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1.
Actas Urol Esp (Engl Ed) ; 47(1): 47-55, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36328875

RESUMO

INTRODUCTION AND OBJECTIVE: The most frequently studied factors in patients treated by robotic radical prostatectomy are PSA and pathological features of the biopsy and prostatectomy specimen. Studies on the factors associated with the surgical technique are scarce and with controversial results. The objective is to identify all possible surgical factors and their relationship with disease-free and metastasis-free survival. PATIENTS AND METHOD: Prospective study approved by the Ethics Committee, including patients who underwent robotic radical prostatectomy since January 2009 with a minimum follow-up of 5 years. Surgeon, surgical time, blood loss, fascial access, continence techniques, preservation of the fascia, neurovascular bundles, bladder neck, urethra, learning curve and surgical complications, were analyzed as possible prognostic factors. We performed univariate and matched comparisons of survival using Kaplan-Meier estimation and long-rank tests. The significance level for multiple comparisons was established with False Discovery Rate-adjustment (adjusted p). RESULTS: Cohort of 667 patients with a median follow-up of 69 months. In univariate analysis, surgeon (adjp=0.018), preservation of puboprostatic ligaments (adjp=0.02), preservation of endopelvic fascia (adjp=0.001) and performing periurethral suspension (adjp<0.001) are poor prognostic factors for disease-free survival. Fascia preservation also negatively affects metastasis-free survival (adjp=0.04). Previous abdominal surgeries, prostate, surgical time, blood loss, type of residual urethra, middle lobe, fascial access, fascia or bladder neck preservation, have no statistical significance. CONCLUSIONS: The surgeon and specific aspects of the surgical technique are determining factors in disease-free survival. Preservation of the fascia is the only factor that negatively affects metastasis-free survival.


Assuntos
Procedimentos Cirúrgicos Robóticos , Incontinência Urinária , Masculino , Humanos , Próstata , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Incontinência Urinária/etiologia , Prognóstico , Estudos Prospectivos , Prostatectomia/métodos
3.
Rev. chil. urol ; 77(4): 326-328, 2012. ilus
Artigo em Espanhol | LILACS | ID: lil-783406

RESUMO

Presentar un caso de sintomatología del tracto urinario inferior provocada por obstrucción al fluido urinario por un quiste lateral de próstata y los resultados de la enucleación del mismo con láser Holmium. Presentamos el caso de un paciente joven con sintomatología miccional de 1 año de evolución. Diagnosticado mediante ecografía de quiste prostático. Ante el diagnóstico de quiste obstructivo, se plantea enucleación con láser holmium obteniendo resultadospost operatorios inmediatos y excelentes. Los quistes prostáticos simples son el tipo más frecuente, siendo asintomáticos en la mayoría de los casos y descubiertos incidentalmente. Dichos quistes adquieren importancia clínica si provocan sintomatología del tracto urinario inferior, infertilidad o son el asiento de neoplasia prostática. El tratamiento habitual es la resección transuretral. En este paciente planteamos enucleación del quiste con láser holmium. Esta técnica permite et alta hospitalaria sin sonda en menos de 24 horas, se evita el riesgo de síndrome de reabsorción, provoca un mínimo sangrado y rápida remisión de la sintomatología...


The purpose of this paper is to present a case of lower urinary tract symptomatology caused by flow obstruction due to a lateral cyst of the prostate and the results obtained by enucleating using the Holmium laser. We present the case of a young patient with one year of lower urinary-tract symptoms. The diagnosis of a prostatic cyst was confirmed by ultrasound examination. Having the finding of an obstructive prostatic cyst it was treated by means of Holmium laser enucleation with excellent postoperative results. Simple prostatic cysts are the most frequent type and are generally asymptomatic and are incidentally discovered during routine examination. These cysts become clinically relevant when they cause lower urinary tract symptoms, infertility or are associated with cancer. Usual treatment is endoscopic resection. ln this case we preformed an Holmium laser enuclation of the c yst, thus permitting the discharge of the patient without catheter in less than 24h. And minimizes reabsortion syndrome and bleeding, with a very fast resolution of the clinical symptomatology...


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças Prostáticas/cirurgia , Hólmio , Cistos/cirurgia , Terapia a Laser , Doenças Prostáticas/diagnóstico , Cistos/diagnóstico , Resultado do Tratamento
5.
Actas Urol Esp ; 34(7): 630-3, 2010 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-20540881

RESUMO

OBJECTIVE: Radical cystectomy with urinary diversion is a procedure in which a reduction of morbidity, quick postoperative rehabilitation, limited length of stay and cost containment are difficult to achieve. Postoperative ileus has been identified as the most common cause of delayed recovery and prolonged length of stay. With our review, we try to establish the main causes. MATERIAL AND METHODS: A total of 154 patients underwent radical cystectomy from 1990 to 2008. We examined demographic and perioperative variables of the patients who did and did not develop ileus. RESULTS: No significant association was found between ileus and all the factors we studied. CONCLUSIONS: Postoperative ileus stands out as one of the most frequent complications that causes increased length of stay. More detailed studies are required to determine perioperative regimens to reduce this complication.


Assuntos
Cistectomia/efeitos adversos , Íleus/etiologia , Feminino , Previsões , Humanos , Íleus/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Actas Urol Esp ; 23(10): 873-5, 1999.
Artigo em Espanhol | MEDLINE | ID: mdl-10670130

RESUMO

We report a strange case of a bladder whose first metastasic manifestation, after two years of the diagnosis, was a peripheric polyneuropathia. This patient was treated with immunotherapy with BCG for superficial carcinoma of the bladder during one year. Gradually central neurological symptoms appeared and the patient died one month later. A meningeal carcinomatosis was identify as the cause. No bone metastases existed, which is the most frequent way of tumours extension towards leptomeninges. We argue about the way to arrive at meninges.


Assuntos
Carcinoma de Células de Transição/secundário , Neoplasias Meníngeas/secundário , Neoplasias da Bexiga Urinária/patologia , Humanos , Masculino , Pessoa de Meia-Idade
7.
Actas Urol Esp ; 21(1): 44-8, 1997 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-9182445

RESUMO

Review of 17 female patients who underwent placing of Suburethral Sling as anti-incontinence procedure with the purpose of assessing the results obtained. The most frequent complications were urinary retention and post-surgical urgency. A larger proportion of patients with Stress Urinary Incontinence had retention and during more days than those with Mixed Urinary Incontinence. In most cases of mixed urinary incontinence, asymptomatic prior to surgery, the placing of a suburethral sling provokes signs and symptoms of urgency, and even of post-surgical urgency-incontinence. Both complications were attenuated in all cases using measures such as conservation of urinary by-pass or administration of anti-cholinergics. Results at 2 years have been successful in 68.75% cases, thus encouraging us to reduce the number of indications for this technique.


Assuntos
Incontinência Urinária por Estresse/cirurgia , Idoso , Colágeno , Feminino , Humanos , Pessoa de Meia-Idade , Indução de Remissão , Estudos Retrospectivos , Uretra
8.
Arch Esp Urol ; 48(8): 823-6; discussion 827, 1995 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-8526539

RESUMO

OBJECTIVE: Trigonocervicoprostatotomy (TCP) has been considered up to now an alternative treatment to transurethral resection of the prostate (TURP) when evaluating the size of the prostate. This paper demonstrates that endoscopic visualization is more important when choosing the surgical procedure and that both techniques can achieve satisfactory results. METHODS: The prostate volume is evaluated by ultrasound and according to the endoscopic findings, TURP or TCP is performed. The prostatic lobes are routinely biopsied if the latter procedure is chosen. RESULTS: We compared the results of 34 TCP and 30 TURP procedures using the values of I-PSS and uroflowmetry before and after surgery. In 86.2% of the TCPs and 80% of the TURPs, the patients are asymptomatic with I-PSS less than 7 and significantly improved uroflowmetry data. Biopsy disclosed adenocarcinoma in one patient submitted to TCP. CONCLUSIONS: TCP represents an alternative to TURP not only for small prostates (30 gm) but also for medium-sized prostates (50-60 gms), depending on the endoscopic findings. TCP is not indicated for lateral lobes that fall on the prostate floor. Performing a biopsy routinely in TCP does not prolong the operating time significantly and permits detecting subclinical adenocarcinoma of the prostate.


Assuntos
Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade
9.
Arch Esp Urol ; 48(3): 261-5, 1995 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-7755431

RESUMO

OBJECTIVES: We attempted to determine whether or not incidental renal cell carcinoma had a better prognosis. METHODS: We reviewed 53 cases of renal cell carcinoma that had been surgically treated over the periods 1985-1988 and 1989-1993. The form of presentation, stage of the incidental tumors, sex, compromised side and the diagnostic imaging technique utilized were analyzed. RESULTS: GI pathology most frequently led to the diagnosis of the tumor. Tumor stages were A or B with a slightly higher prevalence for the incidental tumors. However, the prognosis was not better than that of clinically suspected renal cell carcinoma. The male to female ratio was 1.17:1, the mean age was 63 years, the tumors were frequently right-sided and ultrasound was superior in the diagnosis of incidental tumors. CONCLUSIONS: No prognostic difference was observed between clinically suspected and incidental renal cell carcinoma of the same tumor stage.


Assuntos
Carcinoma de Células Renais/diagnóstico , Neoplasias Renais/diagnóstico , Adulto , Idoso , Carcinoma de Células Renais/epidemiologia , Carcinoma de Células Renais/patologia , Feminino , Seguimentos , Humanos , Incidência , Rim/diagnóstico por imagem , Rim/patologia , Neoplasias Renais/epidemiologia , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Radiografia , Estudos Retrospectivos , Espanha/epidemiologia , Ultrassonografia
10.
Actas Urol Esp ; 18(10): 980-2, 1994.
Artigo em Espanhol | MEDLINE | ID: mdl-7856489

RESUMO

Confusion surrounding diagnosis of central prostate cysts is explained for the rarity of the condition. Deferento-vesiculography is diagnostic and must be performed independently (right-left) for a better anatomical evaluation of the area. The endoscopic images do not allow differential diagnosis from other prostate cysts. Recovery of bearer's fertile ability following endoscopic resection does not result, in our experience, as effective as it could be expected from resolving the obstructive cause.


Assuntos
Cistos/diagnóstico , Ductos Ejaculatórios , Adulto , Cistos/terapia , Doenças dos Genitais Masculinos/diagnóstico , Doenças dos Genitais Masculinos/terapia , Humanos , Masculino , Pessoa de Meia-Idade
11.
Arch Esp Urol ; 47(8): 812-4, 1994 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-7818306

RESUMO

We report a case of leiomyoma of the bladder in a male patient who presented with cystitic syndrome and hematuria. The literature is briefly reviewed and the benign nature of this condition is underscored. The prognosis is excellent with correct treatment.


Assuntos
Leiomioma , Neoplasias da Bexiga Urinária , Humanos , Leiomioma/diagnóstico , Leiomioma/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/cirurgia
12.
Arch Esp Urol ; 46(6): 459-62, 1993.
Artigo em Espanhol | MEDLINE | ID: mdl-8379695

RESUMO

Four cases of vesicoscrotal herniation are described. The different etiology and forms of presentation (from an incidental finding to one requiring emergency treatment) of this condition are discussed. Surgical treatment is based on its size, location and coexisting pathology (prostatic hyperplasia, calculus, bladder tumor, etc.).


Assuntos
Doenças da Bexiga Urinária , Idoso , Idoso de 80 Anos ou mais , Hérnia/diagnóstico , Herniorrafia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Bexiga Urinária/diagnóstico , Doenças da Bexiga Urinária/cirurgia
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