[Stress urinary incontinence surgical treatment with suburethral suprapubic SPARC sling]. / Tratamiento quirúrgico de la incontinencia urinaria de esfuerzo mediante cabestrillo suburetral SPARC. Análisis de nuestra experiencia.

INTRODUCTION: Stress urinary incontinence (SUI) has a high incidence and important morbidity. Multiple surgical techniques have been described to treat it, with despair results. Suburethral slings have become, in recent years, a simpler and less invasive method to treat SUI surgically. MATERIAL AND METHOD: The purpose of this paper is to review, retrospectively, 86 patients treated at our institution, from 10/01 to 12/05 of SUI, with a suprapubic suburethral sling (SPARC). RESULTS: Medium (range) age is 58.7 (39-80), hospital stay was 2.43 d (1-8) and catheter was removed 1.52 d (1-10). 14.5% of patients underwent other vaginal surgeries at same time, most frequently anterior colpoperineoplasty (10.7%). Complications are not very frequent; bladder perforation (5.8%), acute urinary retention (7%), chronic urinary retention (3.5%) and UTI (15.3%). Sling release was performed in 3.5% of women with chronic urinary retention. Total continence was found in 71.4% of patients with 10.1 months medium follow up (1-32). De novo urge symptoms were found in 26.2% of women, with urge incontinence in 54.5% of them. (p < 0.002; OR 5.0 (IC 95% 1.75-14.28). CONCLUSIONS: Suprapubic suburethral SPARC sling is a simple method, with few complications and fast social recovery. Outcome can be measured soon, with a high continence rate. De novo urge symptoms are high and they worsen functional results. It is necessary longer follow-up to evaluate long term outcomes.

[Penile adenoma: clinical case]. / Melanoma de pene: caso clínico.

Penile melanoma is a very uncommon neoplasm, being reported less than 60 cases. Event yet it outlines not few doubts about its diagnosis and treatment, and in advanced stages represents a challenge for the future since it prognosis is awful at short time. In the present article, its presented a glans melanoma diagnosed and treated at our Service. We make a brief revision of the literature and some basic issues on the management of this entity when it's localized in penis, since in the cases in which it extends far from this organ is yet oncological field.

Tratamiento quirúrgico de la incontinencia urinaria de esfuerzo mediante cabestrillo suburetral SPARC. Análisis de nuestra experiencia / Stress urinary incontinence surgical treatment with suburethral suprapubic sparc sling

Introducción: La incontinencia urinaria de esfuerzo (IUE) presenta una gran morbilidad y una elevada incidencia. Existen múltiples técnicas quirúrgicas descritas para el tratamiento de la misma, con diversos resultados. Los cabestrillos suburetrales se han establecido en los últimos años como un método simple y poco invasivo para el tratamiento de la incontinencia urinaria de esfuerzo. Material y Método: Analizamos retrospectivamente nuestra serie de 86 pacientes diagnosticadas de IUE, intervenidas, entre Octubre de 2001 y Diciembre de 2005, mediante un cabestrillo suburetral suprapúbico (SPARC(C)). Resultados: La media de edad es de 58,7 años (39-80). La estancia media hospitalaria es de 2,43 días (1-8) y la duración media de sonda de 1,52 días (1-10). En el 14,5% de los casos, se realizó cirugía asociada, siendo la más frecuente, la colpoperineoplastia anterior (10,7 %). Las complicaciones son poco frecuentes; perforación vesical (5,8%), RAO antes del alta (7%), ITU (15,3%), RAO crónica (3,5%). En el 3,5% de las mujeres, se realizó lisis del cabestrillo, por retención crónica. El seguimiento medio es de 10,14 meses, encontrándose un 71,4% de continencia total. Un 26,2% de las pacientes presentaron síntomas de hiperactividad de novo, con problemas de incontinencia en el 54,5% de estas. (p<0,002; OR 5.0 (IC 95% 1,75-14,28). Conclusiones: El SPARC© es un método sencillo, con un tiempo hospitalario corto y una rápida reincorporación a la vida social. Los resultados pueden ser valorados rápidamente y con una tasa elevada de éxito. La aparición de urgencia de novo es elevada y empeora los resultados funcionales. Es necesario un mayor seguimiento para valorar resultados funcionales a largo plazo

Introduction: Stress urinary incontinence (SUI) has a high incidence and important morbidity. Multiple surgical techniques have been described to treat it, with despair results. Suburethral slings have become, in recent years, a simpler and less invasive method to treat SUI surgically. Material and method: The purpose of this paper is to review, retrospectively, 86 patients treated at our institution, from 10/01 to 12/05 of SUI, with a suprapubic suburethral sling (SPARC). Results: Medium (range) age is 58.7 (39-80), hospital stay was 2.43 d (1-8) and catheter was removed 1.52 d (1-10). 14.5% of patients underwent other vaginal surgeries at same time, most frequently anterior colpoperineoplasty (10.7%). Complications are not very frequent; bladder perforation (5.8%), acute urinary retention (7%), chronic urinary retention (3.5%) and UTI (15.3%). Sling release was performed in 3.5% of women with chronic urinary retention. Total continence was found in 71.4% of patients with 10.1 months medium follow up (1-32). De novo urge symptoms were found in 26.2% of women, with urge incontinence in 54.5% of them. (p < 0,002; OR 5.0 (IC 95% 1.75-14.28). Conclusions: Suprapubic suburethral SPARC sling is a simple method, with few complications and fast social recovery. Outcome can be measured soon, with a high continence rate. De novo urge symptoms are high and they worsen functional results. It is necessary longer follow-up to evaluate long term outcomes

Melanoma de pene: caso clínico / Penile melanoma: case report

El melanoma de pene es un tumor muy poco frecuente del que apenas se han reportado 60 casos hasta la fecha. Aún así plantea no pocas dudas en cuanto a su diagnóstico y tratamiento, y en estadios avanzados representa un reto para el futuro ya que su pronóstico es malo a corto plazo. En el presente artículo presentamos un melanoma de glande diagnosticado y tratado en nuestro servicio, y realizamos una revisión de la literatura y de algunos conceptos básicos en el manejo de esta entidad cuando está localizada en pene, ya que los casos en que se extiende más allá de este órgano es campo de la oncología (AU)

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