[Climacturia, a symptom to take into account after radical prostatectomy]. / Climacturia, un sintoma a tener en cuenta tras prostatectomía radical.

INTRODUCTION AND OBJECTIVES: Patients after radical prostatectomy describe sexual dysfunctions such as orgasm-associated incontinence also termed climacturia. Our aim is to analyse incidence and data in relation with this symptom. METHODS: 119 phone surveys carried out to patients after radical prostatectomy to Know about climacturia incidence. We are trying to show the relationship between this symptom and the degree and type of incontinence, affectation at bladder neck and apex, and the age. RESULTS: The climacturia incidence came to 20%. The average age of the patients with this symptom was 59 years, the same as for those without it. The patients with both, incontinence and climacturia perform stress incontinence basically but urgency-incontinence to a greater extent (20%) that those with no climacturia (5%). Most patients with climacturia suffer a light leakage (87%) and a 62% always associated to orgasm. Negative effect of the symptom in the patient's and partner's sexual life appeared only in 2 cases (13%). CONCLUSIONS: We suggest the same term in Spanish than in English. Age and affectation of the bladder neck and apex do not have an effect on climacturia. Stress incontinence is more often related to patients with climacturia and the degree of incontinence is higher than in those without it.

Climacturia, un síntoma a tener en cuenta tras prostatectomía radical / Climaturia, a symptom to take into account after radical prostatectomy

Introducción y objetivos: Los pacientes a los que se les ha realizado una prostatectomía radical describen disfunciones sexuales entre las que se encuentra el orgasmo asociado a incontinencia. Pretendemos valorar la incidencia y datos relacionados con este síntoma. Métodos: Realizamos a 119 pacientes a los que se había realizado una prostatectomía radical, una encuesta telefónica dirigida a conocer la incidencia de climacturia. Pretendemos establecer la relación de éste síntoma con el grado y tipo de incontinencia, afectación a nivel de cuello vesical y apex, y la edad. Resultados: La incidencia de climacturia fue del 20%. La edad media de presentación del síntoma fue de 59 años, la misma que para los pacientes sin climacturia. Los pacientes con incontinencia y climacturia presentan fundamentalmente incontinencia de esfuerzo pero urgencia -incontinencia en mayor proporción (20%) que los pacientes sin climacturia (5%). El paciente que tiene climacturia la presenta en forma de unas gotas en un 87% y siempre que llegan al orgasmo en un 62%. La influencia negativa del síntoma en la vida sexual del paciente y de su pareja solo se presentó en 2 casos (13%). Conclusiones: Proponemos el uso del mismo término en lengua castellana que en lengua inglesa. La edad y la afectación en cuello vesical y apex no influyen en la aparición de climacturia. En los pacientes con climacturia se asocia mas frecuentemente incontinencia de esfuerzo y el grado de incontinencia es mayor que en los que no la padecen

Introduction and objectives: Patients after radical prostatectomy describe sexual dysfunctions such as orgasm-associated incontinence also termed climacturia. Our aim is to analyse incidence and data in relation with this symptom. Methods: 119 phone surveys carried out to patients after radical prostatectomy to Know about climacturia incidence. We are trying to show the relationship between this symptom and the degree and type of incontinence, affectation at bladder neck and apex, and the age. Results: The climacturia incidence came to 20%.The average age of the patients with this symptom was 59 years, the same as for those without it. The patients with both, incontinence and climacturia perform stress incontinence basically but urgency-incontinence to a greater extent (20%) that those with no climacturia (5%). Most patients with climacturia suffer a light leakage (87%) and a 62% always associated to orgasm. Negative effect of the symptom in the patient´s and partner´s sexual life appeared only in 2 cases (13%). Conclusions: We suggest the same term in Spanish than in English. Age and affectation of the bladder neck and apex do not have an effect on climacturia. Stress incontinence is more often related to patients with climacturia and the degree of incontinence is higher than in those without it

[Suburethral sling in the treatment of urinary incontinence: our experience]. / Cabestrillo suburetral en el tratamiento de la incontinencia urinaria: nuestra experiencia.

Review of 17 female patients who underwent placing of Suburethral Sling as anti-incontinence procedure with the purpose of assessing the results obtained. The most frequent complications were urinary retention and post-surgical urgency. A larger proportion of patients with Stress Urinary Incontinence had retention and during more days than those with Mixed Urinary Incontinence. In most cases of mixed urinary incontinence, asymptomatic prior to surgery, the placing of a suburethral sling provokes signs and symptoms of urgency, and even of post-surgical urgency-incontinence. Both complications were attenuated in all cases using measures such as conservation of urinary by-pass or administration of anti-cholinergics. Results at 2 years have been successful in 68.75% cases, thus encouraging us to reduce the number of indications for this technique.

[Trigono-cervico-prostatotomy (TCP) versus transurethral resection of the prostate (TURP). Our experience]. / Trigonocervicoprostatotomía (TCP) versus resección transuretral de próstata (RTU). Nuestra experiencia.

OBJECTIVE: Trigonocervicoprostatotomy (TCP) has been considered up to now an alternative treatment to transurethral resection of the prostate (TURP) when evaluating the size of the prostate. This paper demonstrates that endoscopic visualization is more important when choosing the surgical procedure and that both techniques can achieve satisfactory results. METHODS: The prostate volume is evaluated by ultrasound and according to the endoscopic findings, TURP or TCP is performed. The prostatic lobes are routinely biopsied if the latter procedure is chosen. RESULTS: We compared the results of 34 TCP and 30 TURP procedures using the values of I-PSS and uroflowmetry before and after surgery. In 86.2% of the TCPs and 80% of the TURPs, the patients are asymptomatic with I-PSS less than 7 and significantly improved uroflowmetry data. Biopsy disclosed adenocarcinoma in one patient submitted to TCP. CONCLUSIONS: TCP represents an alternative to TURP not only for small prostates (30 gm) but also for medium-sized prostates (50-60 gms), depending on the endoscopic findings. TCP is not indicated for lateral lobes that fall on the prostate floor. Performing a biopsy routinely in TCP does not prolong the operating time significantly and permits detecting subclinical adenocarcinoma of the prostate.

[Renal-cell adenocarcinoma as an incidental finding. Its diagnosis and tumor evolution]. / Adenocarcinoma renal como hallazgo incidental. Diagnóstico y evolución tumoral.

OBJECTIVES: We attempted to determine whether or not incidental renal cell carcinoma had a better prognosis. METHODS: We reviewed 53 cases of renal cell carcinoma that had been surgically treated over the periods 1985-1988 and 1989-1993. The form of presentation, stage of the incidental tumors, sex, compromised side and the diagnostic imaging technique utilized were analyzed. RESULTS: GI pathology most frequently led to the diagnosis of the tumor. Tumor stages were A or B with a slightly higher prevalence for the incidental tumors. However, the prognosis was not better than that of clinically suspected renal cell carcinoma. The male to female ratio was 1.17:1, the mean age was 63 years, the tumors were frequently right-sided and ultrasound was superior in the diagnosis of incidental tumors. CONCLUSIONS: No prognostic difference was observed between clinically suspected and incidental renal cell carcinoma of the same tumor stage.

[Cysts of the ejaculatory ducts. Diagnosis and clinical course after treatment]. / Quistes de conducto eyaculador. Diagnóstico y evolución tras tratamiento.

Confusion surrounding diagnosis of central prostate cysts is explained for the rarity of the condition. Deferento-vesiculography is diagnostic and must be performed independently (right-left) for a better anatomical evaluation of the area. The endoscopic images do not allow differential diagnosis from other prostate cysts. Recovery of bearer's fertile ability following endoscopic resection does not result, in our experience, as effective as it could be expected from resolving the obstructive cause.

[Bladder hernia. Report of 4 cases]. / Hernias vesicales. Aportación de cuatro casos.

Four cases of vesicoscrotal herniation are described. The different etiology and forms of presentation (from an incidental finding to one requiring emergency treatment) of this condition are discussed. Surgical treatment is based on its size, location and coexisting pathology (prostatic hyperplasia, calculus, bladder tumor, etc.).