Evaluación de las propiedades psicométricas de la versión en español del cuestionario ICIQ-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) en España / Assessment of the Psychometric Properties of the Spanish Language Version of Questionnaire ICIQ-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS)

Objetivos: Evaluar las propiedades psicométricas de la versión en castellano del cuestionario ICIQ-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS): factibilidad (porcentaje de cumplimentación y efecto suelo y techo), fiabilidad (test-retest), validez convergente (vs. Cuestionario de Autoevaluación del Control de la Vejiga [CACV] y vs. International Prostate Symptom Score [I-PSS]) y validez de criterio (según presencia o no de síntoma). Material y métodos: Estudio observacional, no intervencionista y multicéntrico. Participaron 223 pacientes varones de 18-65 años con síntomas del tracto urinario inferior (STUI), predominantemente de llenado. Los pacientes cumplimentaron el ICIQ-MLUTS (test-retest), el I-PSS y el CACV y refirieron sus síntomas urinarios en visita única, a excepción de un subgrupo de 49 pacientes que lo cumplimentaron 15 días después para evaluar la fiabilidad test-retest. El cuestionario contiene 13 ítems en 2 subescalas: Vaciado (V), de 0-20, e Incontinencia (I), de 0-24. Resultados: Porcentaje de pacientes que responden a todos los ítems: 98,84%. Efecto suelo, 0%, y techo menor de 6% en las 2 subescalas del cuestionario. Fiabilidad test-retest: el coeficiente de correlación intraclase (CCI) osciló entre 0,66 y 0,88, salvo en Retardo. El kappa muestra buen acuerdo, entre 0,60 y 0,81, a excepción de Nicturia. Validez convergente: la correlación (Spearman) entre las puntuaciones de las subescalas del cuestionario y el resto de medidas es estadísticamente significativa (p < 0,01 y p < 0,05). Validez de criterio: diferencias estadísticamente significativas (p < 0,05) entre las puntuaciones en el ICIQ-MLUTS de los pacientes que refieren los síntomas respecto a los que no. Conclusión: El ICIQ-MLUTS versión en español muestra adecuada factibilidad, fiabilidad y validez

Objectives: To evaluate the psychometric properties of the Spanish version of the ICIQ-Male Lower Urinary Tract Symptoms Questionnaire (ICIQ-MLUTS): feasibility (% of completion and ceiling/ground effects), reliability (test-retest), convergent validity (vs. Bladder Control Self-Assessment Questionnaire [BSAQ] and vs. International Prostate Symptom Score [I-PSS]) and criterion validity (according to presence or absence of symptoms). Materials and methods: This was an observational, non-interventionist and multicenter study. 223 male patients with lower urinary tract symptoms (LUTS), predominantly storage symptoms and aged 18-65, took part in the study. Patients completed the ICIQ-MLUTS (test), I-PSS and BSAQ questionnaires and referred their urinary symptoms in a single visit, with the exception of a subgroup composed by 49 patients who completed the questionnaire again 15 days after initial visit to evaluate test-retest reliability. The questionnaire includes 13 items divided in 2 sub-scales: Voiding symptoms (V) from 0 to 20 and Incontinence symptoms (I) from 0 to 24. Results: Percentage of patients who completed all items: 98.84%. Ground effect is 0 and ceiling effect was under 6% in both sub-scales. Test-retest reliability: Intraclass correlation coefficient (ICC) ranged from 0.68 to 0.88, except on Delay. Kappa shows a good agreement, between 0.60 and 0.81, except for Nocturia. Convergent validity: Correlation (Spearman) between the questionnaire sub-scales scores and the rest of measures is statistically significant (p < 0.01 and p < 0.05). Criterion validity: Statistically significant differences (p < 0.05) between scores on ICIQ-MLUTS, from patients who refer experiencing symptoms and those who do not. Conclusion: The Spanish version of the ICIQ-MLUTS questionnaire shows adequate feasibility, reliability and validity

Assessment of the psychometric properties of the Spanish language version of questionnaire ICIQ-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS).

OBJECTIVES: To evaluate the psychometric properties of the Spanish version of the ICIQ-Male Lower Urinary Tract Symptoms Questionnaire (ICIQ-MLUTS): Feasibility (% of completion and ceiling/ground effects), reliability (Test-retest), convergent validity (vs Bladder Control Self-Assessment Questionnaire [BSAQ] and vs International Prostate Symptom Score [I-PSS]) and criterion validity (according to presence or absence of symptoms). MATERIAL AND METHODS: This was an observational, non-interventionist and multicenter study. 223 male patients with lower urinary tract symptoms (LUTS), predominantly storage symptoms and aged 18-65, took part in the study. Patients completed the ICIQ-MLUTS (test), I-PSS and BSAQ questionnaires and referred their urinary symptoms in a single visit, with the exception of a subgroup composed by 49 patients that completed the questionnaire again 15 days after initial visit to evaluate test-retest reliability. The questionnaire includes 13 items divided in 2 sub-scales: Voiding symptoms (V) from 0-20 and Incontinence symptoms (I) from 0-24. RESULTS: Percentage of patients that completed all items: 98.84%. Ground effect is 0 and ceiling effect was under 6% in both sub-scales. Test-retest reliability: Intraclass correlation coefficient (ICC) ranged from 0.68 to 0.88, except on Delay. Kappa shows a good agreement, between 0.60 and 0.81, except for Nocturia. Convergent validity: Correlation (Spearman) between the questionnaire sub-scales scores and the rest of measures is statistically significant (P < .01 and P < .05). Criterion validity: Statistically significant differences (P < .05) between scores on ICIQ-MLUTS, from patients that refer experiencing symptoms and those who do not. CONCLUSION: The Spanish version of the ICIQ-MLUTS questionnaire shows adequate feasibility, reliability and validity.

Eficacia y durabilidad de la electroestimulación percutánea del nervio tibial posterior en el tratamiento de la vejiga hiperactiva idiopática con procedimiento enfermero asociado / No disponible

El objetivo de este estudio es evaluar la respuesta a la electroestimulación percutánea del nervio tibial posterior (PTNS), en un grupo de pacientes con diagnóstico de vejiga hiperactiva y determinar cuándo se debe reiniciar un nuevo tratamiento. Se presenta una cohorte retrospectiva de 53 mujeres, de edades comprendidas entre 30 y 82 años, con una media de 61,5 años. Todas fueron sometidas a estudios urodinámicos antes y después del tratamiento, realizados de acuerdo a las recomendaciones de la Sociedad Internacional de Continencia (ICS).Paralelamente se diseñó y realizó un procedimiento enfermero a lo largo de todas las sesiones del tratamiento, orientado a la enseñanza de ejercicios y técnicas conductuales para el control voluntario de la micción. Se ha utilizado el programa SPSS 15.0 para el tratamiento estadístico de los datos, llegando a la conclusión de que la PTNS es segura, efectiva y una buena opción en pacientes con vejiga hiperactiva refractaria al tratamiento médico o con intolerancia al mismo y que el tratamiento debería reiniciarse después de 24 meses. La tasa de pacientes con reducción superior al 50% en los episodios de micción fue mayor que el reportado por otros autores. Los conocimientos adquiridos por medio del procedimiento enfermero utilizado ayudan a mantener la mejoría, aunque se ha observado que después de un tiempo se relajan estos hábitos (AU)

The purpose of this study is to assess the answer to the (PTNS) for a group of patients diagnosed with, determining the optimal timing for reinitiating a new treatment plan. This retrospective cohort study included a total of 53 patients (range 30-82 years; median age 61.5 years), with an age range from 30 to 82 years; with an median age of 61.5 years. They underwent urodynamic studies before and after the treatment, conducted in accordance with the recommendations set forth by the International Continence Society (ICS). Simultaneously a nursing procedure was designed and performed all along the sessions of the treatment, oriented towards training exercises and behavioural techniques for voluntary control of urination. Patients with > 50% reduction in episodes of urination were higher than those reported by other authors. Knowledge gained throughout the Nursing procedure help to maintain improvement, although it has been observed that these habits get relaxed after some time (AU)

[Spontaneous retroperitoneal hematoma secondary to the rupture of suprarenal myelolipoma]. / Hematoma retroperitoneal espontáneo secundario a rotura de un mielipoma suprarrenal.

OBJECTIVE: To describe a case of adrenal myelolipoma in a patient that presented with retroperitoneal hemorrhage. METHODS/RESULTS: A 53-year-old patient that presented with retroperitoneal hemorrhage is described. A CT scan showed a 14 cm fat-containing mass in the right adrenal area surrounded by another hyperdense mass suggestive of hemorrhage. A right adrenalectomy was performed. Histopathologic analysis of the mass confirmed the clinical diagnosis of ruptured adrenal myelolipoma. The clinical and therapeutic aspects are discussed and the literature is briefly reviewed. CONCLUSIONS: Adrenal myelolipomas are rare benign lesions and are usually asymptomatic. Spontaneous rupture is very uncommon and is related with the size of the tumor. To our knowledge, only six cases have been previously reported in the literature.

[Spontaneous retroperitoneal hematoma: our experience]. / Hematoma retroperitoneal espontáneo: nuestra experiencia.

We report 15 cases of spontaneous retroperitoneal haematoma. The etiology and the diagnostic and therapeutic procedures were evaluated. The haematoma source was the adrenal gland in 4 patients and the causes were pheochromocytoma (1), adenoma (1), myelolipoma (1) and idiopathic (1). In 10 patients the source was the kidney and the causes were angiomyolipoma rupture (6), renal cell carcinoma (3) and ureteral calculi (1). In the remaining case, the haematoma was produced by fibrinolytic and anticoagulant therapy in a patient with acute myocardial infarction. The imaging diagnostic techniques employed were abdominal ultrasonography and CT scan, which allowed the diagnosis of haematoma and showed his size and extension in all the cases. With these two techniques, and with the retrograde pyelography in one patient, we obtained the etiologic diagnosis in 12 of the 15 cases. Surgical treatment was performed in 12 patients (adrenalectomy in 2, simple nephrectomy in 3, radical nephrectomy in 5 and partial nephrectomy in 2).

[Pyonephrosis caused by torulosis glabrata]. / Pionefrosis por torulopsis glabrata.

Fungal urinary infections are becoming increasingly frequent as a result of widespread use of broad spectrum antibiotics, an increased number of immunocompromised patients and the greater longevity of chronic patients. Urinary tract infections by Toruplosis glabrata only come second in frequency after those caused by Candida albicans, accounting for 5 to 25% of all infections caused by fungi. The paper presents one case of pyonephrosis by Toruplosis glabrata in a female patient treated with fluconazole who later underwent nephrectomy. A description is made of the clinical picture, diagnosis and treatment of these infections.