Extensively drug-resistant Pseudomonas Aeruginosa outbreak in a burn unit: management and solutions.

Infections are still the main cause of mortality in burn patients. Multidrug resistant bacteria can cause outbreaks in critical care and burn units. We describe an outbreak of infection by extensively drug-resistant Pseudomonas aeruginosa in the Burn Unit of a University Hospital in Barcelona (Spain) between April and July 2016. A descriptive study of all cases, a bacterial colonization screening of all admitted patients and a microbiological environmental study were performed in order to detect a possible common focus. Contact isolation and cohortization of healthcare workers of all infected or colonized patients were applied. Environmental control measures were instituted for possible sources of infection. The outbreak was caused by a strain of P. aeruginosa only sensitive to colistin. Ten patients were infected or colonized and two of them died. The same strain was detected in several taps and drains in different rooms of the Unit. After applying control measures, changing faucets and drains, carrying out thermal disinfection of the hot water installation of the unit, disinfecting the rooms with ultraviolet radiation and placing antibacterial filtration devices in all the taps among other measures, an effective control of the outbreak was achieved.

Les infections sont toujours une cause majeure de mortalité chez les brûlés. Des épidémies à bactéries multirésistantes (BMR) dans les CTB sont régulièrement rapportées. Nous décrivons une épidémie due à Pseudomonas æruginosa BMR, sensible uniquement à la colimycine, survenue dans le CTB d'un hôpital universitaire de Barcelone entre avril et juillet 2016. Elle a touché 10 patients dont 2 sont morts. Une étude de chaque cas, un dépistage chez tous les entrants et une étude environnementale ont été réalisées, afin de trouver d'éventuelles similitudes. Un isolement contact et un cohorting ont été mis en place. Des mesures de contrôle de l'environnement ont été implémentées. La souche incriminée a été retrouvée dans plusieurs robinets et siphons du service. Cette épidémie a été résolue après, outre les mesures précitées, changement des robinets et des siphons (avec mise en place d'ultrafiltres sur les robinets), choc thermique du réseau d'adduction d'eau, désinfection terminale UV des chambres.

Hidatidosis paravesical. Presentación de un caso clínico / Bladder hidatidosis. Presentation of a clinical case

La hidatidosis primaria pélvica o paravesical es una forma excepcional de presentación de la enfermedad, mucho más común en pulmón, hígado y riñón. La clínica suele corresponder a trastornos irritativos miccionales. El diagnóstico de imagen es por ecografía, TAC y RNM. La serología es complementaria. El tratamiento médico es con albendazol pero la solución definitiva del quiste hidatídico paravesical es la cirugía. Se presenta un caso clínico de quiste hidatídico paravesical tratado con cirugía abierta, con una breve revisión de la literatura (AU)

Primary pelvic or paravesical hydatid disease is an exceptional presentation of the disease, more common in lung, liver and kidney. The symptoms are typically for irritative micturition disorders. The image diagnosis is by ultrasound, CT and MRI. The serology is complementary. Albendazole is pharmacological treatment but the final solution for the paravesical hydatid cyst is surgery. We present a case of paravesical hydatid cyst treated with open surgery, with a brief review of the literatura (AU)

Divertículo vesical adquirido. Caso clínico / Acquired bladder diverticulum. A clinical case

El divertículo vesical (DV) puede ser congénito o adquirido. Consiste en una herniación de la mucosa vesical. Los adquiridos se deben a un mecanismo de hiperpresión endovesical generalmente en pacientes con obstrucción infravesical secundaria a hiperplasia benigna de próstata (HBP), patología del cuello vesical o uretral. Cuando los DV son sintomáticos o producen complicaciones se debe plantear tratamiento quirúrgico. En los últimos años la diverticulectomía laparoscópica ha presentado muy buenos resultados aunque la cirugía abierta está indicada en algunos casos más complejos. En DV adquiridos de tamaño pequeño y mediano está indicado el tratamiento transuretral. Se presenta un caso clínico y una revisión de diferentes aspectos diagnósticos y quirúrgicos del DV (AU)

The bladder diverticulum (DV) can be congenital or acquired. It consists of a herniation of the bladder mucosa. The acquired is due to a mechanism of intravesical hyperpressure usually in patients with bladder outlet obstruction secondary to BPH, cervical or urethral pathology. When DV are symptomatic or produce complications surgical treatment should be considered. In recent years laparoscopic diverticulectomy has shown very good results although open surgery is indicated in some more complex cases. In small and medium acquired DV transurethral treatment is indicated. One clinical case and a review of various diagnostic and surgical aspects of DV are presented (AU)

Nuevo enfoque de la uretroplastia en estenosis corta de uretra bulbar / New approach to urethroplasty in bulbar urethral stricture

La uretroplastia termino-terminal es el tratamiento habitual en las estenosis cortas de la uretra bulbar. Esta técnica lleva implícita, en la mayoría de casos, la sección de las arterias bulbares que dan suministro de sangre al cuerpo esponjoso y uretra bulbomembranosa. La técnica de uretroplastia dorsal bulbar sin resección del pedículo bulbocavernoso con cierre romboidal, utilizando el concepto de Heineke-Mikulicz, fue descrita por Andrich y Mundy en 2003 . Sus resultados son similares a la uretroplastia término-terminal con menos trauma quirúrgico. Se presenta un caso clínico y datos de nuestra experiencia inicial con esta nueva técnica de uretroplastia para el tratamiento de la estenosis bulbar corta de la uretra bulbar (AU)

The end-to-end urethroplasty is the usual treatment for short strictures of the bulbar urethra. This technique implies, in most cases, the section of the bulbar arteries that feed blood to the spongy body and bulbomembranous urethra. The technique of dorsal bulbar urethroplasty without resection of the pedicle with rhomboid closing using the Heineke-Mikulicz concept was described by Andrich and Mundy in 2003. Their results are similar to the end to end urethroplasty with the advantage of less surgical trauma. A clinical case and data of our initial experience with this new technique of urethroplasty for the treatment of short bulbar strictures of the bulbar urethra is presented (AU)

Phylogenetic and structural response of heterotrophic bacteria to dissolved organic matter of different chemical composition in a continuous culture study.

Dissolved organic matter (DOM) and heterotrophic bacteria are highly diverse components of the ocean system, and their interactions are key in regulating the biogeochemical cycles of major elements. How chemical and phylogenetic diversity are linked remains largely unexplored to date. To investigate interactions between bacterial diversity and DOM, we followed the response of natural bacterial communities to two sources of phytoplankton-derived DOM over six bacterial generation times in continuous cultures. Analyses of total hydrolysable neutral sugars and amino acids, and ultrahigh resolution mass spectrometry revealed large differences in the chemical composition of the two DOM sources. According to 454 pyrosequences of 16S ribosomal ribonucleic acid genes, diatom-derived DOM sustained higher levels of bacterial richness, evenness and phylogenetic diversity than cyanobacteria-derived DOM. These distinct community structures were, however, not associated with specific taxa. Grazing pressure affected bacterial community composition without changing the overall pattern of bacterial diversity levels set by DOM. Our results demonstrate that resource composition can shape several facets of bacterial diversity without influencing the phylogenetic composition of bacterial communities, suggesting functional redundancy at different taxonomic levels for the degradation of phytoplankton-derived DOM.

Trauma uretral en pacientes politraumáticos / Urethral trauma in polytraumatized patients

El traumatismo de uretra afecta sobre todo a hombres. En mujeres es muy raro y requiere un manejo diferenciado. Con mayor frecuencia se producen en el contexto de una fractura de la pelvis. La lesión de la uretra en el paciente politraumático puede pasar desapercibida si no se tienen en cuenta los signos que lo ponen de manifiesto, como la uretrorragia. La dificultad para realizar la micción: con frecuencia la lesión uretral se sospecha a partir de las dificultades de un sondaje uretral. Las fracturas de la pelvis son el contexto en que con mayor frecuencia se halla el traumatismo de la uretra. Ante la duda no se debe manipular la uretra con sondas y se realizará una uretrografía. Los traumas de la uretra se dividen en 2 según afecten a uretra posterior y anterior. El trauma de uretra posterior requiere una primera maniobra de realineación uretral para proceder, semanas después a una reconstrucción o repermeabilización de la uretra posterior por vía abierta o endoscópica. Tiene tendencia a la estenosis y provocan con frecuencia incontinencia de orina. El trauma de uretra anterior se trata con sondaje si la lesión es parcial y con anastomosis termino-terminal si la rotura es completa. Es importante diagnosticar correctamente el trauma uretral para optimizar los resultados del tratamiento reconstructivo (AU)

Urethral trauma primarily affects men. In women is very rare requiring different handling. Most often occur in the context of a pelvic fracture. Urethal injury could be misdiagnosed if not taken into account urethral trauma signs as urethrorragy or difficulty for urination. Often urethral injury is suspected from the difficulties of urethral catheterization in cases of pelvic fractures in polytraumatized patients. When in doubt should not manipulate the urethra with probes and urethrogram is recommended. The urethral injury is divided into 2 as they affect posterior and anterior urethra. The posterior urethral injury requires an initial manoeuvre to proceed urethral realignment, weeks after a reconstruction with open or endoscopic surgery. It has a tendency to stricture and often causes incontinence. The anterior urethral injury can be treated with probing if the injury is partial and end to end anastomosis if the break is complete. It is important to optimize the outcome of reconstructive treatment correctly diagnose urethral injury (AU)

Origin and fate of copper in a small Mediterranean vineyard catchment: new insights from combined chemical extraction and δ65Cu isotopic composition.

For centuries, many Mediterranean catchments were covered with vineyards in which copper was widely applied to protect grapevines against fungus. In the Mediterranean-type flow regime, brief and intense flood events increase the stream water discharge by up to 10 times and cause soil leaching and storm runoff. Because vineyards are primarily cultivated on steep slopes, high Cu fluxes are discharged by surface water runoff into the rivers. The purpose of this work was to investigate the riverine behavior and transport of anthropogenic Cu by coupling a sequential chemical extraction (SCE) procedure, used to determine Cu partitioning between residual and non-residual fractions, with δ(65)Cu isotopic measurements in each fraction. In the Baillaury catchment, France, we sampled soils (cultivated and abandoned), river bed sediments (BS), suspended particulate matter (SPM), and river water during the flash flood event of February 2009. Copper partitioning using SCE show that most of Cu in abandoned vineyard soil was in the residual phase (>60%) whereas in cultivated soil, BS and SPM, Cu was mostly (>25%) in non-residual fractions, mainly adsorbed onto iron oxide fractions. A small fraction of Cu was associated with organic matter (5 to 10%). Calculated enrichment factors (EF) are higher than 2 and the anthropogenic contribution was estimated between 50 to 85%. Values for δ(65)Cu in bulk samples were similar to bedrock therefore; δ(65)Cu on SCE fractions of superficial soils and SPM allowed for discrimination between Cu origin and distribution. Copper in residual fractions was of natural mineral origin (δ(65)Cu close to local bedrock, +0.07‰). Copper in water soluble fraction of SPM (δ(65)Cu=+0.26‰) was similar to dissolved river Cu (δ(65)Cu=+0.31‰). Copper from fungicide treatment (δ(65)Cu=-0.35‰) was bound to organic matter (δ(65)Cu=-0.20‰) without or with slight isotopic fractioning. A preferential adsorption of (65)Cu onto iron oxides (δ(65)Cu=+0.5‰) is shown.

Celdopatía prostática incrustante: a propósito de un caso / Encrusted prostatitis: a report of a case

Presentamos un caso clínico de celda prostática incrustada de litiasis, a la que denominamos celdopatía incrustante, raramente reportada en la literatura, que comparte características fisiopatológicas con la cistitis alcalina incrustante, descrita desde inicios del siglo XX. Ambas presentan síntomas urinarios irritativos, hematuria, orina alcalina y necrosis tisular por debajo de una capa de calcificación, asociada a bacteria ureolítica, en su mayor parte. El tratamiento de la celditis, cistitis, y pielitis incrustante incluye antibióticos específicos, acidificación urinaria y escisión endoscópica de las lesiones calcificadas (AU)

We report a case of an encrusted prostatic celdopathy fouling or encrusted prostatitis, rarely reported, that accordingly to literature reviwed, seems to share physiopathological features with alkaline encrusted cystitis, described from the early twentieth century. Both cause irritative urinary symptoms, haematuria, alkaline urine and tissue necrosis below a layer of calcification, this associated to ureolytic bacteria, mostly. The treatment of encrusted prostatitis, cystitis, and pyelitis includes specific antibiotics, urinary acidification and endoscopic excision of the calcified lesions (AU)

Fistula uretrorectal post prostatectomia radical: reparación vía perineal con interposición del músculo gracilis. Caso clinico / Post radical prostatectomy fistula: perineal repair with gracilis muscle interposition. Clinical case

Existen diversas técnicas quirúrgicas para la solución de las fístulas uretrorectales debidasa cirugía prostática. La plastia con interposición de músculo gracilis vía perineal es una técnica eficaz. Se presenta un caso clínico de fístula uretrorectal post prostatectomía radical y su resolución por vía perineal con músculo gracilis (AU)

There are several surgical techniques for the solution of uretrorectales fistulas due to prostate surgery. Plasty with gracilis muscle interposition perineal approach is an effective technique. We report a case of fistula uretrorectal post radical prostatectomy and perineal resolution with gracilis muscle (AU)

Quiluria. Presentación de un caso y revisión de la literatura / Chyluria. Case report and literature review

La quiluria, se deriva del paso anómalo de linfa al sistema urinario por fistulización. Su principal causa es la filariasis, una infección parasitaria causada en el 90% por el nemátodo Wuchereria bancrofti, aunque paralelamente existen diversas etiologías como enfermedades granulomatosas, infecciones, tumores o yatrogenia postquirúrgica. Su diagnóstico es clínico al observar la orina densa de color blanco y su confirmación se realiza al encontrar triglicéridos, quilomicrones y proteínas elevadas en orina. El tratamiento se realiza de manera individualizada y varía desde un manejo conservador con medidas higiénico dietéticas, esclerosis de las fístulas con instilaciones piélicas de povidona yodada, N-butil 2- cianoacrilato o nitrato de plata hasta procedimientos quirúrgicos de diversa índole. Se presenta el caso deuna paciente mujer de 60 años que inicia quiluria tras someterse a una cirugía pélvica (AU)

Chyluria, is the clinical manifestation of a fistulous process between the lymphatic and urinary systems. It is often due to parasitic infections, principally filarial roundworms of the genera Wuchereria bancrofti. Although other causes such as granulomatous diseases, urinary tract infections, tumors or iatrogenic can be present. Diagnosis is made by clinical evidence of chyluria and detection of elevated triglyceride and proteins levels in urine samples. Treatment options are individualized and can vary from medical management, sclerotherapy with povidone iodine, silver nitrate or N-butyl-2-cyanoacrylate, to surgical approaches. We present a case of a 60 years old women ho presented chyluria after pelvic surgery (AU)

Hidatidosis renal tratada con nefrectomía abierta: a propósito de un caso / Renal hydatidosis treated with open nephrectomy: report of a case

INTRODUCCIÓN: La hidatidosis o equinococosis es una enfermedad parasitaria que afecta al riñón de forma excepcional. El diagnóstico se basa en pruebas serológicas y radiológicas como la TAC. Conviene realizar un buen diagnóstico diferencial y distinguir otras tumoraciones quísticas renales. MATERIAL Y MÉTODOS: A partir de un caso clínico, se revisa la sistemática diagnóstica y las opciones de tratamiento de la hidatidosis renal. RESULTADOS: La TAC es la prueba de imagen más eficaz. La serología no es demasiado útil. La nefrectomía total extraperitoneal es el tratamiento de elección. Debe ser precedida de tratamiento escolicida. Otras opciones son la cirugía parcial y la punción percutánea. CONCLUSIONES: La hidatidosis renal es una rara enfermedad que precisa diagnóstico preciso (TAC). Cuando es sintomática el tratamiento es la nefrectomía. La laparoscopia, retroperitoneoscopia o la punción percutánea se han practicado en casos aislados (AU)

INTRODUCTION: Hydatid disease or echinococcosis is a parasitic disease that affects the kidney by way of exception. The diagnosis is based on serology and radiological tests such as CT. It should make a good differential diagnosis and distinguish other renal cystic tumors. MATERIAL AND METHODS: From a case report, we review the diagnosis and treatment options for renal hydatidosis. RESULTS CT is the imaging more efficient. Serology is not very useful. Concerning the treatment, extraperitoneal nephrectomy is the gold standard. Other options include partial surgery and percutaneous puncture. Medical treatment with Scolicides is applied before and after surgery. CONCLUSIONS: Renal hydatid disease is a rare condition that requires accurate diagnosis (TAC). When it is symptomatic nephrectomy is required. Laparoscopy, retroperitoneoscopy and percutaneous punction have been practiced in isolated cases (AU)

Síndrome del cascanueces (nutcracker) secundario a vena renal izquierda retroaórtica: tratamiento quirúrgico con transposición de la vena renal / Nutcracker syndrome secondary to retroaortic left renal vein: surgical treatment with transposition of the renal vein

INTRODUCCIÓN: El síndrome del cascanueces renal producido por una vena renal izquierda retro-aórtica (VRIR) es excepcional. Si produce clínica significativa, el tratamiento es quirúrgico (transposición de vena renal) MATERIAL Y MÉTODO: Se presenta un caso clínico y se revisa brevemente la literatura. RESULTADOS: Tras la transposición de la VRIR la paciente evolucionó correctamente. RESUMEN: La cirugía en casos de síndrome del cascanueces por VRIR es una opción útil para controlar la clínica en estas situaciones (AU)

INTRODUCTION: Renal nutcracker syndrome caused by left retro-aortic renal vein (LRRV) is an exceptional condition. In case of significant clinical problems, surgical treatment is required (renal vein transposition). MATERIAL AND METHOD: We report a case of LRRV and literature is reviewed briefly. RESULTS: After the transposition of the LRRV the patient developed properly. SUMMARY: The surgery in cases of nutcracker syndrome by LRRV is useful to control symptoms (AU)

Hiperplasia benigna de próstata: valoración inicial y tratamiento médico. Revisión a partir de guías clínicas internacionales y ensayos clínicos multicéntricos / Benign prostatic hyperplasia: initial assessment and treatment. Review from international clinical guidelines and multicenter clinical trials

INTRODUCCIÓN: La hiperplasia benigna de próstata (HBP) es una enfermedad prevalente en varones adultos de más de 45-50 años, aunque no siempre presenta manifestaciones clínicas. La aparición de síntomas del tracto urinario inferior (STUI) puede estar relacionada con la HBP en muchos casos. MATERIAL Y MÉTODOS: Se realiza una revisión de artículos relevantes sobre abordaje diagnóstico y terapia médica en HBP, así como ensayos clínicos publicados en los últimos años: MTOPS y PLESS y combAT. RESULTADOS: Para establecer la relación entre STUI y HBP es necesario realizar un buen interrogatorio al paciente (IPSS) y realizar una serie de exploraciones complementarias como análisis de sangre, con PSA, análisis de orina, ecografía y flujometría miccional. Una vez establecido el diagnóstico existen diversas opciones de tratamiento médico en función del IPSS, volumen protático y valor de PSA, avalados por diversos ensayos clínicos (AU)

INTRODUCTION: Benign prostatic hyperplasia (BPH) is a prevalent disease in male adults aged 45-50 years, although not always clinical manifestations are present. The occurrence of lower urinary tract symptoms (LUTS) can be related to BPH in many cases. MATERIAL AND METHODS: A review of relevant articles on medical diagnostic and therapeutic approach in BPH, and clinical trials published in recent years: (MTOPS, PLESS and combAT) was performed. RESULTS: To establish the relationship between LUTS and BPH is necessary to make a good anamnesis of the patient (IPSS) and additional tests such as blood tests with PSA, urianalysis, ultrasound and urinary flow measurement. Once the diagnosis there are several medical treatment options in terms of IPSS, prostate volume and PSA value, backed by several clinical trials (AU)

Uretroplastia con injerto de mucosa bucal a nivel dorsal bulbar tipo Barbagli / Urethroplasty with buccal mucosa graft at dorsal bulbar level type Barbagli

La estenosis de uretra sigue siendo un tema controvertido y no existe consenso universal en cuanto a su tratamiento. Las técnicas de uretroplastia con parche de material autólogo prometen ser una alternativa efectiva en las estenosis bulbares mayores a 3 y 4 cms, con una tasa de éxito que alcanza los 85-90% con tasas de restenosis de menos de 10%, pero aún quedan por valorar los resultados a largo plazo. Se presenta el caso de un paciente con estenosis de uretra bulbar de 34 cms. De etiología traumática, intervenido de uretroplastia con parche de mucosa bucal según técnica de Barbagli (AU)

Urethral strictures remains a controversial subject with no universal consensus regarding its treatment. Urethroplasty techniques with autologous material seem to represent an effective choice in bulbar strictures over 3-4 cms, with a 85-90% rate of success and less than 10% restemosis rates but still long term follow up is needed. We present the case of a patient with a 3 cms. Bulbar stricture of traumatic etiology in wich a buccal mucosa graft urethoplasty was performed according to the Barbagli procedure (AU)

Fournier's gangrene: a monographic urology center experience with twenty patients.

BACKGROUND: Fournier's gangrene (FG) is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in males and the vulva in females. The aim of this study was to share our experience in the management of this infectious disease. METHODS: A retrospective chart review was performed in 20 patients with a diagnosis of FG between January 1991 and December 2007. Patient's age, source and predisposing factors, microbiological findings, duration of hospital stay, treatment modalities, and outcome were analyzed. RESULTS: The mean age of the patients was 53.9 +/- 9.56 (range 23-71) years. The source of gangrene was urinary in 5 patients, perirectal in 5, cutaneous in 1, and unknown in 9 patients. The main predisposing factors included diabetes mellitus in 9 patients (45%) and immunosuppression in 5 patients (25%). The mean duration of hospital stay was 39 +/- 10 (range 6-62) days. Although early intervention and intensive treatment were carried out, 4 patients died with an overall mortality of 20% as a result of septicemia complications. The mortality rate was higher in elderly patients and those with diabetes mellitus, but it was not statistically significant. Regarding the mortality rate, duration of symptoms, number of debridements, culture results and source of infection were not found to be significant factors. CONCLUSIONS: FG is still a severe disease. Management of this infectious entity must be aggressive. Despite the use of contemporary effective antibiotic treatment, aggressive debridements, and state-of-the-art intensive-care conditions, FG still has high mortality and morbidity rates.

Nefroureterectomía en pacientes con sustitución ureteral / Nephrourecterectomy in a patient with ureteral substitution

Presentamos el caso clínico de una paciente de 26 años de edad con antecedentes de sustitución ureteral izquierda con íleon, por traumatismo abdominal en la infancia que requirió cirugía urgente y posterior cirugía antirreflujo; que consulta a nuestro centro por infecciones del tracto urinario de repetición. Se incluye una revisión de la literatura de la sustitución ureteral con íleon (AU)

We report a clinical case of a 26 years old patient with a left ureteral replacement with ileum in the chidhood due to an abdominal trauma –requiring an urgent surgery- and an anti-reflux surgery; who consults to our center complaining of recurrent urinary tract infections. A literature review of ureteral replacement with ileum is done (AU)

Endometriosis ureteral: a propósito de un caso / Ureteral endometriosis: a clinical case

Se presenta un caso de hidronefrosis derecha secundaria a endometriosis ureteral unilateral con revisión de la literatura. La endometriosis afecta a las mujeres jóvenes en edad fértil, siendo la vejiga la localización preferente. La afectación ureteral corresponde al 15%, manifestándose como uropatía obstructiva. El diagnóstico se realiza con ecografía, UIV, TAC o RM, pero es la biopsia la forma de obtener un diagnóstico preciso. El tratamiento es quirúrgico. En nuestro caso se realizó ureterectomía segmentaria iliaca con anastomosis ureteral término-terminal, con buena recuperación de la unidad renal. El análisis histopatológico confirmó la presencia de tejido endometrial en la pared ureteral

We present the case of a patient with a right kidney hydronephrosis due to a unilateral ureteric endometriosis, as well as a bibliographic review. Endometriosis presents in fertile-age women, being bladder its main localization. Ureteric implication corresponds to 15% being hydronephrosis its clinical presentation. Diagnosis is made by IVU, CtT-Scan or MRI, but biopsy is the only way of having a precise diagnosis, It demands a surgical approach. An iliac segmentary ureterectomy with a an end to end anastomosis was performed in our patient with a complete recovery of renal function. Pathology confirmed the presence of endometrial tissue in ureteric wall

Uterocaliorrafia: tratamiento de la estenosis del ostium recidivada / No disponible

La ureterocaliorrafia es un tratamiento alternativo para la resolución de la estenosis del ostium recidivada. Presentamos el caso de un paciente afecto de estenosis del ostium recidivada tras pieloplastia dilatación percutánea con balón, que se solucionó mediante ureterocaliorrafia. Realizamos revisión bibliográfica sobre el tema (AU)

The ureterocalicostomy is an alternative treatment for the recurrence of ureteropelvic junction obstruction. We present one patient case affected of ureteropelvic juntion obstruction recurrence after pyeloplasty and percutaneous dilatation. This was solved with a ureterocalicostomy. Under review of the literature (AU)

Protocolo clínico asistencial de la fibrosis retroperitoneal / No disponible

No disponible

Endometriosis ureteral / Ureteral endometriosis

La endometriosis ureteral es una patología poco frecuente (1 por ciento de la endometriosis). Su forma de presentación es a menudo silente, de manera que el diagnóstico puede resultar complicado: Las técnicas de imagen y la laparoscopia exploradora pueden resultar de utilidad para el diagnóstico. El tratamiento está basado en terapia hormonal y en la resolución de la obstrucción ureteral (AU)