Tratamiento del cáncer de próstata y cáncer renal con fármacos orales (abiraterona y antiangiogénicos): posicionamiento de la Asociación Española de Urología / Treatment of prostate and renal cancer with oral drugs (abiratarone and antiangiogenic agents): Positioning statement from the Spanish Association of Urology

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[Abdominal echography to determine the weight of the prostate]. / La ecografía abdominal en la determinación del peso prostático.

The relationship of post-operatively determined prostatic gland weight and that calculated prior the procedure, by means of abdominal ultrasound techniques using the "ellipsoid method", has been studied in 88 patients undergoing retropubic adenectomy. The regression line was nearly optimal, Y = 0.946 X + 2.295, and the correlation coefficient between both weight measures was r = 0.915. Abdominal ultrasound examinations are a simple, quick and safe means to evaluate prostate weight, prior to deciding the type of surgery (open adenectomy or transurethral resection) for prostate adenoma.

[Surgical treatment of uretero-vaginal fistulae caused by gynecologic surgery]. / Tratamiento quirúrgico de las fístulas uretero-vaginales debidas a cirugía ginecológica.

The present paper is a review of 71 cases of uretero-vaginal fistulae secondary to pelvic surgery which were treated in the Urology Unit of our hospital. Surgical management of these fistula intrinsically depends on their number, location and severity. The results obtained by the different techniques were analyzed, emphasizing their merit when using the Turner-Warwick technique (uretero-cystoneostomy on psoic bladder) and any urodynamic troubles this technique can bring about when used bilaterally in patients from radical gynaecological surgery.

Unusual foreign bodies in the urethra and bladder.

We report 8 cases of self-inserted unusual foreign bodies in the lower urinary tract, all being treated from 1976 to 1990. Three of them were located in the urethra and 5 in the bladder. Several objects were found (electric cable, tweezers, hairpin, drawing pin, pebbles, paper clip). In 4 cases the objects were inserted for masturbatory purposes. Five of the patients were psychologically ill or handicapped. The most common reason for consultation was dysuria, and the treatment procedures were endoscopy in 5 patients and cystotomy in the other 3.

[Treatment of obstruction caused by prostatic hypertrophy with prazosin. 1-year follow-up]. / Tratamiento de la obstrucción por hipertrofia prostática con prazosin. Un año de seguimiento.

Since Caine demonstrated the presence of alpha-adrenergic receptors in prostate tissue in 1975, an alpha-blocker capable of producing maximum relaxation of prostatic tissue with minimum side effects has been sought. Prazosin, a selective alpha-1 blocking agent, must meet these requirements. We report the results of a study undertaken in 28 patients with benign hyperplasia of the prostate demonstrated by flowmetry, clinically and by ultrasound. A significant improvement was observed in all patients except for the ultrasound measured prostate size, which remained unchanged. Undesired effects were observed in 36% of the patients. Despite the initial improvement, 89.3% had abandoned treatment at 1 year principally owing to deterioration of the clinical picture and because they were submitted to surgery (the majority) or treatment with other drugs. We can conclude from our results that prazosin is useful for short-term therapy; i.e., until the patient can be referred for surgery.

[Dimethyl sulfoxide in the treatment of interstitial cystitis]. / Dimetilsulfóxido en el tratamiento de la cistitis intersticial.

The paper presents the results obtained with endovesical dimethylsulphoxide in the treatment of interstitial cystitis in 30 women. Up to 80% patients showed clinical improvement with an average of 10 installations. Volume of maximal vesical capacity was increased in 24 patients (80%), the increase being greater than 100 cc in 10 cases. Presently, 24 (80%) patients remain under treatment, 14 with one instillation monthly and 10 once every six months. Six patients are fully asymptomatic without treatment after an average symptoms-free interval of 32 months. Since this is directly related to a decrease both in pain and miction frequency, the increase in vesical capacity appears to be a good improvement index. Dimethylsulphoxide in neither a healing nor a definite therapy but it seems to be effective in the management of this unknown disease.

Renal cell carcinoma: late recurrence in 2 cases.

We present 2 patients with late recurrence 16 and 11 years after nephrectomy for renal cell carcinoma. Metastases were solitary and their location very uncommon (vastus externo muscle and colon). In the reviewed series of 5,758 patients with renal cell carcinoma only a temporal muscle metastasis and another in the colon were observed but none of them was solitary.

ABO blood groups and bladder carcinoma.

Following some reports concerning the possible influence of ABO blood groups on constitutional types and different features of human pathology, we have investigated if there are relationships between ABO blood groups and bladder tumors. Our findings show that tumoral behavior in patients with bladder carcinoma and blood group O has a tendency to an increased aggressivity with higher tumoral grade and more relapses than what is seen in tumors of patients with A blood group. Although this difference is not statistically significant, we believe that blood group ABO should be considered as a constitutional prognostic factor in bladder carcinoma and further investigations in this field are needed.

Follow-up of superficial bladder cancer: how to spare cystoscopies?

To study the efficacy, specificity and sensitivity of ultrasonography, cytology and phospholipid/fatty acid quotient (PL/FA) in the detection of recurrences in patients with superficial bladder cancer we performed these three examinations simultaneously with cystoscopy. In over 405 cystoscopies, 348 were negative and 57 were positive for tumor. Sensitivity, the most important parameter, was 73% for the three examinations together. Each method separately had the following sensitivity: ultrasound 26%; cytology 14%, and PL/FA 47%. Considering that there were only 15 false-negatives, with this follow-up scheme we save the patient from a lot of cystoscopies, avoiding their inherent morbidity.

Renal leiomyosarcoma associated with xeroderma pigmentosum.

We report a case of leiomyosarcoma of the kidney, presenting in the course of xeroderma pigmentosum, which debuted clinically as Wünderlich's syndrome due to spontaneous rupture of the tumor. We describe the case history and discuss the cutaneous disorder, analyzing the clinical and etiopathogenic factors, and conclude with an attempt to establish a relationship between the two pathologies.

[Aztreonam versus tobramycin in acute pyelonephritis. A comparative study]. / Aztrenonam versus tobramicina en pielonefritis agudas. Estudio comparativo.

We performed a comparative study between the monobactam antibiotic aztreonam and the aminoglycoside tobramycin in patients diagnosed as having acute pyelonephritis. The respective doses were 1 gr. IM daily for 7 days, and 100 mgr. IM q 12 h for the same period of time. Clinically, 100% of uncomplicated acute pyelonephritis and 87.5% of complicated infections cured with aztreonam. Tobramycin achieved an 80% cure rate for both types of infections. Microbiologically aztreonam was effective in all uncomplicated acute pyelonephritis, and in 69.56% of the complicated cases (overall microbiological cure rate = 78.7%). The therapeutic failures were ascribable to infections from S. faecalis, an organism naturally resistant to aztreonam. Thus, the microbiological cure rate was 84.2% in complicated pyelonephritis from organisms sensitive to this antimicrobial. The microbiological cure rate for tobramycin was 70% in acute uncomplicated, and 80% in complicated infections. We observed a good clinical and biological tolerance to both antimicrobials. No side effects were observed. Serum and blood biochemical analyses, and coagulation tests revealed no changes.