Dorsal Vascular Complex Nonligation Method and Preservation of Puboprostatic Ligaments and Endopelvic Fascia During Laparoscopic Radical Prostatectomy: Effect on Continence.

OBJECTIVE: To evaluate the impact on continence rate during 1-year follow-up of a preservation technique that included nonligation of the dorsal vascular complex and sparing of the puboprostatic ligaments and the endopelvic fascia during laparoscopic radical prostatectomy. MATERIAL AND METHODS: Information from 30 patients who underwent the preservation technique was prospectively collected and compared with data from 60 patients who underwent the nonpreservation traditional technique. A single surgeon performed all procedures. RESULTS: Demographic and preoperative characteristics were similar. The mean patient age was 59 years in both groups. All patients were stage cT1c or cT2. Operative time was significantly lower in the preservation technique group (229.6 vs. 262.7 minutes, P < .001). There were no significant differences in intraoperative bleeding, discharge hemoglobin level, blood transfusion rate, length of hospitalization, and drop in the hemoglobin level. The probability of continence recovery was significantly higher in the preservation technique group than in the traditional technique group (hazard ratio = 0.50, 95% CI = 0.31-0.81). The continence rate (0 pads/day) for the preservation technique group versus the traditional technique group at 1, 3, 6, and 12 months was, respectively, 53.3% versus 30% (P = .031), 90% versus 45% (P < .001), 90% versus 63.3% (P = .008), and 96.6% versus 78.3% (P = .024). There were no significant differences between the groups regarding potency and oncologic outcomes. CONCLUSION: Nonligation of the dorsal vascular complex and preservation of the puboprostatic ligaments and the endopelvic fascia improved urinary continence compared with the traditional nonpreservation technique, with no impact in terms of bleeding and oncologic outcomes.

Prospective evaluation of the association between varicocele and benign prostatic hyperplasia in men over 40 years of age.

We investigated the association between varicocele and benign prostatic hyperplasia in men over the age of 40 years. A total of 296 outpatients were evaluated. Prostate volume was measured with transrectal ultrasound. Varicocele was diagnosed by physical examination and ultrasound. Prostatic hyperplasia was defined as prostate volume greater than or equal to 40 ml. Two groups were compared: patients with prostate volume less than 40 ml and patients with prostate volume greater than or equal to 40 ml. There was a statistically significant difference between the groups in terms of mean age, post-void residual, International Prostate Symptom Score and PSA. The percentage of patients with clinical varicocele in the group with a volume less than 40 ml and the group with a volume equal to or greater than 40 ml was 38.2% and 47.7% respectively (p = .12). There were no differences between the two groups in the percentage of patients with clinical or subclinical varicocele (43.2% vs. 52.2%, respectively, p = .12). No differences were found in the percentage of patients with varicocele when comparing men with prostates smaller than 40 ml and greater than or equal to 40 ml.

Factores de riesgo para nefropatía inducida por agentes de contraste radiológico en pacientes sometidos a tomografía axial computarizada contrastada: Clínica Universitaria Bolivariana 2008 / Risk factors for contrast-induced nephropathy among patients undergoing contrasted computed tomography: Clínica Universitaria Bolivariana 2008

Introducción: la Nefropatía Inducida por Agentes de Contraste Radiológico (NIACR) se define como un daño renal de grado variable que se presenta después de la exposición del paciente a agentes de contraste radiológico. Existe un número significativo de factores de riesgo definidos para la patología, aunque la mayoría de los datos son extrapolados de estudios internacionales. Métodos: estudio de series clínicas con una muestra por conveniencia de 85 pacientes sometidos a tomografía axial computarizada en el Centro de Imágenes Diagnósticas de la Clínica Universitaria Bolivariana. Resultados: la edad promedio de la serie fue de 55 ± 19 años, con un valor de creatinina sérica de 0.92 ± 0.53 mg/dL. Se encontró que el 70.58% de los pacientes estudiados tiene, por lo menos, un factor de riesgo para la patología en el momento de ser sometidos al procedimiento imagenológico. Conclusión: existe en nuestro medio una prevalencia alta de factores de riesgo para nefropatía inducida por agentes de contraste radiológico.

Introduction: Constrast-induced nephropathy is defined as a renal damage of variable degree which develops after exposition to radiocontrast agents. There is a number of defined risk factors that may predispose the patient to develop such complication, although most data used on Colombian clinical practice is extrapolated from foreign studies. Methods: The following is a clinicalseries study comprising a simple of 85 patients who underwent a contrasted axial tomography at the Clinica Universitaria Bolivariana’s Diagnostic Images Center. Results: The mean age in the series was 55±19 years, with an average serum creatinine value of 0.92± 0.53mg/dL. It was found that 70.58% of all patients undergoing such image procedure had at least one risk factor for contrast-induced nephropathy. Conclusion: There is a very high prevalence of risk factors for contrastinduced nephropathy among our patients.

Pacientes con tromboembolismo pulmonar: caracterizacion / Patients with pulmonary thromboembolism: characterization

El tromboembolismo pulmonar, es una complicacion frecuente en la practica medica, con una letalidad que oscila entre 13 y 58 %, de acuerdo con su gravedad. Es por esta razon, que es necesario conocer las caracteristicas epidemiologicas y clinicas, de los pacientes con esta patologia en nuestro medio. Metodos:se reslizó un estudio descriptivo retrospectivo,en pacientes atendidos en la Clínica Cardiovascular Sabta María de la ciudad de Medellín, durante los años 1996 a 2004. Resultados: en total, se encontraron 94 registros con diagnóstico de tromboembolismo pulmonar confirmado. el 51% de los pacientes, se encontraban hospitalizados. los principales factores de riesgo encontrados, fueron: trombosis venosa profunda, reposo en cama, síndrome de falla cardíaca y antecedente de enfermedad tromboembolitica...

Background: Pulmonary embolism (PE), is a common complication in clinical practice. Mortality is between 13% and 58%, according to severity. Because of that, it is very important to know the epidemiologic and clinic characteristics of patients in our city. Methods: This was a retrospective descriptive study on patients admitted at the Santa Maria Cardiovascular Clinic ofMedellín, between 1994 and 2004. Results: We found 94 charts with confirmed diagnosis of PE, 51% belonged to inpatients. The main risk factors found, were deep venous thrombosis (DVT), being bedridden, heart failure and patients with priorvenous embolism...