. CONCLUSIONS Our surgical complication rate in patients undergoing renal transplantation was 19.2%. The most common complication was urinary tract obstruction from stenosis (3.3%), lymphocele (4.3%) and clotting (1.6%); 78.1% of these obstructive complications were resolved by endourologic techniques. Percutaneous drainage and esclerotherapy of the lymphoceles resolved 66.6% of them. Renal biopsy performed with a 14G needle caused 5 severe hemorrhagic complications. There were no complications when an 18G needle was utilized.
Collapse
|
39
|
[Urethral catheters]. REVISTA DE ENFERMERIA (BARCELONA, SPAIN) 1998; 21:71-8. [PMID: 9582852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
After a historical summary on the development of urethral catheters, this article analyzes various aspects about catheters. These aspects include: types of catheters and their recommended use, their counterindications, their classification, how to select the appropriate catheter, the information which a patient should be provided regarding the use of a catheter, the techniques and equipment necessary for their use, the most common problems encountered and how to solve them,...
Collapse
|
40
|
[Analysis of a series of radical prostatectomies]. Actas Urol Esp 1997; 21:809-16. [PMID: 9471862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023]
Abstract
OBJECTIVE Radical prostatectomy (RP) is an elective therapeutical procedure for localized prostate cancer. The paper describes the critical analysis of our 10-year series. MATERIAL AND METHODS A total of 216 RP have been performed between June 1986 and December 1996 (60 of them in the last year); with the purpose of securing a minimum follow-up of 4 months, the 204 procedures performed up to October 1996 were studied. Mean age was 64.9 years and PSA median 10.8 ng/ml. Intraglandular clinical stage was found in 192 cases versus 12 cases extraglandular. Up to the end of 1993 Walsh's technique with erectors' preservation was being used although the poor results obtained with regard to potency as well as the existence of positive borders have compelled us to perform the standard extracapsular technique since beginning of 1994. RESULTS Mean follow-up in our series has been 29.62 months. Post-operative complications reached 29.9%, anastomosis fistula (21 cases) among the early ones and anastomosis stenosis (16 cases) among the late ones. 82.04% patients have total continence or minimal incontinence, the percentage of obstruction being 3.58%. Total impotence is estimated at 92.77%. One patient (0.49%) died in the immediate post-operative. Understaging was observed in 36.7%. 84 patients had extracapsular disease. Our percentage of positive surgical borders is of around 43.13%. Progression has been seen in 47 of 204 patients (23.03%): 8 local relapses, 12 metastasis, 3 with both conditions and 24 biological progression. Progression has been related to pathological stage, pre-operative PSA and Gleason's sum of the specimen. Difference was statistically significant. Overall survival at 1 and 5 years is 99.2% and 95.5% respectively while tumour specific survival is 97.8% and 75.8% at 1 and 5 years. CONCLUSIONS RP is a surgery with minimal mortality but noticeable morbidity (incontinence 14.35%; impotence 92.77%; other complications from surgical technique 29.9%). Our clinical understaging is of around 36.7%. Progression is related to the specimen's pathological stage, and pre-operative PSA and Gleason. Our overall survival at 1 and 5 years is 99.2% and 95.5% respectively while tumour specific survival is 97.8% and 75.8%.
Collapse
|
41
|
[Retroperitoneal cystic mass. Giant exophytic gastric leiomyosarcoma]. Actas Urol Esp 1997; 21:624-7. [PMID: 9412199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Presentation of an unusual case of pre-operatively non-striated retroperitoneal cystic mass confirmed to be a gastric leiomyosarcoma after pathoanatomical study. Considering the rarity of the case, we reviewed the literature as well as the epidemiological, clinical, pathoanatomical and surgical characteristics of gastric leiomyosarcomas which, as in the present case, can appear as retroperitoneal mass.
Collapse
|
42
|
[Primary retroperitoneal hydatidosis]. Actas Urol Esp 1997; 21:524-7. [PMID: 9412184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Genitourinary involvement by the Echinococcus granulosus larvae (urinary hydatidosis) ranks third in order of frequency after liver and lung involvement. The finding of a primary hydatidic cyst with retroperitoneal location is an uncommon fact. This paper presents once case of this infrequent disease. A revision of the different etiopathogenic mechanisms, as well as diagnostic and therapeutic approaches is made.
Collapse
|
43
|
[LXI Santander National Urology Congress 1996. Clinical decision in urology. Is it measurable?]. Actas Urol Esp 1997; 21:301-13. [PMID: 9324902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
44
|
[Long-term results of the treatment with intracavernous injection of vasoactive drugs]. ARCH ESP UROL 1996; 49:257-69. [PMID: 8702347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate the long-term results of treatment of erectile dysfunction with intracavernous self-injection of vasoactive drugs. METHODS The study comprised 144 patients treated with intracavernous self-injection. The most common etiologies were arterial (27%), corporal-veno-occlusive (22.2%) and diabetic (17.5%). The mean follow up was 15.6 months (range 12-44) and the total number of injections was 7,190. PGE1 was utilized in 135 patients and papaverine + PGE1 in 9 patients. RESULTS Patients with psychogenic or neurogenic impotence responded to low doses of PGE1 (9.6 microgram and 8.4 microgram, respectively). Adequate rigidity was achieved in 96% for over 30 min in 90%, and coitus was satisfactory in 92%. There were 20 (13.9%) dropouts and 5 (3.5%) recovered erection. The most important local complications were intense pain (4 pts, 0.05%), prolonged erection (3 pts, 0.04%) and secondary fibrosis without penile curvature (3 pts, 2.1%). Systemic complications were observed in only 4 cases: palpitation (1 pt), headache (1 pt) and dizziness (2 pts). CONCLUSIONS Patients with psychogenic and neurogenic impotence responded to low dose therapy, whereas those with veno-occlusive impotence required the highest doses of PGE1 or papaverine + PGE1. This pharmacological erection program achieved adequate rigidity in 96% and satisfactory coitus in 92%. There were minimal complications: prolonged erection (0.04%), intense pain (0.05%) and fibrosis (2.1%).
Collapse
|
45
|
[Edema of the left lower limb]. Rev Clin Esp 1996; 196:125-6. [PMID: 8685485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|