[An analysis of our experience in cryopreservation of semen from cancer patients]. / Análisis de nuestra experiencia en la criopreservación del semen en pacientes oncológicos.

OBJECTIVE: To analyze the characteristics of patients with oncological problems who were users of the sperm bank, as well as use of cryopreserved semen. MATERIALS AND METHODS: A retrospective analysis was made of all cryopreserved semen samples from males diagnosed with cancer from April 1992 to October 2007 at the province of Las Palmas. RESULTS: One hundred and one male patients with cancer were referred to the sperm bank before cancer therapy. Eighty percent of them were contacted by telephone. Mean freezing age was 25 years. Forty-one percent of patients had testicular tumors. Thirty-three percent had no prior biological children. Only one patient had known fertility problems before treatment. Sixty-seven percent of patients were warned by the healthcare team about the possibility of infertility at the time of cancer diagnosis. Only 1% of samples were not adequate for cryopreservation. The frozen sample was used by 4% of the patients. When patients were asked about future use of semen, 63% of them wanted to continue with semen cryopreservation, as compared to 17% who had no interest in having offspring in the future. CONCLUSION: The number of fertile patients who cryopreserve semen is extremely low. It is very important that the healthcare team warns patients of potential infertility after treatment. A high proportion of patients have valid samples for cryopreservation, but semen is used by a low number of patients. A high proportion of patients want to maintain their semen frozen.

Análisis de nuestra experiencia en la criopreservación del semen en pacientes oncológicos / An analysis of our experience in cryopreservation of semen from cancer patients

Objetivo: analizar las características de los pacientes con problemas oncológicos, usuarios del banco de semen, así como el uso del semen criopreservado. Material y métodos: de forma restrospectiva se han analizado todas las muestras de semen criopreservadas de varones con el diagnóstico de cáncer, entre abril de 1992 y octubre del 2007, en la provincia de Las Palmas. Resultados: fueron remitidos al banco de semen 101 varones con tumores, previo tratamiento oncológico. Se contactó por vía telefónica con el 80%. La edad media de congelación fue de 25 años. El 41% de los pacientes padecían de tumores testiculares; no tenían hijos biológicos previos el 33%. Sólo un paciente tenía problemas de infertilidad previo al tratamiento. En el momento del diagnóstico del cáncer el equipo sanitario advirtió al 67% de los pacientes de la posibilidad de infertilidad. Sólo el 1% de las muestras no fue apta para la criopreservación. Se usó la muestra congelada en el 4% de las muestras, y cuando se les preguntaba sobre el uso futuro del semen el 63% de los pacientes deseaba continuar con el criopreservado, frente al 17%, que no mostraba interés por tener descendencia en el futuro. Conclusión: el número de enfermos en edad fértil que criopreservan el semen es extremadamente bajo. Advertir a los pacientes de la posibilidad de infertilidad tras el tratamiento, por parte del equipo sanitario, es de una vital importancia. Hay un alto porcentaje de pacientes con muestras válidas para criopreservación, un escaso número de pacientes hacen uso del semen, aunque existe un alto porcentaje de pacientes con deseo de continuar con su semen congelado(AU)

Objective: To analyze the characteristics of patients with oncological problems who were users of the sperm bank, as well as use of cryopreserved semen. Materials and methods: A retrospective analysis was made of all cryopreserved semen samples from males diagnosed with cancer from April 1992 to October 2007 at the province of Las Palmas. Results: One hundred and one male patients with cancer were referred to the sperm bank before cancer therapy. Eighty percent of them were contacted by telephone. Mean freezing age was 25 years. Forty-one percent of patients had testicular tumors. Thirty-three percent had no prior biological children. Only one patient had known fertility problems before treatment. Sixty-seven percent of patients were warned by the healthcare team about the possibility of infertility at the time of cancer diagnosis. Only 1% of samples were not adequate for cryopreservation. The frozen sample was used by 4% of the patients. When patients were asked about future use of semen, 63% of them wanted to continue with semen cryopreservation, as compared to 17% who had no interest in having offspring in the future. Conclusion: The number of fertile patients who cryopreserve semen is extremely low. It is very important that the healthcare team warns patients of potential infertility after treatment. A high proportion of patients have valid samples for cryopreservation, but semen is used by a low number of patients. A high proportion of patients want to maintain their semen frozen(AU)

[Clinical-pathology relationship in bladder cancer]. / Relación clinico-patólogica en cáncer vesical.

OBJECTIVES: Analyze the role of the Computerized Axial Tomography (TAC) like image study of pre-surgery stadification, in the subjected patients to radical cystectomy, for the treatment of muscle infiltrate bladder cancer. METHODS: Retrospective study of cohorts on 63 subjected patients to radical cystectomy for bladder cancer, in oneself service, between january of 1995 and december of 2.005. The capacity of the TAC was determined for the stadification bladder (pT), node (pN) and the results were compared, with the obtained ones in the pathological anatomy after the radical cystectomy, acording to TNM clasification. The possible impact of this image technique was evaluated in the change of surgical attitude in these patients. RESULTS: The estimate of bladder affectation with TAC was correct in 28.6%, sub-estadificate in 50.8%, and up-estadificate in 20.6%. The TAC for the bladder possesses a lower sensibility the more outpost it is this affectation. It specificity is higher the more advanced locally is the cancer, oscillating among 44% in the pT2 and 94% in the pT4. Regarding the estadification node, it is correct in 73.5% of all cases, although this percentage depends almost exclusively on the patients with negative node (N -). These data offer us a sensibility of 28%, specificity of 55%, positive predictive value of 68% and negative predictive of 67%. SUMMARY: The impact of the TAC in the clinical estadification of the infiltrate bladder cancer is relatively low. The biggest benefit is obtained in patient with suspicion of advanced illness. Its limitation to this group would suppose a significant reduction of costs, with low risk of an inappropriate surgical handling.

Relación clinico-patólogica en cáncer vesical / Clinical-pathology relationship in bladder cancer

Objetivos: Analizar el papel de la Tomografía Axial Computerizada (TAC) como estudio de estadificación prequirúrgica, en los pacientes sometidos a cistectomía radical, para el tratamiento del carcinoma vesical infiltrante. Métodos: Estudio de cohortes retrospectivo sobre 63 pacientes sometidos a cistectomía radical por carcinoma urotelial de vejiga, en un mismo servicio, entre enero del 1995 y diciembre del 2005. Se determinó la capacidad de la TAC para el estadiaje vesical, ganglionar y se compararon los resultados, con los obtenidos en la anatomía patológica tras la cistectomia radical, según la clasificación TNM, actual. Se evaluó el posible impacto de esta técnica de imagen en el cambio de actitud quirúrgica en estos pacientes. Resultados: La estimación de afectación perivesical con TAC fue correcta en 28,6%, subestadiada en 50,8%, y sobreestadiada en 20,6%. La TAC para el estadiaje perivesical posee una sensibilidad más baja cuanto más avanzada es dicha afectación. Su especificidad es más elevada cuanto más avanzado localmente sea el tumor, oscilando entre 44% en los pT2 y el 94% en los pT4. En lo referente al estadiaje ganglionar, es correcto en 73,5 % de los casos, aunque este porcentaje depende casi exclusivamente de los pacientes con ganglios negativos (N-). Estos datos nos ofrecen una sensibilidad del 28%, especificidad de 55%, valor predictivo positivo de 68% y predictivo negativo de 67%. Conclusiones: El impacto de la TAC en el estadiaje clínico del cáncer vesical infiltrante es relativamente bajo. El mayor beneficio se obtiene en pacientes con sospecha de enfermedad avanzada. Su limitación a este grupo supondría una significativa reducción de costes, con bajo riesgo de un manejo quirúrgico inapropiado (AU)

Objectives: Analyze the role of the Computerized Axial Tomography (TAC) like image study of pre-surgery stadification, in the subjected patients to radical cystectomy, for the treatment of muscle infiltrate bladder cancer. Methods: Retrospective study of cohorts on 63 subjected patients to radical cystectomy for bladder cancer, in oneself service, between january of 1995 and december of 2.005. The capacity of the TAC was determined for the stadification bladder (pT), node (pN) and the results were compared, with the obtained ones in the pathological anatomy after the radical cystectomy, acording to TNM clasification. The possible impact of this image technique was evaluated in the change of surgical attitude in these patients. Results: The estimate of bladder affectation with TAC was correct in 28,6%, sub-estadificate in 50,8%, and up estadificate in 20,6%. The TAC for the bladder possesses a lower sensibility the more outpost it is this affectation. It specificity is higher the more advanced locally is the cancer, oscillating among 44% in the pT2 and 94% in thepT4. Regarding the estadification node, it is correct in 73,5% of all cases, although this percentage depends almost exclusively on the patients with negative node (N -). These data offer us a sensibility of 28%, specificity of 55%, positive predictive value of 68% and negative predictive of 67%. Summary: The impact of the TAC in the clinical estadification of the infiltrate bladder cancer is relatively low. The biggest benefit is obtained in patient with suspicion of advanced illness. Its limitation to this group would suppose a significant reduction of costs, with low risk of an inappropriate surgical handling (AU)

Uropatía obstructiva bilateral secundaria a hernia vesical masiva / Bilateral ureterohydronephrosis secondary massive vesical hernia

La hernia vesical no es una patología infrecuente, aparece entre el 0,3 y 3% según los autores. La aparición de hernia vesical masiva constituye una rareza. Presentamos un nuevo caso de fracaso renal secundario a hernia vesical inguinoescrotal con uropatía obstructiva bilateral, analizando la presentación clínica, el esquema diagnostico y el tratamiento de estas hernias (AU)

Bladder hernia is not a rare pathological condition, with a frequency between 0,3 and 3%. Massive bladder hernia is less frequent an very rarely ureterohydronephrosis with this pathology. We will present a case a renal failure secondary to inguinoscrotal bladder hernia with bilateral obstructive uropathy and an analyzed the clinical presentation, the diagnosis and the treatment for those hernias (AU)