ABSTRACT
INTRODUCTION: High grade, non-muscle invasive bladder cancer (NMIBC) is usually treated with intravesical Bacillus Calmette-Guérin. Chemohyperthermia therapy (CHT) may be a novel alternative therapy for the treatment of NMIBC. OBJECTIVE: To evaluate the recurrence-free survival (RFS) of patients treated with CHT using the Combat bladder recirculation system (BRS) for NMIBC. METHODS: This was a prospective multi-institutional study of 1,028 consecutive patients with NMIBC undergoing CHT between 2012 and 2020. A total of 835 patients were treated with CHT with Mitomycin C (MMC). Disease was confirmed on transurethral resection of bladder tumor (TURBT) prior to starting CHT. Follow-up included cystoscopy and subsequent TURBT if recurrence/progression was suspected. The primary endpoint was RFS. Secondary endpoints were progression-free survival (PFS) and adverse events from CHT. RESULTS AND LIMITATIONS: Median follow up was 22.4 months (Interquartile range (IQR): 12.8 -35.8). Median age was 70.4 years (IQR: 62.1 -78.6). A total of 557 (66.7%), 172 (20.6) and 74 (8.9%) of patients were classified to BCG naïve, BCG unresponsive and BCG failure, respectively. The RFS at 12 months and 24 months for BCG naïve was 87.6% (95% CI 85.0% - 90.4%) and 75.0% (95% CI 71.3% - 78.8%), respectively. The RFS at 12 months and 24 months for BCG unresponsive cohort was 78.1% (95% CI 72.0% - 84.7%) and 57.4% (95% CI 49.7% - 66.3%), respectively. The RFS at 24 months for the BCG unresponsive cohort for CIS with/without papillary disease and papillary only disease were 43.6% (95% CI 31.4% -60.4%) and 64.5% (95% CI 55.4% - 75.1%), respectively. Minor adverse events occurred in 216 (25.6%) patients and severe events occurred in 17 (2.0%) patients. CONCLUSIONS: CHT with MMC using the Combat BRS is effective in the medium term and has a favorable adverse event profile.
ABSTRACT
OBJECTIVES: In this paper we describe the history of lithiasis and the development of its treatment. We discuss the steps that led to the birth of endoscopic surgery and extracorporeal shockwave lithotripsy. METHODS: We reviewed books and writings of History of Urology and Endourology. RESULTS/CONCLUSIONS: To know a little of the history and treatment of lithiasis, the contributions of Spanish urologists, as well as the instruments that made it possible.
Subject(s)
Urolithiasis/history , History, 15th Century , History, 16th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , History, Medieval , Humans , Urolithiasis/therapyABSTRACT
OBJETIVO: En este trabajo se realiza una descripción histórica de los descubrimientos sobre la litiasis y la evolución de su tratamiento. Se exponen los antecedentes que llevan al nacimiento de la endourología y de la litotricia por ondas de choque.MÉTODOS: Hemos revisado los libros y las publicaciones de la historia de la urología y de la endourología.RESULTADOS/CONCLUSIONES: Conocer la historia y el tratamiento de la litiasis, las aportaciones de los urólogos españoles así como el desarrollo de los materiales que han contribuido a conseguirlo(AU)
OBJECTIVES: In this paper we describe the history of lithiasis and the development of its treatment. We discuss the steps that led to the birth of endoscopic surgery and extracorporeal shockwave lithotripsy.METHODS: We reviewed books and writings of History of Urology and Endourology.RESULTS/CONCLUSIONS: To know a little of the history and treatment of lithiasis, the contributions of Spanish urologists, as well as the instruments that made it possible(AU)
Subject(s)
Urolithiasis/epidemiology , Urolithiasis/etiology , Urolithiasis/history , Urolithiasis/therapy , Lithiasis , Lithiasis/epidemiology , Lithiasis/etiology , Lithiasis/history , Lithiasis/therapyABSTRACT
OBJECTIVES: The objective of this work is to analyze the treatment of staghorn calculi at our Department of Urology. We have to know the recent development of endoscopic surgery (percutaneous renal surgery) and external shock wave lithotripsy. METHODS: We reviewed the surgical management of staghorn calculi during the period between 1987 and 2004. RESULTS: Percutaneous renal surgery was performed successfully in 24.1% of the cases. Persisting residual fragments appeared in 75.9% and were treated by ESWL or second endoscopic surgery. CONCLUSIONS: Percutaneous renal surgery may be considered the technique of choice to treat staghorn calculi. Endoscopic surgery has good results and little complications with low morbidity. In other cases the treatment is combined therapy, percutaneous renal surgery and ESWL.
Subject(s)
Kidney Calculi/therapy , Kidney Pelvis , Adult , Aged , Aged, 80 and over , Female , Humans , Kidney Calculi/surgery , Lithotripsy , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Objetivo: Analizar los resultados del tratamiento de la litiasis coraliforme en nuestro servicio atendiendo a los avances tecnológicos que se han producido en los últimos años destacando el papel fundamental que supone el desarrollo de la cirugía endoscópica y de la litotricia extracorpórea por ondas de choque. Métodos: Hemos revisado todos los pacientes tratados de litiasis coraliforme en nuestro servicio entre los años 1987 y 2004. Resultados: Se consiguió la extracción completa con un sólo acto quirúrgico mediante nefrolitotomía percutánea en un 24.1%. En el 75.9% restante se realizó un tratamiento combinado mediante litotricia extracorpórea con ondas de choque o una segunda nefrolitotomía percutánea. Conclusiones: La endourología ha revolucionado el tratamiento de la litiasis coraliforme. Es eficaz sola y en combinación con la LEOC para el manejo de esta patología con un número reducido de complicaciones y una alta tolerabilidad por parte de los pacientes (AU)
Objectives: The objective of this work is to analyze the treatment of staghorn calculi at our Department of Urology. We have to know the recent development of endoscopic surgery (percutaneous renal surgery) and external shock wave lithotripsy. Methods: We reviewed the surgical management of staghorn calculi during the period between 1987 and 2004. Results: Percutaneous renal surgery was performed successfully in 24.1% of the cases. Persisting residual fragments appeared in 75.9% and were treated by ESWL or second endoscopic surgery. Conclusions: Percutaneous renal surgery may be considered the technique of choice to treat staghorn calculi. Endoscopic surgery has good results and little complications with low morbidity. In other cases the treatment is combined therapy, percutaneous renal surgery and ESWL (AU)
Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Kidney Calculi/therapy , Kidney Calculi/classification , Lithotripsy , Retrospective StudiesABSTRACT
OBJECTIVES: The goal of this work is to evaluate the usefulness of NMP22 BladderChek in the diagnosis and follow-up of bladder cancer, comparing it with cystoscopy and urine cytology. METHODS: Group 1: 109 asymptomatic patients on follow up for bladder cancer underwent cystoscopy, cytology and NMP22 BladderChek. Group 2:15 patients with history of hematuria underwent cystoscopy and NMP22 BladderChek. RESULTS: Group 1: 9 patients had tumor relapse. Sensitivity was 25% for NMP22 test, 50% for citology and 100% for cystoscopy Specificity was 91.1%, 94.1% and 95% respectively. Group 2: 12 patients had bladder cancer. The sensitivity was of 83.3% for NMP22 BladderChek and 100% for cystoscopy. The specificity was of 100% for NMP22 BladderChek and 66.7% for cystoscopy. CONCLUSIONS: The low sensitivity of NMP22 Bladder-Chek invalidates it as alternative method to cystoscopy in the follow-up of bladder cancer. But it can be recommended for screening in patients without history of bladder cancer but with an increased risk (smokers, patients with dysuria and hematuria).
Subject(s)
Biomarkers, Tumor/urine , Neoplasm Recurrence, Local/diagnosis , Nuclear Proteins/urine , Urinary Bladder Neoplasms/diagnosis , Adult , Aged , Aged, 80 and over , Carcinoma, Transitional Cell/pathology , Cystoscopy , Cytodiagnosis , Female , Hematuria/etiology , Hematuria/urine , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Predictive Value of Tests , Reagent Strips , Urinary Bladder Neoplasms/pathologyABSTRACT
OBJECTIVES: To show the beginning of spinal and epidural anesthesia in our country and the contributions of Spanish urologists. METHODS: We reviewed books and writings of History of Medicine, Urology and Anesthesia and Doctoral thesis about spinal and epidural anesthesia. RESULTS: In the 20th century, surgeons also gave the anesthetic drugs to the patients. Spinal and epidural anesthesia were used for the first time in 1900. A lot of Spanish urologists like F Rusca Doménech, J.M. Batrina, M. Barragán Bonet, R. Lozano Monzón, L. Guedea Calvo, Gil Vernet, Fidel Pagés Miravé, V Sagarra Lascurain, Gómez Ulla, etc, did research, writings in scientific journals and Doctoral thesis about anesthesia.
Subject(s)
Anesthesia, Epidural/history , Anesthesia, Spinal/history , History, 20th Century , SpainABSTRACT
Objetivo: Conocer como se desarrollaron en nuestro país las técnicas de la raquianestesia y la anestesia epidural, y cuales fueron las aportaciones de los urólogos españoles. Métodos: Hemos revisado los libros de Historia de la Medicina, de la Urología y de Anestesia, las publicaciones periódicas y las Tesis Doctorales que sobre este tema se realizaron en la época. Resultados: En buena parte del siglo XX aquellos que se dedicaban a la cirugía administraban también la anestesia. Es a partir del año 1900 cuando comienzan a desarrollarse la raquianestesia y la anestesia epidural siendo numerosas y fundamentales las aportaciones de los urólogos españoles como F. Rusca Doménech, J.M. Batrina, M. Barragán Bonet, R. Lozano Monzón, L. Guedea Calvo, Gil Vernet, Fidel Pagés Miravé, V. Sagarra Lascuraín, Gómez Ulla, etc. realizando publicaciones en revistas de prestigio, comunicaciones en congresos y tesis doctorales sobre la anestesia raquídea y epidural (AU)
Objectives: To show the beginning of spinal and epidural anesthesia in our country and the contributions of Spanish urologists. Methods: We reviewed books and writings of History of Medicine, Urology and Anesthesia and Doctoral thesis about spinal and epidural anesthesia. Results: In the 20th century, surgeons also gave the anesthetic drugs to the patients. Spinal and epidural anesthesia were used for the first time in 1900. A lot of Spanish urologists like F. Rusca Doménech, J.M. Batrina, M. Barragán Bonet, R. Lozano Monzón, L. Guedea Calvo, Gil Vernet, Fidel Pagés Miravé, V. Sagarra Lascuraín, Gómez Ulla, etc, did research, writings in scientific journals and Doctoral thesis about anesthesia (AU)
