[Single center experience with Siemens Lithostar Modularis for treatment of 1500 solitiary urinary stones]. / Resultado del tratamiento con Lithostar Modularis de Siemens de 1500 pacientes con litiasis unica.

OBJECTIVES: the aim of the study was to evaluate the results of extracorporeal shock wave lithotripsy (ESWL) treatment with Siemens Lithostar Modularis in urinary stones. PATIENTS AND METHODS: from May 2000 until September 2006, 1500 patients, 62% men and 38% women, ages 15 to 89 years (mean age 53), underwent ESWL as treatment of urinary stones at the Lithotripsy Unit of León. Data were analized retrospectively. More than half (56%) had left urinary stones. The most frequent ureteral localization (55%) was proximal (420 patients), and the most frecuent renal was renal pelvis (345 patients). The mean stone diameter was 1.3 cm. (1.01 ureteral and 1.7 renal). All patients received ESWL-session under i.v. analgesia with alfentanil and midazolam. RESULTS: Mean number of sessions per lithiasis was 1.5 (ureteral stones 1.4 and renal stones 1.7). The retreatment rate was 33%, 28% for ureteral stones and 39% for renal stones with a cumulative success of 86% with two sessions. 22% of the patients required auxiliary manouvers, 24% of the patients with ureteral stones and 18% of the renal stones patients. Stone free rate was 91%, 97% in ureteral stones and 82% in renal stones. CONCLUSIONS: treatment of urinary stones with Siemens Lithostar Modularis showed good results, with a stone free patient rate of more than 90%, although 33% of the patients need multiple ESWL treatment sessions and 20% of the patient required auxiliary procedures.

[Bladder endometriosis. Diagnostic and treatment]. / Endometriosis vesical. Diagnóstico y tratamiento.

Endometriosis is a common gynecologic disease in which endometrial tissue is deposited outside the normal confines of the uterine cavity. Rarely endometriosis involves urinary tract. The bladder is the most frequent organ affected into this tract. A delay in detection can result in months or years of morbidity.

[Adjuvant therapy with systemic JM-8 (carboplatin) in superficial bladder tumors. Results after 3 years of use]. / Tratamiento adyuvante con JM-8 (carboplatino), por vía sistémica, en los tumores superficiales de vejiga. Resultados después de tres años de utilización.

We evaluated the 3-year efficacy of adjuvant treatment (after complete TUR) with systemic carboplatin in 34 patients with transitional cell bladder tumors in the superficial stages. Twenty-six patients with a one-year follow-up had a recurrence rate of 23%. Twenty-three patients with a two-year follow-up had a recurrence rate of 65.3%. Six patients with a three-year follow-up had a recurrence rate of 83.3%. Seventeen patients with tumor recurrence within three years had "minimal" recurrence. The course of the disease was very stable and remained unchanged in 4 cases that required no other treatment for one year. This treatment modality indicates a therapeutic effect; however, further studies and changes are warranted in order to obtain better results.

[Use of systemic carboplatin in superficial tumors of the bladder. Preliminary phase II study (toxicity)]. / Empleo de carboplatino sistémico en los tumores superficiales de vejiga. Estudio preliminar en fase II (toxicidad).

The high recurrence rate of superficial bladder tumors, its frequent association with premalignant tumors, and its evolution into infiltrating tumors in 15% of the cases justify the use of tumoricidal agents as adjuvant therapy. For the past 20 years, several agents have been used intravesically with limited efficacy (+/- 40% recurrence/year), high local morbidity (cystitis, urethral stenosis), and excessively long duration of treatment (+/- 1 year). The efficacy of CDDP in the treatment of bladder tumors has been reported elsewhere. An objective response of +/- 50% (RC + RP) at a dose of 50-70 mg/m2 has been observed. The new generations of platinum, less toxic and easier to use, have raised hopes vis-à-vis its efficacy in the treatment of this tumor type. To date, we have evaluated 26 patients with superficial tumor of the bladder over a period of one year. These patients had been submitted to a treatment protocol with systemic carboplatinum following complete TUR and assessment of bone marrow; renal function, WHO, audiometry, urinary cytology, determination of tumor cell markers (CEA, çGT). Treatment consisted of 3 cycles of i.v. carboplatinum at a dose of 300 mg/m2 (1/30 days). We have corroborated the following features: ease of use, good patient tolerance and scant toxicity. However, its efficacy has as yet to be determined through the disease-free interval.(ABSTRACT TRUNCATED AT 250 WORDS)