Subject(s)
Bacteremia , Lactobacillus delbrueckii , Urinary Tract , Bacteremia/drug therapy , HumansABSTRACT
Objetivo: La cistectomía radical con derivación urinaria es un procedimiento en el cual la reducción de la morbilidad, una rehabilitación postoperatoria rápida, una estancia hospitalaria reducida y una reducción de costes son difíciles de conseguir. El íleo postoperatorio ha sido identificado como la causa más frecuente de retraso en la recuperación y de una mayor estancia hospitalaria. Con nuestro trabajo, intentamos establecer cuáles podrían ser sus principales causas. Material y métodos: Realizamos 154 cistectomías entre 19902008. Examinamos diferentes variables demográficas y perioperatorias de los pacientes con y sin íleo. Resultados: No se encontró significación estadística al relacionar el íleo con ninguno de los factores estudiados. Conclusiones: El íleo postoperatorio se presenta como una de las complicaciones más frecuentes que ocasionan una estancia hospitalaria prolongada. Se requieren otros estudios detallados que determinen regímenes perioperatorios destinados a reducir esta complicación (AU)
Objective: Radical cystectomy with urinary diversion is a procedure in which a reduction of morbidity, quick postoperative rehabilitation, limited length of stay and cost containment are difficult to achieve. Postoperative ileus has been identified as the most common cause of delayed recovery and prolonged length of stay. With our review, we try to establish the main causes. Material and methods: A total of 154 patients underwent radical cystectomy from 1990 to 2008. We examined demographic and perioperative variables of the patients who did and did not develop ileus. Results: No significant association was found between ileus and all the factors we studied. Conclusions: Postoperative ileus stands out as one of the most frecuent complications that causes increased length of stay. More detailed studies are required to determine perioperative regimens to reduce this complication (AU)
Subject(s)
Humans , Ileus/epidemiology , Cystectomy/adverse effects , Prospective Studies , Postoperative Complications/epidemiology , Intraoperative Care/methodsABSTRACT
OBJECTIVE: Radical cystectomy with urinary diversion is a procedure in which a reduction of morbidity, quick postoperative rehabilitation, limited length of stay and cost containment are difficult to achieve. Postoperative ileus has been identified as the most common cause of delayed recovery and prolonged length of stay. With our review, we try to establish the main causes. MATERIAL AND METHODS: A total of 154 patients underwent radical cystectomy from 1990 to 2008. We examined demographic and perioperative variables of the patients who did and did not develop ileus. RESULTS: No significant association was found between ileus and all the factors we studied. CONCLUSIONS: Postoperative ileus stands out as one of the most frequent complications that causes increased length of stay. More detailed studies are required to determine perioperative regimens to reduce this complication.
Subject(s)
Cystectomy/adverse effects , Ileus/etiology , Female , Forecasting , Humans , Ileus/epidemiology , Male , Middle Aged , Retrospective StudiesABSTRACT
INTRODUCTION AND OBJECTIVES: Patients after radical prostatectomy describe sexual dysfunctions such as orgasm-associated incontinence also termed climacturia. Our aim is to analyse incidence and data in relation with this symptom. METHODS: 119 phone surveys carried out to patients after radical prostatectomy to Know about climacturia incidence. We are trying to show the relationship between this symptom and the degree and type of incontinence, affectation at bladder neck and apex, and the age. RESULTS: The climacturia incidence came to 20%. The average age of the patients with this symptom was 59 years, the same as for those without it. The patients with both, incontinence and climacturia perform stress incontinence basically but urgency-incontinence to a greater extent (20%) that those with no climacturia (5%). Most patients with climacturia suffer a light leakage (87%) and a 62% always associated to orgasm. Negative effect of the symptom in the patient's and partner's sexual life appeared only in 2 cases (13%). CONCLUSIONS: We suggest the same term in Spanish than in English. Age and affectation of the bladder neck and apex do not have an effect on climacturia. Stress incontinence is more often related to patients with climacturia and the degree of incontinence is higher than in those without it.
Subject(s)
Orgasm , Prostatectomy/adverse effects , Sexual Dysfunction, Physiological/etiology , Urinary Incontinence/etiology , Humans , Incidence , Male , Middle Aged , Sexual Dysfunction, Physiological/epidemiology , Urinary Incontinence/epidemiologyABSTRACT
We report a strange case of a bladder whose first metastasic manifestation, after two years of the diagnosis, was a peripheric polyneuropathia. This patient was treated with immunotherapy with BCG for superficial carcinoma of the bladder during one year. Gradually central neurological symptoms appeared and the patient died one month later. A meningeal carcinomatosis was identify as the cause. No bone metastases existed, which is the most frequent way of tumours extension towards leptomeninges. We argue about the way to arrive at meninges.
Subject(s)
Carcinoma, Transitional Cell/secondary , Meningeal Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To identify the factors that influence response to treatment of vesical instability. METHODS: A retrospective study was conducted to assess the efficacy of drug therapy with oxybutinin and imipramine in 89 patients with urodynamically demonstrated detrusor hyperreactivity. Control evaluations were performed at 2, 5 and 8 months. Evaluation of the results took into account the etiology, pressure and volume at which the wave of instability appeared. RESULTS: The results were evaluated according to patient subjective criteria. We observed a positive response (cure and improvement) to treatment with oxybutinin alone or oxybutinin+imipramine in 66.25% of the cases; side effects were observed in 44%. There was a 20% improvement in the positive response rate when the wave intensity was greater than 55 cm H2O and the bladder volume at which this occurred was greater than 150 ml. No patient treated with second line drug therapy (flavoxate, nifedipine and trospium chloride) cured. CONCLUSIONS: The etiology of vesical instability did not influence response to therapy. Waves with a greater intensity and those that appeared at higher volumes responded better to treatment. Nearly half of the patients with side effects required a reduction of the dosage or withdrawal of the drug. Our results and those reported elsewhere indicate that non-responders to treatment with oxybutinin alone or in combination with imipramine are unlikely to improve with currently available drug therapy.
