Double J catheter migrated to the bladder and encrusted. Case report and bibliographic review.

OBJECTIVE: Urinary tract obstruction is one of the most prevalent diseases in urology. The handling of it includes conservative (analgesia and fluid therapy) and invasive (urinary diversion) measures. Ureteral stent is the method currently employed for urinary tract diversion. Complications of urinary tract stents maintenance have already been studied and are well known. We report a case of ureteral stent migrated to the bladder, calcified and embedded and we review the existing literature. METHODS: A 28 year-old man with the diagnosis of ureteral stent coiled in bladder and calcified. The patient was successfully operated of suprapubic cystolithotomy. We conducted a Medline search using the terms "ureteral stent "+" embedded stent, "" bladder ureteral stent, "incrusted bladder stent" and "ureteral stent complicactions". RESULTS: He is currently free of disease. We found a total of 45 articles that responded to the search criteria, from which we select the highest citation index. CONCLUSIONS: The use of ureteral stents for urinary diversion of the upper urinary tract is safe and well tolerated but not without complications, that is why we have to raise awareness among patients of the need to undergo periodic inspections and instruct them to possible symptoms and / or signs that may indicate changes in position and / or state of the stent.

Cateter doble J migrado e incrustado en vejiga. Presentación de un caso y revisión de la literatura / Double J catheter migrated to the bladder and encrusted. Case report and bibliographic review

OBJETIVO: La obstrucción de vía urinaria es una de las patologías de mayor prevalencia en Urología. El manejo de la misma incluye medidas conservadoras (analgesia y fluidoterapia) e invasivas (derivación de vía urinaria). El método más empleado en la actualidad para derivar la vía es la utilización de catéter ureterales de tipo doble J. Las complicaciones del mantenimiento en vía urinaria de los stents doble J han sido ya estudiadas y son bien conocidas. Presentamos un caso clínico de un catéter doble J migrado a vejida, calcificado e incrustado y hacemos una revisión de la literatura existente. MÉTODOS: Hombre de 28 años de edad al que se le diagnostica de catéter doble J enrollado en vejiga y calcificado. El paciente es intervenido de cistolitotomía suprapúbica satisfactoriamente. Realizamos una búsqueda bibliográfica en Medline mediante los términos "ureteral stent" + "incrusted stent", "bladder ureteral stent", "bladder incrusted stent" y "ureteral stent complicactions". RESULTADOS: En la actualidad se encuentra libre de enfermedad. Encontramos un total de 45 artículos que respondieron a los criterios de búsqueda, de los que seleccionamos los de mayor índice de citación. CONCLUSIONES: EL empleo de catéter doble J para derivar la vía urinaria es un método seguro y bien tolerado aunque no exento de complicaciones, es por ello por lo que hemos de concienciar a los pacientes de la necesidad de someterse a controles periódicos e instruirlos ante posibles síntomas y/o signos que puedan indicar alteraciones de la posición y/o estado del stent(AU)

OBJECTIVE: Urinary tract obstruction is one of the most prevalent diseases in urology. The handling of it includes conservative (analgesia and fluid therapy) and invasive (urinary diversion) measures. Ureteral stent is the method currently employed for urinary tract diversion. Complications of urinary tract stents maintenance have already been studied and are well known. We report a case of ureteral stent migrated to the bladder, calcified and embedded and we review the existing literature. METHODS: A 28 year-old man with the diagnosis of ureteral stent coiled in bladder and calcified. The patient was successfully operated of suprapubic cystolithotomy.We conducted a Medline search using the terms "ureteral stent" + "embedded stent", "bladder ureteral stent", "incrusted bladder stent" and "ureteral stent complicactions". RESULTS: He is currently free of disease. We found a total of 45 articles that responded to the search criteria, from which we select the highest citation index. CONCLUSIONS: The use of ureteral stents for urinary diversion of the upper urinary tract is safe and well tolerated but not without complications, that is why we have to raise awareness among patients of the need to undergo periodic inspections and instruct them to possible symptoms and / or signs that may indicate changes in position and / or state of the stent(AU)

Oxigenoterapia Hiperbárica (OHB) en el manejo de la cistitis hemorrágica radioinducida / Hyperbaric Oxygen Therapy for the management of hemorrhagic radio-induced cystitis

OBJETIVO: La Cistitis rádica (CRAD) es una enfermedad inflamatoria vesical que se presenta de forma más grave como hematuria anemizante. Los tratamientos clásicos no consiguen controlar la enfermedad a medio-largo plazo ya que no actúan sobre su patogénesis. Evaluamos la respuesta clínica de pacientes con cistitis radioinducida tras ser tratados mediante Oxigenoterapia Hiperbárica.MÉTODOS: Estudio prospectivo en el que se incluyen 38 pacientes, 21 hombres y 17 mujeres, edades desde los 46 a los 75 (media de edad de 66.5 años) sometidos a radioterapia (RT) pélvica, diagnosticados de CRAD +/- proctitis radioinducida (PRAD) y que clínicamente referían hematuria, y síndrome miccional. El tratamiento se aplicó en una cámara de tipo multiplaza, los pacientes respiraban O2 al 100% a una presión ambiental de 2-2,5 ATAs (atmósferas de presión ambiental). Recibieron una media de 29.9 sesiones (rango 10-48 sesiones), el seguimiento medio fue de 56 meses (rango 4-72 meses).RESULTADOS: La hematuria se ha resuelto hasta la fecha de forma completa en 35 pacientes, un paciente presenta actualmente hematurias no anemizantes ocasionales, a razón de una 1 trimensual. Requiriendo reingreso 6 de ellos, 5 por hematuria anemizante y 1 por pielonefritis aguda obstructiva. El tratamiento fue bien tolerado por los pacientes, 1 experimentó barotrauma que requirió de miringotomía.CONCLUSIONES: La CRAD puede tratarse de forma satisfactoria mediante OHB, consiguiendo mejoría clínica, desde las primeras sesiones en la mayoría de ocasiones, con una tolerancia más que aceptable por parte de los pacientes(AU)

OBJECTIVES: Radio-induced cystitis (RADC) is an inflammatory bladder disease that presents as anemic-hematuria in its most serious form. Classic treatments can not control the disease in the mid-to-long term because they don`t treat the pathogenesis of the disease. Thus, we evaluated the effectiveness of hyperbaric oxygen (HBO) therapy as a potential treatment for patients with RADC.METHODS: This prospective study included 38 patients, 21 men and 17 women, mean age of 66.5 years (46-75), who had been subjected to pelvic radiotherapy (RT), with the diagnosis of RADC with or without radio-induced proctitis (RADP), gross hematuria and lower seurinarytract symptoms. HBO treatment was applied in a multi-place chamber; patients breathed pure oxygen (100%) at 2-2.5 atmospheres of pressure (ATAs). Patients received an average of 31.2 sessions (10-48 sessions) and the median follow-up period was 56 months (4-72 months).RESULTS: Hematuria was completely resolved in 34 of the 38 patients. After HBO 6 patients required readmission, 5 for anemic hematuria and 1 for acute obstructive pyelonephritis. In general, patients tolerated treatment well; however, one patient experienced barotrauma requiring myringotomy.CONCLUSIONS: HBO can be used to satisfactorily treat RADC, leading to clinical improvements that begin during the initial sessions in the majority of cases, and with a more than acceptable level of patient tolerance(AU)

Empleo de la oxigenoterapia hiperbárica en Urología / Hypebaric oxygen treatment in urology

OBJETIVO: La oxigenoterapia hiperbárica (OHB) se ha empleado de forma existosa en numerosas patologías que derivan de la hipoxia tisular gracias al aporte extra de oxígeno que permite a los tejidos.En este trabajo se realiza una revisión exhaustiva acerca de toda la literatura existente en 2010 en la que se emplea OHB en patología urológica.MÉTODOS: Realizamos una búsqueda en Medline introduciendo los términos “hyperbaric oxygen”, “radic cistitis”, “interstitial cistitys”, “ hemorraghic cistitys”, “urological/pelvic fistula” y “Fournier´s gangrene”.Las búsquedas se centraron en estudios en humanos únicamente publicados en cualquier idioma.RESULTADOS: 56 trabajos publicados, 1 ensayo clínico controlado aleatorizado (ECA), 7 revisiones (review) y 48 series de casos (SC) de los que tan solo uno fué prospectivo en los que se exponen a un total de 695 pacientes. Sólo en un estudio se emplearon mediciones de oxígeno tisular para definir la hipoxia. El número de las sesiones de terapia de oxígeno hiperbárico varió desde 4 hasta 44 sesiones. (media 19,2 sesiones/paciente)CONCLUSIONES: La evidencia que se extrae de la mayoría de trabajos consultados procede de series de casos, de modo que es baja, sin embrago, en la mayoría de estudios los resultados en cuanto al manejo de los pacientes es bueno o muy bueno así que parece que la OHB puede ser de gran utilidad en enfermedades urológicas que deriven de hipoxia tisular(AU)

OBJECTIVES: Hyperbaric oxygen therapy (HBO) has been successfully used in several disorders derived from tissue hypoxia, due to the extra oxygen supply to the tissues it enables.In this manuscript we performed a systematic review including all the existing data published until 2010 about HBO in urologic disorders.METHODS: We performed a Medline search using the terms “hyperbaric oxygen”, “radical cystitis”, “interstitial cystitis”, “hemorrhagic cystitis”, “urological/pelvic fistula” and “Fournier´s gangrene”. The search was restricted to human clinical trials published in any language. RESULTS: We found 56 papers: 1 randomized controlled trial, 7 reviews and 48 case reports; only one of them was a prospective study. A total of 695 patients were included. Just one study used tissue oxygen measurement to define hypoxia. The number of hyperbaric oxygen therapy sessions ranged from 4 to 44 (mean 19.2 sessions/patient).CONCLUSIONS: The level of evidence from most reviewed papers is low because most of them are case series. Nevertheless, results of most of those studies regarding patient management are good or very good. So it seems that HBO can be very useful in urological diseases related to tissue hypoxia(AU)

Hypebaric oxygen treatment in urology.

OBJECTIVES: Hyperbaric oxygen therapy (HBO) has been successfully used in several disorders derived from tissue hypoxia, due to the extra oxygen supply to the tissues it enables. In this manuscript we performed a systematic review including all the existing data published until 2010 about HBO in urologic disorders. METHODS: We performed a Medline search using the terms "hyperbaric oxygen", "radical cystitis", "interstitial cystitis", "hemorrhagic cystitis", "urological/pelvic fistula"and "Fournier's gangrene". The search was restricted to human clinical trials published in any language. RESULTS: We found 56 papers: 1 randomized controlled trial, 7 reviews and 48 case reports; only one of them was a prospective study. A total of 695 patients were included. Just one study used tissue oxygen measurement to define hypoxia. The number of hyperbaric oxygen therapy sessions ranged from 4 to 44 (mean 19.2 sessions/patient). CONCLUSIONS: The level of evidence from most reviewed papers is low because most of them are case series. Nevertheless, results of most of those studies regarding patient management are good or very good. So it seems that HBO can be very useful in urological diseases related to tissue hypoxia.

Giant bladder lithiasis: case report and bibliographic review.

OBJECTIVE: Urinary lithiasis is a very frequent urological disease but bladder lithiasis is very uncommon.Patients usually refer voiding symptoms and hematuria. The diagnosis is made after imaging tests. We report a clinical case describing a giant bladder stone and perform a bibliographic review. METHODS: A 43 year old man with the diagnosis of giant bladder stone (more than 10 cm diameter). We searched Medline using the terms: giant bladder stone, giant bladder lithiasis, bladder lithiasis, giant bladder lithiasis. RESULTS: We made the diagnosis of giant bladder stone after a simple kidney, ureter and bladder (KUB) X Ray. The treatment for this patient was a cystolithotomy. We found more than 230 reports at Medline and chose the most referred ones and the last 10 years reports. CONCLUSIONS: Giant bladder lithiasis is a very rare pathology. The gold standard for diagnosis is cystoscopy but sometimes with a KUB Xray or an ultrasound is enough. Because of its size, cistolitotomy is the correct treatment for giant bladder stone.

Litiasis vesical gigante. Presentación de un caso y revisión de la literatura / No disponible

OBJETIVO: La litiasis es una de las patologías más prevalentes en urología. Sin embargo son poco frecuentes a nivel vesical.Las litiasis vesicales producen, generalmente, síndrome miccional y hematuria y se llega al diagnóstico después de pruebas de imagen.Presentamos un caso clínico en el que se describe la litiasis vesical primaria de mayor tamaño recopilada y hacemos una revisión de la literatura existente. MÉTODOS: Presentamos un caso clínico de un hombre de 43 años de edad diagnosticado de litiasis vesical de más de 10 cm de diámetro.Realizamos una búsqueda en Medline utilizando los siguientes términos: giant bladder stone, giant bladder lithiasis, blader lithiasis, giant bladder litiasis.RESULTADO: Nuestro paciente fue diagnosticado de litiasis vesical tras realización de Rx simple de aparato urinario y sometido a cistolitotomía. Actualmente se encuentra asintomático y libre en enfermedad.Encontramos más de 232 artículos referentes a este tema en Medline de los que seleccionamos los de mayor citación y los de los últimos 10 años.CONCLUSIONES: La litiasis vesical gigante es una enfermedad muy rara que requiere diagnósticos por imagen, la prueba patrón oro para su filiación es la cistoscopia diagnóstica aunque en ocasiones, mediante una Rx simple de abdomen o ECO urológica es suficiente.Debido a su tamaño, la cistolitotomía es todavía el tratamiento de elección para esta enfermedad(AU)

OBJECTIVE: Urinary lithiasis is a very frequent urological disease but bladder lithiasis is very uncommon.Patients usually refer voiding symptoms and hematuria. The diagnosis is made after imaging tests.We report a clinical case describing a giant bladder stone and perform a bibliographic review.METHODS: A 43 year old man with the diagnosis of giant bladder stone (more than 10 cm diameter).We searched Medline using the terms: giant bladder stone, giant bladder lithiasis, bladder lithiasis, giant bladder lithiasis.RESULTS: We made the diagnosis of giant bladder stone after a simple kidney, ureter and bladder (KUB) X Ray. The treatment for this patient was a cystolithotomy.We found more than 230 reports at Medline and chose the most referred ones and the last 10 years reports.CONCLUSIONS: Giant bladder lithiasis is a very rare pathology. The gold standard for diagnosis is cystoscopy but sometimes with a KUB Xray or an ultrasound is enough.Because of its size, cistolitotomy is the correct treatment for giant bladder stone(AU)