Perioperative complications and surgical oncology outcomes in an initial study from 84 patients submitted to laparoscopic radical cystectomy.

OBJECTIVES: The Gold Standard treatment for a non-metastatic, invasive bladder cancer is an open radical cystoprostatectomy (ORCP). Laparoscopic radical cystoprostatectomy (LRCP) is still an experimental technique in evaluation. We describe our perioperative results defined as surgical and safety oncology variables. METHODS: Every patient who underwent a LRCP between January 2007 and July 2011 in the urology department of the University Public Hospital was evaluated. We perform a descriptive retrospective analysis. RESULTS: We evaluated 84 patients, 72 males and 12 females, with a mean age of 68 (44-79). A Bricker diversion was performed in 80 patients, a Camey II bladder replacement was performed in 3 patients, and a Studer bladder replacement was performed in 1 patient. Seventeen patients (20.23%) presented with previous abdominal surgery, and 6 patients (7.14%) presented a medical history of urological surgery. The mean surgery time was 257.57 minutes (180-420). The mean hospital stay was 11.875 days (standard deviation (SD): 6.28). The onset of tolerance to surgery occurred after 3.7 days (SD: 2.21).The transfusion rate after surgical intervention was 20.2%. The mean number of nodes removed, by means of ilio-obturator lymphadenectomy, was 17 (13-19). There were no intraoperative complications. Early complications (less than 1 month after the intervention) occurred in 28 patients (33.3% ).There were no post-operative deaths. There were late complications (starting one month after the intervention) in 7 patients (8.3% ). CONCLUSIONS: Our study demonstrated that LRCP is safe and reproducible and represents a minimally invasive option for patients with infiltrative bladder cancer.

[Spontaneous rupture of a simple renal cyst to the pyelocalyceal system. Evolution from Bosniak I to IIF]. / Ruptura espontánea de quiste renal simple en el sistema pielocalicial. Evolución desde Bosniak I a IIF.

OBJECTIVE: To report the spontaneous rupture of a renal cyst into the adjacent pyelocalyceal collecting system. METHODS: We present the case of a 47 year old woman with a 17 centimeter simple renal cyst (Bosniak I) as well as ipsilateral nephrolithiasis. The patient had a febrile urinary tract infection with flank pain. A subsequent CT scan revealed that this cyst spontaneously ruptured into the renal pelvis. RESULTS: Follow up evaluations showed the former cyst has decreased in size and contain thick and nodular calcifications. At present it is a Bosniak IIF cyst. CONCLUSION: Simple renal cysts can spontaneously rupture and drain into the adjacent renal collecting system.

[Bilateral femoral neuropathy after prostatectomy. Case report and bibliographic review]. / Neuropatía femoral bilateral tras prostatectomía. Presentación de un caso y revisión del tema.

OBJECTIVE: To report one case of postoperative lateral femoral neuropathy presenting after a retropubic radical prostatectomy. We review the topic. METHODS: We describe the case of a 72-year-old patient undergoing radical prostatectomy. Combined anesthesia, general and spinal, was given. A self-retaining automatic retractor (Omnitract) was employed. In the immediate postoperative period the patient presented bilateral femoral neuropathy, with difficulties for knees extension and hips flexion, diminished patellar reflex, and absence of sensitivity in the anterior area of the thighs. MRI was performed to rule out spinal pathology. RESULTS: The symptoms improved a lot within a week, completely recovering after two months. CONCLUSIONS: Femoral neuropathy is a rare complication after pelvic surgery. In our case we believe it was secondary to nerve compression by the retractor.

[Idiopathic progressive bilateral ureteral stenosis]. / Estenosis ureteral bilateral progresiva e idiopática.

OBJECTIVE: To report one case of progressive bilateral ureteral stenosis without demonstrable etiologic cause. METHODS: We diagnosed and treated a 73-year-old female patient who developed progressive bilateral distal ureteral stenosis without a demonstrable cause. RESULTS: Surgery was carried out and the pathologic study showed a bilateral ureteral stenosis secondary to fibrosis and chronic unspecific inflammation. CONCLUSIONS: Idiopathic ureteral stenosis is a rare clinical picture, more if progressive and bilateral.

[Vasovasostomy: our experience]. / Vasovasostomía: nuestra experiencia.

OBJECTIVES: From August 1997 to December 2004 we performed 47 vasovasostomies for vasectomy reversal in the same number of patients. Only 42 patients are available for follow-up, with a mean follow-up of at least six months. Mean age is 40.7 years for the patients and 30.8 for the couples. METHODS: The two-layer technique was applied under microscope magnification in the first 22 patients; single layer technique was performed in the others. RESULTS: Overall spermatozoid potency rate was 71.42%, and pregnancy rate was 32.45%. Surgical technique did not have influence on results. CONCLUSIONS: Better prognosis is expected in young men; the longer the interval between vasectomy and reversal, the lower the potency rate. Regarding pregnancy rate, it is not influenced by delay of reversal.