ABSTRACT
Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...
Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...
Subject(s)
Kidney Diseases , Constriction, Pathologic , HumansABSTRACT
OBJECTIVE: To evaluate percutaneous tibial nerve stimulation (PTNS) effectiveness, durability, and impact on the pathophysiology of overactive bladder syndrome (OAB) in patients who have been previously treated with antimuscarinics without success. MATERIALS AND METHODS: A prospective study that included 200 women diagnosed with OAB between 2007 and 2015 at Virgen de la Victoria University Hospital (Málaga, Spain) was conducted. OAB patients were treated with PTNS therapy after antimuscarinic treatment failed. To evaluate OAB symptoms, clinical and urodynamic studies were performed before and after PTNS treatment. Treatment's success was defined as a reduction of clinical parameters by >50% and an improvement of at least 2 urodynamic parameters by >50%. The Kolmogorov-Smirnov test and Student's t test or Wilcoxon test were used based on the data. A linear correlation analysis and a multivariate linear regression analysis were performed to determine factors associated with the success of PTNS therapy. RESULTS: Of the patients, 94% experienced a positive response to PTNS considering clinical and urodynamic parameters. PTNS benefits were extended by 24 months. We identified daytime urinary frequency (r = -0.165; P = .024; 95% confidence interval, -0.248 to -0.018) and first sensation of bladder filling (r = 0.208; P = .030; 95% confidence interval, 0.001-0.028) as significant independent predictor factors for PTNS success. CONCLUSION: The current data confirmed a high effectiveness of PTNS improving OAB symptoms through 24 months. Furthermore, daytime urinary frequency and first sensation of bladder filling act as a significant independent predictor factors for PTNS success.
Subject(s)
Transcutaneous Electric Nerve Stimulation/methods , Urinary Bladder, Overactive/therapy , Urinary Bladder/physiopathology , Urodynamics/physiology , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Syndrome , Tibial Nerve , Treatment Outcome , Urinary Bladder, Overactive/physiopathology , Young AdultABSTRACT
A 33 year-old male, who five years earlier was operated for a nodular melanoma in vertical growth phase of 1.5mm thick (Breslow), Clark II-III, presented to the Emergency department with a progressive increase of the left testicle. Ultrasound scan examination revealed a 2 x 2 cm solid mass in the left testis, with normal right testis.With the diagnosis of testicular neoplasm, we requested Alpha-fetoprotein and beta HCG levels, and patient underwent radical orchiectomy.
Subject(s)
Melanoma/secondary , Testicular Neoplasms/secondary , Adult , Fatal Outcome , Humans , Male , Melanoma/pathology , Testicular Neoplasms/pathologyABSTRACT
OBJECTIVE: Testicular epidermoid cyst is a rare clinical entity that accounts for 1% of testicular neoplasias. METHODS AND RESULTS: We report two cases of testicular epidermoid cysts in a 18 and 19 year old males with a painless testicular lesion. Testicular US was carried out showing a hypoechoic nodule in both cases. With the suspicion of testicular neoplasm inguinal orchiectomy was carried out with placement of testicular prostheses in the same act. The pathology report was testicular epidermoid cyst in both cases. CONCLUSIONS: Testicular epidermoid cysts are an uncommon benign entity. When there is a suspicion of this diagnosis, based on tumor markers and ultrasound or MRI images, testicular parenchyma-sparing surgery must be attempted.
Subject(s)
Epidermal Cyst , Testicular Diseases , Adolescent , Epidermal Cyst/diagnostic imaging , Humans , Male , Testicular Diseases/diagnostic imaging , Ultrasonography , Young AdultABSTRACT
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