ABSTRACT
The chapter of injuries to the ureter during obstetric-gynaecological surgery continues to be ignored in the literature published over the last decades, in spite of its prevalence in the practice. This has motivated our review and update of this issue. The interest of urological diagnostic procedures prior to surgery and conduit examination at any time during the operation exert some influence on the prevention of this pathology. Preoperative finding and reconstruction lead to better results, which benefit from the use of the urinary route, thus leaving the gut route and self-transplantation for exceptional situations. A new iatrogenic pathology has emerged from the most frequent use of gynaecological endoscopic surgery.
Subject(s)
Genital Diseases, Female/surgery , Intraoperative Complications , Pregnancy Complications/surgery , Ureter/injuries , Endoscopy , Female , Gynecology/instrumentation , Gynecology/methods , Humans , Intraoperative Complications/classification , Intraoperative Complications/epidemiology , Intraoperative Complications/therapy , Obstetrics/instrumentation , Obstetrics/methods , Postoperative Care , Pregnancy , Preoperative Care , Ureter/anatomy & histology , Ureter/surgeryABSTRACT
The present study investigated cystinuria and cystine calculi. Inexplicably, of 987 calculi that had been analyzed ultrastructurally at the Department of Urology of the University Hospital of Salamanca over a period of 15 years only 3 (0.3%) were cystine. The foregoing finding does not coincide with the 0.5-1% incidence reported in the world literature. Apart from the chemical analyses, infrared spectroscopy disclosed the typical findings of multiple bands 1600-625 cm-1. Analysis by x-ray diffraction revealed a slight variation from the ASTM values. One of the calculi, which we considered to be a mixed calculus (probably of calcium phosphate), showed a peak at 43 degrees, instead of the usual 34.5. Scanning electron microscopy disclosed two forms of crystallization: The typical hexagonal form of cystine stones and the rectangular form of different sizes. The material comprising the matrix was observed in many areas, covering and joining the crystals as if it were cement. Whenever possible, treatment of these recurrent calculi should be conservative. Some advocate the use of ESWL, although others consider these calculi to be extremely hard and, therefore, not amenable to ESWL. Chemical dissolution is advocated by some, although its critics consider it to be of little use. Concerning prophylaxis, forced fluids and alkalinization may reduce recurrence. Ultrastructural studies have provided further insight into the structure and composition of cystine calculi. The foregoing may be useful in determining the most appropriate form of treatment based upon stone size, shape, composition (pure or mixed), etc.
Subject(s)
Cystine/analysis , Urinary Calculi/chemistry , Adult , Crystallization , Cystinuria/complications , Female , Humans , Male , Microscopy, Electron, Scanning , Spectrophotometry, Infrared , Urinary Calculi/pathology , X-Ray DiffractionSubject(s)
Awards and Prizes , Urology/history , History, 16th Century , History, 20th Century , SpainABSTRACT
A study was made on a series of 348 patients with uni- and bilateral cryptorchid, a right location being predominant in the former cases, and in the canaliculus the most common testicular one. The associated pathology is usually irrelevant. In view of the results revealed by optical and ultrastructural histological study, the introduction of definitive corrective medical treatment appears to be essential within 2 years. Despite existing discrepancies with regard to dosage and efficacy of hormonal therapy with HCG or LH-RH analogues we believe they should be used at doses no higher than 12000 IU of HCG in order to achieve a decrease or ease the surgical treatment. Higher doses would damage the testicle or produce early puberty with growth failure. Scrotum-bound funiculolysis is the procedure accomplishing a larger amount of therapeutic success and in our experience the results are conditioned to the testicle's anatomic location. In the event of abdominal testicles or with high canaliculus location, a section of the spermatic canals could be performed followed later by auto-transplantations using microsurgery procedures.
Subject(s)
Cryptorchidism/epidemiology , Child , Cryptorchidism/complications , Cryptorchidism/pathology , Cryptorchidism/therapy , Humans , MaleABSTRACT
Dentro de la patologia urológica, la estenosis uretral masculina es uno de los capítulos que mayores controversias sucita. Básicamente han sido tres las fórmulas propuestas en su terapéutica: dilataciones periódicas, uretrotomia ciega y numerosisimas técnicas de uretroplastia cruenta. Durante la última década y merced sobre todo a los trabajos desarrollados por Sachse, la uretrotomia interna, bajo visión directa y con corte frio, ha surgido con fuerza mostrándose, cada vez más, como alternativa validad frente a otros procederes más agresivos. . Presentamos en esta revisión, los resultados obtenidos en 45 pacientes tratados con esta técnica
Subject(s)
Humans , Male , Urethral Stricture/surgery , MethodsABSTRACT
Dentro de la patologia urológica, la estenosis uretral masculina es uno de los capítulos que mayores controversias sucita. Básicamente han sido tres las fórmulas propuestas en su terapéutica: dilataciones periódicas, uretrotomia ciega y numerosisimas técnicas de uretroplastia cruenta. Durante la última década y merced sobre todo a los trabajos desarrollados por Sachse, la uretrotomia interna, bajo visión directa y con corte frio, ha surgido con fuerza mostrándose, cada vez más, como alternativa validad frente a otros procederes más agresivos. . Presentamos en esta revisión, los resultados obtenidos en 45 pacientes tratados con esta técnica (AU)
Subject(s)
Humans , Male , Urethral Stricture/surgery , MethodsABSTRACT
Se presenta un estudio comparativo de los resultados obtenidos en el tratamiento medicamertoso, mediante la administración de cimetidina o somatostatina en pacientes con hemorragias digestivas altas por ulcus gastroduodenal y L.A.M.G
Subject(s)
Humans , Cimetidine/therapeutic use , Gastrointestinal Hemorrhage/drug therapy , Somatostatin/therapeutic useABSTRACT
Se presenta un estudio comparativo de los resultados obtenidos en el tratamiento medicamertoso, mediante la administración de cimetidina o somatostatina en pacientes con hemorragias digestivas altas por ulcus gastroduodenal y L.A.M.G (AU)
Subject(s)
Humans , Comparative Study , Cimetidine/therapeutic use , Gastrointestinal Hemorrhage/drug therapy , Somatostatin/therapeutic useABSTRACT
A rare case of hydatid disease, presenting as a 12 cm. cyst in the arterial wall of the abdominal aorta, with progressive chronic ischemia of the lower limbs and repeated episodes of shock is reported. The diagnostic problems, surgical procedure and follow-up are presented. This is the first reported case in the literature.
Subject(s)
Aorta, Abdominal , Echinococcosis , Adult , Echinococcosis/diagnosis , Echinococcosis/pathology , Echinococcosis/surgery , Humans , MaleABSTRACT
Se detalla un estudio de pacientes sometidos a cirugía biliar y referente a la litiasis residual, en cuanto a su incidencia, profilaxis y terapéutica compleja que motivó a revisar la experiencia de los autores en esa patología
Subject(s)
Humans , Male , Female , Gallstones/surgeryABSTRACT
Se detalla un estudio de pacientes sometidos a cirugía biliar y referente a la litiasis residual, en cuanto a su incidencia, profilaxis y terapéutica compleja que motivó a revisar la experiencia de los autores en esa patología (AU)
Subject(s)
Humans , Male , Female , Gallstones/surgeryABSTRACT
En nuestro trabajo revisamos los quistes hidatídicos únicos y primitivos, no asociados con localizaciones hepáticas o pulmonares, y que no competen a otras especialidades, como los que tienen asiento renal, óseo, encefálico o cardíaco, habiendo sido tratados todos ellos en el Departamento de Cirugía del Hospital Clínico Universitario de Salamanca
Subject(s)
Adolescent , Adult , Middle Aged , Humans , EchinococcosisABSTRACT
En nuestro trabajo revisamos los quistes hidatídicos únicos y primitivos, no asociados con localizaciones hepáticas o pulmonares, y que no competen a otras especialidades, como los que tienen asiento renal, óseo, encefálico o cardíaco, habiendo sido tratados todos ellos en el Departamento de Cirugía del Hospital Clínico Universitario de Salamanca (AU)
Subject(s)
Adolescent , Adult , Middle Aged , Aged , Humans , EchinococcosisABSTRACT
A case of traumatic thrombosis of renal vascular pedicule in a 15 years old patient is presented. The different diagnostic and therapeutic problems which were seen are discussed. Special emphasis is made on the necessity of an early diagnosis for the revascularization techniques to be effective, or the nephrectomy is otherwise indicated.
