[Female paraurethral cysts. Experience of 4 cases]. / Quistes parauretrales femeninos. Experiencia de 4 casos.

Parauthreal cysts are an uncommon pathology. We present 4 cases diagnosed and treated in our hospital during the last 10 years.

[Urinary bacteriologic study prior to endoscopic urologic surgery]. / Estudio bacteriológico de la orina previa a la cirugía urológica endoscópica.

OBJECTIVE: The objectives of this study are to know the incidence of preoperative bacteriuria in patients undergoing endoscopic urologic surgery, to analyze the most frequent microorganisms appearing in the cultures and their resistance to antibiotics in order to select the most appropriate prophylactic one for our population, and to determine the risk factors related to postoperative bacteriuria or sepsis of urologic origin. MATERIAL AND METHODS: 449 patients undergoing endoscopic urologic surgery were included in the study. Urinary samples were collected for culture prior to prophylactic antibiotic administration and again a week after bladder catheter removal once the antibiotic treatment was finished. Variables related to an increase in infectious complications were analyzed. Special attention was paid to postoperatory incidences, mainly those of infectious nature. RESULTS: Preoperative bacteriuria was found in 66 out of 428 patients (15.4%). It was found to be related to age, sex, previous infection episodes, diabetes mellitus, indwelling catheter and to the pathology for which operation was indicated. The most frequently found microorganism was Escherichia Coli. Resistance to prophylactic antibiotic was found in 37.9% of patients with preoperatory bacteriuria. Postoperatory bacteriuria, observed in 22.0% of the patients was exclusively related to preoperatory bacteriuria. 2.9% of patients showed sepsis of urinary origin criteria during hospital staying, and it was found to be exclusively related to length of surgery and neither to preoperatory bacteriuria nor to indwelling catheter time or the "inappropriate" prophylactic antibiotic use in these cases. CONCLUSIONS: A good part of patients who underwent endoscopic surgery showed preoperatory bacteriuria, responsible for postoperative bacteriuria in less than 25% of the cases. The length of surgery seemed to be the only related cause whit sepsis of urinary origin.

[On the need of pubic region shaving in patients undergoing endoscopic urologic surgery]. / Sobre la necesidad del rasurado de la región púbica en los pacientes que van a ser sometidos a cirugía urológica endoscópica.

OBJECTIVE: The objective of this study is to assess the effects of preoperative shaving of the pubic region on post-operative bacteriuria after endoscopic urological surgery. MATERIALS AND METHOD: The study was carried out distributing the patients undergoing endoscopic urological surgery in a controlled randomized way in two groups. In a group the pubic region was shaved, according to the habitual techniques, while the other group was not shaved; the rest of the preparation was the same for both groups. Urine samples were collected for their culture before the administration of the prophylactic antibiotic and a week after the removal of the Foley catheter, yet without antibiotic treatment. Special attention was paid to the postoperative incidences, mainly, those of infectious nature. RESULTS: They were included a total of 449 patients, of which 149 were removed from the study by different causes. Of these, 149 were shaved and 151 were not it. In the group of unshaved patients a 19.5% of postoperative bacteriurias was observed, while in the other group it was of 16.6%. Differences in both groups were not statistically significant. CONCLUSIONS: We conclude that there is no an increase of postoperative bacteriurias in the unshaved patients undergoing endoscopic urological surgery, compared with the group of patients shaved with disposable bladders.

[A diagnostic algorithm based on transrectal echography in failure of surgery correcting stress urinary incontinence]. / Algoritmo diagnóstico basado en la ecografía transrectal en los fracasos de la cirugía correctora de la incontinencia urinaria de stress.

Transrectal ultrasound is a dynamic imaging diagnostic technique for the study of stress urinary incontinence (SUI). The highest efficiency is obtained in the study of failed corrective surgery of SUI. Our group studied 23 patients reporting clinical SUI after undergoing corrective surgery, 23.3% patients with transrectal ultrasound showed no condition that could justify it (bladder neck hypermobility, intrinsic sphincteral incompetence, calcification of suspension threads, urethra diverticulum...); 34.8% showed bladder neck hypermobility, indicative of failed corrective surgery; 34.8% showed presence of open urethra at rest, an echographic sign of intrinsic sphincteral incompetence; and in 4.3% cases the existence of intravesical calcifications of the suspension threads was diagnosed. Transrectal ultrasound can become the choice test to perform in this group of patients, leading to the performance of other diagnostic tests and offering an adequate customized solution for each patient's problem.

[Antimicrobial prophylaxis in urology]. / Profilaxis antimicrobiana en urología.

UNLABELLED: Antimicrobial prophylaxis in surgery has proven to be effective in controlled randomized trials. Usage in Urology is known at least since the '30s although its effectiveness has only become known since 1979. METHODS: Review of literature related to surgical antibiotic prophylaxis, more specifically urological surgery, basically from 1991 to 1995, but without overlooking those papers that have become classics due to their impact. RESULTS AND CONCLUSIONS: Efficacy of antimicrobial prophylaxis in urological surgery is nowadays beyond all doubt. Usage is indicated in the presence of sterile urine and dosage must be short, in single dosis in the immediate pre-operative or within 24 hours after the procedure. However, there is a number of issues that deserve to be treated in more detail for better understanding. Those are the establishment of adequate prophylactic regimes in renal transplantation and the use of antimicrobials based on their pharmacokinetic characteristics to optimize the prophylactic purpose.