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1.
Actas urol. esp ; 42(3): 198-201, abr. 2018. tab
Article in Spanish | IBECS | ID: ibc-172871

ABSTRACT

Introducción: Los síntomas del tracto urinario inferior secundarios al aumento del volumen prostático están asociados con la edad, y se están volviendo más prevalentes por el aumento de la esperanza de vida. Presentamos nuestra experiencia con la adenomectomía laparoscópica transperitoneal para el manejo de la obstrucción infravesical de origen prostático. Materiales y métodos: Se realizó una revisión retrospectiva de los pacientes sometidos a una adenomectomía laparoscópica entre 2005 y 2015. Se registró la edad, el flujo máximo y el residuo posmiccional pre y posquirúrgicos, el tiempo quirúrgico, el sangrado operatorio, el peso y la anatomía patológica, los días de sondaje y hospitalización y las complicaciones. Resultados: Se incluyeron 80 pacientes con una edad media de 70 años. El Qmáx medio prequirúrgico fue 8,21 ml/s y el posterior 22,52 ml/s. La media del residuo posmiccional previo fue 91,4 ml y el posterior 14,2ml. El tiempo quirúrgico medio fue 137,7 minutos. Fue necesaria la conversión a cirugía abierta en un caso por lesión intestinal. El sangrado intraoperatorio medio fue 227,6 ml. La estancia hospitalaria media fueron 5,46 días, y el tiempo de sondaje 4,86 días. Tuvimos 13 complicaciones que se registraron según el sistema Clavien-Dindo, siendo 3 de gravedad. El peso medio de la pieza quirúrgica fue 80,02 g. La anatomía patológica mostró hiperplasia benigna en 75 casos y cáncer de próstata en los 5 restantes. Conclusión: La adenomectomía laparoscópica es una técnica segura, reproducible y con los mismos resultados funcionales de la cirugía abierta. Nuestra serie muestra que este abordaje es útil, seguro y con una baja tasa de complicaciones


Introduction: Lower urinary tract symptoms secondary to increased prostate volume are associated with ageing and are becoming more prevalent due to increased life expectancy. We present our experience with transperitoneal laparoscopic adenomectomy for the management of bladder outlet obstruction caused by benign prostatic enlargement. Materials and methods: We performed a retrospective review of patients who underwent laparoscopic adenomectomy between 2005 and 2015. We recorded age, maximum flow and postvoid residual urine (preoperative and postoperative), surgical time, operative bleeding, weight and pathology, complications and duration of catheterisation and hospitalisation. Results: We included 80 patients with a mean age of 70 years. The mean preoperative and postoperative Qmax was 8.21 mL/s and 22.52 mL/s, respectively. The mean preoperative and postoperative postvoid residual urine was 91.4 mL and 14.2 mL, respectively. The mean surgical time was 137.7 min. Conversion to open surgery was necessary in one case due to intestinal injury. The mean intraoperative bleeding was 227.6 mL. The mean hospital stay was 5.46 days, and the catheterisation time was 4.86 days. There were 13 complications, which were recorded according to the Clavien-Dindo system, 3 of which were severe. The mean weight of the surgical specimen was 80.02 g. Pathology showed benign hyperplasia in 75 cases and prostate cancer in the remaining 5. Conclusion: Laparoscopic adenomectomy is a safe, reproducible technique with the same functional results as open surgery. Our series shows that this approach is useful and safe and has a low rate of complications


Subject(s)
Humans , Male , Aged , Urinary Bladder Neck Obstruction/surgery , Prostatic Hyperplasia/surgery , Urologic Surgical Procedures, Male/methods , Retrospective Studies , Peritoneum/surgery , Lymph Node Excision/methods , Urethral Stricture/surgery , Laparoscopy/methods
2.
Actas Urol Esp (Engl Ed) ; 42(3): 198-201, 2018 Apr.
Article in English, Spanish | MEDLINE | ID: mdl-29017737

ABSTRACT

INTRODUCTION: Lower urinary tract symptoms secondary to increased prostate volume are associated with ageing and are becoming more prevalent due to increased life expectancy. We present our experience with transperitoneal laparoscopic adenomectomy for the management of bladder outlet obstruction caused by benign prostatic enlargement. MATERIALS AND METHODS: We performed a retrospective review of patients who underwent laparoscopic adenomectomy between 2005 and 2015. We recorded age, maximum flow and postvoid residual urine (preoperative and postoperative), surgical time, operative bleeding, weight and pathology, complications and duration of catheterisation and hospitalisation. RESULTS: We included 80 patients with a mean age of 70 years. The mean preoperative and postoperative Qmax was 8.21mL/s and 22.52mL/s, respectively. The mean preoperative and postoperative postvoid residual urine was 91.4mL and 14.2mL, respectively. The mean surgical time was 137.7min. Conversion to open surgery was necessary in one case due to intestinal injury. The mean intraoperative bleeding was 227.6mL. The mean hospital stay was 5.46 days, and the catheterisation time was 4.86 days. There were 13 complications, which were recorded according to the Clavien-Dindo system, 3 of which were severe. The mean weight of the surgical specimen was 80.02g. Pathology showed benign hyperplasia in 75 cases and prostate cancer in the remaining 5. CONCLUSION: Laparoscopic adenomectomy is a safe, reproducible technique with the same functional results as open surgery. Our series shows that this approach is useful and safe and has a low rate of complications.


Subject(s)
Laparoscopy , Prostatectomy/methods , Prostatic Hyperplasia/surgery , Urinary Bladder Neck Obstruction/surgery , Aged , Aged, 80 and over , History, 18th Century , Humans , Male , Middle Aged , Prostatic Hyperplasia/complications , Retrospective Studies , Time Factors , Treatment Outcome , Urinary Bladder Neck Obstruction/etiology
3.
Actas Urol Esp ; 34(3): 223-31, 2010 Mar.
Article in Spanish | MEDLINE | ID: mdl-20416238

ABSTRACT

INTRODUCTION: Laparoscopic surgery has been increasingly used in urology in recent years. Laparoscopy has been performed at our center since 2001. Changes over time in the indication of open versus laparoscopic/robotic surgery, hospital stay, and learning curve are reviewed. MATERIALS AND METHODS: A retrospective review of our database from 1997 to the end of 2007. A total of 3622 procedures were performed during this time (endoscopic procedures were excluded): 67.75% open, 26.17% laparoscopic, 2.29% perineal, and 3.78% robotic surgeries. Of these, 83.79% were performed in males and 16.20% in females. Mean patient age was 58.8 years. Data from the study period, including mean hospital stay and changes over time in operating time as a function of the learning curve, were analyzed and compared to data for the last 12 months of the study period. RESULTS: The percentages of all surgical procedures performed using a laparoscopic approach in the 1997-2006 versus the last 12 study months were as follows: nephrectomy, 31.8% versus 74.7%; living donor nephrectomy, 93% versus 100%; nephroureterectomy, 28.1% vs. 93.4%; partial nephrectomy, 31.3% vs 87%; and radical prostatectomy, 17.6% versus 73.5% including laparoscopic and robotic approaches. Shorter mean hospital stays and operating times were also seen. CONCLUSIONS: Use of the laparoscopic approach has greatly increased in the 10-year period studied. In renal surgery, few indications remain for open surgery. In prostate surgery, introduction of robotic surgery in 2005 and learning of laparoscopy by several of our urologists have dramatically changed the therapeutic approach. Gradual incorporation of laparoscopic surgery has led to a decreased hospital stay and to a shortening of the learning curve.


Subject(s)
Laparoscopy , Nephrectomy/methods , Prostatectomy/methods , Robotics , Female , Humans , Male , Middle Aged , Retrospective Studies , Time Factors , Urologic Surgical Procedures/methods , Urologic Surgical Procedures/trends
5.
Actas urol. esp ; 34(3): 223-231, mar. 2010. tab, graf
Article in Spanish | IBECS | ID: ibc-81693

ABSTRACT

Introducción: Durante los últimos años se ha producido un incremento en la cirugía laparoscópica en urología. Nuestra institución realiza laparoscopia de forma continuada desde 2001. Revisamos la evolución de la indicación de cirugía abierta vs. laparoscópica/robótica, la estancia hospitalaria y la curva de aprendizaje. Material y métodos: Retrospectivamente revisamos nuestra base de datos desde 1997 hasta finales del 2007. Son 3,622 cirugías (excluyendo todas las de abordaje endoscópico): 67,75% abiertas, 26,17% laparoscópicas, 2,29% perineales y 3,78% robóticas. El 83,79% en hombres y el 16,20% en mujeres. La edad media es de 58,8 años. Se analizan los datos de la década estudiada incluyendo estancia media hospitalaria y evolución del tiempo quirúrgico en función de la curva de aprendizaje y se comparan con los de los últimos doce meses de la misma. Resultados: El porcentaje de cirugías laparoscópicas respecto de las totales, realizadas en los 9 primeros años frente a las de los 12 últimos meses del estudio son: nefrectomías: 31,8 y 74,7%; nefrectomías de donante vivo: 93 y 100%; nefroureterectomías: 28,1 y 93,4%; nefrectomías parciales: 31,3 y 87%, y prostatectomías radicales: 17,6 y 73,5% sumando laparoscópicas y robóticas. Se observa disminución de la estancia media y disminución del tiempo quirúrgico. Conclusiones: En los 10 años estudiados se ha producido un gran incremento en el abordaje laparoscópico. En la cirugía renal, son escasas las indicaciones de cirugía abierta. En cirugía prostática, la introducción de la cirugía robótica así como el aprendizaje laparoscópico por varios urólogos de nuestro centro ha cambiado radicalmente el enfoque terapéutico. La incorporación de la cirugía laparoscópica ha supuesto una disminución de la estancia hospitalaria y un acortamiento de la curva de aprendizaje (AU)


Introduction: Laparoscopic surgery has been increasingly used in urology in recent years. Laparoscopy has been performed at our center since 2001. Changes over time in the indication of open versus laparoscopic/robotic surgery, hospital stay, and learning curve are reviewed. Materials and methods: A retrospective review of our database from 1997 to the end of 2007. A total of 3622 procedures were performed during this time (endoscopic procedures were excluded): 67,75% open, 26,17% laparoscopic, 2,29% perineal, and 3,78% robotic surgeries. Of these, 83,79% were performed in males and 16,20% in females. Mean patient age was 58,8 years. Data from the study period, including mean hospital stay and changes over time in operating time as a function of the learning curve, were analyzed and compared to data for the last 12 months of the study period. Results: The percentages of all surgical procedures performed using a laparoscopic approach in the 1997–2006 versus the last 12 study months were as follows: nephrectomy, 31,8% versus 74,7%; living donor nephrectomy, 93% versus 100%; nephroureterectomy, 28,1% vs. 93,4%; partial nephrectomy, 31,3% vs 87%; and radical prostatectomy, 17,6% versus 73,5% including laparoscopic and robotic approaches. Shorter mean hospital stays and operating times were also seen. Conclusions: Use of the laparoscopic approach has greatly increased in the 10-year period studied. In renal surgery, few indications remain for open surgery. In prostate surgery, introduction of robotic surgery in 2005 and learning of laparoscopy by several of our urologists have dramatically changed the therapeutic approach. Gradual incorporation of laparoscopic surgery has led to a decreased hospital stay and to a shortening of the learning curve (AU)


Subject(s)
Humans , Male , Laparoscopy , Robotics , Urologic Diseases/surgery , Prostatectomy/methods , Nephrectomy/methods , Urogenital Surgical Procedures/methods , Male Urogenital Diseases/surgery , Age and Sex Distribution
7.
Actas Urol Esp ; 32(7): 717-21, 2008.
Article in Spanish | MEDLINE | ID: mdl-18788488

ABSTRACT

INTRODUCTION: Quality is defined as an essential and distinguishing attribute of something, which allows to evaluate its worth. The quality evaluation has become something necessary during the last years. The assistencial quality should be something inherent to the offered service, including scientific and technical quality, management and quality noticed. A periodical assesment, as auto-evaluation or through an outsourcing, is a recommendable way to detect potential improvement items. MATERIAL AND METHODS: Using the EFQM,ISO 9001:2000 and Malcolm Baldrige model, and through the items from National Health System, a self-questionnaire of urological emergency room quality evaluation is proposed. CONCLUSION: A new self-questionnaire of urological emergency room quality evaluation is proposed.


Subject(s)
Emergency Service, Hospital/standards , Quality Assurance, Health Care , Surveys and Questionnaires , Urologic Diseases/therapy , Humans
8.
Actas urol. esp ; 32(7): 717-721, jul.-ago. 2008. ilus
Article in Es | IBECS | ID: ibc-66895

ABSTRACT

Introducción: Definida calidad por la propiedad o conjunto de propiedades inherentes a algo, que permiten juzgar su valor, su evaluación se ha convertido en algo obligado en las últimas décadas. La calidad asistencial debe, por tanto, ser inherente al servicio ofrecido. Ha de incluir calidad científica, calidad técnica, gestión y calidad percibida. La evaluación periódica, bien a través de una empresa externa o como auto-evaluación, constituye una forma directa de detectar aspectos susceptibles de mejora. Material y métodos: Siguiendo los modelos Europeo de Excelencia empresarial (EFQM), la Norma ISO 9001:2000 y el modelo Malcom Baldrige, y partiendo de los indicadores clave del Sistema Nacional de Salud se crea un formulario de evaluación de la calidad global. Conclusiones: Se propone un cuestionario destinado a evaluar la calidad asistencial de un servicio de urgencias urológicas (AU)


Introduction: Quality is defined as an essential and distinguishing attribute of something, which allows to evaluate its worth. The quality evaluation has become something necessary during the last years. The assistencial quality should be something inherent to the offered service, including scientific and technical quality, management and quality noticed. A periodical assesment, as auto-evaluation or through an outsourcing, is a recommendable way to detect potential improvement items. Material and methods: Using the EFQM, ISO 9001:2000 and Malcolm Baldrige model, and through the items from National Health System, a self-questionnaire of urological emergency room quality evaluation is proposed. Conclusion: A new self-questionnaire of urological emergency room quality evaluation is proposed (AU)


Subject(s)
Humans , Male , Surveys and Questionnaires , Emergency Medical Services/methods , Emergency Medical Services/trends , Evaluation Study , Emergency Medical Services/statistics & numerical data , Emergency Medicine/methods , Emergency Medicine/trends , Quality Control , Primary Health Care/methods , Quality Assurance, Health Care , Quality Control
9.
Actas Urol Esp ; 32(2): 179-83, 2008 Feb.
Article in Spanish | MEDLINE | ID: mdl-18409466

ABSTRACT

BACKGROUND: One of the prostate cancer progression complications is the obstructive uropathy, by infiltration and compression of the distal ureteral section, that can entail to an acute renal insufficiency, with affectation of the quality of life and the survival of these patients. The treatment of prostate cancer with secondary ureterohidronefrosis is palliative and following the present tendencies, the positioning of a nephrostomy is considered. MATERIALS AND METHODS: A search was made in PUBMED and the most representative articles were reviewed. The algorithm was constructed with the daily routine clinical base, the protocol of our center and with the scientific evidence available in medical literature. RESULTS: An algorithm of decisions sets out to define the urinary derivation in patients with obstructive uropathy secondary to prostate cancer. CONCLUSIONS: The indication to place a nephrostomy in patients with obstructive uropathy secondary to prostate cancer must be approached individually, according to the general conditions and the quality of life of the patient with base in scales defined in literature (ECOG and Karnofsky) and in factors of good or bad prognosis, always considering ethical considerations and the consent of the patient and his family.


Subject(s)
Algorithms , Prostatic Neoplasms/complications , Ureteral Obstruction/etiology , Ureteral Obstruction/therapy , Humans , Male
10.
Actas urol. esp ; 32(2): 179-183, feb. 2008. ilus, tab
Article in Es | IBECS | ID: ibc-62838

ABSTRACT

Introducción: Una de las complicaciones de la progresión del cáncer de próstata es la uropatía obstructiva, por infiltración y compresión del tramo ureteral distal, que puede conllevar a una insuficiencia renal aguda, con afectación de la calidad de vida y la supervivencia de estos pacientes. El tratamiento del cáncer de próstata con ureterohidronefrosis secundaria es paliativo y siguiendo las tendencias actuales, se debe considerar la colocación de una nefrostomía. Materiales y Métodos: Se realizó una búsqueda en PUBMED y se revisaron los artículos más representativos. El algoritmo se construyó con base en la práctica clínica diaria basada en la rutina, el protocolo de nuestro centro y con la evidencia científica disponible en la literatura médica. Resultados: Se propone un algoritmo de decisiones para definir la derivación urinaria en pacientes con uropatía obstructiva secundaria a cáncer de próstata. Conclusiones: La indicación de colocar una nefrostomía en pacientes con uropatía obstructiva secundaria a cáncer de próstata debe abordarse individualmente, de acuerdo a las condiciones generales y la calidad de vida del paciente con base en escalas ya definidas en la literatura (ECOG y Karnofsky) y en factores de buen o mal pronóstico, siempre teniendo en cuenta consideraciones éticas y el consentimiento del paciente y de su familia (AU)


Background: One of the prostate cancer progression complications is the obstructive uropathy, by infiltration and compression of the distal ureteral section, that can entail to an acute renal insufficiency, with affectation of the quality of life and the survival of these patients. The treatment of prostate cancer with secondary ureterohidronefrosis is palliative and following the present tendencies, the positioning of a nephrostomy is considered. Materials and Methods: A search was made in PUBMED and the most representative articles were reviewed. The algorithm was constructed with the daily routine clinical base, the protocol of our center and with the scientific evidence available in medical literature. Results: An algorithm of decisions sets out to define the urinary derivation in patients with obstructive uropathy secondary to prostate cancer. Conclusions: The indication to place a nephrostomy in patients with obstructive uropathy secondary to prostate cancer must be approached individually, according to the general conditions and the quality of life of the patient with base in scales defined in literature (ECOG and Karnofsky) and in factors of good or bad prognosis, always considering ethical considerations and the consent of the patient and his family (AU)


Subject(s)
Humans , Prostatic Neoplasms/complications , Ureteral Obstruction/etiology , Ureteral Obstruction/surgery , Algorithms , Nephrostomy, Percutaneous , Prognosis
13.
Actas Urol Esp ; 30(9): 879-95, 2006 Oct.
Article in Spanish | MEDLINE | ID: mdl-17175928

ABSTRACT

UNLABELLED: The objective of this article is to quote under the form of a document the opinions expressed by the participants of the round table "Lasers in Urology Today" (january 2006). The material and method used is the compilation of critical and updated notions on the usefulness of lasers in urology, supplemented by bibliographic references, a limited iconography. The results achieved by lasers today enable us to state that: Holmium laser is the choice treatment for in situ lithotripsy; however, it has not significantly improved previous results when treating urologic tumours and stenoses. Nowadays we have two types of lasers: KTP and HoL, which obtain results similar to surgery regarding BPH, but with reduced morbidity. The usefulness of laser in laparoscopic surgery is still under development. CONCLUSION: Lasers in Urology Today play an active role in in situ lithotripsy (HoL), and a competitive one in BPH surgery (KTP and HoL). Regarding the rest of indications, i.e. tumours, stenoses, laparoscopic surgery, etc., further studies and enough follow-up times are still needed.


Subject(s)
Laser Coagulation , Laser Therapy , Urologic Diseases/surgery , Equipment Design , Humans , Laser Therapy/instrumentation , Lithotripsy, Laser , Urinary Calculi/therapy
14.
Actas urol. esp ; 30(9): 879-895, oct. 2006. ilus, tab
Article in Es | IBECS | ID: ibc-049448

ABSTRACT

El objetivo de este artículo, es reproducir en forma de texto las opiniones vertidas por los componentes de laMesa Redonda "Lásers en Urología Hoy", durante su celebración (enero 2006). El material y método empleados ha sido la recopilación de los conceptos críticos y actuales sobre la utilidad de los lásers en urología, acompañados de bibliografía/iconografía limitada y seleccionada. Los resultados conseguidos por los lásers en la actualidad permiten establecer que: EL láser Holmium es el tratamiento de elección como litotricia in situ pero que no ha mejorado significativamente los resultados precedentes, en el tratamiento de los tumores y estenosis urológicos. Disponemos hoy de dos tipos de lásers: KTP y HoL que consiguen resultados similares a los de la cirugía en la HBP, pero con menor morbilidad. La utilidad del láser en cirugía laparoscópica está todavía en desarrollo. En conclusión: los Lásers en Urología Hoy desempeñan un papel electivo en litotricia in situ (HoL) y competitivo en cirugía de la HBP (KTP y HoL). En el resto de sus indicaciones: tumores, estenosis, cirugía laparoscópica etc., se precisan estudios y tiempo de seguimiento suficientes para establecer conclusiones fiables


The objective of this article is to quote under the form of a document the opinions expressed by the participants of the round table "Lasers in Urology Today" (january 2006). The material and method used is the compilation of critical and updated notions on the usefulness of lasers in urology, supplemented by bibliographic references, a limited iconography. The results achieved by lasers today enable us to state: Holmium laser is the choice treatment for in situ lithotripsy; however, it has not significantly improved previous results when treating urologic tumours and stenoses. Nowadays we have two types of lasers: KTP and HoL, which obtain results similar to surgery regarding BHP, but with reduced morbidity. The usefulness of laser in laparoscopic surgery is still under development. Conclusion: Lasers in Urology Today play an active role in in situ lithotripsy (HoL), and competitive one in BPH surgery (KTP and HoL). Regarding the rest of indications, i. e. tumours, stenoses, laparoscopic surgery, etc., further studies and enough follow-up times are still needed


Subject(s)
Humans , Lasers/therapeutic use , Urologic Diseases/surgery , Laser Therapy , Lithotripsy, Laser , Prostatic Hyperplasia/surgery , Urethral Stricture/surgery , Laparoscopy , Urologic Neoplasms/surgery
15.
Actas Urol Esp ; 30(5): 492-500, 2006 May.
Article in Spanish | MEDLINE | ID: mdl-16884100

ABSTRACT

Laparoscopic surgery is a surgical technique the urologist should add to his surgical armamentarium. Its performance tries to mimic the surgical phases of open surgery, and also its indications. Laparoscopic partial nephrectomy is a sophisticated technique that requires wide experience in the performance of endoscopic strategies. We are submitting our experience with 35 laparoscopic partial transperitoneal nephrectomies with a mean follow-up of 25 months. The mean surgical time was 200 minutes, the mean bleeding 190 cc, and the mean hospitalisation five days. Two postoperative bleedings were identified, there were no conversions, and positive margins were notified in two cases, where upon a conservative attitude was adopted.


Subject(s)
Kidney Neoplasms/surgery , Laparoscopy/methods , Nephrectomy/methods , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Peritoneum
16.
Actas urol. esp ; 30(5): 492-500, mayo 2006. ilus, tab
Article in Es | IBECS | ID: ibc-046165

ABSTRACT

La cirugía laparoscópica constituye una técnica quirúrgica que el urólogo debe incorporar a su armamentario quirúrgico. Su realización intenta simular los pasos quirúrgicos de la cirugía abierta, así como sus indicaciones. La nefrectomía parcial laparoscópica es una técnica compleja que implica para su desarrollo una experiencia amplia en el manejo de las técnicas endoscópicas. Presentamos nuestra experiencia de 35 nefrectomías parciales laparoscópicas transperitoneales con una media de seguimiento de 25 meses. El tiempo medio de cirugía fue de 200 minutos, el sangrado de 190 cc, y la estancia media de cinco días. Se han objetivado dos sangrados postoperatorios, ninguna conversión y en dos casos se informó de márgenes positivos, optándose por una actitud conservadora


Laparoscopic surgery is a surgical technique the urologist should add to his surgical armamentarium. Its performance tries to mimic the surgical phases of open surgery, and also its indications. Laparoscopic partial nephrectomy is a sophisticated technique that requires wide experience in the performance of endoscopic strategies. We are submitting our experience with 35 laparoscopic partial transperitoneal nephrectomies with a mean follow-up of 25 months. The mean surgical time was 200 minutes, the mean bleeding 190 cc, and the mean hospitalisation five days. Two postoperative bleedings were identified, there were no conversions, and positive margins were notified in two cases, whereupon a conservative attitude was adopted


Subject(s)
Humans , Nephrectomy/methods , Laparoscopy/methods , Kidney Neoplasms/surgery , Laparoscopes
17.
Actas Urol Esp ; 29(8): 787-90, 2005 Sep.
Article in Spanish | MEDLINE | ID: mdl-16304912

ABSTRACT

Upper tract transitional cell carcinoma is a low prevalent tumour and frequently associated to bladder carcinoma. The antegrade endoscopic access represents a safe, efficient and minimally invasive access. The association to immunotherapy seems effective in decreasing recurrence. We present one patient with multiple upper tract carcinoma treated with percutaneous surgery and BCG.


Subject(s)
Adjuvants, Immunologic/therapeutic use , BCG Vaccine/therapeutic use , Carcinoma, Transitional Cell/drug therapy , Urinary Bladder Neoplasms/drug therapy , Carcinoma, Transitional Cell/diagnostic imaging , Cystoscopy , Humans , Male , Middle Aged , Tomography, X-Ray Computed , Treatment Outcome , Urinary Bladder Neoplasms/diagnostic imaging , Urography
18.
Actas urol. esp ; 29(8): 787-790, sept. 2005. ilus
Article in Es | IBECS | ID: ibc-041399

ABSTRACT

El tumor urotelial del tracto urinario superior constituye un tipo de tumor de baja prevalencia, frecuentemente asociado a tumor vesical. El uso de la vía endoscópica con acceso anterógrado representa un método de tratamiento seguro, eficaz y mínimamente invasivo. La asociación con inmunoterapia parece efectiva para disminuir la recurrencia. Presentamos un caso de tumor de tramo urinario superior múltiple tratado mediante exéresis percutánea e inmunoterapia terapéutica (AU)


Upper tract transitional cell carcinoma is a low prevalent tumour and frequently associated to bladder carcinoma. The antegrade endoscopic access represents a safe, efficient and minimally invasive access. The association to immunotherapy seems effective in decreasing recurrence. We present one patient with multiple upper tract carcinoma treated with percutaneous surgery and BCG (AU)


Subject(s)
Male , Middle Aged , Humans , Adjuvants, Immunologic/adverse effects , BCG Vaccine/therapeutic use , Carcinoma, Transitional Cell/drug therapy , Urinary Bladder Neoplasms/drug therapy , Carcinoma, Transitional Cell/radiotherapy , Cystoscopy , Tomography, X-Ray Computed , Treatment Outcome , Urography , Urinary Bladder Neoplasms
19.
Actas Urol Esp ; 24(8): 626-31, 2000 Sep.
Article in Spanish | MEDLINE | ID: mdl-11103499

ABSTRACT

The intracranial metastasis due to prostatic adenocarcinoma are quite rare, inside them, the ones placed in the parasellar region on the cranial base are exceptional. There are only 3 clinical cases found in the literature consulted, now we report here two more cases and we review the etiopathogenia, clinic presentation, diagnosis and treatment for this type of lesions. Usually there are very undifferentiated neoplasms, developed stages and with multiple metastasis at others levels. A patient with prostatic carcinoma known and neurological signs we should suspect the presence of intracranial metastasis. The diagnosis is made with image tests (basically with CT and MRI), being necessary in some cases the histological confirmation with a biopsy. Although the prognostic of these patients (less than 6 months in our cases) depends more of the evolutive stage of the illness than the type of treatment that the patients will be someated, we should establish it rapidly, on this way we can revert the neurological status and we will improve the quality of life of these patients.


Subject(s)
Adenocarcinoma/secondary , Brain Neoplasms/secondary , Prostatic Neoplasms/pathology , Aged , Humans , Male
20.
Arch Esp Urol ; 53(6): 469-71, 2000.
Article in Spanish | MEDLINE | ID: mdl-11002514

ABSTRACT

OBJECTIVE: To describe 11 cases of metastatic carcinoma of the testicular parenchyma presenting as a scrotal mass. METHODS: A descriptive and retrospective study of metastatic carcinoma of the testis was performed. Eleven cases of testicular metastasis from prostate cancer (7), renal adenocarcinoma (2), bladder carcinoma (1) and carcinoma of the pancreas (1) are presented. RESULTS: All the patients had multiple disseminated disease from their underlying condition, which is a sign of poor prognosis. CONCLUSIONS: Testicular metastasis from carcinoma is rare and frequently arises from adenocarcinoma of the prostate. Clinically, testicular metastases cannot be distinguished from primary tumors and generally affect males over 60 years old.


Subject(s)
Testicular Neoplasms/secondary , Humans , Male , Retrospective Studies
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