Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty.

INTRODUCTION: We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years. METHODS: This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both. RESULTS: In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success. CONCLUSION: In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.

Segmental testicular infarction: partial orchiectomy in a very rare pathology.

Segmental testicular infarctions are a rare disease with a low prevalence and few cases have been reported in the literature. We present a 26-year-old male without any relevant medical history who consulted at the Urology Department due to mild pain in the right testicle over the last month. He had no previous trauma or acute testicular pain. Partial orchiectomy was performed through an inguinal incision with removal of lesions and reconstruction of the testicular parenchyma. Histological examination revealed testicular infarction with no presence of neoplastic cells.

Relationship between biopsy Gleason score and radical prostatectomy specimen Gleason score in patients undergoing sextant vs 12 core biopsies.

OBJECTIVES: Our goal is to analyze the degree of concordance between the Gleason score (GS) obtained in prostate biopsies and the one after radical prostatectomy. The intention is to know whether 12-core biopsy, instead of 6 (sextant biopsy), improves, or not, this correlation. METHODS: A Cohort/prevalence study was conducted on 128 patients who underwent prostate biopsy and subsequent radical prostatectomy. Patients showing biopsy Gleason values greater or equal to 6 were selected as candidates for radical prostatectomy. RESULTS: Mean age of the group of 128 patients was 62.9 years, with a mean PSA value of 8.53ng/ml. There was concordance between biopsy Gleason score and that obtained after radical prostatectomy in 63.28% of cases, while discordance was found in 36.72% of cases. There were not significant statistical differences after comparing results obtained between Gleason score concordance after 6 or 12-core biopsies and that obtained after radical prostatectomy. CONCLUSIONS: We have noticed a low correlation between Gleason score after biopsy when it was compared with that obtained after radical prostatectomy, while these results are similar to those found in the literature. We did not find better results regarding Gleason score correlation after biopsies performed with 12 cores instead of 6.

Relación entre score gleason biópsico y score gleason tras prostatectomía radical en pacientes sometidos a biopsia sextante vs 12 cilindros / Relationship between biopsy gleason score and radical prostatectomy specimen gleason score in patients undergoing sextant vs 12 core biopsies

OBJETIVO: El cáncer de próstata es una patología cada vez más prevalente por la longevidad de la población. Es por ello que cada vez con más frecuencia se somete a los pacientes a realización de biopsia prostática para realizar su diagnóstico de certeza.Nuestro objetivo fue analizar la relación del score gleason obtenido en la biopsia de próstata con el obtenido tras prostatectomía radical. Se pretendió analizar si la obtención de 12 cilindros en lugar de 6 (biopsia sextante) mejora o no esta relación.MÉTODOS: Se realizó un estudio de casos y controles con 128 pacientes (98 casos en los que se obtuvó 6 cilindros y 30 controles en los que se obtuvieron 12 cilindros) que fueron sometidos a biopsia de próstata y posterior prostatectomía radical. Para ello se seleccionaron a pacientes con Gleason biópsico mayor o igual de 6 y candidatos a prostatectomía radical.RESULTADOS: La media de edad de los 128 pacientes incluidos en el estudio fue de 62,9 años, con una media de PSA de 8,53 ng/ml. Se observó igualdad de Score Gleason biopsia/prostatectomía en el 63,28 % de los pacientes y desigualdad en el 36,72 %. Tras comparar los resultados obtenidos entre la relación del score gleason tras extracción de 6 o 12 cilindros y tras prostatectomía radical no se apreciaron diferencias estadísticamente significativasCONCLUSIONES: La correlación gleason biopsia-prostatectomía radical es baja. No apreciamos mejoría significativa para esta correlación el obtener 12 cilindros en lugar de 6(AU)

OBJECTIVES: Our goal is to analyze the degree of concordance between the Gleason score (GS) obtained in prostate biopsies and the one after radical prostatectomy. The intention is to know whether 12-core biopsy, ins-tead of 6 (sextant biopsy), improves, or not, this correla-tion.METHODS: A Cohort/prevalence study was conducted on 128 patients who underwent prostate biopsy and subsequent radical prostatectomy. Patients showing biop-sy Gleason values greater or equal to 6 were selected as candidates for radical prostatectomy.RESULTS: Mean age of the group of 128 patients was 62.9 years, with a mean PSA value of 8.53ng/ml. There was concordance between biopsy Gleason score and that obtained after radical prostatectomy in 63.28% of cases, while discordance was found in 36.72% of cases. There were not significant statistical differences after comparing results obtained between Gleason sco-re concordance after 6 or 12-core biopsies and that obtained after radical prostatectomy.CONCLUSIONS: We have noticed a low correlation between Gleason score after biopsy when it was com-pared with that obtained after radical prostatectomy, while these results are similar to those found in the lite-rature. We did not find better results regarding Gleason score correlation after biopsies performed with 12 cores instead of 6(AU)

Spontaneous retroperitoneal abscess as the first clinical manifestation of a non-functioning retroperitoneal paraganglioma.

We demonstrate a novel clinical presentation of paraganglioma not described in the literature. The paraganglioma is a catecholamine secretory, or non-secretory, neuroendocrine tumour that derives from chromaffin cells. Its frequency, with regard to pheochromocytoma, is low, and the abdominal region is the most frequent localisation site, followed in importance by the cervical region. We report the case of a 54-year-old woman diagnosed with a retroperitoneal abscess; after drainage of the lesion, samples indicated necrotic paraganglioma cells, so it was decided to conduct a survey to determine catecholamine levels in urine, and carry out a MIBG gammagraphy, which described a non-functioning retroperitoneal paraganglioma that underwent surgical removal. There was no residual disease after 3-month follow-up.

Uso de la solución de hidratación oral con o sin tomas de agua intermedia en niños deshidratados por diarrea aguda / Oral rehydration therapy with or without intermediate water in dehydrated children with acute diarrhea

Se estudiaron prospectivamente 50 niños deshidratados con diarrea aguda con edades entre uno a 18 meses, a quienes se dividió en dos grupos: 25 niños del grupo A recibieron la solución de hidratación oral (SHO) recomendada por la Organización Mundial de la Salud (OMS) y 25 niños del grupo B recibieron la misma SHO pero con una toma de agua intermedia por cada dos tomas de la SHO. Se observó corrección de la deshidratación en todos los casos. En el grupo A, 18 niños presentaron isonatremia al ingreso, la cual se mantuvo en 16 casos al rehidratarse; en cambio, de nueve niños del grupo B con isonatremia al ingreso, se desarrolló hiponatremia en cuatro al corregir su deshidratación. Asimismo, de siete niños del grupo A y 16 del grupo B que presentaron hiponatremia al ingreso, normalizáron su natremia al hidratarse seis y ocho, respectivamente. Los resultados descritos confirman la eficacia y seguridad de la SHO recomendada por la OMS, administrada sin tomas de agua intermedia, en el manejo de la deshidratación del niño con diarrea aguda

1,144 niños con diarrea aguda hidratados por vía oral con solución de 90 mmol/l de sodio / 1,144 children with acute diarrhea treated by oral route with sodium solution at 90 mmol/l

Se estudiaron 1,335 niños con deshidratación (DH) secundaria a diarrea aguda que ingresaron a la Unidad de Hidratación Oral del Hospital del Niño de Villahermosa Tabasco, México, de junio de 1984 a marzo de 1986. A todos los niños se les hidrató por vía oral de primera intención, usando la solución oral (SO) de 90 mmol/L de sodio, sin agua extra. Se corrigió la deshidratación entre las cuatro y seis horas del ingreso, en 1,144 casos (85.7% ); en 191 (14.3% ) pacientes no se logró corrección de la deshidratación; no hubo defunciones. La edad de los niños recuperados fluctuó de los 12 días a seis años. Predominó la DH leve en un 89.4% ; de estos 654 (57.1% ) presentaron vómito al ingreso, y 112 (9.7% ) en su estancia. La SO fue aceptada voluntariamente en 1,109 (97% ) casos y sólo en 35 casos (3.0% ) se requirió gastroclísis. Regresaron al control de la hidratación el 46% de los egresados y reingresaron 17 (3.20% ), que requirieron nuevo manejo. Se reportan los buenos resultados obtenidos con la hidratación oral usando la SO pura de la Organización Mundial de la Salud