ABSTRACT
OBJETIVO: Analizar de una manera breve y concisa el diagnóstico y tratamiento de las fracturas de ambos cuerpos cavernosos y uretra.MÉTODOS: Se presenta un caso raro de fractura de ambos cuerpos cavernosos asociada a rotura completa de uretra.RESULTADO/CONCLUSIONES: El diagnóstico de las fracturas de pene puede ser realizado exclusivamente basado en la historia clínica y en los hallazgos de la exploración física. El tratamiento de elección es quirúrgico y tiene como objetivo permitir la micción y restaurar el pene a su estado original para prevenir complicaciones como la disfunción eréctil(AU)
OBJECTIVE: To analyze in a short and concise way the diagnosis and treatment of traumatic fracture of both corpora cavernosa and urethra.METHODS: We present our experience with a rare case of traumatic fracture of both corpora cavernosa associated to complete urethral rupture.RESULTS/CONCLUSIONS: The diagnosis of penile fractures can be done with the clinical history and physical examination only. Surgery is the best treatment, the main objective of which is to enable voiding and restore the anatomy of the penis to prevent complications such as erectile dysfunction(AU)
Subject(s)
Humans , Male , Middle Aged , Penis/injuries , Urethra/injuries , Genitalia, Male/surgery , Soft Tissue Injuries/complications , Hematoma/surgeryABSTRACT
OBJECTIVE: To evaluate the feasibility and long-term outcomes of our initial series of robot-assisted laparoscopic sacrocolpopexy. METHODS: We conducted a prospective analysis of our series of robotic sacrocolpopexy. INCLUSION CRITERIA: patients with grades III and IV cystocele and or other symptomatic pelvic organ prolapse. We performed a transperitoneal four-trocar technique with the Da Vinci robotic system using two polypropylene meshes for fixation to the sacral promontory. The primary outcome was recurrence; secondary outcomes included operating room time, blood loss, conversion to open surgery, complications and length of stay. RESULTS: 31 consecutive procedures were included. Mean patient age was 65.2 (50-81) years. Mean operating room time was 186 (150-230) min. We converted 1 case to laparoscopy (3.2%). There were two major complications (1 acute myocardial infarction and 1 reoperation for excess tension with syncopes), two minor complications (1 wound infection and 1 ileus) and no recurrences at a mean follow-up of 24.5 (16-33) months. CONCLUSIONS: Robotic sacrocolpopexy could possibly improve with experience after overcoming the learning curve. There is no doubt it is a reproducible technique, but its safety and efficacy still need to be proven. Our initial series demonstrated good outcomes and no recurrences at 24.5 months of follow-up.
Subject(s)
Laparoscopy/methods , Pelvic Organ Prolapse/surgery , Pelvic Organ Prolapse/therapy , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Middle Aged , Postoperative Complications , Prospective Studies , Recurrence , Robotics , Surgery, Computer-Assisted/methods , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVES: To evaluate the influence of receptor's age on the outcomes of kidney transplants with organs from non heart beating donors. METHODS: Observational study of the historic cohort of 570 kidney transplants performed at the Hospital Clínico San Carlos between 1991 and 1999. Receptor's were divided into two age groups, group 1 younger than 50 years, and group 2 older than 50 years. All organs where harvested from non heart beating donors. RESULTS: We studied 110 kidney transplants coming from non heart beating donors; 52 belonged to group 1, and 57 to group 2. Three-year patient survival for receptor's younger than 50 years was 100%. The probability of three-year survival for receptor's older than 50 years was 79.39% (p 0.07). Graft survival was 88.46%, 86.54%, and 86.54% at 12, 24, and 36 months respectively for receptor's younger than 50 years. When receptors were older than 50 years the probability of functioning graft in the same periods of time was 89.20%, 89.20%, and 86.32% respectively. CONCLUSIONS: Receptor's age doesn't seem to influence graft survival when kidneys from non heart beating donors are used.
Subject(s)
Heart Arrest , Kidney Transplantation/statistics & numerical data , Tissue Donors , Adolescent , Adult , Age Factors , Cohort Studies , Creatinine/blood , Female , Graft Survival , Humans , Male , Middle Aged , Retrospective Studies , Survival Analysis , Survival Rate , Tissue and Organ ProcurementABSTRACT
OBJETIVO: Examinar la influencia que pueda ejercer la edad del receptor en la evolución de los trasplantes renales realizados con órganos procedentes de donantes en parada cardiaca irreversible. MÉTODO: Estudio observacional de cohorte histórica de los 570 trasplantes realizados en el Hospital Clínico San Carlos entre los años 1991 a 1999. Los receptores se dividieron según su edad en dos grupos, el primero por debajo de 50 años y un segundo, por encima de dicha edad. Todos los órganos procedían de donantes en asistolia. RESULTADOS: Se estudian 110 trasplantes renales realizados con donantes en asistolia, de ellos 52 pertenecían al grupo I y 57 al grupo II. La supervivencia del paciente en los receptores menores de 50 años fue del 100 por ciento a los 36 meses. En los receptores mayores de 50 años la probabilidad de supervivencia a los 36 meses se sitúa en el 79,39 por ciento (p 0,07). La supervivencia del injerto se situó cuando los receptores eran menores de 50 años en el 88,46 por ciento, 86,54 por ciento y 86,54 por ciento a los 12, 24 y 36 meses respectivamente. Cuando el receptor era mayor de 50 años la probabilidaddeinjertofuncionantefuedel89,20 por ciento,89,20 por ciento y 86,32 por ciento en los mismos periodos. CONCLUSIONES: La edad del receptor no parece influir en la supervivencia del injerto cuando se utilizan órganos procedentes de donantes asistolia (AU)
