[Laparoscopic surgery in urology]. / Cirugía laparoscópica en urología.

At the present time minimally invasive surgery is present in all the standards of quality of a surgical service. Laparoscopic surgery, the basis of this minimally invasive surgery, is revolutionizing the teaching and handling of many surgical pathologies. In the urological sphere, although with a delay of 5 years with respect to neighbouring countries, laparoscopy has become established as a prevalent technique in many processes of the urinary-genital apparatus. At present it is the chosen technique for the surgical treatment of the suprarenal, and it is rapidly becoming established in different pathologies such as renal tumours, prostate tumours, staging in neoplastic diseases of the testicles, benign surgical pathology and in reconstructive surgery. Since 1995, the Urology Service at the Hospital de Navarra has been a pioneer in the employment of this type of technique, and, since 1998, it has been a pioneer of so-called advanced laparoscopic surgery, in which it is a national reference point in some of the procedures, such as laparoscopic adrenalectomy. At present, all of the laparoscopic procedures are incorporated in the service, with a learning curve that has been surpassed. All of this has made it possible to improve patient care, to obtain a reduction in postoperative pain and in length of hospital stay, and a rapid return to labour activity with oncological results that can be equivalent on those of open surgery.

Cirugía laparoscópica en urología / Laparoscopic surgery in urology

La cirugía mínimamente invasiva está presente en el momento actual en todos los estándares de calidad de un servicio quirúrgico. La cirugía laparoscópica, base de esta cirugía de mínima invasión, está revolucionando la enseñanza y el manejo de muchas patologías quirúrgicas. En el ámbito urológico, aunque con un retraso de 5 años con respecto a los países de nuestro entorno, la laparoscopia se ha afianzado como una técnica prevalente en muchos procesos del aparato genito-urinario, siendo actualmente la técnica de elección para el tratamiento quirúrgico de la suprarrenal y afianzándose rápidamente en patologías diversas como tumores renales, prostáticos, estadiaje en enfermedades neoplásicas testiculares, patología quirúrgica benigna y en cirugía reconstructiva.El Servicio de Urología del Hospital de Navarra es pionero en el empleo de este tipo de técnicas desde 1995 y desde 1998 en la llamada cirugía laparoscópica avanzada, siendo referente nacional en alguno de los procedimientos como la adrenalectomía laparoscópica. Actualmente están incorporados en el servicio todos los procedimientos laparoscópicos avanzados en urología, con una curva de aprendizaje superada. Todo ello ha permitido mejorar la atención al paciente, consiguiendo una disminución del dolor postoperatorio, estancia hospitalaria y rápida reincorporación a la actividad laboral con unos resultados oncológicos superponibles a los de la cirugía abierta

At the present time minimally invasive surgery is present in all the standards of quality of a surgical service. Laparoscopic surgery, the basis of this minimally invasive surgery, is revolutionising the teaching and handling of many surgical pathologies. In the urological sphere, although with a delay of 5 years with respect to neighbouring countries, laparoscopy has become established as a prevalent technique in many processes of the urinary-genital apparatus. At present it is the chosen technique for the surgical treatment of the suprarenal, and it is rapidly becoming established in different pathologies such as renal tumours, prostate tumours, staging in neoplastic diseases of the testicles, benign surgical pathology and in reconstructive surgery. ;;Since 1995, the Urology Service at the Hospital de Navarra has been a pioneer in the employment of this type of technique, and, since 1998, it has been a pioneer of so-called advanced laparoscopic surgery, in which it is a national reference point in some of the procedures, such as laparoscopic adrenalectomy. At present, all of the laparoscopic procedures are incorporated in the service, with a learning curve that has been surpassed. All of this has made it possible to improve patient care, to obtain a reduction in postoperative pain and in length of hospital stay, and a rapid return to labour activity with oncological results that can be equivalent on those of open surgery

[Emergency treatment of urological complications in cancer patients]. / Manejo urgente de las complicaciones urológicas en el paciente tumoral.

Patients affected by neoplastic diseases frequently come for consultation to the emergency services of our hospitals. A large part of these consultations occur due to complications of an urological type, whatever the origin of the tumour that the patient presents. The pathology can be secondary to the neoplasy or to the means used in its treatment, although they are often complications that appear independently of the course of the disease. We offer an outline of the most frequent causes of emergency consultation due to urological problems in the patient affected by neoplastic diseases, whether they are in the urogential apparatus or not. We comment especially on the initial study and treatment by the emergency doctor or by the oncologist.

Manejo urgente de las complicaciones urológicas en el paciente tumoral / Emergency treatment of urological complications in cancer patients

Los pacientes afectos de enfermedades neoplásicas consultan a menudo en los servicios de urgencias de nuestros hospitales. Buena parte de esas consultas ocurren por complicaciones de tipo urológico, sea cual sea el origen del tumor que presenta el paciente. La patología puede ser secundaria a la neoplasia o a los medios utilizados para tratarla, aunque muchas veces son complicaciones que aparecen independientemente del curso de su enfermedad. Pretendemos dar unas pinceladas acerca de las causas de consulta urgente por problemas urológicos más frecuentes en el paciente afecto de enfermedades neoplásicas, ya sean del aparato urogenital o no. Comentaremos sobre todo el estudio y tratamiento iniciales por parte del médico de urgencias o del oncólogo (AU)

Patients affected by neoplastic diseases frequently come for consultation to the emergency services of our hospitals. A large part of these consultations occur due to complications of an urological type, whatever the origin of the tumour that the patient presents. The pathology can be secondary to the neoplasy or to the means used in its treatment, although they are often complications that appear independently of the course of the disease. We offer an outline of the most frequent causes of emergency consultation due to urological problems in the patient affected by neoplastic diseases, whether they are in the urogential apparatus or not. We comment especially on the initial study and treatment by the emergency doctor or by the oncologist (AU)

[Five years experience in the treatment of urinary lithiasis with the extracorporal lithotriptor MFL-5000]. / Cinco años de experiencia en el tratamiento de la litiasis urinaria con el litotriptor extracorpóreo MFL-5000.

We present a review of the treatments of the urinary calculations carried out in the Lithotrity Unit in its first five years of working with the Dornier lithotriptor MFL-5000. We describe the location and size of the calculations, distribution by age and sex of the patients, energy applied and time employed, and we compare our retreatment index and the number of sessions per calculation with those published by other authors.