[Diet and bladder cancer]. / Dieta y cáncer de vejiga.

OBJECTIVES: To perform an update on the bibliography about the influence of dietetic factors on bladder cancer. METHODS: Bibliography search in various databases (PubMed, Ovid) on each one of the dietetic agents that can influence on the incidence of bladder tumors. RESULTS/CONCLUSIONS: There is a growing number of evidences that a great number of substances present in our usual diet have an influence on bladder cancer.

Dieta y cáncer de vejiga / Diet and bladder cancer

OBJETIVO: Realizar una revisión actual de la bibliografía de la influencia ejercida por factores dietéticos sobre el cáncer vesical. MÉTODOS: Búsqueda de la bibliografía existente en diferentes bases de datos (Pubmed, Ovid) sobre cada uno de los agentes dietéticos que pueden influir la incidencia de los tumores vesicales. RESULTADOS/CONCLUSIONES: Cada vez existen más evidencias que un gran número de sustancias presentes en nuestra dieta habitual ejercen una influencia en el cáncer de vejiga

OBJECTIVES: To perform an update on the bibliography about the influence of dietetic factors on bladder cancer. METHODS: Bibliography search in various databases (PubMed, Ovid) on each one of the dietetic agents that can influence on the incidence of bladder tumors. RESULTS/CONCLUSIONS: There is a growing number of evidences that a great number of substances present in our usual diet have an influence on bladder cancer

Prótesis de pene. Resultados de calidad y morbilidad / Penile prosthesis. Quality outcomes and morbidity

OBJETIVO: Conocer la satisfacción ycomplicaciones presentadas en una serie de pacientescon disfunción eréctil sometidos a la implantación deuna prótesis peneana.MÉTODOS: Estudio retrospectivo de los pacientes intervenidosquirúrgicamente por D.E. mediante la colocaciónde una prótesis de pene en el periodo comprendidoentre 1993 y 2003. Se recogieron datos comola edad del paciente en el momento de la intervención,el tratamiento previo y los diferentes antecedentes patológicos.Se revisaron los distintos modelos de prótesis, el tipo de incisión empleada y las distintas complicacionesque surgieron. Por último se elaboró un cuestionariopara determinar el nivel de satisfacción delpaciente.RESULTADOS: En el periodo comprendido entre losaños 1993 y 2003 se implantaron 24 prótesis. Laedad media de los pacientes fue 56,6 +/- 7,56 (36-63) años mediana de 59,5. La incisión peno-escrotalse empleó en 13 (54,16%) pacientes, suprapúbica en6 (25%) y subcoronal en 1 (4,16%). En cuanto a losmodelos empleados, en 9 (37,5%) se utilizó la prótesissemirrígida AMS 600, y en 10 (41,66%) el modeloAMS 650, también semirrígida. Unicamente en unaocasión se empleó una prótesis hidráulica de dos componentesAMS Ambicor. Se presentaron complicacionesen 6 (25%) pacientes, de las cuales el 12,5% fueronmenores como cavernositis, dolor o hematoma. En3 (12,5%) ocasiones fue necesaria la retirada de lamisma. Respondieron a la encuesta telefónica 13(54,16%) pacientes, de los cuales un 85 % emplea laprótesis. Un 54% presentan una satisfacción propia yen la pareja adecuada (buena o mucha), un 23 %regular y el resto, otro 23 % mala o muy mala.CONCLUSIÓN: A pesar de la elevada tasa de complicacionespostoperatorias, la prótesis de pene esaceptada adecuadamente, incluso en los modelosmaleables, por los enfermos con disfunción eréctil. Lasatisfacción por parte del paciente es alta, siendomayor en la pareja. La mayor parte de los enfermosdesearía volver a ser intervenido en el caso de encontrarse en una situación similar anterior al implante

OBJECTIVES: To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS: Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 1993 and 2003. Collected data included patient age at the time of surgery, previous treatment, and significant medical history. We reviewed the models of prosthesis employed, incisions, and complications appeared. Finally, a questionnaire was elaborated to establish the level of patient satisfaction. RESULTS: 24 prostheses were implanted between 1993 and 2003. Mean patient age was 56.6 ± 7.56 years (36-63), median 59.5 yr. Penile-scrotal incision was employed in 13 (54.16%) patients, suprapubic incision in 6 (25%) and subcoronal incision in 1 (4.16%). Type of prosthesis: semirrigid AMS 600 9 (37.5%), semirrigid AMS 650 10 (41.66%); the two component hydraulic prosthesis AMS Ambicor was used only in one case. Six (25%) patients presented complications. 16.66% were minor, cavernositis, pain, hematoma or prosthesis extrusion. Prosthesis extraction was necessary in 2 (8.33%) cases. 13 (54.16%) patients responded to the telephone survey. 85% of them use their prosthesis. 54% percent refer adequate self-satisfaction and partner satisfaction (well satisfied/much satisfaction).23% not too bad, and the remainder 23% bad or very bad. CONCLUSIONS: Despite the highest rate of postoperative complications, penile prosthesis is adequately accepted by patients with erectile dysfunction, even malleable models. Patient satisfaction is high, being higher in partners. Most patients would desire to undergo surgery again if they were in the same situation

[Penile prosthesis. Quality outcomes and morbidity]. / Prótesis de pene. Resultados de calidad y morbilidad.

OBJECTIVES: To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS: Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 1993 and 2003. Collected data included patient age at the time of surgery, previous treatment, and significant medical history. We reviewed the models of prosthesis employed, incisions, and complications appeared. Finally, a questionnaire was elaborated to establish the level of patient satisfaction. RESULTS: 24 prostheses were implanted between 1993 and 2003. Mean patient age was 56.6 +/- 7.56 years (36-63), median 59.5 yr. Penile-scrotal incision was employed in 13 (54.16%) patients, suprapubic incision in 6 (25%) and subcoronal incision in 1 (4.16%). Type of prosthesis: semirrigid AMS 600 9 (37.5%), semirrigid AMS 650 10 (41.66%); the two component hydraulic prosthesis AMS Ambicor was used only in one case. Six (25%) patients presented complications. 16.66% were minor, cavernositis, pain, hematoma or prosthesis extrusion. Prosthesis extraction was necessary in 2 (8.33%) cases. 13 (54.16%) patients responded to the telephone survey 85% of them use their prosthesis. 54% percent refer adequate self-satisfaction and partner satisfaction (well satisfied/much satisfaction). 23% not too bad, and the remainder 23% bad or very bad. CONCLUSIONS: Despite the highest rate of postoperative complications, penile prosthesis is adequately accepted by patients with erectile dysfunction, even malleable models. Patient satisfaction is high, being higher in partners. Most patients would desire to undergo surgery again if they were in the same situation.

[Epidemiological trends in prostate cancer over the last years]. / Tendencias epidemiologicas en cancer de prostata durante los ultimos años.

OBJECTIVES: To analyze the evolution of prostate cancer (PCa) in our community health area over the last years, in terms of incidence, clinical-epidemiological characteristics, and cancer-specific mortality. METHODS: Retrospective analysis of the medical records of patients with PCa in our hospital over the 1991-2003 period. We calculated the annual incidence rates for our community health area as well as its trend over the period of study. Changes of several clinical-epidemiological parameters over time were studied. The evolution of PCa mortality was also analyzed. RESULTS: 730 patients with PCa were evaluated. Median age and PSA at diagnosis were 69 years and 11.4 ng/ml, respectively. 60.5% tumors were detected in a localized clinical stage, and 18.6% were metastasic. 30.4% of PCa in the study (the most numerous group) had a Gleason score between 5 and 6. A constant increase of PCa incidence was observed with an annual percentage increase of 5.5% (p < 0.001). Standardized incidence rate for the year 2003 Spanish population pyramid was 100.9 cases/100,000 males. A significant trend to a greater proportion of PCa cases diagnosed by uncontrolled screening was observed, being the cases currently detected after symptoms only a small proportion (p < 0.001). Decreases in the age at diagnosis (p < 0.001), PSA level (p < 0.001), proportion of advanced clinical stages (p < 0.001), as well as proportion of cancers with well-differentiated Gleason score (2-4) (p < 0.001) were also detected. PCa mortality adjusted by the population pyramid was 8.7 deaths/100,000 males in the year 2003. CONCLUSIONS: We found an increase in the incidence of prostate cancer in our community health area over the last years, parallel to an increase in the proportion of cases detected by screening in asymptomatic population. Because of that, tumors currently detected tend to appear in younger ages, with lower PSA levels, and localized clinical stages.

Significado clínico de la neoplasia intraepitelial prostática / Clinical significance of prostatic intraepithelial neoplasia

OBJETIVO: Determinar el valor de la neoplasia intraepitelial prostática (PIN) de alto grado (con o sin la influencia de determinados factores de riesgo) para predecir la existencia de cáncer de próstata (CaP) en posteriores biopsias. MÉTODO: Hemos estudiado 41 pacientes procedentes de un programa de screening del CaP a quienes se detectó PIN de alto grado. Se revisaron las biopsias posteriores, calculando la probabilidad de detectar un CaP en las mismas. También se analizó la influencia de la edad, el tacto rectal (TR), nivel de PSA, ecografía transrectal (ECOTR), y densidad del PSA (DPSA) sobre el resultado de estas rebiopsias. RESULTADOS: La edad de los pacientes estudiados osciló entre los 50 y 83 años, con una media de 62,8 (error estándar 1,6), y mediana de 61. De un total de 41 pacientes con diagnóstico de PIN de alto grado, sólo 27 aceptaron la repetición de la biopsia). De estos, 11 presentaron CaP (40,7 por ciento, todos ellos clínicamente localizados al diagnóstico), y 16 no presentaron alteraciones (59,3 por ciento) en la rebiopsia. Ni el análisis univariante, ni el multivariante, identificaron a la edad, PSA, TR, ECOTR, o DPSA como predictores de la existencia de cáncer en las posteriores biopsias. CONCLUSIONES: El hallazgo de un PIN de alto grado en la biopsia prostática conlleva un riesgo importante de detectar un cáncer en biopsias posteriores. Por este motivo, recomendamos la repetición sistemática de la biopsia en estos pacientes (AU)