Factores relacionados con el ajuste diádico conyugal en parejas con hijos en edad pediátrica / Factors related to dyadic adjustment in couples with children of pediatric age

Objetivo: Determinar si el apoyo social, el ciclo vital familiar, la transición familiar y los acontecimientos estresantes se relacionan con el ajuste diádico de parejas con hijos en edad pediátrica. Método: Estudio descriptivo, observacional y de corte transversal. Noventa y cinco parejas de la provincia de Sevilla fueron escogidas mediante muestreo consecutivo estratificado por cuotas, y cumplimentaron un cuestionario con las variables de estudio y las escalas Ajuste Diádico Conyugal y Apoyo Social Percibido. La recogida de datos se realizó en el último trimestre del 2015 con el visto bueno del Comité Ético de Investigación de la Universidad de Sevilla. Se aplicaron los test no paramétricos U de Mann-Whitney y Kruskal-Wallis. Para la relación entre variables se utilizó el test de correlación de Spearman y para demostrar correlaciones significativas se comprobó que p<0,05. Resultados: Las parejas mayoritariamente eran matrimonios con buen ajuste diádico y apoyo social. El 26,3% tenían hijos lactantes y el 73,7% en edad escolar. No existe influencia del ciclo vital y la transición familiar sobre el ajuste diádico. El comienzo-fin de la escolaridad influye en la cohesión conyugal y existen correlaciones positivas entre ajuste diádico y apoyo social, y negativas entre el número de hijos y el apoyo social, el consenso y la satisfacción de la pareja. Conclusiones: El apoyo social y el número de hijos se identifican como los principales factores condicionantes del ajuste diádico. En este sentido, es fundamental conocer los recursos de los que dispone cada pareja para hacer frente a las dificultades donde el apoyo social y la unión entre los cónyuges pueden ayudarles a enfrentar los desafíos.(AU)

Aim: To identify a relationship between social support, family life cycle, family transition and stressful events; and the dyadic adjustment among couples from Seville with children of pediatric age. Method: Descriptive, observational and cross-sectional study. Ninety-five Sevillian couples were recruited following a consecutive stratified sampling by quotas. They filled in a questionnaire with the study variables and the Dyadic Adjustment and Social Support scales. Data collection was carried out in 2015. The project was approved by the Research Ethics Committee of the University of Seville. Mann-Whitney U and Kruskall-Wallis non-parametric tests were used for statistical analysis, and Spearman test for correlation between variables. Significance was stated for P<.05. Results: The couples were mostly marriages with good dyadic adjustment and social support. A percentage of 26.3 had infant and 73.7% children of school age. No relationship between the life cycle nor the family transition and the dyadic adjustment were identified. The beginning-end of schooling was related to spousal cohesion and there were positive correlations between dyadic adjustment and social support; and negative correlations between the number of children and social support, consensus and satisfaction of the couple. Conclusions: Social support and the number of children are identified as the main conditioning factors of dyadic adjustment. In this sense, it is essential to know the resources available to each couple to face the difficulties where social support and the union between the spouses can help them face the challenges.(AU)

Factors related to dyadic adjustment in couples with children of pediatric age. / Factores relacionados con el ajuste diádico conyugal en parejas con hijos en edad pediátrica.

AIM: To identify a relationship between social support, family life cycle, family transition and stressful events; and the dyadic adjustment among couples from Seville with children of pediatric age. METHOD: Descriptive, observational and cross-sectional study. Ninety-five Sevillian couples were recruited following a consecutive stratified sampling by quotas. They filled in a questionnaire with the study variables and the Dyadic Adjustment and Social Support scales. Data collection was carried out in 2015. The project was approved by the Research Ethics Committee of the University of Seville. Mann-Whitney U and Kruskall-Wallis non-parametric tests were used for statistical analysis, and Spearman test for correlation between variables. Significance was stated for P<.05. RESULTS: The couples were mostly marriages with good dyadic adjustment and social support. A percentage of 26.3 had infant and 73.7% children of school age. No relationship between the life cycle nor the family transition and the dyadic adjustment were identified. The beginning-end of schooling was related to spousal cohesion and there were positive correlations between dyadic adjustment and social support; and negative correlations between the number of children and social support, consensus and satisfaction of the couple. CONCLUSIONS: Social support and the number of children are identified as the main conditioning factors of dyadic adjustment. In this sense, it is essential to know the resources available to each couple to face the difficulties where social support and the union between the spouses can help them face the challenges.

Nursing Students' Perception on the Effectiveness of Emergency Competence Learning through Simulation.

(1) Background: Simulation is a part of the day-to-day of the learning method in health sciences. The objective is to determine if the clinical simulation is useful for learning in the emergency setting, from the point of view of the nursing students. (2) Methods: A pre- and post-test exploratory study with an analytical and quasi-experimental design was used. The population is made up of nursing students from the Seville Red Cross Nursing Centre, who conducted a simulation exercise in the form of a drill for the care of multiple victims. A specific questionnaire was employed as a tool to analyse the dimensions of satisfaction, confidence and motivation, clinical experience, and decision making and technical abilities. (3) Results: There were favourable significant differences in the set of global responses, with p < 0.0001 for the "satisfaction" dimension and d = 1.25 for the "large" size of the effect, and p < 0.0069 for the "confidence and motivation" dimension and d = 0.58 for the "moderate-large" size of the effect. (4) Conclusions: The results are similar to those obtained in other studies in the scope of the 4 dimensions studied, thus coming to the conclusion that the perception of the nursing students on learning through clinical simulation is positive and favourable.

The Effect of Anticholinergics for Prevention of Storage Symptoms After Prostate Photovaporization.

PURPOSE: To evaluate the efficacy of oral anticholinergics as a preventive strategy of storage symptoms and urinary incontinence associated with the early postoperative period after Greenlight laser photovaporization of the prostate (PVP). To analyze potential variables related to the onset of these symptoms. MATERIALS AND METHODS: Retrospective study of 105 patients who underwent PVP using a 180-W Greenlight laser (XPS). Patients were divided into two groups, depending on whether they were or weren´t prescribed anticholinergics when discharged (oral solifenacin 5 mg for 1 month after surgery). Differences between both groups were analyzed according to IPSS, ICIQ-SF and OABq-SF scores at 1 and 6 months. The potentially predictive variables of the symptomatology after undergoing PVP that we analyzed included age, prostate volume, PSA, IPSS, ICIQ-SF, OABq-SF, Qmax, previous use of a permanent urinary catheter, energy used, and laser application time. RESULTS: 58 patients in the group with anticholinergics and 47 in the group without anticholinergics were compared. No significant differences were observed between both groups in IPSS (p = .521), ICIQ-SF (p = .720) or OABq-SF (p = .851) at 1 and 6 months after surgery. Regardless of the use of anticholinergics, there was a significant score improvement between the first and second checkup in all the questionnaires: there was a significant decrease in the mean IPSS (p < .001) and the mean score of the eighth IPSS question on patient's quality of life (p = .026), ICIQ- SF (p = .010) and OAB-q related to symptoms (p = .001) as well as a significant increase in the mean OAB-q score regarding quality of life (p = .005). None of the variables analyzed showed a significant relation to the storage-symptom rate, rate of incontinence, or ICIQ-SF and OABq-SF scores. CONCLUSIONS: The use of solifenacin 5 mg after Greenlight laser PVP is not an effective preventive treatment for storage and incontinence symptoms associated with this procedure, which seem to self-limit over time.

Origin of disinfection by-products in cheese.

The disinfection of water, equipment and surfaces in a cheese factory is one of the factors that can originate disinfection by-products (DBPs) in cheese. This research has focused on studying cheese factories in order to evaluate the individual contribution of each step of the cheese-making process that can contribute to the presence of DBPs in cheese. Ten factories were selected according to their salting processes (brine or dry salting). Each factory was monitored by the collection of six representative samples (factory water supply, brine solution, milk, whey, curd and cheese) in which the concentrations of up to eight chemicals were detected. The study shows that contact with brine solutions containing significant levels of DBPs is the main source of these chemicals in cheese. A minor factor is the pasteurised milk used in their manufacture.

[The role of therapies in the treatment of small renal masses]. / Papel de las terapias diana en el tratamiento de las masas renales pequeñas.

OBJECTIVES: To analize the current role of target therapies in the treatment of small renal masses. METHODS: We performed a bibliographic review on the effect of target therapies on primary renal tumor, including our initial experience with two cases of small renal tumor in single kidneys treated with sunitinib. RESULTS: There is very limited experience with target therapies, being possible to use them, as the reviewed literature shows, to increase safety in nephron sparing surgery or tissue ablation technique, or as the treatment for small renal tumors in patients with single kidney in whom nephron sparing surgery is not feasible. Of our two cases with small renal tumors in patients with single kidney, the first case has had complete response to sunitinib after 21 months of follow up, and the second has had tumor stabilization after 33 months of follow up, shifting from sunitinib to pazopanib due to intolerance. CONCLUSIONS: The indication of target therapies in the treatment of metastatic renal cancer could be expanded. These therapies could be useful in localized small renal cancer and, although experience with this indication is limited, results are promising.

Papel de las terapias diana en el tratamiento de las masas renales pequeñas / The role of target therapies in the treatment of small renal masses

OBJETIVO: Analizar el papel actual de las terapias diana en el tratamiento de las masas renales pequeñas. MÉTODOS: Realizamos una revisión bibliográfica del efecto de las terapias diana sobre el tumor renal primario, aportando nuestra experiencia inicial de dos casos de pacientes monorrenos con tumor renal pequeño tratados con sunitinib. RESULTADO: Existe muy poca experiencia con terapias diana, pudiendo utilizarse, según la literatura revisada, para aumentar la seguridad de una cirugía conservadora de nefronas o la de una técnica ablativa, o como tratamiento de tumores renales en pacientes monorrenos en los que no se pueda realizar una cirugía conservadora de nefronas. De nuestros dos casos aportados con tumor renal pequeño en pacientes monorrenos, en el primer caso se ha producido una respuesta completa con sunitinib tras 21 meses de seguimiento, y en el segundo se ha producido una estabilización tumoral tras 33 meses de seguimiento, cambiando sunitinib por pazopanib por intolerancia. CONCLUSIONES: La indicación de las terapias diana en el tratamiento del cáncer renal metastásico podría ampliarse, pudiendo ser útiles estas terapias en el cáncer renal pequeño localizado, y aunque la experiencia con esta indicación es limitada, los resultados son prometedores(AU)

OBJECTIVES: To analize the current role of target therapies in the treatment of small renal masses. METHODS: We performed a bibliographic review on the effect of target therapies on primary renal tumor, including our initial experience with two cases of small renal tumor in single kidneys treated with sunitinib. RESULTS: There is very limited experience with target therapies, being possible to use them, as the reviewed literature shows, to increase safety in nephron sparing surgery or tissue ablation technique, or as the treatment for small renal tumors in patients with single kidney in whom nephron sparing surgery is not feasible. Of our two cases with small renal tumors in patients with single kidney, the first case has had complete response to sunitinib after 21 months of follow up, and the second has had tumor stabilization after 33 months of follow up, shifting from sunitinib to pazopanib due to intolerance. CONCLUSIONS: The indication of target therapies in the treatment of metastatic renal cancer could be expanded. These therapies could be useful in localized small renal cancer and, although experience with this indication is limited, results are promising(AU)

Primary renal lymphoma: report of three new cases and literature review.

OBJECTIVES: We report the cases of three patients with primary renal lymphoma. Diagnosis and subsequent treatment are discussed. METHODS: The literature on the origin, epidemiology, clinical presentation, diagnosis, treatment and prognosis of primary renal lymphoma was reviewed. RESULTS: The first patient was diagnosed after radical nephrectomy and subsequently was given six cycles of CVP (cyclophosphamide, vincristine, prednisone). The diagnosis of the second patient was established by renal biopsy, and the patient received six cycles of CHOP (cyclophosphamide, adriamycin, vincristine and predisone). The last patient had a lymphoma, secondary to immunosuppression, in a transplanted kidney. In this case transplant nephrectomy sufficed to cure the patient's lymphoma. All patients had B-cell non-Hodgkin lymphoma (an extrarenal origin was ruled out by bone marrow biopsy), and were disease-free 15 months, 7 months, and 6.5 years after diagnosis, respectively. CONCLUSIONS: Primary renal lymphoma is rare. Diagnosis is established by renal biopsy, although it often presents as a mass simulating renal cell cancer and diagnosis is obtained after radical nephrectomy. Treatment consists of chemotherapy (CHOP). associated with rituximab.

[Renal cell carcinoma with vena cava involvement: update and review of our series]. / Carcinoma de células renales con extensión a vena cava: puesta al día y revisión de nuestra casuística.

OBJECTIVE: To assess current management of renal cell carcinoma (RCC) extending into the inferior vena cava (IVC): staging, diagnosis, surgical approach, adjuvant therapy, prognostic factors and survival rate. MATERIALS AND METHODS: Nineteen cases of RCC extending into the IVC undergoing surgical resection from January 1988 to August 2008 were reviewed. TNM staging and Neves-Zincke grading of the tumor were also assessed. Surgical approach depended on thrombus level. RESULTS: With a perioperative mortality rate of 10.5% and a mean follow-up of 22.65 months (range 2-79), 5 patients are still alive, while 11 patients died from the disease, 1 from an unrelated cause, and 2 were lost to follow-up. Patients with metastatic disease received adjuvant treatment with immunotherapy or kinase inhibitors. Mean survival was 15.1 months. Significant differences were found in 3- and 5-year survival rates in patients staged as N0M0 as compared to all other stages (N+M0, N0M+, N+M+). No differences were found depending on thrombus level. CONCLUSIONS: RCC with thrombus in the IVC is a tumor with a high mortality rate. Surgery continues to be the best option, and requires adequate preoperative evaluation and the support of an experienced and well trained multidisciplinary team. Survival depends on disease extension.

Linfoma renal primario: Aportación de tres nuevos casos y Revisión de la literatura / Primary renal lymphoma: Report of three new cases and literature review

OBJETIVOS: Se presentan tres casos clínicos de pacientes con linfoma renal primario, su diagnóstico y posterior tratamiento.MÉTODOS: Se realiza una revisión bibliográfica del origen, epidemiología, características clínicas, diagnóstico, tratamiento y pronóstico de esta enfermedad.RESULTADOS: En nuestro primer caso la paciente es diagnosticada tras una nefrectomía radical y tratada posteriormente con seis ciclos de CVP (ciclofosfamida, vincristina, prednisona). En el segundo paciente el diagnóstico se llevó a cabo mediante biopsia renal, administrándose seis ciclos de CHOP (ciclofosfamida, adriamicina, vincristina y prednisona). El último caso se trata de un linfoma secundario a la inmunosupresión en un riñón trasplantado en la que la realización de una trasplantectomía fue suficiente. Todos los casos fueron linfomas no-Hodgkin de células B descartándose el origen extrarrenal con biopsia de médula ósea, estando libres de enfermedad tras 15, 7 meses y 6.5 años del diagnóstico respectivamente.CONCLUSIONES: El linfoma renal primario es muy raro. El diagnóstico se realiza mediante biopsia renal aunque con frecuencia se presenta como una masa simulando un cáncer renal y es diagnosticado tras nefrectomía radical. El tratamiento consiste en quimioterapia (CHOP) asociada a rituximab(AU)

OBJECTIVES: We report the cases of three patients with primary renal lymphoma. Diagnosis and subsequent treatment are discussed.METHODS: The literature on the origin, epidemiology, clinical presentation, diagnosis, treatment and prognosis of primary renal lymphoma was reviewed.RESULTS: The first patient was diagnosed after radical nephrectomy and subsequently was given six cycles of CVP (cyclophosphamide, vincristine, prednisone). The diagnosis of the second patient was established by renal biopsy, and the patient received six cycles of CHOP (cyclophosphamide, adriamycin, vincristine and prednisone). The last patient had a lymphoma, secondary to immunosuppression, in a transplanted kidney. In this case transplant nephrectomy sufficed to cure the patient’s lymphoma. All patients had B-cell non-Hodgkin lymphoma (an extrarenal origin was ruled out by bone marrow biopsy), and were disease-free 15 months, 7 months, and 6.5 years after diagnosis, respectively.CONCLUSIONS: Primary renal lymphoma is rare. Diagnosis is established by renal biopsy, although it often presents as a mass simulating renal cell cancer and diagnosis is obtained after radical nephrectomy. Treatment consists of chemotherapy (CHOP) associated with rituximab(AU)

Carcinoma de células renales con extensión a vena cava: puesta al día y revisión de nuestra casuística / Renal cell carcinoma with vena cava involvement: update and review of our series

Objetivo: Valorar la situación actual en el tratamiento del carcinoma renal con extensión a vena cava inferior (VCI): Clasificación, diagnóstico, abordaje quirúrgico, terapia adyuvante, factores de pronóstico y supervivencia. Materiales y Métodos: Se revisan 19 casos de carcinomas renales con extensión a VCI intervenidos entre enero de 1988 y agosto de 2008. Se valoran la edad, el sexo, lateralidad y función renal de los pacientes. Con respecto al tumor se valoran: estadio según TNM y la clasificación de Neves-Zincke. Se describe el abordaje quirúrgico según el nivel del trombo. Resultados: Con una tasa de mortalidad perioperatoria del 10.5% y una media de seguimiento de 22,65 meses (rango 2-79), sobreviven 5 pacientes; 11 han fallecido por la enfermedad; uno por otra causa y 2 se han perdido. Los pacientes metastásicos han recibido tratamiento adyuvante con Inmunoterapia o inhibidores de las kinasas. La supervivencia media es de 15,1 meses. Existen diferencias significativas a tres y cinco años en la supervivencia de los pacientes estadiados como N0M0 vs resto (N+M0, N0M+, N+M+). No hay diferencias en función del nivel del trombo. Conclusiones: El carcinoma renal con trombo en VCI es un tumor con alta mortalidad. El abordaje quirúrgico del mismo es la opción más valida y precisa una correcta valoración prequirúrgica y el apoyo de un equipo multidisciplinar preparado y con experiencia. La supervivencia depende de la extensión de la enfermedad (AU)

Objective: To assess current management of renal cell carcinoma (RCC) extending into the inferior vena cava (IVC): staging, diagnosis, surgical approach, adjuvant therapy, prognostic factors and survival rate. Materials and Methods: Nineteen cases of RCC extending into the IVC undergoing surgical resection from January 1988to August 2008 were reviewed. TNM staging and Neves-Zincke grading of the tumor were also assessed. Surgical approach depended on thrombus level. Results: With a perioperative mortality rate of 10.5% and a mean follow-up of 22.65 months (range 2-79), 5 patients are still alive, while 11 patients died from the disease, 1 from an unrelated cause, and 2 were lost to follow-up. Patients with metastatic disease received adjuvant treatment with immunotherapy or kinase inhibitors. Mean survival was 15.1 months. Significant differences were found in 3- and 5-year survival rates in patients staged as N0M0 as compared to all other stages (N+M0, N0M+, N+M+). No differences were found depending on thrombus level. Conclusions: RCC with thrombus in the IVC is a tumor with a high mortality rate. Surgery continues to be the best option, and requires adequate preoperative evaluation and the support of an experienced and well trained multidisciplinary team. Survival depends on disease extension (AU)

[Intrathoracic ectopic kidney in an adult: case report and bibliographic review]. / Riñón ectópico intratorácico en un adulto: aportación de un caso y revisión de la literatura.

OBJECTIVE: We report the case of a 61-year-old male with the incidental diagnosis of intrathoracic renal ectopia during the workup study for a possible lung mass. METHODS: We performed a bibliographic review on the incidence, origin, clinical presentation and diagnosis of this type of renal ectopia. RESULTS: Chest x-ray showed a left posterior mediastinum mass. Bronchoscopy was performed showing signs of extrinsic compression with absence of neoplastic cells. CT scan revealed a left intrathoracic ectopic kidney with diaphragmatic hernia. CONCLUSIONS: Intrathoracic renal ectopia is a very unfrequent finding, often asymptomatic, frequently an incidental diagnosis that does not require treatment.

Riñón ectópico intratorácico en un adulto: aportación de un caso y revisión de la literatura / Intrathoracic ectopic kidney in an adult: case report and bibliographic review

Objetivo: Se presenta el caso clínico de un varón de 61 años diagnosticado de manera incidental de ectopia renal intratorácica durante el estudio de posible masa pulmonar. Métodos: Se realiza una revisión bibliográfica de la incidencia, origen, clínica y diagnóstico de este tipo de ectopia renal. Resultados: En la radiografía de tórax se aprecia una masa en mediastino posterior izquierdo. Es practicada una fibrobroncoscopia apreciando signos de compresión extrínseca con ausencia de células neoplásicas. El TAC revela un riñón ectópico intratorácico con hernia diafragmática izquierda. Conclusiones: La ectopia renal intratorácica es un hallazgo muy infrecuente, habitualmente asintomático, diagnosticado con frecuencia de manera incidental y que no suele requerir tratamiento (AU)

Objective: We report the case of a 61-year-old male with the incidental diagnosis of intrathoracic renal ectopia during the workup study for a possible lung mass. Methods: We performed a bibliographic review on the incidence, origin, clinical presentation and diagnosis of this type of renal ectopia. Results: Chest x-ray showed a left posterior mediastinum mass. Bronchoscopy was performed showing signs of extrinsic compression with absence of neoplastic cells. CT scan revealed a left intrathoracic ectopic kidney with diaphragmatic hernia. Conclusions: Intrathoracic renal ectopia is a very unfrequent finding, often asymptomatic, frequently an incidental diagnosis that does not require treatment (AU)

[Low flow priapism. Treatment by sapheno-cavernous shunt]. / Priapismo de bajo flujo. Tratamiento mediante shunt safeno-cavernoso.

OBJECTIVE: We report the clinical case of a 21-year-old male presenting with a 36 hour history of low flow priapism, its diagnosis and treatment. METHODS: We performed a bibliography review on the etiology, physiopathology, diagnosis and treatment options. RESULTS: The patient underwent unsuccessful punction-aspiration of intracavernous blood with phenylephrine injection and cavernous irrigation with saline solution. A covernous-spongiosum shunt was performed subsequently, firstly using the Winter technique and followed by the AlGorab technique with a final positive response. CONCLUSIONS: The performance of a sapheno-cavernous shunt is an effective treatment for the low flow priapism resistant to usual medical-surgical treatment.

[Metachronic testicular tumor secondary to invasive bladder carcinoma]. / Tumor testicular metacronico secundario a carcinoma vesical infiltrante.

OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cell carcinoma years after radical surgery. CASE REPORT: 71-year-old male patient with history of infiltrative bladder tumor, status post radical cystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the right testicle. Inguinal orchyectomy was carried out with the pathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review. RESULTS: The patient is disease-free twelve months after orchyectomy. CONCLUSIONS: Apart from leukemia and lymphoma, testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improve prognosis.

Priapismo de bajo flujo. Tratamiento mediante shunt safeno-cavernoso / Low flow priapism. Treatment by sapheno-cavernous shunt

Objetivo: Se presenta el caso clínico de un varón de 21 años con priapismo de bajo flujo de 36 horas de evolución, su diagnóstico y su posterior tratamiento. Métodos: Se realiza una revisión bibliográfica de la etiología, fisiopatología, diagnóstico y diferentes tratamientos posibles. Resultados: El paciente es sometido a la punción-aspiración de sangre intracavernosa con inyección de fenilefrina y lavados con suero fisiológico sin éxito. Posteriormente se realiza una derivación cavernoesponjosa, primero según la técnica de Winter seguida de la de Al Ghorab, respondiendo finalmente a la realización de un shunt safeno-cavernoso. Conclusiones: La realización de un shunt safeno-cavernoso es un tratamiento eficaz para la resolución de un priapismo de bajo flujo rebelde al tratamiento médico-quirúrgico habitual (AU)

Objective: We report the clinical case of a 21-year-old male presenting with a 36 hour history of low flow priapism, its diagnosis and treatment. Methods: We performed a bibliography review on the etiology, physiopathology, diagnosis and treatment options. Results: The patient underwent unsuccessful punction-aspiration of intracavernous blood with phenylephrine injection and cavernous irrigation with saline solution. A cavernous-spongiosum shunt was performed subsequently, firstly using the Winter technique and followed by the AlGorab technique with a final positive response. Conclusions: The performance of a sapheno-cavernous shunt is an effective treatment for the low flow priapism resistant to usual medical-surgical treatment (AU)

Tumor testicular metacrónico secundario a carcinoma vesical infiltrante / Metachronic testicular tumor secondary to invasive bladder carcinoma

OBJETIVOS: Presentar un caso raro de metástasis testicular secundaria a carcinoma urotelial infiltrante años después de practicada cirugía radical. METODOS: Exposición del caso clínico: paciente de 71 años sometido a cistoprostatectomía radical con uretrectomía por tumor vesical infiltrante. A los siete años debuta con dolor y aumento del tamaño testicular derecho. Se le practicó orquiectomía por vía inguinal siendo diagnosticado de metástasis testicular de carcinoma vesical de alto grado. y revisión de la literatura publicada al respecto. RESULTADOS: Supervivencia libre de enfermedad a los 12 meses de la orquiectomía. CONCLUSIONES: El tumor testicular metastático excluyendo leucemias y linfomas es extremadamente raro. La presencia de metástasis testiculares supone una diseminación metastásica a otros niveles y por ello la Quimioterapia podría mejorar el pronóstico (AU)

OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cell carcinoma years after radical surgery. METHODS: Case Report: 71-year-old male patient with history of infiltrative bladder tumor, status post radical cystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the right testicle. Inguinal orchyectomy was carried out with the pathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review. RESULTS: The patient is disease-free twelve months after orchyectomy. CONCLUSIONS: Apart from leukemia and lymphoma, testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improve prognosis

[Dorsal onlay urethroplasty with foreskin mucosa free graft (Barbagli's technique): preliminary results of our case series]. / Uretroplastia dorsal con injerto libre de mucosa prepucial (técnica de Barbagli): resultados preliminares de nuestra serie.

OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli's technique. METHODS: We retrospectively review 8 patients undergoing dorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results. RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to end anastomosis) with good outcome. CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results.

Uretroplastia dorsal con injerto libre de mucosa prepucial (Técnica de Barbagli): resultados preliminares de nuestra serie) / Dorsal onlay urethroplasty with foreskin mucosa free graft (Barbagli´s technique): preliminary results of our case series

OBJETIVO: Valoramos la indicación y nuestros resultados en el tratamiento de la estenosis de uretra compleja mediante la Técnica de Barbagli.MÉTODO: Realizamos una revisión retrospectiva de 8 pacientes a los que se indica la uretroplastia dorsal con injerto de mucosa libre prepucial. Analizamos las característicaspreoperatorias de los pacientes. La longitud media de la estenosis fue de 6,25 cm, la localización bulbar en 7 casos y peneana en uno. El flujo medio obtenido en la flujometría preoperatoria fue de 8,78 ml/seg. Describimos la técnica y presentamos los resultadosobtenidos con la misma. RESULTADOS: Con un tiempo medio de seguimiento de 22 meses tenemos un 87,5% de buenos resultados, entendiendo estos como la resolución definitiva de la estenosis. Sólo 1 paciente ha precisado un nuevo tratamientoquirúrgico (anastomosis término terminal), con buen resultado evolutivo.CONCLUSIONES: Concluimos que la uretroplastia dorsalcon injerto libre de mucosa prepucial es una técnica efectiva en estenosis de uretra larga y compleja y que por los resultados obtenidos, la consideramos técnica de primera elección en este tipo de estenosis uretrales

OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli`s technique.METHODS: We retrospectively review 8 patients undergoingdorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results.RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to endanastomosis) with good outcome.CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results

[Malacoplakia within a female urethral diverticulum]. / Malacoplaquia en divertículo uretral femenino.

OBJECTIVES: We report one case of malakoplakia within a female urethral diverticulum. METHODS: 33-year-old patient who consulted for an asymptomatic vaginal tumor. Physical examination, blood and urine analysis and microbiology tests, as well as urethrocystoscopy and intravenous pyelogram were performed. With the diagnosis of urethral diverticulum we undertook surgical excision through a vaginal approach. RESULTS: Pathology revealed the typical characteristics of malakoplakia within the diverticular lumen. CONCLUSIONS: Malakoplakia is an infrequent inflammatory disease which involves the urinary tract in most cases. Urethra location is exceptional.