Prevalence of Anxiety and Depression in Prostate Cancer Patients and Their Spouses: An Unaddressed Reality.

OBJECTIVES: To estimate the prevalence of unsuspected anxiety or depression in prostate cancer patients and their spouses, as well as factors involved in its onset. Materials and Methods. A prospective study of 184 patients and 137 spouses evaluated in our hospital during 2019 using the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire depression module (PHQ-9). This study provides an internal validity assessment of the scales and their correlation (alpha and rho coefficients; index r). The contributions of age, education level, months after diagnosis, pain, prostate-specific antigen (PSA) level, stage of the disease and treatment performed to the positivity of the questionnaires were studied using the Wilcoxon-Mann-Whitney and chi-square tests. RESULTS: The prevalence of anxiety was 10.9% (MAX-PC) and 28.3% (MAX-PC-PSA). The HADS-A questionnaire indicated pathology in 14.1% of the patients and 16.05% of the spouses. Depression was detected in 7% (HADS-D) and 9.2% (PHQ-9) of patients as well as in 8.8% (HADS-D) and 16.05% (PHQ-9) of their spouses. The greatest concordance between men and women was with the PHQ-9 (Spearman's rho: 0.78; p = 0.01). Education level is significantly related to the presence of anxiety and depression, regardless of the questionnaire applied. The probability of detecting pathology in the MAX-PC varied from 6% in patients with elementary education to 23.5% in university students (p = 0.04). The greatest differences were detected when applying the PHQ-9 to patients (4% pathological, elementary education vs. 35.3% pathological, university education). Our study confirms the lack of a relationship between rates of anxiety and depression and factors such as PSA level, age of the patient and number of comorbidities. CONCLUSION: There is a high prevalence of unsuspected anxiety and depression in patients with prostate cancer and their wives. Education level correlates with such prevalence.

[Our experience with the Nesbit technique for the treatment of Peyronie's disease]. / Nuestra experiencia en la enfermedad de Peyronie con la técnica de Nesbit.

OBJECTIVES: The Nesbit technique is the reference technique for the surgical correction of the penile incurvation of Peyronie's disease. We report our experience at the Centro Urológico San Ignacio. METHODS: 68 patients with stable penile incurvation who requested surgical correction. Correction of the curvature is defined as > or = 80% rectification of the pathologic angle. Mean patient age was 44 years (31-77). 53% of the patients presented difficulties for penetration, 20% partner's discomfort on intercourse, and 27% requested surgery for aesthetic reasons. Penile deviation was dorsal in 42% of the patients, to the left in 46% and to the right in 12%. The curvature angle was less than 30 degrees in 28%, between 30 degrees-45 degrees in 36%, between 45 degrees-60 degrees in 37% and > 60 degrees in 7%. RESULTS: Mean follow-up of the series was 36 months. 20% of the patients had a penile shortening longer than 1.5 cm. 85% of the patients are satisfied with the results. The most frequent complaint was penile shortening. Correction was achieved in 92% of the patients. Four patients were reoperated: two of them for significant phimosis three months after surgery, and the other two for curvature recurrence. CONCLUSIONS: The Nesbit technique is a simple technique, with a low complication rate, and good results both in curvature correction and patient satisfaction.

Nuestra experiencia en la enfermedad de Peyronie con la técnica de Nesbit / Our experience with the Nesbit technique for the treatment of Peyronie´s disease

OBJETIVO: La técnica de Nesbit esa la técnica de referencia en la cirugía correctora de la incurvaciónpenenana en la enfermedad de Peyronie. Presentamos nuestra experiencia en el Centro Urológico san Ignacio.MÉTODO: 68 pacientes con incurvación peneana establey que deseaban corrección quirúrgica de la misma. Se considera corrección de la curvatura cuando la rectificaciónes igual o superior al 80% de la angulación patológica. La edad media de los pacientes es de 44 años (31-77). Un 53% presentaban dificultad para la penetración, un 20% molestias en su pareja, un 27% se intervinieron por razones estéticas. La desviación peneanaera dorsal en el 42%, izquierda en el 46% y derecha en el 12%. El ángulo de incurvación medido en grados era menor de 30º en el 28%, entre 30 y 45 en el 36%, entre 45 y 60 en el 37% y mayor de 60% en el 7%.RESULTADOS: El seguimiento medio de la serie es de 46 meses. Acortamiento peneano superior a 1,5 cm en el 20% de los enfermos. El 85% de los enfermos están satisfechos con los resultados obtenidos. La queja más frecuente es el acortamiento peneano. Se ha corregidola desviación en el 92% de los pacientes. Hemos reintervenido a cuatro pacientes, A dos por fimosis marcadaa los tres meses de la intervención, los otros dos enfermos presentaron recidiva de la curvatura.CONCLUSIONES: La técnica de Nesbit es una técnica sencilla, con escasas complicaciones y buenos resultadostanto en corrección de curvatura como en satisfaccióndel enfermo

OBJECTIVES: The Nesbit technique is the reference technique for the surgical correction of the penile incurvation of Peyronie’s disease. We report our experience at the Centro Urológico San Ignacio.METHODS: 68 patients with stable penile incurvation who requested surgical correction. Correction of the curvature is defined as ≥ 80% rectification of the pathologic angle. Mean patient age was 44 years (31-77). 53% of the patients presented difficulties for penetration, 20% partner`s discomfort on intercourse, and 27% requested surgery for aesthetic reasons. Penile deviation was dorsal in 42% of the patients, to the left in 46% and to the right in 12%. The curvature angle was less than 30 ° in 28%, between 30º-45 ° in 36%, between 45 °-60 ° in 37% and > 60 ° in 7%.RESULTS: Mean follow-up of the series was 36 months. 20% of the patients had a penile shortening longer than 1.5 cm. 85% of the patients are satisfied with the results. The most frequent complaint was penile shortening.Correction was achieved in 92% of the patients. Four patients were reoperated: two of them for significantphimosis three months after surgery, and the other two for curvature recurrence.CONCLUSIONS: The Nesbit technique is a simpletechnique, with a low complication rate, and good results both in curvature correction and patient satisfaction

Leiomioma vesical en paciente varón de diecisiete años / Bladder leiomyoma in a 17-year-old male patient

OBJETIVO: El leiomioma vesical es untumor de presentación rara, cifrándose su frecuencia enla literatura en menos de un 1% MÉTODO: Presentamos el caso de un varón de 17años, con dos pequeñas neoformaciones vesicales descubiertaspor hematuria y clínica irritativa miccional.RESULTADOS: Tras RTU de la lesión es diagnosticadode leiomioma vesical, sin recidiva en el periodo deseguimiento.CONCLUSIONES: El leiomioma vesical es un tumorbenigno, por lo que hay que realizar cirugía lo másconservadora posible. En la revisión realizada de lasrevistas urológicas españolas, es el caso más joven presentadohasta ahora

OBJECTIVES: Bladder leiomyoma is a rare tumor, its frequency being estimated below 1%. METHODS: We report the case of a 17-year-old male patient presenting with hematuria and lower urinary tract irritative symptoms whose work up discovered two small bladder tumors. RESULTS: After TUR of the lesions the diagnosis of bladder leiomyoma was established; no recurrences have appeared on follow-up. CONCLUSIONS: Bladder leiomyoma is a benign tumor, therefore surgery should be the most conservative. Bibliographic review of the Spanish urologic journals shows that this is the youngest patient reported to date

[Bladder leiomyoma in a 17-year-old male patient]. / Leiomioma vesical en paciente varón de diecisiete años.

OBJECTIVES: Bladder leiomyoma is a rare tumor, its frequency being estimated below 1%. METHODS: We report the case of a 17-year-old mole patient presenting with hematuria and lower urinary tract irritative symptoms whose work up discovered two small bladder tumors. RESULTS: After TUR of the lesions the diagnosis of bladder leiomyoma was established; no recurrences have appeared on follow-up. CONCLUSIONS: Bladder leiomyoma is a benign tumor, therefore surgery should be the most conservative. Bibliographic review of the Spanish urologic journals shows that this is the youngest patient reported to date.

[Ambulatory ureteroscopy and pneumatic lithotripsy. Our experience after 1803 ureteral stones]. / Ureteroscopia y litotricia neumática ambulatoria. Nuestra experiencia en 1803 litiasis ureterales.

OBJECTIVES: Ureteroscopy with endoscopical stone fragmentation is effective in the treatment of ureteral lithiasis. We report our experience, as well as our methods. METHODS: 1803 cases of ureteral stones were treated as outpatient. 44% were located in the lumbar ureter, 11% in the iliac ureter, and 45% in the pelvic ureter. Average size was 0.87 (0.4-2.2) cm. A 7 Fr Wolf rigid ureteroscope and a lithoclast type pneumatic lithotripter were employed. Lithotripsy was performed to an extent that small fragments might be spontaneously passed. RESULTS: 98% of the stones were solved. 16% required additional ESWL. 16% of the patients required the insertion of a double J stent. 12% of the patients required more than one session. Complications appeared in 8% of the patients. CONCLUSIONS: Good results: 98% success rate. It can be performed as outpatient. The support of an ESWL unit is basic.

[Bladder leiomyoma: diagnosis by imaging]. / Leiomioma vesical: diagnóstico por imagen.

OBJECTIVE: To report a case of leiomyoma of the bladder in a patient with unspecific urinary symptoms and discuss the utility of the diagnostic imaging techniques. METHODS/RESULTS: A 56-year-old woman who consulted for unspecific urinary symptoms is described. Patient evaluation with ultrasound, CT and MRI showed a mass in the posterior aspect of the urinary bladder. CONCLUSIONS: Leiomyoma of the bladder is an uncommon benign tumor that is asymptomatic in most of the cases and is frequently discovered incidentally during assessment for other conditions. The case described herein presented with unspecific urinary symptoms. Patient evaluation with different diagnostic imaging techniques was required for correct diagnosis and treatment.

Leiomioma vesical: diagnóstico por imagen / Leiomyoma of the bladder: Dyagnosis by imaging techniques

OBJETIVOS: Presentación de un caso de leiomioma vesical con sintomatología urinaria inespecífica, una patología muy poco frecuente y en la mayoría de los casos asintomática, con un estudio diagnostico por imagen que nos orienta hacia la patología del caso.MÉTODOS: Paciente de 56 años de edad que consulta por síntomas urinarios inespecíficos, que tras su estudio se diagnostica de masa en cara posterior de vejiga mediante ecografía, T.A.C. y R.M.N.CONCLUSIONES: El leiomioma vesical es un tumor benigno de baja incidencia que en la mayoría de los casos se diagnostica de forma incidental en el transcurso del estudio de otra especialidad u otra patología. El caso que nosotros presentamos debutó con clínica urinaria inespecífica y fue necesaria la realización de diversas técnicas de diagnostico por imagen hasta llegar a un correcto enfoque terapéutico del caso (AU)

Litiasis urinaria secundaria a indinavir en enfermo HIV positivo / Indinavir urolithiasis in a VIH-positive patient

OBJETIVOS: El Indinavir es un inhibidor de la proteasa utilizado en el tratamiento del HIV y que posee capacidad litógena como efecto secundario urológico. Se hace un breve repaso de la litiasis urinaria de Indinavir, desde los puntos de vista patogénico, diagnóstico y terapéutico MÉTODO: Varón de 37 años HIV positivo en tto con Indinavir, Lamiduvina y Zidovudina, que acude por dolor lumbar izquierdo tipo cólico, náuseas, vómitos y orinas oscuras desde hace tres días. RESULTADO: El estudio del enfermo muestra anulación funcional del riñón izquierdo con ureterohidronefrosis sin poder precisar causa. Se realiza URS observándose material friable amarillento de aspecto mucinoso que ocupa toda la luz del uréter, procediéndose a su disgregación con la varilla del litotritor. A los seis meses la recuperación es completa, estando el enfermo asintomático. CONCLUSIÓN: Es una patología en aumento, debemos realizar diagnóstico diferencial con litiasis de ácido úrico, ya que el tratamiento de esta agrava la litiasis por Indinavir (AU)

Litiasis vesical yatrogénica en la técnica de Burch. Una complicación infrecuente / Iatrogenic bladder lithiasis following colposuspension: An uncommon complication

OBJETIVOS: Utilidad de las técnicas endoscópicas para resolver litiasis yatrogénicas tras intervención de incontinencia urinaria de esfuerzo (IUE) en la mujer. Presentamos el caso de una mujer intervenida mediante técnica de Burch de incontinencia urinaria de esfuerzo, que acude dos años después por presentar clínica irritativa. MÉTODO: Sección endoscópica, bajo anestesia local de litiasis adherida a hilo. RESULTADO: Extracción De la litiasis sin afectar la continencia. CONCLUSIONES: Las técnicas endoscópicas permiten resolver las litiasis yatrogénicas por perforación vesical con hilo de sutura en la mujer sin afectar la continencia (AU)