Prevalence of storage lower urinary tract symptoms in male patients attending Spanish urology office. Urinary urgency as predictor of quality of life. / Prevalencia de síntomas del tracto urinario inferior de llenado en pacientes varones que acuden a consulta de urología en España. La urgencia urinaria como predictor de calidad de vida.

INTRODUCTION: The study sought to determine the symptomatic profile of men with lower urinary tract symptoms (LUTS) who visited a urology clinic in Spain and its impact on their health-related quality of life (HRQL). MATERIALS AND METHODS: A national, epidemiological cross-sectional study was conducted and included 291 urology clinics. The prevalence of storage LUTS was investigated in 25,482 men. The study collected sociodemographic and clinical data from a subgroup of 1015 patients with storage LUTS who filled out the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire Short Form (OABq-SF) and Patient Perception of Bladder Condition (PPBC) questionnaires. The impact of urinary urgency on HRQL was analysed. RESULTS: The prevalence of storage LUTS was 41%, increasing with age: 14.1%, 41.5% and 60.8% for patients aged 18-49, 50-64 and ≥65 years, respectively. Of the 1015 selected patients, only 2.6% had storage symptoms exclusively. Symptom severity (IPSS) increased with age. Nocturia, frequency and urgency were the most common symptoms and had the most impact on HRQL (IPSS and OABq-SF). The number of urgency episodes was inversely correlated with the HRQL (r=-.773; P<.0001). In the multivariate analysis, only the IPSS and OABq-SF bother scores were significant predictors of HRQL (P<.001). CONCLUSION: Storage LUTS are highly prevalent among patients attending urology clinics in Spain. The severity of the urgency (number of urgency episodes) predicted a poorer quality of life for the patient.

[Expression of the cerbB-2 (HER-2/neu) oncoprotein in prostatic adenocarcinoma]. / Estudio de la expresión de cerbB-2 en el adenocarcinoma de próstata.

OBJECTIVES: Our aim is to determine the expression of the cerbB-2 oncoprotein in prostate cancers using an immunohistochemistry staining and to compare these results with several clinical and histological prognostic factors. METHODS: An immunohistochemical staining using the cerbB-2 monoclonal antibody (Dako) was performed in 32 radical prostatectomy specimens diagnosed of adenocarcinoma. The intensity of cerbB-2 expression was evaluated with a scale that variated from 0 (no staining) to 3+ (strong complete membrane staining) according to published guidelines. Association of cerbB-2 index immunoreactivity with clinical and histological prognostic factors was examined. RESULTS: Definite positive membranous staining was detected in 14 of 32 neoplastic cases (44%). Such overexpression was correlated with higher Gleason grade (p=0.04) and higher stage of disease (p=0.038). CONCLUSIONS: 1) This study shows that 44% of all prostate cancer express the cerbB-2 oncoprotein with immunohistochemical technique. 2) These findings suggest that is necessary to standardize the immunohistochemical staining procedure with cerbB-2 in prostate adenocarcinoma. 3) The level of cerbB-2 expression was correlated with Gleason grade and clinical stage.

[Laparoscopic pyelolithotomy in a pelvic kidney]. / Pielolitotomía laparoscópica en riñón pelviano.

INTRODUCTION: Pelvic renal ectopia bearing stones is a particularly rare case of complex calculi. Several percutaneous and laparoscopic procedures had been proposed in the last years to treat this challenge problem in a minimally invasive way. CLINICAL CASE: We describe the procedure of laparoscopic pyelolithotomy under general anesthesia, using three port sites, in a male patient with symptomatic stones in a left pelvic kidney with normal function. Two stones were successfully removed, with the help of flexible nephroscopy through a port, and the pyelotomy was closed with intracorporeal suture. COMMENT: Laparoscopic pyelolithotomy of a pelvic kidney is a minimally invasive technique that is not difficult to perform, making laparotomy unnecessary. Laparoscopic technique must be take into account when dealing with the infrequent complex stone patient candidate to an open stone surgery. A review of the Spanish bibliography shows this to be the second reported case of pelvic kidney calculi treated by laparoscopic pyelolithotomy.

[Non-palpable prostatic cancer. Cure with adenomectomy?]. / Cáncer de próstata no palpable. Curación con adenomectomía?

The currently growing importance of prostate cancer (PC) is given by the large increase in the number of cases diagnosed with this condition, to a great extent due to the diffusion of the most recent diagnostic techniques. Together with the traditional rectal examination, we have available today the PSA (prostate specific antigen) and the transrectal ultrasound, which allow to diagnose tumours undetectable with palpation. This paper presents the case of a male patient with high levels of PSA (in metastatic values), normal rectal examination and three series of negative prostate biopsies in spite of a high suspicion of PC, the diagnosis being confirmed after adenomectomy, with a subsequent PSA levels normalization, these levels remaining below 3 ng/ml after 22 months follow-up, which allows to think of a "recovery" (?) with just the removal of the prostate adenoma.

[Prostate leiomyosarcoma with perineal exophytic mass]. / Leiomiosarcoma prostático con masa exofítica perineal.

Report on one case of prostate leiomyosarcoma, an infrequent and usually highly aggressive urologic neoplasia. Emphasis on the imaging and pathoanatomical diagnosis, highlighting the high value of the later as immunohistochemistry is usually essential to establish its nature. Choice treatment is oncologically radical surgery. Quite often this is impossible to carry out and so chemo- and radiotherapy schedules are commonly associated as neoadjuvant, adjuvant or palliative therapies. The reported case showed aggressive evolution unresponsive to management. Also, during the condition development a rare complication such as occurrence of an exophytic tumoral mass in the perineum appeared.

[Genitourinary malacoplakia]. / Malacoplaquia genitourinaria.

Malacoplakia is a chronic inflammatory disease the etiology of which remains obscure. It has a very low incidence and affects primarily the genitourinary tract, although it has been described in some other organs. This paper presents a historic insight of the clinical cases diagnosed in this centre, and includes a review and update of several issues related to this entity such as pathogenesis, pathological anatomy and treatment. Also, the peculiarities related to the involvement of each separate organ with regard to diagnosis, prognosis and treatment are described.

[Urethral catheters]. / Catéteres uretrales.

After a historical summary on the development of urethral catheters, this article analyzes various aspects about catheters. These aspects include: types of catheters and their recommended use, their counterindications, their classification, how to select the appropriate catheter, the information which a patient should be provided regarding the use of a catheter, the techniques and equipment necessary for their use, the most common problems encountered and how to solve them,...

Prevalencia de síntomas del tracto urinario inferior de llenado en pacientes varones que acuden a consulta de urología en España. La urgencia urinaria como predictor de calidad de vida / Prevalence of storage lower urinary tract symptoms in male patients attending Spanish urology office. Urinary urgency as predictor of quality of life

Introducción: Se buscó conocer el perfil sintomático de pacientes varones con síntomas del tracto urinario inferior (STUI) que acuden a consulta de urología en España, y el impacto en la calidad de vida relacionada con la salud (CVRS). Materiales y métodos: Estudio nacional, epidemiológico, transversal. Incluyó 291 consultas de urología. La prevalencia de STUI de llenado se investigó en 25.482 varones. Se recogieron datos sociodemográficos y clínicos de un subgrupo de 1.015 pacientes con STUI de llenado que completó los cuestionarios IPSS, OABq-SF y PPBC. Se analizó el impacto de la urgencia urinaria en la CVRS. Resultados: La prevalencia de STUI de llenado fue 41%, aumentando con la edad: 14,1%, 41,5% y 60,8% de los pacientes con 18-49, 50-64 y ≥ 65 años, respectivamente. De los 1.015 pacientes seleccionados solo el 2,6% presentaba exclusivamente síntomas de llenado. La gravedad de los síntomas (IPSS) aumentó con la edad. La nocturia, la frecuencia y la urgencia fueron los síntomas más frecuentes y con más impacto en la CVRS (IPSS y OABq-SF). El número de episodios de urgencia se correlacionó inversamente con la CVRS (r = −0,773; p < 0,0001). En el análisis multivariado solo el IPSS y el OABq-SF de molestias fueron predictores significativos de CVRS (p < 0,001). Conclusión. Existe una alta prevalencia de STUI de llenado entre los pacientes que acuden a consulta de urología en España. La gravedad de la urgencia (número de episodios de urgencia) predijo una peor calidad de vida del paciente

Introduction: The study sought to determine the symptomatic profile of men with lower urinary tract symptoms (LUTS) who visited a urology clinic in Spain and its impact on their health-related quality of life (HRQL). Materials and methods: A national, epidemiological cross-sectional study was conducted and included 291 urology clinics. The prevalence of storage LUTS was investigated in 25,482 men. The study collected sociodemographic and clinical data from a subgroup of 1015 patients with storage LUTS who filled out the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire Short Form (OABq-SF) and Patient Perception of Bladder Condition (PPBC) questionnaires. The impact of urinary urgency on HRQL was analysed. Results: The prevalence of storage LUTS was 41%, increasing with age: 14.1%, 41.5% and 60.8% for patients aged 18-49, 50-64 and ≥ 65 years, respectively. Of the 1015 selected patients, only 2.6% had storage symptoms exclusively. Symptom severity (IPSS) increased with age. Nocturia, frequency and urgency were the most common symptoms and had the most impact on HRQL (IPSS and OABq-SF). The number of urgency episodes was inversely correlated with the HRQL (r = −.773; P < .0001). In the multivariate analysis, only the IPSS and OABq-SF bother scores were significant predictors of HRQL (P < .001). Conclusion: Storage LUTS are highly prevalent among patients attending urology clinics in Spain. The severity of the urgency (number of urgency episodes) predicted a poorer quality of life for the patient

Laparoscopia en la fibrosis retroperitoneal / Laparoscopy in retroperitoneal fibrosis

No disponible

Estudio de la expresión de cerbB-2 en el adenocarcinoma de prostata / Expression of the cerbB-2 (HER-2/neu) oncoprotein in prostatic adenocarcinoma

Objetivos: Determinar la expresión de la oncoproteína cerbB-2 en carcinomas de próstata con técnicas de inmunohistoquímica de próstata y comparar estos resultados con diversos factores pronósticos clínicos e histológicos. Material y métodos: Se realizó tinción inmunohistoquímica con el anticuerpo cerbB-2 (DAKO) en 32 piezas de prostatectomia radical infiltradas por un adenocarcinoma. La expresión de cerbB-2 fue evaluada de 0 (no-tinción) a 3+ (tinción intensa y continua en la membrana celular) según protocolo. Se analizó la asociación estadística entre la expresión de cerbB-2 con algunos parámetros clínicos e histológicos. Resultados: Se demostró positividad de membrana en 14 de las 32 neoplasias evaluadas (44%). La sobreexpresión de cerbB-2 se correlacionó estadísticamente con el índice de Gleason (p=0.04) y estadio clínico (p=0.038). Conclusiones: 1) Nuestro estudio muestra que aproximadamente el 44% de los carcinomas prostáticos expresan cerbB-2 con técnicas de inmunohistoquímica. 2) Esta serie permite deducir la necesidad de estandarizar la técnica inmunohistoquímica de cerbB-2 en el adenocarcinoma prostático. 3) En nuestro trabajo existe asociación estadística significativa de la expresión de cerbB-2, según el método modificado, con el estadío clínico e índice de Gleason

Objectives: Our aim is to determine the expression of the cerbB-2 oncoprotein in prostate cancers using an immunohistochemistry staining and to compare these results with several clinical and histological prognostic factors. Methods: An immunohistochemical staining using the cerbB-2 monoclonal antibody (Dako) was performed in 32 radical prostatectomy specimens diagnosed of adenocarcinoma. The intensity of cerbB-2 expression was evaluated with a scale that variated from 0 (no staining) to 3+ (strong complete membrane staining) according to published guidelines. Association of cerbB-2 index immunoreactivity with clinical and histological prognostic factors was examined. Results: Definite positive membranous staining was detected in 14 of 32 neoplastic cases (44%). Such overexpression was correlated with higher Gleason grade (p=0.04) and higher stage of disease (p=0.038). Conclusions: 1) This study shows that 44% of all prostate cancer express the cerbB-2 oncoprotein with immunohistochemical technique. 2) These findings suggest that is necessary to standardize the immunohistochemical staining procedure with cerbB-2 in prostate adenocarcinoma. 3) The level of cerbB-2 expression was correlated with Gleason grade and clinical stage

Pielolitotomía laparoscópica en riñón pelviano / Laparoscopic pyelolithotomy in a pelvic kidney

INTRODUCCIÓN: El riñón pelviano afecto de cálculos es un caso particularmente raro de litiasis compleja. Diversos procedimientos, percutáneos y laparoscópicos, se han propuesto en los últimos años para resolverlo de manera poco invasiva. CASO CLÍNICO: Se muestra el procedimiento de pielolitotomía laparoscópica mediante tres únicos accesos, en un varón con cálculos sintomáticos en un riñón pelviano izquierdo con función normal. Se extrajeron dos cálculos con ayuda del nefroscopio flexible introducido a través de uno de los accesos, y cerrando la pelvis renal con sutura intracorpórea. COMENTARIO: La pielolitotomía laparoscópica de un riñón pelviano es poco invasiva y puede hacerse con facilidad, haciendo innecesaria una laparotomía. La técnica laparoscópica debe tenerse en cuenta en el infrecuente paciente con litiasis compleja en el que se considere una intervención abierta. Este es el segundo caso de riñón pelviano operado mediante laparoscopia, en la bibliografía española

INTRODUCTION: Pelvic renal ectopia bearing stones is a particularly rare case of complex calculi. Several percutaneous and laparoscopic procedures had been proposed in the last years to treat this challenge problem in a minimally invasive way. CLINICAL CASE: We describe the procedure of laparoscopic pyelolithotomy under general anesthesia, using three port sites, in a male patient with symptomatic stones in a left pelvic kidney with normal function. Two stones were successfully removed, with the help of flexible nephroscopy through a port, and the pyelotomy was closed with intracorporeal suture. COMMENT: Laparoscopic pyelolithotomy of a pelvic kidney is a minimally invasive technique that is not difficult to perform, making laparotomy unnecessary. Laparoscopic technique must be take into account when dealing with the infrequent complex stone patient candidate to an open stone surgery. A review of the Spanish bibliography shows this to be the second reported case of pelvic kidney calculi treated by laparoscopic pyelolithotomy

Metástasis pancreática de adenocarcinoma renal / Pancreatic metastasis from renal adenocarcinoma

Presentamos un caso de metástasis pancreática de adenocarcinoma renal en una paciente intervenida hacía 14 años por un adenocarcinoma renal, en la revisión de su enfermedad se objetivó, en la ecografía y en la TAC, un nuevo adenocarcinoma renal en el riñón contralateral con un nódulo en cuerpo pancreático, siendo éste una metástasis de adenocarcinoma renal, que se confirmó con la PAAF. Se realizó una nefrectomía parcial y una resección corporocaudal pancreática por lumbotomía, no siendo el abordaje de elección pero permitiendo un buen campo para la resección pancreática parcial. Tras 20 meses de seguimiento, la paciente presenta una remisión total de su enfermedad (AU)